Exploring Spiritual Concerns, Needs, and Resources in Outpatient Healthcare Facilities Serving Under-Resourced Black Patients: A Qualitative Study

Shena Gazaway; Kwaku Duah Oppong; Emily S Burke; Tamara Nix-Parker; Alexia M Torke; Shelley Varner Perez; George Fitchett; Raegan W Durant; Rachel Wells; Marie Bakitas; Deborah Ejem

doi:10.1007/s40615-024-02258-9

Exploring Spiritual Concerns, Needs, and Resources in Outpatient Healthcare Facilities Serving Under-Resourced Black Patients: A Qualitative Study

J Racial Ethn Health Disparities. 2024 Dec 11. doi: 10.1007/s40615-024-02258-9. Online ahead of print.

Authors

Shena Gazaway¹, Kwaku Duah Oppong², Emily S Burke^{3

4}, Tamara Nix-Parker¹, Alexia M Torke^{3

4}, Shelley Varner Perez^{3

4}, George Fitchett⁵, Raegan W Durant⁶, Rachel Wells¹, Marie Bakitas¹, Deborah Ejem⁷

Affiliations

¹ School of Nursing, University of Alabama at Birmingham, 485K, 1701 University Blvd, Birmingham, AL, 35294, USA.
² School of Nursing, University of Texas at Austin, Austin, TX, USA.
³ Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA.
⁴ Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indianapolis, IN, USA.
⁵ Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA.
⁶ Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
⁷ School of Nursing, University of Alabama at Birmingham, 485K, 1701 University Blvd, Birmingham, AL, 35294, USA. tejem@uab.edu.

PMID: 39661302
DOI: 10.1007/s40615-024-02258-9

Abstract

Background: Acknowledging patients' spiritual concerns can enhance well-being and is essential to patient-centered chronic illness care. However, unmet spiritual care needs remain a major area of suffering, particularly among under-resourced populations. Limited research exists on how spiritual concerns are acknowledged and integrated into the care of chronically ill older Black patients in these settings.

Purpose: This study aimed to explore the spiritual concerns and needs of chronically ill older Black patients from under-resourced areas and to identify available spiritual support resources for patients seeking healthcare through a community safety net health service.

Methods: Using a qualitative descriptive design, we interviewed 13 chronically ill, older Black patients and key clinicians (physicians, nurse practitioners, allied health, and clergy). The interview focused on patients' illness-related spiritual concerns, sources of distress, and desired spiritual support resources. Participants also reviewed the Spiritual Care and Assessment Intervention (SCAI), a spiritual care intervention, and provided feedback on its content, format, and delivery.

Results: Five themes emerged from qualitative interviews: (1) spirituality is integral to seriously ill Southern patients; (2) clinicians should strive to address spiritual health in encounters; (3) socioeconomic barriers and competing demands impact priority of accessing spiritual care services; (4) spiritual care interventions should be patient-driven, compassionate, and fully integrated into medical care as a comprehensive service; and (5) participants thought SCAI was appropriate for use but should be shortened and provided in-person to increase accessibility.

Discussion: Findings will inform the development and piloting of small-scale culturally responsive spiritual care intervention tailored for seriously ill older Black adults in an ambulatory care setting.

Keywords: Black; Outpatient; Serious illness; Spiritual care; Under-resourced.

Abstract

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