The impact of the hospice environment on patient spiritual expression.

PURPOSE/OBJECTIVES To understand how hospital inpatients express their spirituality and to investigate the impact of hospice environment on this expression. RESEARCH APPROACH Qualitative. SETTING Two metropolitan hospice centers in southern Australia. PARTICIPANTS 12 inpatients (7 males, 5 females) who were residents for at least four days. METHODOLOGIC APPROACH Influenced by Heidegger's Phenomenological Hermeneutics, semistructured interviews were conducted. Interview transcripts and field notes were analyzed to reduce data into codes and themes. Data were coded by extracting verbatim phrases used to describe spiritual expression and the impact of hospice environment on it. MAIN RESEARCH VARIABLES The nature of spiritual expression and the impact of the hospice environment on the spiritual expression of hospice inpatients. FINDINGS Participants were comfortable discussing their spiritual expression within the context of four main themes: Relationships, That Which Uplifts, Spiritual Practice, and Having Hope. Finding meaning was a common link among these themes. The impact of the hospice environment was variable. Most believed that it facilitated their spiritual expression to some degree. CONCLUSIONS Spiritual expression is important but is facilitated by individualized spiritual care. Nurses play an important role in the provision of spiritual care within a hospice setting. INTERPRETATION Nurses are significant in assisting in patients' spiritual expression. Nurses' needs for training in listening skills, confidence in discussing spiritual issues, and time to provide individualized spiritual care should be assessed to ensure optimal patient expression.