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Spiritual support remains one of the most complex and, at the same time, most essential elements of palliative care. In the February PACED digest, we present articles exploring the integration of spiritual care into nursing practice, families' experiences in paediatric palliative care, and the role of professionals in discussing end-of-life issues with children and adolescents. This issue includes materials on professional competencies, system-level recommendations, and parents’ lived experiences. Together, they offer insight into how spiritual and value-based questions shape clinical practice and influence the quality of support provided to families.

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Integrating Spiritual Support into Nursing Practice

This discursive paper explores various ways to incorporate spiritual support into nursing practice as part of holistic, person-centred care. The authors emphasise essential professional skills for this work, including self-reflection and awareness of one’s own position, spiritual assessment, respectful dialogue, recognition of cultural and worldview diversity, interdisciplinary collaboration, and the ability to involve relevant specialists when necessary. The paper also discusses issues related to education, mentorship, and organisational support necessary to systematically embed spiritual care into nursing practice.

Read the article: https://onlinelibrary.wiley.com/doi/10.1111/jan.70231
Psychosocial Support Guidelines for Children and Their Families: The Dutch Experience

This article describes national guidelines developed in the Netherlands for psychosocial support in paediatric palliative care, including help for families during bereavement. The guidance was developed through a systematic review by a multidisciplinary working group of 25 professionals and nine parents of children who received palliative care, ensuring that families’ real needs were included in the recommendations. The guidelines cover psychological interventions, practical and social support, and cultural and spiritual aspects of care. Special focus is given to spiritual and value-based issues important to families. Although these guidelines were developed within a national context, the approaches can be adapted to other countries, taking account of cultural differences.

Read the article: https://link.springer.com/article/10.1186/s12904-025-01763-w
The Spiritual Context of Families in Paediatric Palliative Care: A Qualitative Study

This study investigates spirituality, religion, and life philosophy among parents of children receiving palliative care in Spain—a country where traditional religious affiliation is increasingly influenced by secularisation and more individualised worldviews. In a context of growing cultural and religious diversity, parents’ spiritual experiences are complex and cannot be reduced to formal religious identity alone. The study highlights parents’ own words, enabling readers to understand how they perceive and interpret their child’s illness. The authors identify three interconnected aspects of spiritual experience—life philosophy, relational, and transcendent—and propose a framework that may assist professionals in better recognising the spiritual context of families and fostering more sensitive dialogue in paediatric palliative care.

Read the article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10868107/
How to Discuss Death with Children with Intellectual Disabilities: Perspectives from Paediatric Palliative Care Professionals

Nearly half of children receiving palliative care have intellectual and developmental disorders. This qualitative study, based on semi-structured interviews, explores how paediatric palliative care professionals in Germany communicate about end-of-life issues with these children and adolescents. Many professionals recognise that they sometimes avoid direct conversations, questioning whether a child will understand what is happening. At the same time, they try to adapt communication to each child’s age, health condition, and communication abilities. Engaging in dialogue can be especially challenging with children who have limited ways to express their thoughts and feelings. In such cases, the needs of the most vulnerable patients may go unnoticed. The authors emphasise the importance of improving communication skills and encouraging interdisciplinary collaboration in this practice area.

Read the article: https://onlinelibrary.wiley.com/doi/10.1111/jar.70121
Spirituality in Bereavement: How Parents Make Sense of Their Child's Death

This qualitative descriptive study explores how religion and spirituality appear in the stories of parents who have lost a child to cancer. Through detailed interviews, the authors identify four aspects of spiritual experience: belief in life after death, perceptions of divine control, transformation of faith following loss, and interactions with healthcare professionals within a spiritual context. Parents describe how conversations with hospital chaplains and the presence and support of physicians—regardless of their personal beliefs—brought a sense of peace and shared humanity. The study emphasises the importance of developing healthcare professionals’ communication skills and responding sensitively to the diverse spiritual needs of families during bereavement.

Read the article: https://www.tandfonline.com/doi/full/10.1080/07481187.2024.2348059#d1e277
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