Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness

Background: Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of
patients’ expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions.
Aim: To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs,
as found in the research literature.
Design: A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI)
approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review
was registered in PROSPERO (CRD42019133571).
Data sources: The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and
spiritual needs from the patients’ perspective and were published between January 1st 2008 and October 2020. The quality of
evidence was assessed using JBI Critical Appraisal Tools.
Results: Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings
encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive
outlook, and dealing with dying and death.
Conclusion: What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social
from spiritual needs based on patients’ linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual
approach that honors and preserves the multidimensionality of patients’ needs and enables interdisciplinary teamwork to allocate
patient-tailored care.