Palliative and Supportive Care

Original Articles

The spirit of palliative practice: A qualitative inquiry into the spiritual journey of palliative care physicians

Adrienne Penderella1a2 and Kevin Brazila1a3a4 c1

a1 Division of Palliative Care, Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

a2 East End Hamilton/Stoney Creek Enhanced Palliative Care Team, HNHB Organization of Palliative Care Physicians/Services Enhancements (HOPE Group), Hamilton, Ontario, Canada

a3 St. Joseph's Health System, Hamilton, Ontario, Canada

a4 Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada


Objective: Much is known about the important role of spirituality in the delivery of multidimensional care for patients at the end of life. Establishing a strong physician–patient relationship in a palliative context requires physicians to have the self-awareness essential to establishing shared meaning and relationships with their patients. However, little is known about this phenomenon and therefore, this study seeks a greater understanding of physician spirituality and how caring for the terminally ill influences this inner aspect.

Method: A qualitative descriptive study was used involving face-to-face interviews with six practicing palliative care physicians.

Results: Conceptualized as a separate entity from religion, spirituality was described by participants as a notion relating to meaning, personal discovery, self-reflection, support, connectedness, and guidance. Spirituality and the delivery of care for the terminally ill appeared to be interrelated in a dynamic relationship where a physician's spiritual growth occurred as a result of patient interaction and that spiritual growth, in turn, was essential for providing compassionate care for the palliative patient. Spirituality also served as an influential force for physicians to engage in self-care practices.

Significance of results: With spirituality as a pervasive force not only in the lives of palliative care patients, but also in those of healthcare providers, it may prove to be beneficial to use this information to guide future practice in training and education for palliative physicians in both the spiritual care of patients and in practitioner self care.

(Received April 01 2010)

(Accepted April 15 2010)


c1 Address correspondence and reprint requests to: Kevin Brazil, 105 Main Street East, Level P1, Hamilton, Ontario, L8N 1G6, Canada. E-mail: