%0 Journal Article
%T Implementing Spiritual Care for Patients Receiving End-of-Life Palliative Care: A Mixed-Methods Systematic Review
%A Ananya Sen
%A Priya Dutta
%A Rahul Bose
%A Meera Ghosh
%J Journal of Integrative Nursing and Palliative Care
%@ 3006-5550
%D 2026
%V 7
%N 1
%R 10.51847/CpHCyBLT6f
%P 174-189
%X Using the Theoretical Domains Framework (TDF), this systematic investigation aims to analyze and integrate current data on impediments and facilitators to integrating spiritual care within palliative programs for terminal populations. A comprehensive search was executed across six digital repositories (PubMed, Embase, CLNAHL, Web of Science, ProQuest, and the Cochrane Library) for literature published before July 2025. This review incorporated both qualitative and quantitative papers detailing how patients and clinical staff view the delivery of spiritual support at life’s end. Methodological rigor was assessed using a mixed-methods appraisal tool. The extracted barriers and drivers were then mapped onto specific TDF categories using a blended deductive-inductive qualitative approach. The final analysis comprised 27 papers: 13 quantitative, 7 qualitative, and 7 mixed-method studies. Patient viewpoints were captured in 7 of these papers, whereas healthcare clinician perspectives were featured in 23. While factors aligned with most TDF domains, two distinct themes emerged outside the framework: “Providers’ Spiritual Self-Care and Reflection” and “Provider-patient’ Longitudinal relationships”. The analysis yielded 16 distinct sub-themes for hindering factors and 16 for facilitating factors. Conversely, two TDF categories lacked any corresponding data: Memory, Attention, and Decision Process (for barriers) and Behavior Regulation (for enablers). This review outlines the key factors influencing the delivery of spiritual care to terminally ill patients. Truly embedding this care requires moving away from reactive “end-of-life spiritual rescue” toward a model of continuous spiritual care. Healthcare workers must see themselves as active behavioral change agents who can bridge latent patient vulnerabilities with perceived professional boundaries. Future policy should center on interdisciplinary schooling, embedding spiritual metrics directly into standard clinical records, and protecting structural continuity between clinicians and patients.
%U https://journalinpc.com/article/implementing-spiritual-care-for-patients-receiving-end-of-life-palliative-care-a-mixed-methods-syst-fwbgpgeaqjzlahi