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Spiritual Uncertainty Among Hospice Providers

“There Were Tensions”

Stephenson, Pam Shockey, PhD, RN, AOCNS; Sheehan, Denice, PhD, RN; Hansen, Dana, PhD, ACHPN, APRN; Mayo, M. Murray, PhD, RN

Journal of Hospice & Palliative Nursing: February 2019 - Volume 21 - Issue 1 - p 90–95
doi: 10.1097/NJH.0000000000000485
Feature Articles

How providers of end-of-life care perceive spirituality both within themselves and for others can directly impact their ability to provide spiritual care to patients and families. Uncertainty about spirituality can contribute to the awkwardness of spiritual care. Spiritual uncertainty includes the questions, worries, and doubts people have about the meaning, beliefs, connections, self-transcendence, and value that comprise spirituality. This article reports qualitative findings from a mixed-methods study that sought to understand spiritual uncertainty among hospice providers. Data were collected from 28 hospice team members (nurses, physicians, social workers, and expressive therapist) using focus groups, reflective journals, and one-on-one interviews. An overarching theme emerged that described the tensions perceived by providers caring for hospice patients. Those tensions were further categorized as being interpersonal, intrapersonal, and transpersonal in nature. The identification of tension as a source of strain for providers delivering spiritual care is necessary to the development of future interventions that can assist providers and patients navigating end-of-life spirituality.

Pam Shockey Stephenson, PhD, RN, AOCNS, is assistant professor, College of Nursing, Kent State University, Ohio.

Denice Sheehan, PhD, RN, is associate professor, College of Nursing, Kent State University, Ohio.

Dana Hansen, PhD, ACHPN, APRN, is assistant professor, College of Nursing, Kent State University, Ohio.

M. Murray Mayo, PhD, RN, is assistant professor, School of Nursing, Ursuline College, Pepper Pike, Ohio.

Address correspondence to Pam Shockey Stephenson, PhD, RN, AOCNS, 113 Henderson Hall, College of Nursing, Kent State University, Kent, OH 44242 (

P.S.S. is a Chow/Togasaski-Breitenbach scholar of the American Nurses Foundation, who funded this research.

The authors have no conflicts of interest to disclose.

© 2019 by The Hospice and Palliative Nurses Association.