end-of-life interventions, existential/spiritual, life review, palliative care nurses



  1. Keall, Robyn MS, RN
  2. Clayton, Josephine M. PhD
  3. Butow, Phyllis PhD


The objective of this study was to understand Australian palliative care nurses' experience with existential/spiritual interventions and their critical appraisal of Outlook. Existential/spiritual interventions are showing positive results with palliative care patients. The majority of interventions are conducted by nonnurses, yet nurses are the most populous health care workers and are willing to provide holistic care, and patients are open to their help. A qualitative study through semistructured interviews was conducted. Participants were recruited using purposive sampling of a cross section of 20 palliative care nurses. Questions focused on their experience and review of existential/spiritual interventions in general and a published intervention Outlook. Their responses were transcribed and subjected to thematic analysis. The nurses' responses yielded both a range of experiences with existential/spiritual interventions and a review of Outlook. The review of Outlook identified a further 6 subthemes, including (1) Outlook can provide a framework, (2) session II difficult but valuable, (3) benefit for the bereaved, (4) benefit for the nurse/health care team, (5) potential difficulties in delivering Outlook, and (6) possible modifications. Australian palliative care nurses have limited experience with published existential/spiritual interventions, but many are already including elements of these in their practice, and most welcomed the validated tool. Identified needs included training, experience, dedicated space, and time.