Abstract
Registered dietitians assess, diagnose and treat nutritional problems. Although integral to healthcare, their role in spiritual care is unknown. We conducted a systematic review of spiritual needs and spiritual care in nutrition and dietetic practice. Subject Headings and keywords were used to search Medline, CINAHL, PsycINFO and AMED for studies exploring spiritual care and nutrition or dietetic practice. From 1433 records, 13 studies were included. Medium quality evidence showed unmet spiritual needs among dietetic patients suffering from cancer, COPD, heart failure and diabetes. Unmet needs occurred in patients from a variety of ethnicities, religions and none. However, dietitians were only involved in spiritual care regarding nutrition and hydration at the end of life. Integrating spiritual screening and sign-posting within dietetic practice is prudent, but clinical trials are needed to evaluate its effectiveness.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abu-Raiya, H., Pargament, K. I., Krause, N., & Ironson, G. (2015). Robust links between religious/spiritual struggles, psychological distress, and well-being in a national sample of American adults. American Journal of Orthopsychiatry, 85(6), 565–575. https://doi.org/10.1037/ort0000084
Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology and Behavior, 91(4), 449–458. https://doi.org/10.1016/j.physbeh.2007.04.011
Aitaoto, N., Campo, S., Snetselaar, L. G., Janz, K. F., Farris, K. B., Parker, E., Belyeu-Camacho, T., & Jimenez, R. P. (2015). Formative research to inform nutrition interventions in Chuuk and the US Pacific. Journal of the Academy of Nutrition and Dietetics, 115(6), 947–953. https://doi.org/10.1016/j.jand.2014.11.018*
Altman, D. G., Simera, I., Hoey, J., Moher, D., & Schulz, K. (2008). EQUATOR: reporting guidelines for health research. Open Medicine, 2(2), e49-e50 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090180/.
Anandarajah, G., Hight, E. (2001). Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. American Family Physician, 63(1), 81–89 https://www.aafp.org/afp/2001/0101/p81.html?ref=Guzels.TV.
Andersen, A. H., Assing Hvidt, E., Hvidt, N. C., & Roessler, K. K. (2019). Doctor–patient communication about existential, spiritual and religious needs in chronic pain: A systematic review. Archive for the Psychology of Religion, 41(3), 277–299. https://doi.org/10.1177/0084672419883339
Ano, G. G., & Vasconcelles, E. B. (2005). Religious co** and psychological adjustment to stress: A meta-analysis. Journal of Clinical Psychology, 61(4), 461–480. https://doi.org/10.1002/jclp.20049
Astrow, A. B., Wexler, A., Texeira, K., He, M. K., & Sulmasy, D. P. (2007). Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? Journal of Clinical Oncology, 25(36), 5753–5757. https://doi.org/10.1200/jco.2007.12.4362
Balboni, T., Balboni, M., Paulk, M. E., Phelps, A., Wright, A., Peteet, J., &... Prigerson, H. (2011). Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer, 117(23), 5383–5391. https://doi.org/10.1002/cncr.26221
Balboni, T. A., Paulk, M. E., Balboni, M. J., Phelps, A. C., Loggers, E. T., Wright, A. A., & Prigerson, H. G. (2010). Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death. Journal of Clinical Oncology, 28(3), 445–452. https://doi.org/10.1200/JCO.2009.24.8005
Balboni, M. J., Sullivan, A., Amobi, A., Phelps, A. C., Gorman, D. P., Zollfrank, A., & Balboni, T. A. (2013). Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. Journal of Clinical Oncology, 31(4), 461–467. https://doi.org/10.1200/JCO.2012.44.6443
Balboni, T. A., Vanderwerker, L. C., Block, S. D., Paulk, M. E., Lathan, C. S., Peteet, J. R., & Prigerson, H. G. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25(5), 555–560. https://doi.org/10.1200/JCO.2006.07.9046
Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosomatic Medicine, 66(6), 802–813. https://doi.org/10.1097/01.psy.0000146332.53619.b2
Bertran, E. A., Pinelli, N. R., Sills, S. J., & Jaber, L. A. (2017). The Arab American experience with diabetes: Perceptions, myths and implications for culturally-specific interventions. Primary Care Diabetes, 11(1), 13–19. https://doi.org/10.1016/j.pcd.2016.07.004.*
Best, M., Butow, P., & Olver, I. (2015). Do patients want doctors to talk about spirituality? A systematic literature review. Patient Education and Counseling, 98(11), 1320–1328. https://doi.org/10.1016/j.pec.2015.04.017
Best, M., Leget, C., Goodhead, A., & Paal, P. (2020). An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliative Care, 19(1), 1–10. https://doi.org/10.1186/s12904-019-0508-4
Borneman, T., Ferrell, B., & Puchalski, C. M. (2010). Evaluation of the FICA tool for spiritual assessment. Journal of Pain and Symptom Management, 40(2), 163–173. https://doi.org/10.1016/j.jpainsymman.2009.12.019
British Dietetic Association (2020). What is a dietitian? https://www.bda.uk.com/about-dietetics/what-is-dietitian.html
British Dietetic Association, (2013). A Curriculum Framework for the pre-registration education and training of dietitians. https://www.bda.uk.com/training/practice/preregcurriculum
Dickinson, J. (2009). An exploratory study of patient interventions and nutritional advice for patients with chronic obstructive pulmonary disease, living in the community. International Journal on Disability and Human Development, 8(1), 43–49. https://doi.org/10.1515/IJDHD.2009.8.1.43.*
Druml, C., Ballmer, P. E., Druml, W., Oehmichen, F., Shenkin, A., Singer, P., Soeters, P., Weimann, A., & Bischoff, S. C. (2016). ESPEN guideline on ethical aspects of artificial nutrition and hydration. Clinical Nutrition, 35(3), 545–556. https://doi.org/10.1016/j.clnu.2016.02.006.*
European Federation of Dietitians (EFAD). (2016). Dietitians in Europe Definition, Profession and Education Statement by the European Federation of the Associations of Dietitians (EFAD). http://www.efad.org/media/1417/revised-definition-of-a-dietitian.pdf.
Exline, J. J., Pargament, K. I., Grubbs, J. B., & Yali, A. M. (2014). The religious and spiritual struggles scale: Development and initial validation. Psychology of Religion and Spirituality, 6(3), 208–222. https://doi.org/10.1037/a0036465
Exline, J. J., Homolka, S. J., & Harriott, V. A. (2016). Divine struggles: Links with body image concerns, binging, and compensatory behaviours around eating. Mental Health, Religion and Culture, 19(1), 8–22. https://doi.org/10.1080/13674676.2015.1087977
Fitchett, G., & Risk, J. L. (2009). Screening for spiritual struggle. Journal of Pastoral Care & Counseling, 63(1–2), 1–12. https://doi.org/10.1177/154230500906300104
Gijsberts, M. J. H., Liefbroer, A. I., Otten, R., & Olsman, E. (2019). Spiritual care in palliative care: A systematic review of the recent European literature. Medical Sciences, 7(25), 1–21. https://doi.org/10.3390/medsci7020025
Hamilton, J., & Kroska, E. B. (2019). Distress predicts utilization of psychosocial health services in oncology patients. Psycho-Oncology, 28(1), 61–67. https://doi.org/10.1002/pon.4910.*
Hancock, R. E. E., Bonner, G., Hollingdale, R., & Madden, A. M. (2012). ‘If you listen to me properly, I feel good’ a qualitative examination of patient experiences of dietetic consultations. Journal of Humand Nutrition and Dietetics, 25, 275–284. https://doi.org/10.1111/j.1365-277X.2012.01244.x
Hatala, A. R. (2013). Towards a biopsychosocial–spiritual approach in health psychology: Exploring theoretical orientations and future directions. Journal of Spirituality in Mental Health, 15(4), 256–276. https://doi.org/10.1080/19349637.2013.776448
Ho, J. Q., Nguyen, C. D., Lopes, R., Ezeji-Okoye, S. C., & Kuschner, W. G. (2018). Spiritual care in the intensive care unit: A narrative review. Journal of Intensive Care Medicine, 33(5), 279–287. https://doi.org/10.1177/0885066617712677
Hvidt, N. C., Nielsen, K. T., Kørup, A. K., Prinds, C., Hansen, D. G., Viftrup, D. T., Hvidt, E. A., Hammer, E. R., Falkø, E., Locher, F., & Boelsbjerg, H. B. (2020). What is spiritual care? Professional perspectives on the concept of spiritual care identified through group concept map**. British Medical Journal Open, 10(12), e042142. https://doi.org/10.1136/bmjopen-2020-042142
International Confederation of Dietetic Associations (ICOD) (2016). Definition of Dietitian-Nutritionist, ICDA By-Law https://www.internationaldietetics.org/Downloads/International-Definition-of-Dietitian.aspx
Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of Clinical Nursing., 23(21–22), 3197–3205. https://doi.org/10.1111/jocn.12566
Koenig, H. G., King, D. E., & Carson, V. B. (2012). Handbook of religion and health (2nd ed.). Oxford University Press.
Krause, N., Ellison, C. G., Shaw, B. A., Marcum, J. P., & Boardman, J. D. (2001). Church-based social support and religious co**. Journal for the Scientific Study of Religion, 40(4), 637–656. https://doi.org/10.1111/0021-8294.00082
Lancaster, K. J., Carter-Edwards, L., Grilo, S., Shen, C., & Schoenthaler, A. M. (2014). Obesity interventions in African American faith-based organizations: A systematic review. Obesity Reviews, 15, 159–176. https://doi.org/10.1111/obr.12207
Lycett, D. (2018). Protocol for a cluster randomised controlled trial to compare the “taste & see” programme—a church-based programme to develop a healthy relationship with food—with a wait-list control. Religions, 9(3), 1–9. https://doi.org/10.3390/rel9030088
Lycett, D., (2020). Spiritual Care and Dietetic Practice – A call beyond cultural competency. Dietetics Today. BDA Membership Magazine.
Lycett, D., Patel, R., Coufopoulos, A., & Turner, A. (2016). Protocol of Taste and See: A feasibility study of a church-based, healthy, intuitive eating programme. Religions, 7(4), 1–13. https://doi.org/10.3390/rel7040041
Maeyama, E., Kawa, M., Miyashita, M., Ozawa, T., Futami, N., Nakagami, Y., Sugishita, C., & Kazuma, K. (2003). Multiprofessional team approach in palliative care units in Japan. Supportive Care in Cancer, 11(8), 509–515. https://doi.org/10.1007/s00520-003-0465-5.*
McSherry, W., & Ross, L. (2010). Spiritual assessment in healthcare practice. M&K Update Ltd.
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264–269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Morris, A., Biggerstaff, D., & Lycett, D. (2016). Capturing whole person care. Journal of Renal Care, 42(2), 71–72. https://doi.org/10.1111/jorc.12158
NHS England (2015). NHS England NHS Chaplaincy Guidelines 2015: Promoting Excellence in Pastoral, Spiritual & Religious Care https://www.england.nhs.uk/wp-content/uploads/2015/03/nhs-chaplaincy-guidelines-2015.pdf
O’Sullivan Maillet, J. (1995). Position of the American dietetic association. Legal and ethical issues in feeding permanently unconscious patients. Journal of the American Dietetic Association, 95(2), 231–234. https://doi.org/10.1016/S0002-8223(95)00055-0.*
O’Sullivan Maillet, J., Potter, R. L., & Heller, L. (2002). Position of the American Dietetic Association: Ethical and legal issues in nutrition, hydration, and feeding. Journal of the American Dietetic Association, 102(5), 716–726. https://doi.org/10.1016/j.jada.2008.03.027.*
O’Sullivan Maillet, J., & Posthauer, M. E. (2013). Position of the academy of nutrition and dietetics: Ethical and legal issues in feeding and hydration. Journal of the Academy of Nutrition and Dietetics, 113(6), 828–833. https://doi.org/10.1016/j.jand.2013.03.020.*
Pargament, K. I. (1997). The psychology of religion and co**: Theory, research, practice. Guilford Press.
Pargament, K. I. (2007). Spiritually integrated psychotherapy. Guilford.
Patel, R., Lycett, D., Coufopoulos, A., & Turner, A. (2017a). A Feasibility study of taste & see: A church based programme to develop a healthy relationship with food. Religions, 8(2), 1–21. https://doi.org/10.3390/rel8020029
Patel, R., Lycett, D., Coufopoulos, A., &... Turner, A. (2017b). Moving forward in their journey: Participants’ experience of taste & see, a church-based programme to develop a healthy relationship with food. Religions, 8(1), 1–21. https://doi.org/10.3390/rel8010014
Pathy, R., Mills, K. E., Gazeley, S., Ridgley, A., & Kiran, T. (2011). Health is a spiritual thing: Perspectives of health care professionals and female Somali and Bangladeshi women on the health impacts of fasting during Ramadan. Ethnicity & Health, 16(1), 43–56. https://doi.org/10.1080/13557858.2010.523780.*
Pearce, M. J., Coan, A. D., Herndon, J. E., Koenig, H. G., & Abernethy, A. P. (2012). Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Supportive Care in Cancer, 20(10), 2269–2276. https://doi.org/10.1007/s00520-011-1335-1
Phelps, A. C., Lauderdale, K. E., Alcorn, S., Dillinger, J., Balboni, M. T., Van Wert, M., & Balboni, T. A. (2012). Addressing spirituality within the care of patients at the end of life: Perspectives of patients with advanced cancer, oncologists, and oncology nurses. Journal of Clinical Oncology, 30(20), 2538–2544. https://doi.org/10.1200/jco.2011.40.3766
Puchalski, C., & Ferrell, B. (2010). Making health care whole: Integrating spirituality into patient care. Boston: Templeton Foundation Press.
Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., &... Sulmasy, D. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12(10), 885–904. https://doi.org/10.1089/jpm.2009.0142
Puchalski, C., Jafari, N., Buller, H., Haythorn, T., Jacobs, C., & Ferrell, B. (2020). Interprofessional spiritual care education curriculum: A milestone toward the provision of spiritual care. Journal of Palliative Medicine, 23(6), 777–784. https://doi.org/10.1089/jpm.2019.0375
Rachel, H., Chiara, C., Robert, K., & Francesco, S. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta Bio Medica: Atenei Parmensis, 90(4), 44–55.
Riazi, A., Pickup, J., & Bradley, C. (2004). Daily stress and glycaemic control in type 1 diabetes: Individual differences in magnitude, direction, and timing of stress-reactivity. Diabetes Research and Clinical Practice, 66(3), 237–244. https://doi.org/10.1016/j.diabres.2004.04.001
Richards, P. S., Weinberger-Litman, S. L., Susov, S., & Berrett, M. E. (2013). Religiousness and spirituality in the etiology and treatment of eating disorders. In K. I. Pargament, A. Mahoney, & E. P. Shafranske (Eds.), APA handbook of psychology, religion, and spirituality (Vol. 2): An applied psychology of religion and spirituality (pp. 319–333). USA: American Psychological Association.
Rong, X., Peng, Y., Yu, H. P., & Li, D. (2017). Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure. Journal of Clinical Nursing, 26, 717–726.
Schwartz, D. B., Barrocas, A., Wesley, J. R., Kliger, G., Pontes-Arruda, A., Márquez, H. A., James, R. L., Monturo, C., Lysen, L. K., & DiTucci, A. (2014). Gastrostomy tube placement in patients with advanced dementia or near end of life. Nutrition in Clinical Practice, 29(6), 829–840. https://doi.org/10.1177/0884533614546890.*
Selman, L. E., Brighton, L. J., Sinclair, S., Karvinen, I., Egan, R., Speck, P., & Collaborative, I. S. (2018). Patients’ and caregivers’ needs, experiences, preferences and research priorities in spiritual care: A focus group study across nine countries. Palliative Medicine, 32(1), 216–230.
Sladdin, I., Chaboyer, W., & Ball, L. (2018). Patients’ perceptions and experiences of patient-centred care in dietetic consultations. Journal of Human Nutrition and Dietetics, 31, 188–196. https://doi.org/10.1111/jhn.12507
Sohi, J., Champagne, M., & Shidler, S. (2015). Improving health care professionals’ collaboration to facilitate patient participation in decisions regarding life-prolonging care: An action research project. Journal of Interprofessional Care, 29(5), 409–414. https://doi.org/10.3109/13561820.2015.1027335.*
Sulmasy, D. P. (2002). A biopsychosocial-spiritual model for the care of patients at the end of life. The Gerontologist, 42, 24–33. https://doi.org/10.1093/geront/42.suppl_3.24
Vieten, C., & Scammell, S. (2015). Spiritual and religious competencies in clinical practice: Guidelines for psychotherapists and mental health professionals. New Harbinger Publications.
Windgassen, S., Moss-Morris, R., Chilcot, J., Sibelli, A., Goldsmith, K., & Chalder, T. (2017). The journey between brain and gut: A systematic review of psychological mechanisms of treatment effect in irritable bowel syndrome. British Journal of Health Psychology, 22(4), 701–736. https://doi.org/10.1111/bjhp.12250
World Health Organisation, (2009). Interventions on diet and physical activity: what works: summary report. https://www.who.int/dietphysicalactivity/whatworks-religious/en/
Zhang, X., Pang, L., Sharma, S. V., Li, R., Nyitray, A. G., & Edwards, B. J. (2019). Prevalence and factors associated with malnutrition in older patients with cancer. Journal of Geriatric Oncology, 10(5), 763–769. https://doi.org/10.1016/j.jgo.2019.01.021
Funding
Coventry University pays the salary of the authors; no additional funding was received.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have none to declare.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lycett, D., Patel, R. Spiritual Care within Dietetic Practice: A Systematic Literature Review. J Relig Health 62, 1223–1250 (2023). https://doi.org/10.1007/s10943-022-01555-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-022-01555-z