The Spiritual Dimension of Palliative Care Patients and Their Caregivers in a Compassionate Community in Two Brazilian Favelas1: A Mixed-Methods Study.

Abstract

Spirituality is a key dimension of palliative care, contributing to well-being, supporting adjustment to illness, and serving as an important coping resource for patients and caregivers. In socially vulnerable settings, compassionate community initiatives may facilitate the integration of spiritual care and help mitigate the effects of limited access to health and social resources. This study aimed to describe spirituality-related attitudes and religiosity and to explore how patients receiving palliative care and their caregivers understood and experienced these within a compassionate community in two Brazilian favelas. A convergent parallel mixed-methods design was used. The sample included 29 participants, consisting of patients receiving palliative care and their caregivers. Quantitative data were collected using the Attitudes Related to Spirituality Scale and the Duke Religiosity Index, and qualitative data were obtained through semi-structured interviews. Statistical analyses were conducted using R, and qualitative data were analyzed through a combined lexical statistical approach and inductive content analysis. The findings showed ARES scores near the upper end of the scale, reflecting strong endorsement of spirituality-related attitudes, along with predominantly high non-organizational and intrinsic religiosity. Organizational religiosity was predominantly low. Qualitative accounts described prayer, connection with God, family relationships, nature, and meaning-making as important aspects of participants' experiences of illness and caregiving. The integrated findings showed that spiritual and religious practices were experienced as sources of comfort, support, and meaning within conditions of social vulnerability. These findings reinforce the relevance of considering spiritual needs in palliative care and contribute to understanding spirituality and religiosity in community-based palliative care in socially vulnerable settings.