Spiritual care training needs in hospice palliative care settings in South Africa: Chorused national, provincial and local voices

ABSTRACT Globally, spiritual care is recognized as an important component of palliative care. In the Global North spiritual care training is gaining momentum and being prioritized, but not so in the Global South. This study seeks to establish what the national spiritual care training needs are in hospice palliative care settings with formalized spiritual care services in a middle-income country in the Global South. This was a three-part study: a quantitative national online survey of hospices in South Africa establishing what their spiritual care training needs were – survey results were collated, analyzed and filtered for key issues and overarching themes; a qualitative study consisting of focus group discussions with hospices in the Western Cape Province, South Africa, who have formalized spiritual care services, with the aim of understanding their spiritual care practices and workforce needs – the discussions were analyzed using thematic analysis; and a qualitative study drawing on the experiences of a cohort of spiritual care workers from an established hospice in Cape Town to understand their training needs in spiritual care and explore their workforce issues. Results revealed a chorused need for the development of a national training curriculum in spiritual care for hospices providing palliative care in South Africa and a chorused recognition that spiritual care services are nuanced and require both formalization and flexibility for spiritual care workers to be led by patient needs. Two elements – finance and human capital – were identified as key barriers to developing a spiritual care curriculum.