Browsing by Author "Mahilall, Ronita"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Challenges and opportunities for spiritual care practice in hospices in a middle-income country
    (BMC (part of Springer Nature), 2021-04-22) Mahilall, Ronita; Swartz, Leslie
    Background: Spiritual care is a key component of palliative care, but it has been overlooked and understudied in low- and middle-income country contexts, especially in Africa. In this study we sought to establish what the current spiritual care practices are in hospice palliative care settings in South Africa with a focused view on what spiritual care training is currently offered and what training needs still remain unmet. Methods: We explored spiritual care practices, and training needs, through a national quantitative online study of palliative care organisations in South Africa registered with the Hospice Palliative Care Association of South Africa. A survey was sent to representatives of all member organisations listed on the national database of Hospice Palliative Care Association of South Africa. Viable data from 41% (n = 40) member organisations were analysed through the use of simple statistics. Results: An expressed need (75%; n = 30) was recorded for the development of a national spiritual care curriculum. Although 48% (n = 20) of the member organisations were willing to participate in the development of a spiritual care curriculum, 37% (n = 14) could not participate, citing financial (n = 27), time (n = 31) and expertise constraints (n = 22). A set of hard and soft skills were suggested to suit the diverse South African context. Conclusions: Spiritual care was seen by participants as a key component of palliative care. International curricula in spiritual care, while useful, do not offer easy adaptation to the diversities of South Africa. A bespoke spiritual care curriculum was called for, for diverse South Africa.
  • Thumbnail Image
    Item
    Spiritual care in hospice palliative care settings in south africa: national curriculum needs, description of provincial services, and a local case study
    (Stellenbosch : Stellenbosch University, 2021-12) Mahilall, Ronita; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: Palliative care is gaining momentum in South Africa. Spiritual care is slowly being recognised as an important component of palliative care and hospice work. However, how spiritual care services are offered and prioritised depends largely on the hospices’ ability to fund this service and to have the necessary skilled spiritual care staff in place to offer this specialised service. The aim of this study was to explore whether hospices in palliative care settings in South Africa offered spiritual care services, how spiritual care services were offered, what the spiritual care training needs are and, more critically, to explore if there was a need to develop a national spiritual care training curriculum. To answer these questions, I conducted a three-tiered study. In Sub-Study One, I conducted an online survey of all hospices registered as member organisations of the Hospice Palliative Care Association of South Africa. The aim of Sub-Study One was to explore what spiritual care services were currently being offered at hospices nationally, what spiritual care training needs existed, and how hospices suggested filling the training gap. In Sub-Study Two, I conducted focus group discussions with hospices in the Western Cape province of South Africa. These focus groups explored the above questions but with a focused view on issues of multi-layered contextual diversities and inequalities which, largely, are by-products of the South African Apartheid era. Sub-Study Three took the form of one-on-one interviews and focus group discussions with participants who are practising spiritual care workers registered with St Luke’s Combined Hospices in Cape Town, to explore how they offer spiritual care services and navigate issues of diversity. Further, I explored this cohort’s spiritual care training needs and their ideas of developing a national spiritual care curriculum for South Africa. The findings of this three-part study suggest that hospices in South Africa offer spiritual care services to varying levels, and where such a service is not on offer, arrangements are made to link patients and families to external resources. Common to the three sub-studies was the expressed need to develop a national spiritual care training curriculum that comprised both an academic and practical component. However, the realities of limited funding and limited expertise in spiritual care was a significant consideration towards developing a spiritual care curriculum. Added to that was the consideration of the multi-layered diversities that are part of South Africa and its troubled history. These findings present further perspectives on the fluid, dynamic and often multi-faceted nature of an aspect of health care provision in South Africa. The study concluded by outlining some potential next steps for developing further dialogues on spiritual care services in South Africa
  • Thumbnail Image
    Item
    Spiritual care practices in hospices in the Western cape, South Africa : the challenge of diversity
    (BMC (part of Springer Nature), 2021) Mahilall, Ronita; Swartz, Leslie
    Background: South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods: Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results: Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust. Discussion: Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions: While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.