Identification of Spiritual and Religious Needs of Terminally Ill Patients Receiving Palliative Home-care

To identify the spiritual and religious needs of palliative home-care patients in the region of Quebec City (Canada), we interviewed 24 patients in their homes. Through content analysis, needs were classified according to a temporal perspective: needs linked to the past (issues arising from the patient's history -desire to revisit certain aspects); to the present (issues that emerged following the onset of illness); and to the future (issues for the future -in relation to one's becoming). Since the 1960s and 70s, the marked decline of influence of the Catholic tradition has engendered a secular culture that influences how spiritual care interventions are delivered in Quebec's health care system. In the 1960s, the socio-religious culture was so closely linked to the Christian tradition that it provided patients with the words to express their needs which, in turn, were generally articulated through sacramental requests. This research suggests that for a majority of patients today, spiritual and religious needs are expressed through everyday words, for example, through their fears, their questions, their anger, their joy, etc., related to their past experiences (past), to what they are living now (present) and to what they will become (future). Consequently, the screening and assessment of patients' spiritual and religious needs constitutes an unprecedented challenge for the health care system.