Spiritual Uncertainty: Exemplars of 2 Hospice Patients

Publication Title

Holistic Nursing Practice

Publication Date


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hospice, spirituality, uncertainty




Spirituality is important to persons approaching the end of life. The ambiguous nature of dying and spirituality creates many opportunities for uncertainty. This article presents 2 exemplars from hospice patients about the different ways that spiritual uncertainty affected their dying experience.

Dying is a personal experience that occurs as an event (eg, sudden death) or a process (eg, terminal illness). The process of dying from a terminal illness elicits many emotions that are influenced by the characteristics of the illness, the personal attributes of the individual, and environmental and interpersonal factors.1 Dying is ambiguous and personalized in that no one knows what to expect from dying or death itself.2 Spirituality is also an ambiguous construct that is uniquely interpreted and hard to describe; however, it is salient to dying. The significant impact that spirituality has on persons who are facing death or witnessing the death of others is well documented.3,4 Also, several processes or outcomes of spirituality have been discussed in the literature such as spiritual crisis,5 spiritual relationships,6 and spiritual engagement.7 However, having uncertainties about spirituality at the end of life has not been explicitly researched, demonstrating a gap in the current understanding of spirituality in people who are dying. This article presents 2 exemplars of hospice patients who told especially poignant stories about spiritual uncertainty during qualitative interviews for a separate study. Their stories provide preliminary evidence about the possibility of spiritual uncertainty at the end of life and illustrate the uniquely different ways that these 2 individuals experienced spiritual uncertainty.