Spiritual care experiences by cancer patients, their family caregivers and healthcare team members in oncology practice settings: A qualitative study Soolmaz Moosavi a , Camelia Rohani b,1, *, Fariba Borhani c , Mohammad Esmaeel Akbari d a School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran b Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran c Medical Surgical Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran d Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ARTICLE INFO Article History: Received 17 December 2019 Revised 24 August 2020 Accepted 26 August 2020 Available online xxx ABSTRACT Purpose: Integrating spirituality into the patient care within a healthcare team, increases the ability to pro- vide “holistic care” for cancer patients. The spiritual care experiences of different involved persons can be a guide for future planning. Therefore, this study aimed to explore the spiritual care experiences of hospital- ized cancer patients, their family caregivers and healthcare team members in oncology settings. Methods: This is a descriptive qualitative study which was conducted with 21 participants, who were selected by purposive sampling. Semi-structured interviews were used to collect the data. The data were analyzed with conventional content analysis method. Results: Two themes of "systematic care" and "caring with paradoxical results" were extracted from the spir- itual care experiences of our participants. Conclusions: Spiritual care as professional, comprehensive, collaborative and artistic care should be provided in a multidisciplinary healthcare team for cancer patients. Otherwise, patients may experience deprivation of spiritual services and consequently, spiritual distress. © 2020 Elsevier Inc. All rights reserved. Keywords: Cancer patient Holistic care Oncology setting Spiritual care Background According to the holistic view, the human being is made up of the mind, body and spirit. There is a dynamic interaction between this holistic structure and environment. When all the components are in balance and harmony, the greatest degree of health and wellness appears. 1À3 Human health refers to the state of one’s well-being and includes five dimensions: physical, mental, emotional, social and spiritual. 4 The spiritual dimension has been compared to a central "artery" that permeates other dimensions of a person and keeps them alive by giving them energy. There are values, thoughts, deci- sions, behaviors, experiences and concerns around this artery. With- out spiritual well-being, other dimensions of health (biopsychosocial dimensions) will be unable to function properly. 5 The relationship between spirituality and health has long been of interest to the scien- tific community. 6 Spirituality is an inherent characteristic of human and a powerful source for healing. 7,8 In fact, the individual’s spiritual dimension gives meaning to his relationship with God, himself and the world around him. Communication with a superior being takes one's consciousness beyond time and place and helps him to find meaning and purpose in his life. Communication with one-self ena- bles one's self-awareness to increase. 9,10À13 It seems that "spiritual- ity" as an important source of support can reduce the feeling of vulnerability in humans. 14,15 The results of earlier studies show the significant role of "spiritu- ality" in all stages of cancer. 7,14 Cancer is one of the most important causes of disability and mortality in the world 16À18 which affects all human dimensions. 18 It is necessary to confer special attention to the spiritual dimension of the patients, in addition to other dimensions. One of the important needs of cancer patients is spiritual needs due to the nature of the disease; chronic, fatality and mortality rate. 6,19,20 The spiritual needs of cancer patients would be clear when they are starting to ask their spiritual questions, such as “why did I get can- cer?”, “what is my sin?”, “where is God's justice?”, “why does no one understand me?” and “what will happen to me at last?”. It is a fact, answering these questions is not easy, nevertheless ignoring them is also inappropriate. Ignoring these questions can be disrespectful to the patients, and also it can make more complex the emotional situa- tion of the patient and his communication with others. Furthermore, not responding to them is contrary to professional-ethics rules. 3 * Corresponding author. E-mail address: camelia.rohani@sbmu.ac.ir (C. Rohani). 1 Cross of Vali-Asr Avenue and Hashemi Rafsanjani (Neiaiesh) Highway, Opposite to Rajaee Heart Hospital, Tehran 1996835119, Iran https://doi.org/10.1016/j.explore.2020.08.015 1550-8307/© 2020 Elsevier Inc. All rights reserved. ARTICLE IN PRESS Explore 000 (2020) 1À8 Contents lists available at ScienceDirect Explore journal homepage: www.elsevier.com/locate/jsch