Five spiritual strengths your patients might be pursuing

Another contribution to our Spirituality and Palliative Care series that looks at how people deal with crisis and suffering when confronted with life-threatening disease. Today, our guest writer is Marc Haufe, PhD researcher spiritual care at the Care Ethics department of the University of Humanistic Studies in the Netherlands. Marc is co-author of a longer article on this subject published in ‘BMJ Supportive and Palliative Care’ and now available in Open Access.

Marc Haufe.

Fostering spiritual or existential strength is often mentioned as very important within spiritual palliative care. But when it comes to these strengths, are we aware enough of what they entail?

Let’s look at patient Hanna

“…What I really wish is that when people come to visit we could have a really meaningful conversation. It doesn’t have to be sad and gloomy either… You can talk about meaning and hope and all those things… hope for closure, for knowing that my kids will be ok when I’m gone, that I’ve left them with an ability to live a meaningful life…    Why can’t we talk about our friendship – what the life we share together – means? …  Why can’t they look at me and acknowledge the courage it takes to walk down this road, to make these choices, to believe in myself, to live the best I can for however long I can? Why can’t they tell me I have courage? That I have strength?” (Bell 2018)

Seeing strengths?

Within the context of the DIAMAND project, our research team identified five distinct spiritual strengths in the recent literature that patients and professionals can foster in various ways.

Figure 1: The Propeller; a model of spiritual strength fostering.


Patients may pursue meaning, through deeper understanding and feeling what is truly significant to them. In the above excerpt, we can recognise two of the ways found to foster meaning. Patient Hanna wishes to talk about and reassess what is important to her. She also seeks acknowledgment of an essentially positive self.


Patients can pursue connection, through a feeling of deep sharing with others. Above, Hanna wishes to connect on a deeper level with her friends, to open up about what it’s like to share a life and care for each other


Strength can also be found in agency, through experiencing a capacity to act, to be able to do and affect. Hanna seeks reassurance that the road she takes and the choices she makes attest to this capacity. It takes courage to make choices which, in the palliative phase, often entails the refocusing of goals and continuous adaptation.


Hope can be found through having a positive perspective on the possibilities of the future. Hanna may be said to hope for a special outcome of closure and wishes a meaningful life for her children.


Hanna does not speak of the strength of faith, placing trust in the supernatural and honouring it. But it may well be that in further conversations, spiritual tradition, or a benevolent force, become important themes.

Talking strengths?

Are we sensitive enough to what ‘our Hannas’ seek regarding spiritual strengths, so that we don’t impede and, if desired, aid? Having the above in mind when speaking with them could be useful.

If you want to know more about fostering spiritual strengths you are welcome to email me. Or, please read our article recently published in BMJ Supportive and Palliative Care and available as Open Access, or listen to my oral presentation at the 11th EAPC World Research Congress Online. My presentation, How can existential or spiritual strengths be fostered in palliative care?: An interpretative synthesis of recent literature, is one of the many on-demand presentations now available for registered delegates to view until 31 January 2021. You can also find my presentation free of charge on the EAPC YouTube channel:


  1. The DIAMAND project is a research project that aims to further develop spiritual conversation skills of professional working in palliative care. It is funded by ZonMW and is a collaboration between the University of Humanistic Studies (Carlo Leget, Marieke Potma and Marc Haufe) and the University Medical Centre of Utrecht (Saskia Teunissen).

Whitley Bell, K. (2018) Living at the end of life; a hospice nurse addresses the most common questions. New York, NT: Sterling Publishing.

Haufe, M, Leget, C, Potma, M, Teunissen, S. (2020) How can existential or spiritual strengths be fostered in palliative care? An interpretative synthesis of recent literature. BMJ Supportive and Palliative Care. View the full-text article here.

Links and resources

Editorial note: This post is among the Top Ten most-viewed posts on the EAPC blog in the second six months of 2020.


This entry was posted in 2020 most viewed posts, SPIRITUAL CARE and tagged . Bookmark the permalink.

1 Response to Five spiritual strengths your patients might be pursuing

  1. Pingback: Palliatieve zorg als helende wederkerigheid? -

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