The development of palliative care in Poland has triggered a new examination of medical care, including the spiritual suffering of patients. Dr Małgorzata Fopka-Kowalczyk, Professor Małgorzata Krajnik and Dr Megan Best tell us more.
Palliative care began in Poland in the 1980s, and it has developed in many ways since then. An important initiative, going beyond the field of palliative medicine, was the creation of the Polish Association for Spiritual Care in Medicine (PASCiM) in 2015 to promote implementation of spiritual care into practice, education and research. Among PASCiM members are doctors, as well as other healthcare professionals and chaplains (not only from the Roman Catholic Church, which is the most practiced religion in Poland, but from other denominations as well). One of PASCiM’s first achievements was to widely disseminate the definition of ‘spirituality’ as a dimension of human life that relates to transcendence and other existentially important values (1, 2).
Based on the EAPC’s Reference Group on Spiritual Care’s approach to spirituality, PASCiM similarly recognizes three dimensions of spiritual experience which include the religiousness of a person, their existential quest, and values by which a person lives. Discussions around spirituality, and conferences organised in 2017 and 2018 with the participation of representatives of spiritual support in Europe and the United States (including Philip Larkin, Christina Puchalski and Richard Groves) became the background for the creation of the first compulsory module in Poland for teaching medical students ‘Spirituality in Medicine’ at the Collegium Medicum in Bydgoszcz of Nicolaus Copernicus University in Toruń (2). During a total of twenty-two hours of lectures, seminars and workshops, students talk about their own spirituality and learn to recognise spiritual suffering among sick people, learning how to be more mindful and compassionate, as well as learning how to implement spiritual interventions such as dignity therapy (a form of short-term psychotherapy which addresses the patient’s life story) (3), helping patients to find meaning, and how to work with healthcare chaplains and other specialists.
As our university was the first in Poland to introduce spirituality into the medical curriculum, we wanted to develop a scale to assess the outcomes of this programme. We therefore collaborated to develop the Spiritual Supporter Scale (SpSup Scale) to assess spiritual competencies among professionals or people who are studying for a caregiving profession (4). The questionnaire consisted of questions in five areas: attitude to prayer; beliefs regarding spirituality; spirituality in relation to one’s own suffering and the suffering of others; sensitivity to the suffering of others and attitude to community (i.e., all those providing spiritual support for the individual). Results of the validation and standardisation of our tool are highly satisfactory.
An example of the dynamic development of work in the field of spirituality in Poland is also the PASCiM project implemented in cooperation with medical, religious, healthcare management and business communities during the COVID-19 pandemic under the name ‘Be with me… National Programme of Spiritual and Social Support for Patients Hospitalised for COVID-19’ (5). The goal of this programme was to ensure that no COVID-19 patient is alone in the hospital, especially during a period of life-threatening disease, helplessness and dying – so that no one is deprived of spiritual care just when they need it most. The programme was adopted by 131 hospitals from all over Poland which were equipped with smartphones for patients. PASCiM prepared video materials on providing support and communication with the patient and loved ones, as well as running ongoing monthly webinars for hospital chaplains (6).
Learning from good practice is an important part of developing our services and currently, work is underway (with a grant of the Polish Ministry of Education and Science awarded to PASCIM) on the preparation of almost forty talks delivered by excellent lecturers from around the world, who are involved in the development of spiritual care in medicine. These lectures will be freely available on the website PASCiM (in both English and Polish) in December 2022 and will be helpful in the preparation of the first Polish textbook of spiritual care in medicine (1).
We are proud of all these significant developments to integrate spiritual care as an essential aspect to support our patients.
Links and resources
To find out more about the EAPC Spiritual Care Reference Group or to join, click here.
References
1) Polish Association of Spiritual Care in Medicine PASCiM,. (2020). Available online at: http://ptodm.org.pl/ (accessed September 30, 2022)
2) Fopka-Kowalczyk M, Groves R, Larkin P and Krajnik M (2022) A training programme for medical students in providing spiritual care to people with advanced diseases and their loved ones: A case study from the Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland. Front. Cardiovasc. Med. 9:909959. doi: 10.3389/fcvm.2022.909959
3 ) Brożek, B., Fopka-Kowalczyk, M., Łabuś-Centek, M., Damps-Konstańska, I., Ratajska, A., Jassem, E., Larkin, P., & Krajnik, M. (2019). Dignity Therapy as an aid to coping for COPD patients at their end-of-life stage. Advance Respiratory Medicine, 87(3), 135-145, doi: 10.5603/ARM.a2019.0021
4) Fopka-Kowalczyk, M., Best, M., & Krajnik, M. (2022). The Spiritual Supporter Scale as a New Tool for Assessing Spiritual Care Competencies in Professionals: Design, Validation, and Psychometric Evaluation. Journal of Religion and Health, doi: 10.1007/s10943-022-01608-3.
5) https://ptodm.org.pl/badz-przy-mnie (accessed September 30, 2022).
6) https://ptodm.org.pl/webinaria-kapelani (accessed September 30, 2022)
About the authors
Dr Małgorzata Fopka-Kowalczyk, Ph.D., is a psychologist, pedagogist, psycho-oncologist and lecturer at the Department of Philosophy and Social Sciences, Nicolaus Copernicus University in Toruń, Poland. ORCID: 0000-0002-5785-6227.
Dr Megan Best PhD, MAAE, BMed(Hons) is a Researcher at the Institute of Ethics & Society at the University of Notre Dame Australia, a bioethicist and palliative care physician. ORCID: 0000-0003-1570-8872.
Professor Małgorzata Krajnik, MD, PhD, is Head of Palliative Care Department, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland. She is President of the Palliative Association for Spiritual Care in Medicine. ORCID: 0000-0001-9473-6163.
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