Addressing spiritual needs in palliative care: proposal for a narrative and interfaith spiritual care intervention for chaplaincy.

Although many recognize the importance of addressing the spiritual domain in palliative care, empirically grounded interventions designed to alleviate spiritual needs for patients in palliative care are remarkably scarce. In this paper we argue that the development of such interventions for chaplains is important in order to improve spiritual care in a (post)secular and religiously plural context. We therefore propose an interfaith chaplain-led spiritual care intervention for home-based palliative care that addresses patients' spiritual needs. The intervention is based on elements of spiritual care interventions that have been investigated among other populations. Three important characteristics of the proposed intervention are (1) life review; (2) materiality, ritual and embodiment; and (3) imagination. The aim of this intervention is to improve palliative patients' spiritual wellbeing. It is anticipated that such a structured intervention could assist in improving spiritual care in palliative care.

Mapping letters from the future: exploring narrative processes of imagining the future.

This article uses Letters from the Future (a health promotion instrument) to explore the human capacity of imagining the future. From a narrative perspective, letters from the future are considered to be indicative of a variety of forms through which human beings construct and understand their future selves and worlds. This is consistent with an interpretive approach to understanding the human mind, which offers an alternative for the current dominant causal-explanatory approach in psychology. On the basis of qualitative analysis of 480 letters from the future, collected online from a diverse group of Dutch and German persons, we first identified five narrative processes operating in the letters: imagining, evaluating, orienting, expressing emotions and engaging in dialogue. Second, using comparative analysis, we identified six types of how these processes are organized in the letters as a whole. These types differ regarding functionality (which of the five processes was dominant); temporality (prospective, retrospective and present-oriented); the extent to which a path between present and future was described; and the vividness of the imagination. We suggest that these types can be used in narrative health practice as 'pathways' to locate where letter writers are on their path to imagine the future, rather than as a normative taxonomy. Future research should focus on how these pathways can be used to navigate to health and well-being.