Aims Listen to patients describe the range of spiritual needs they experience, how these needs impinge on their overall health and wellbeing, and who could best meet these needs, Listen to GPs describe the spiritual needs of their patients and explain who could best meet these needs.
Participants: 20 patients receiving the majority of their care in a primary care setting, (advanced cancers, and non malignant illness and a prognosis of under one year). The patient’s GP.
Methods: Two tape recorded open ended interviews with patients with a three month interval,Two interviewswith GPs one week after the patient interviews.
Analysis: Interviews were transcribed and the qualitative computer programme Nvivo was utilised. While few patients used the term ‘‘spiritual’’ they described significant existential need. At diagnosis patients felt a deep sense of loss, and a sickening fear of the unknowness of death. Sleeplessness, constant fear, inexplicable anxiety, a sense of inadequacy at their lack of words to express feelings, and a feeling that there were few around who could listen to their concerns left patients feeling alone, isolated, separated from others and no longer in control of their illness, nor of themselves. Those who had established cosmologies seemed more able to cope than those whose religious commitment was nominal or whose secular world view did not offer a coherent explanation of the present and the future GPs, because they had experience of dying, were looked to to provide advice and often spiritual support. GP’s recognised that patients had spiritual needs, and that those in spiritual distress were often less well, more anxious, and less reachable within the doctor-patient relationship. GP’s felt that spiritual care was important, but few believed they had the time or knowledge to give it.