City of Hope Pain & Palliative Care Resource Center




This section includes City of Hope publications and other resources relating to spirituality in health care including articles relating to cross-cultural topics. There is a listing of tools for assessing spirituality and spiritual concerns, links to organizational position statements relating to spirituality, and recommended publications.

      City of Hope Publications

1.      Ellington, L., Reblin, M., Ferrel, B., Puchalski, C., Otis-Green, S., Handzo, G., Doyon, K. & Clayton, M. F.  (in press). The religion of ‘I don’t know’: Naturalistic observation of spiritual conversations occurring during cancer home hospice nurse visits. Omega: Journal of Death and Dying.

2.      Bulkley, J., McMullen, C. K., Hornbrook, M. C., Grant, M., Altschuler, A., Wendel, C. S. & Krouse, R. S. (2013). Spiritual well-being in long-term colorectal cancer survivors with ostomies. Psycho-Oncology, 22(11), 2513-2521.   DOI: 10.1002/pon.3318.

3.     Ferrell, B., Otis-Green, S., & Economou, D. (2013). Spirituality in cancer care at the end of life. The Cancer Journal: The Journal of Principles and Practice of Oncology, 19(5), 431-437. DOI: 10.1097/PPO.0b013e3182a5baa5.

4.     Ferrell, B. R., & Munevar. C. (2012). Domain of spiritual care. Progress in Palliative Care, 20(2), 66-71.

5.    Otis-Green, S., Ferrell, B. R., Borneman, T., Puchalski, C., Uman, G., & Garcia, A. (2012). Integrating spiritual care within palliative care: An overview of nine demonstration projects. Journal of Palliative Medicine, 15(2), 154-163.
DOI: 10.1089/jpm.2011.0211.

6.     Borneman, T., Ferrell, B. R., & Puchalski, C. M. (2010). Evaluation of the FICA tool for spiritual assessment. Journal of Pain and Symptom Management, 40(20), 163-173. DOI: 10.1016/j.jpainsymman.2009.12.019.

7.     Wong, F. L., Fransisco, L., Togawa, K., Bosworth, A., Golzales, M., Hanby, C., Sabado, M., Grant, M., Forman, S. J., & Bhatia, S., (2010).  Long-term recovery after hematopoietic cell transplantation: Predictors of quality-of-life concerns. Blood, 115(12), 2508-2519. DOI: 10.1182/blood-2009-06-225631.

8.     Puchalski, C., Ferrell, B. R., Virani, R., Otis-Green, S., Baird, P., Bull, J. et al., (2009).  Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference. Journal of Palliative Medicine, 12(10), 885-904. DOI: 10.1089=jpm.2009.0142. 

9.     Baldwin, C. M., Grant, M., Wendel, C. Rawl, S., Schmidt, C. M., Ko, C., & Krouse, R. S. (2008). Influence of intestinal stomal on spiritual quality of life of U.S. veterans. Journal of Holistic Nursing, 26(3), 185-194.
DOI: 10.1177/0898010108315185.

10.   Crane-Okada, R. (2007). A compass for the cancer journey: Scientific, spiritual, and practical directives. Oncology Nursing Forum, 34(5), 945-954. DOI: 10.1188/07.ONF.945-955.

11.     Ferrell, B. R. (2007). Meeting spiritual needs: What is an oncologist to do? Journal of Clinical Oncology, 25(5), 467-468. DOI: 10.1200/JCO.2006.09.3724.

12.    Mularski, R. A., Dy, S. M., Shugarman, L. R., Wilkinson, A. M., Lynn, J., Shekelle, P. G., Morton, S. C., Sun, V. C., Hughes, R. G., Hilton, L. K., et al., (2007). A systematic review of measures of end-of-life care and its outcomes. Health Services Research, 42(5), 1848-1870. DOI: 10.1111/j.1475-6773.2007.00721.x.

13.   Otis-Green, S. (2006). Spiritual palliative care. Journal of Palliative Medicine, 9, 1477-1478.

14.    Ferrell, B. R., Smith, S. L., Juarez, G., & Melancon, C. H. (2003). Meaning of illness and spirituality in ovarian cancer survivors. Oncology Nursing Forum, 30(2), 249-257.  DOI: 10.1188/03.ONF.249-257.

15.    Otis-Green, S., Sherman, R., Perez, M., & Baird, P. (2002). An integrated psychosocial spiritual model for cancer pain management. Cancer Practice, Special Issue: Issues in Cancer Pain Management: Models of Success, 10(Supp. s1), 58-65.
DOI: 10.1046/j.1523-5394.10.s.1.13.x.

      Recommended Publications

1.      Spirituality in Healthcare
       Cobb, M. R., Puchalski, C. M., & Rumbold. B. R. (2012). NY: Oxford University Press. ISBN: 978-0199571390.

2.     Principles and Practice of Palliative Care and Supportive Oncology, 4th Edition, esp. Section II: #54 Spirituality
       Berger, A. M., Shuster Jr., J. L., Von Roenn, J. H. (2012). MA: Lippincott Williams & Wilkins.
                 ISBN: 978-1451121278.

3.     Selman, L., Siegert, R., Harding, R., Harding, R., Gysels, M., Speck, P., & Higginson, I. J. (2011). A psychometric
        evaluation of measures of spirituality validated in culturally diverse palliative care populations. Journal of Pain and
        Symptom Management, 4
2(4), 604-622. DOI: 10.1016/j.jpainsymman.2011.01.015.

4.     Oxford American Handbook of Hospice and Palliative Medicine, esp. Chapter 21: Spiritual Issues in Palliative Care

        -       Bruera, E. & Yennarajalingam, S. (Eds). (2011). Oxford University Press. ISBN: 978-0195380156.


5.     Making Health Care Whole: Integrating Spirituality into Patient Care
        -       Puchalski, C. M., & Ferrell, B. R. (2010). PA: Templeton Press. ISBN: 9781599473505.      

6.     Oxford Textbook of Palliative Nursing, esp. Part IV: Spiritual Care
         -      Ferrell, B. R., & Coyle, N.  (2010). NY: Oxford University Press. ISBN: 9780195391343.

7.     Alcorn, S. R., Balboni, M. J., Prigerson, H. G., Reynolds, A., Phelps, A. C., Wright, A. A., et al., (2010).  If God wanted
        me yesterday, I wouldn’t be here today: Religious and spiritual themes in patients’ experiences of advanced cancer.
        Journal of Palliative Medicine, 13(5), 581-588.  DOI: 10.1089/jpm.2009.0343.

8.     Patterson, M. (2010).  Prayer shawls: A blessing in every stitch.  Health Progress, 91(3), 49-51.

9.     Abu-Ras, W., & Laird, L. (2010).  How Muslim and non-Muslim chaplains serve Muslim patients? Does the interfaith
        chaplaincy model have room for Muslims’ experiences?  Journal of Religious Health, 50(1), 46-61.
        DOI: 10.1007/s10943-010-9357-4.

10.    Salman, K., & Zoucha, R. (2010). Considering faith within culture when caring for the terminally ill Muslim patient and
         family.  Journal of Hospice and Palliative Nursing, 12(3), 156-163. DOI: 10.1097/NJH.0b013e3181e24a52.

11.     Albers, G., Echteld, M. A., de Vet,  H. C. W., Onwuteaka, Philipsen, B. D., van der Linden, M. H. M., & Deliens, L.
         (2010). Content and spiritual items of quality-of-life instruments appropriate for use in palliative care: A review
         Journal of Pain and Symptom Management, 40(2), 290-300. DOI:

12.     Psychology, Religion, and Spirituality
         -     Nelson, J. M. (2009). NY: Springer. ISBN: 978-0-387-87572-9 (Print) 978-0-387-87573-6 (E-book).
                DOI: 10.1007/978-0-387-87573-6.

13.    The Medical Manual for Religio-Cultural Competence: Caring for Religiously Diverse Populations
          -    Tanenbaum. (2009).
Tanenbaum Center for Interreligious Understanding. ASIN: B0033T7O8Q.

14.    Kreitzer, M.J., Gross, C. R., Waleekhachonloet, O., Reilly-Spong, M., & Byrd, M., (2009). The brief serenity scale: a
         psychometric analysis of a measure of spirituality and well-being.  Journal of Holistic Nursing (0898-0101), 27 (1),
         7-16.  Describes a 22-item Serenity Scale, a tool that measures serenity as a dimension of spirituality and well-being.

15.    Phelps, A. C., Maciejewski, P. K., Nilsson, M., Balboni, T. A., Wright, A. A., & Paulk, M. E. (2009).  Religious coping and
         use of intensive life-prolonging care near death in patients with advanced cancer.  Journal of the American Medical 
         Association, 30
1(11), 1140-1147. DOI
: 10.1001/jama.2009.341. 

16.    Yardley, S.J., Walshe, C. E., & Parr, A. (2009).  Improving training in spiritual care: A qualitative study exploring
         patient perceptions of professional educational requirements.  Palliative Medicine, 23(7), 601-607.
         DOI: 10.1177/0269216309105726.

17.    Vachon, M., Fillion, L., & Achille, M. (2009).  A conceptual analysis of spirituality at end of life.  Journal of Palliative
         Medicine, 12
(1), 53-59. DOI: 10.1089/jpm.2008.0189.

18.    The Nature of Suffering and the Goals of Nursing
         -      Ferrell, B., & Coyle, N. (2008). NY: Oxford University Press.  ISBN #:

Ando, M., Morita, T., Okamoto, T., & Ninosaka, Y. (2008).  One-week Short-Term Life Review interview can improve
         spiritual well-being of terminally ill cancer patients. Psycho-oncology, 17(9),  885-890. DOI: 10.1002/pon.1299.

20.   Edmondson, D., Park, C. L., Chaudoir, S. R., & Wortmann, J. H. (2008).  Death without God: Religious struggle, death
         concerns, and depression in the terminally ill
.  Psychological Science, 19(8), 754-758.
         DOI: 10.1111/j.14679280.2008.02152.x.

21.    Daaleman, T. P., Usher, B. M., Williams, S. W., Rawlings, J., & Hanson, L. C. (2008).  An exploratory study of spiritual
         care at the end of life.  Annals of Family Medicine, 6(5), 406-411. DOI: 10.1370/afm.883.

22.    Timmins, F., & Kelly, J., (2008). Spiritual assessment in intensive and cardiac care nursing.  Nursing in Critical Care,
         13(3),  124-131. DOI: 10.1111/j.1478-5153.2008.00276.x.

23.   Vivat, B. (2008).  Measures of spiritual issues for palliative care patients: A literature review. Palliative Medicine,
(0269-2163), 22 (7), 859. A literature review of 29 tools for measuring spirituality.

24.   Vachon, M. L. (2008). Meaning, spirituality, and wellness in cancer survivors.  Seminars in Oncology Nursing, 24(3),
         218-225.  DOI: 10.1016/j.soncn.2008.05.010.

25.   Carpenter, K., Girvin, L., Kitner, W., & Ruth-Sahd, L. A., (2008). Spirituality: A dimension of holistic critical care
.  Dimensions of Critical Care Nursing, 27(1), 16-20. DOI: 10.1097/01.DCC.0000304668.99121.b2.

26.   Larocca-Pitts, M.A. (2008).  FACT: Taking a spiritual history in a clinical setting.  Journal of Health Care Chaplaincy
         (0885-4726), 15 (1), 1.  Outlines CSI-MEMO, FICA, HOPE, FAITH, SPIRIT, and describes FACT—a spiritual 
         assessment  tool for chaplains.

27.   What Do I Say? Talking with Patients about Spirituality (Book & DVD)
         -      Taylor-Johnston, E. (2007). PA: Templeton Press.
ISBN#: 1599471175.       

28.   Goldstein, E. D., (2007). Sacred moments: Implications on well-being and stress. Journal of Clinical Psychology,
         63(10), 1001-1019.
DOI: 10.1002/jclp.20402.

29.   Smith-Stoner, M. (2007). End-of-life preferences for atheists.  Journal of Palliative Medicine, 10(4), 923-928.
         DOI: 10.1089/jpm.2006.0197.

30.   Chaturvedi, S. K. (2007). Spiritual issues at end of life.  Indian Journal of Palliative Care, 13(2), 48.
         DOI: 10.4103/0973-1075.38899.  

31.   Puchalski, C. M., Lunsford, B., Harris, M. H., & Miller, T. (2006). Interdisciplinary spiritual care for seriously ill and
         dying patients: A collaborative model
.  Cancer Journal, 12(5), 398-416.

32.    Taylor, E. J. (2006).  Prevalence and associated factors of spiritual needs among patients with cancer and family
Oncology Nursing Forum, 33(4), 729-735. DOI: 10.1188/06.ONF.729-735.

33.    King, M., Jones, L., Barnes, K, Low, J., Walker, C., Wilkinson, S., Mason, C., Sutherland, J., & Tookman, A.  (2006).
         Measuring spiritual belief: Development and standardization of a beliefs and values scale.
Psychological Medicine
, 36 (3), 417.  Development of a 20-item questionnaire that measures spirituality from both a religious
         and non-religious perspectives. DOI:

34.   Quest, T. E., & Franks, N.  M., (2006). Vulnerable populations: Cultural and spiritual direction. Emergency Medicine
         Clinics of North America
, 24(3), 687-702. DOI: 10.1016/j.emc.2006.05.010.

35.    Sinclair, S., Pereira, J., & Raffin, S., (2006).  A thematic review of the spirituality literature within palliative care.  
         Journal  of Palliative Medicine, 9(2), 464-479.
DOI: 10.1089/jpm.2006.9.464.

36.    Sinclair, S., Raffin, S., Pereira, J., & Guebert, N., (2006). Collective soul: The spirituality of an interdisciplinary palliative
         care team
.  Palliative and Supportive Care, 4(2), 13-24. DOI: 10.1017/S14789515060032.

37.    Brown, A. E., Whitney, S. N., & Duffy, J. D., (2006). The physician's role in the assessment and treatment of spiritual
         distress at the end of life
Palliative & Supportive Care, 4(1), 81-86. DOI: 10.10170S1478951506060093.

38.   Hills, J., Paice, J. A., Cameron, J. R., & Shott, S., (2005). Spirituality and distress in palliative care consultation. Journal 
         of  Palliative Medicine (1096-6218), 8
(4), 782. Pilot study measuring facets of spirituality with several scales
          including RCOPE, FACIT-Sp, FICA, and POMS-SF.
DOI: 10.1089/jpm.2005.8.782.

39.    Baggini, J., & Pym, M. (2005). End-of-life: The humanist view. The Lancet, 366(9492), 1235-1237.

40.  Markwell, H. (2005). End-of-life: A Catholic view. The Lancet, 366(9491), 1132-1135.
         DOI: 10.1016/S0140-6736(05)67425-9.

41.   Engelhardt, H. T., & Iltis, A. S., (2005). End-of-life: The traditional Christian view.  The Lancet, 366(9490), 1045- 
         1049. DOI: 10.1016/S0140-6736(05)67383-7.

42.    Keown, D. (2005).  End-of-life: The Buddhist view. The Lancet, 366(9489), 952-955.
         DOI: 10.1016/S0140-6736(05)67323-0.

43.    Dorff, E. N. (2005).  End-of-life: Jewish perspectives.  The Lancet, 366(9488), 862-865.

44.   Sachedina, A. (2005).  End-of-life: The Islamic view.  The Lancet, 366(9487), 774-779.

45.    Firth, S. (2005).  End-of-life: A Hindu view.  The Lancet, 366(9486), 682-685.

46.   Puchalski, C., & Romer, A. L., (2000). Taking a spiritual history allows clinicians to understand patients more fully.
          Journal of Palliative Medicine (1096-6218), 3 (1), 129.  FICA tool.

Educational Materials/Curriculum

Completing a Life: A Resource for Taking Charge, Finding Comfort, Reaching Closure
      An interactive CD inviting patients and families to learn about the practical, emotional, spiritual, and medical
                 issues faced by those dealing with advanced illness. The CD is available through the Instructional Media Center at
                Michigan State University.

2.     Core Curriculum for Holistic Nursing - American Holistic Nurses Association
      Nurses are increasingly aware of the need to blend technology, mind, and spirit in creating optimal circumstances
                 for healing. Barbara Dossey, a pioneer and leader in the field, has created a core curriculum that will provide a
                 blueprint for what it means to be a holistic nurse. Order online at .  

3.      FACIT Questionnaires
      Functional Assessment of Chronic Illness Therapy, (FACIT), manages questionnaires that measure health-
                 related quality of life for people with chronic illnesses. The first questionnaire, The Functional Assessment of       
                 Cancer Therapy-General (FACT-G), was developed and validated over 10 years ago, and has been used in hundreds
                 of studies worldwide. Since then over 40 questionnaires have been developed and selected questionnaires
                 translated into over 45 different languages. There are three questionnaires relating to spirituality: the FACIT-Sp
                 (Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being), FACIT-Sp-12 (12-item Spiritual Well-
                 Being Scale), FACIT-Sp-Ex (Spiritual Well-Being, Expanded version).

4.      Fast Facts and Concepts – End of Life/Palliative Education Resource Center (EPERC), Milwaukee, WI
 -     Taking a Spiritual History  #019                         
     Music Therapy  #108                                       
     Physicians and Prayer Requests  #120           
     Pain, Suffering and Spiritual Assessment    

5.      Interfaith Care for the Ill – Mobile App
     This app is for healthcare professionals looking for the right words of spiritual comfort in difficult circumstances
                 relating to death or illness. It offers overviews of central beliefs, traditional prayers, and descriptions of common
                 practices relating to illness and end-of-life care for Buddhism, Christianity, Hinduism, Islam, and Judaism.           

6.      GWish SOERCE:  Educational and clinical resources in spirituality, religion, and health
 -    An amazing array of resources on spirituality, religion, and health. Supported by a grant from The John    
Foundation, GWish created SORECE to build the online infrastructure to support medical educators
                 and  other health professionals in their quest to teach about spirituality and health by providing educational
                 materials and resources.
SOERCE covers an array of topics including spiritual assessment, end of life care,
                 palliative care, spiritual distress management and interventions, articles on major faith traditions, educational
                 modules, presentations, and videos.

7.      Marie Curie Cancer Care - London: Marie Curie Cancer Care
    Spiritual & religious care competencies assessment tools for specialists in palliative care.                

8.      Pain Care Fast Facts: 5-Minute Clinical Inservice - UW Health, University of Wisconsin Hospital & Clinics, Madison, WI
Pain, Suffering and Spiritual Assessment        

9.      Passport to Comfort: Reducing Barriers to Pain & Fatigue Management, #27 – City of Hope, Duarte, CA
         This model addresses patient, professional and system barriers to the relief of pain and fatigue and is based on      
         established guidelines developed by the National Comprehensive Cancer Network (NCCN). An NCI supported 
         program.  Most available in English and Spanish.
      Patient Spiritual Care Card
      Spirituality Card

10.     The Clinical Social Work Spiritual Care Lecture Series – City of Hope, Duarte, CA
          -     Lecture series designed with the overall goal of providing training to clinical oncology social workers to develop
                 their skills in identifying and responding to various spiritual care concerns in the cancer and palliative care


         Other Organizational Links   

         American Holistic Medical Association                                                  

         American Holistic Nurses Association                                                     

         Association of Professional Chaplains                                                    

         Canadian Society for Spirituality & Social Work                                

         National Center for Complementary & Alternative Medicine     

         Can’t Believe I Have Cancer

         HealthCare Chaplaincy Network - Helps people faced with the distress of illness and suffering to find comfort and meaning

         National Center for Complementary & Alternative Medicine

         Strengthening the Spirit

         Tanenbaum Center for Interreligious Understanding

         The Importance of Spirituality in Cancer Care

      Position Statements/Standards

1.      American Holistic Nurses Association (AHNA) Position Statements     

2.     Hospice and Palliative Nurses Association (HPNA)  Position Statements
         -     Spiritual Care

3.     National Comprehensive Cancer Network (NCCN)
         You must log in to access these documents. Registration is free.
         -      Palliative Care

         -      Distress Management

4.     National Consensus Project (NCP) for Quality Palliative Care  
-      Clinical Practice Guidelines for Quality Palliative Care


Website last modified:  December 22, 2014