{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:12:16Z","timestamp":1793319136618,"version":"4.5.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1007\/s00520-025-09860-5","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T10:25:46Z","timestamp":1755512746000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Spiritual suffering in palliative care: a concept analysis"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9601-0953","authenticated-orcid":false,"given":"Paula","family":"Jaman-Mewes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5942-2681","authenticated-orcid":false,"given":"Mayara Caetano","family":"da Silva de Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3637-1528","authenticated-orcid":false,"given":"Vinicius Geraldo","family":"Ruas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5441-5311","authenticated-orcid":false,"given":"Vera L\u00facia Mendes","family":"de Paula Pessoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5390-6963","authenticated-orcid":false,"given":"Geana Paula","family":"Kurita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4274-8709","authenticated-orcid":false,"given":"Marina","family":"de G\u00f3es Salvetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"9860_CR1","doi-asserted-by":"publisher","unstructured":"Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, et al (2018) Alleviating the access abyss in palliative care and pain relief\u2014an imperative of universal health coverage: the Lancet Commission report. Lancet. Lancet Publishing Group 391;1391\u2013454. https:\/\/doi.org\/10.1016\/S0140-6736(17)32513-8","DOI":"10.1016\/S0140-6736(17)32513-8"},{"key":"9860_CR2","doi-asserted-by":"publisher","first-page":"100586","DOI":"10.1016\/j.lanepe.2023.100586","volume":"26","author":"WE Rosa","year":"2023","unstructured":"Rosa WE, McDarby M, Chochinov HM (2023) Palliative care access: a matter of life and death. Lancet Reg Health 26:100586. https:\/\/doi.org\/10.1016\/j.lanepe.2023.100586","journal-title":"Lancet Reg Health"},{"key":"9860_CR3","unstructured":"World Health Organization (WHO) (2022) Palliative Care [Internet]. [cited 2023 Mar 16]. Available from: https:\/\/www.who.int\/health-topics\/palliative-care"},{"issue":"7","key":"9860_CR4","doi-asserted-by":"publisher","first-page":"531","DOI":"10.7326\/0003-4819-131-7-199910050-00009","volume":"131","author":"EJ Cassell","year":"1999","unstructured":"Cassell EJ (1999) Diagnosing suffering: a perspective. Ann Intern Med 131(7):531\u2013534","journal-title":"Ann Intern Med"},{"key":"9860_CR5","doi-asserted-by":"crossref","unstructured":"Dame Cicely Saunders. Spiritual Pain. J Palliat Care [Internet] (1988) [cited 2025 Jan 26]4(3), 29\u201332. Available from: https:\/\/www.deepdyve.com\/lp\/sage\/spiritual-pain-0QhLQiJHkz?key=sage","DOI":"10.1177\/082585978800400306"},{"key":"9860_CR6","unstructured":"Yepes R, Aranguren J (2009) La Persona. In: Fundamentos de Antropolog\u00eda, Un ideal de la excelencia humana. 6a ed. Espa\u00f1a: Eunsa. p. 61\u201374"},{"key":"9860_CR7","unstructured":"Moraes F, Casalatti C, Da Andrade SP, Pugliese T (2021) Tratado de Espiritualidade e Sa\u00fade. Teor\u00eda e Pr\u00e1ctica do cuidado em Espiritualidade na \u00e1rea da Sa\u00fade. 1 ed. Moraes F (ed) 1:3\u2013526"},{"key":"9860_CR8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.3389\/fsoc.2023.1286208","volume":"23","author":"M Rattner","year":"2023","unstructured":"Rattner M (2023) \u2018Total pain\u2019: reverence and reconsideration. Front Sociol 23:8. https:\/\/doi.org\/10.3389\/fsoc.2023.1286208","journal-title":"Front Sociol"},{"issue":"3","key":"9860_CR9","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/13576279609696250","volume":"1","author":"LH Heyse-Moore","year":"1996","unstructured":"Heyse-Moore LH (1996) On spiritual pain in the dying. Mortality 1(3):297\u2013315. https:\/\/doi.org\/10.1080\/13576279609696250","journal-title":"Mortality"},{"issue":"6","key":"9860_CR10","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.jpainsymman.2023.02.008","volume":"65","author":"AJ Christie","year":"2023","unstructured":"Christie AJ, Lopez G, Nguyen CH, Chen M, Li Y, Cohen L, Delgado-Guay MO (2023) \u201cA pain deep in your soul (Being) that is not physical:\u201d Assessing spiritual pain in integrative oncology consultations. J Pain Symptom Manage 65(6):562\u2013569. https:\/\/doi.org\/10.1016\/j.jpainsymman.2023.02.008","journal-title":"J Pain Symptom Manage"},{"issue":"10","key":"9860_CR11","doi-asserted-by":"publisher","first-page":"960","DOI":"10.3390\/healthcare12100960","volume":"12","author":"H Martins","year":"2024","unstructured":"Martins H, Silva RS, Bragan\u00e7a J, Romeiro J, Caldeira S (2024) Spiritual distress, hopelessness, and depression in palliative care: simultaneous concept analysis. Healthcare 12(10):960. https:\/\/doi.org\/10.3390\/healthcare12100960","journal-title":"Healthcare"},{"issue":"2","key":"9860_CR12","doi-asserted-by":"publisher","first-page":"525","DOI":"10.21037\/apm-23-474","volume":"13","author":"C Gabl","year":"2024","unstructured":"Gabl C, Feichtner A, Weixler D (2024) Sedation indicated?\u2014Rethinking existential suffering: A narrative review. Annals Palliative Med 13(2):525\u2013537. https:\/\/doi.org\/10.21037\/apm-23-474","journal-title":"Annals Palliative Med"},{"issue":"8","key":"9860_CR13","doi-asserted-by":"publisher","first-page":"156","DOI":"10.3390\/rel8080156","volume":"8","author":"T Velosa","year":"2017","unstructured":"Velosa T, Caldeira S, Capelas ML (2017) Depression and spiritual distress in adult palliative patients: a cross-sectional study. Religions 8(8):156. https:\/\/doi.org\/10.3390\/rel8080156","journal-title":"Religions"},{"issue":"5","key":"9860_CR14","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1177\/1049909112458030","volume":"30","author":"MO Delgado-Guay","year":"2013","unstructured":"Delgado-Guay MO, Parsons HA, Hui D, la Cruz MGD, Thorney S, Bruera E (2013) Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. Am J Hosp Palliat Med [Internet] 30(5):455\u2013461. https:\/\/doi.org\/10.1177\/1049909112458030","journal-title":"Am J Hosp Palliat Med [Internet]"},{"key":"9860_CR15","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.9427","author":"C Puchalski","year":"2014","unstructured":"Puchalski C, Vitillo R, Hull S, Reller N (2014) Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. https:\/\/doi.org\/10.1089\/jpm.2014.9427","journal-title":"J Palliat Med"},{"issue":"3","key":"9860_CR16","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1037\/pst0000409","volume":"59","author":"W Sim","year":"2022","unstructured":"Sim W, Li X, Hwang JY, Hill CE, An M, Kim DH (2022) The process and outcome of spiritually integrated psychotherapies: a cross-cultural study in Asia, Africa, Europe, and Latin America. Psychother 59(3):415\u2013430. https:\/\/doi.org\/10.1037\/pst0000409","journal-title":"Psychother"},{"issue":"12","key":"9860_CR17","doi-asserted-by":"publisher","first-page":"3607","DOI":"10.21037\/apm-22-1199","volume":"11","author":"MC Best","year":"2022","unstructured":"Best MC (2022) Advancing the place of spiritual care within palliative care. Ann Palliat Med 11(12):3607\u20133609. https:\/\/doi.org\/10.21037\/apm-22-1199","journal-title":"Ann Palliat Med"},{"key":"9860_CR18","unstructured":"Walker L, Avant KC (2014) Chapter 13: Concept analysis. In: Strategies of theory construction in Nursing. 5th ed, Pearson Custom Library pp. 111\u2013122"},{"key":"9860_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmj.n71","volume":"71","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 71:1\u20139. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"issue":"2","key":"9860_CR20","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","volume":"24","author":"UH Graneheim","year":"2004","unstructured":"Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24(2):105\u2013112. https:\/\/doi.org\/10.1016\/j.nedt.2003.10.001","journal-title":"Nurse Educ Today"},{"issue":"5","key":"9860_CR21","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1089\/jpm.2005.8.919","volume":"8","author":"CD Millspaugh","year":"2005","unstructured":"Millspaugh CD (2005) Assessment and response to spiritual pain: part I. J Palliat Med 8(5):919\u2013923. https:\/\/doi.org\/10.1089\/jpm.2005.8.919","journal-title":"J Palliat Med"},{"issue":"12","key":"9860_CR22","first-page":"3327","volume":"21","author":"A Krikorian","year":"2013","unstructured":"Krikorian A, Limonero JT, Vargas JJ, Palacio C (2013) Assessing suffering in advanced cancer patients using pictorial representation of illness and self-measure (PRISM), preliminary validation of the Spanish version in a Latin American population. Support Care Cancer 21(12):3327\u20133336","journal-title":"Support Care Cancer"},{"key":"9860_CR23","unstructured":"Oxford English Dictionary (OED) (2024) Spirit, n. In: Oxford english dictionary. Oxford University Press Available: https:\/\/www.oed.com\/discover\/spirit\/?tl=true#:~:text=1.,rational%20being%2C%20and%20extended%20uses"},{"key":"9860_CR24","doi-asserted-by":"crossref","unstructured":"Herdman TH, Kamitsuru S, Tak\u00e1o C (2021) Nursing diagnoses: Definitions and classification 2021\u20132023 . twelfth edition. Thieme; 2021. 1\u2013592","DOI":"10.1055\/b000000888"},{"key":"9860_CR25","unstructured":"Herdman TH, Kamitsuru S (2024) Diagn\u00f3sticos de Enfermagem da NANDA-I: Defini\u00e7\u00f5es e Classifica\u00e7\u00e3o 2024\u20132026. 13th ed. Artmend 1\u2013672"},{"issue":"7","key":"9860_CR26","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s00520-003-0460-x","volume":"11","author":"M Kawa","year":"2003","unstructured":"Kawa M, Kayama M, Maeyama E, Iba N, Murata H, Imamura Y et al (2003) Distress of inpatients with terminal cancer in Japanese palliative care units: from the viewpoint of spirituality. Support Care Cancer 11(7):481\u2013490. https:\/\/doi.org\/10.1007\/s00520-003-0460-x","journal-title":"Support Care Cancer"},{"key":"9860_CR27","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s10741-017-9635-2","volume":"22","author":"R Gillilan","year":"2017","unstructured":"Gillilan R, Qawi S, Weymiller AJ, Puchalski C (2017) Spiritual distress and spiritual care in advanced heart failure. Heart Fail Rev 22:581\u2013591. https:\/\/doi.org\/10.1007\/s10741-017-9635-2","journal-title":"Heart Fail Rev"},{"key":"9860_CR28","doi-asserted-by":"publisher","unstructured":"Bhatnagar S, Gielen J, Satija A, Singh SP, Noble S, Chaturvedi SK (2017) Signs of spiritual distress and its implications for practice in Indian Palliative Care. Indian J Palliat Care 1;23(3):306\u201311. https:\/\/doi.org\/10.4103\/IJPC.IJPC_24_17","DOI":"10.4103\/IJPC.IJPC_24_17"},{"key":"9860_CR29","unstructured":"Brunjes GB. (2010) Tradition, heritage, and spirituality. Spiritual pain and suffering. Asian Pacific J Cancer Prevention. Vol. 11. MECC Supplement 31 Available from: https:\/\/journal.waocp.org\/article_25165_280a3924b97baab094639fbfe0f69001.pdf"},{"key":"9860_CR30","doi-asserted-by":"publisher","unstructured":"Yoosefee S, Cheraghi MA, Asadi Z, Bahramnezhad F (2023) A concept analysis of spiritual pain at the end-of-life in the iranian-islamic context: a qualitative hybrid model. J Relig Health 1;62(3):1933\u201349. https:\/\/doi.org\/10.1007\/s10943-022-01654-x","DOI":"10.1007\/s10943-022-01654-x"},{"key":"9860_CR31","doi-asserted-by":"publisher","unstructured":"Jeuland J, Fitchett G, Schulman-Green D, Kapo J (2017) Chaplains working in palliative care: Who they are and what they do. J Palliat Med 1;20(5):502\u20138. https:\/\/doi.org\/10.1089\/jpm.2016.0308","DOI":"10.1089\/jpm.2016.0308"},{"issue":"3","key":"9860_CR32","doi-asserted-by":"publisher","first-page":"1920","DOI":"10.1007\/s10943-022-01645-y","volume":"62","author":"M Illueca","year":"2023","unstructured":"Illueca M, Bradshaw YS (2023) Carr DB (2023) spiritual pain: a symptom in search of a clinical definition. J Relig Health 62(3):1920\u20131932. https:\/\/doi.org\/10.1007\/s10943-022-01645-y","journal-title":"J Relig Health"},{"issue":"1","key":"9860_CR33","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1177\/1049909112458721","volume":"31","author":"TS Beng","year":"2014","unstructured":"Beng TS, Guan NC, Seang LK, Pathmawathi S, Ming MF, Jane LE et al (2014) The experiences of suffering of palliative care patients in Malaysia: a thematic analysis. Am J Hosp Palliat Med 31(1):45\u201356. https:\/\/doi.org\/10.1177\/1049909112458721","journal-title":"Am J Hosp Palliat Med"},{"key":"9860_CR34","doi-asserted-by":"publisher","unstructured":"Hinshaw DB (2005) Spiritual issues in surgical palliative care. Surgical Clinics of North America. W.B. Saunders 85:257\u201372. https:\/\/doi.org\/10.1016\/j.suc.2004.11.002","DOI":"10.1016\/j.suc.2004.11.002"},{"issue":"1","key":"9860_CR35","doi-asserted-by":"publisher","first-page":"18","DOI":"10.12968\/ijpn.2017.23.1.18","volume":"23","author":"H Walker","year":"2017","unstructured":"Walker H, Waterworth S (2017) New Zealand palliative care nurses experiences of providing spiritual care to patients with life-limiting illness. Int J Palliat Nurs 23(1):18\u201326. https:\/\/doi.org\/10.12968\/ijpn.2017.23.1.18","journal-title":"Int J Palliat Nurs"},{"key":"9860_CR36","doi-asserted-by":"publisher","first-page":"2158","DOI":"10.1100\/tsw.2006.345","volume":"6","author":"AC de Ara\u00fajoElias","year":"2006","unstructured":"de Ara\u00fajoElias AC, Giglio JS, de MattosPimenta CA, El-Dash LG (2006) Therapeutical intervention, relaxation, mental images, and spirituality (RIME) for spiritual pain in terminal patients A training program. ScientificWorld J 6:2158\u201369. https:\/\/doi.org\/10.1100\/tsw.2006.345","journal-title":"ScientificWorld J"},{"key":"9860_CR37","doi-asserted-by":"publisher","unstructured":"Block SD, Andrew Billings J (1995) Patient requests for euthanasia and assisted suicide in tenninal lllness the role ofthe psychiatrist. Psychosomatics 36. https:\/\/doi.org\/10.1016\/S0033-3182(95)71625-5","DOI":"10.1016\/S0033-3182(95)71625-5"},{"issue":"11","key":"9860_CR38","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1089\/jpm.2016.0135","volume":"19","author":"D Selby","year":"2016","unstructured":"Selby D, Seccaraccia D, Huth J, Kurrpa K, Fitch M (2016) A qualitative analysis of a healthcare professional\u2019s understanding and approach to management of spiritual distress in an acute care setting. J Palliat Med 19(11):1197\u20131204. https:\/\/doi.org\/10.1089\/jpm.2016.0135","journal-title":"J Palliat Med"},{"issue":"1","key":"9860_CR39","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1177\/0269216317734954","volume":"32","author":"LE Selman","year":"2018","unstructured":"Selman LE, Brighton LJ, Sinclair S, Karvinen I, Egan R, Speck P et al (2018) Patients\u2019 and caregivers\u2019 needs, experiences, preferences and research priorities in spiritual care: a focus group study across nine countries. Palliat Med 32(1):216\u2013230. https:\/\/doi.org\/10.1177\/0269216317734954","journal-title":"Palliat Med"},{"issue":"2","key":"9860_CR40","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3322\/canjclin.56.2.84","volume":"56","author":"HM Chochinov","year":"2006","unstructured":"Chochinov HM (2006) Dying, dignity, and new horizons in palliative end-of-life care. CA Cancer J Clin 56(2):84\u2013103. https:\/\/doi.org\/10.3322\/canjclin.56.2.84","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"9860_CR41","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1089\/jpm.2016.0422","volume":"20","author":"A Grech","year":"2017","unstructured":"Grech A, Marks A (2017) Existential suffering part 1: definition and diagnosis #319. J Palliat Med 20(1):93\u201394. https:\/\/doi.org\/10.1089\/jpm.2016.0422","journal-title":"J Palliat Med"},{"key":"9860_CR42","doi-asserted-by":"publisher","unstructured":"Altilio T (2011) Oxford textbook of palliative social work. In: Altilio T, Otis-Green S (eds) Oxford University Press 2011. https:\/\/doi.org\/10.1093\/med\/9780199739110.001.0001","DOI":"10.1093\/med\/9780199739110.001.0001"},{"issue":"8","key":"9860_CR43","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1007\/s00520-002-0360-5","volume":"10","author":"P McGrath","year":"2002","unstructured":"McGrath P (2002) Creating a language for \u201cspiritual pain\u201d through research: A beginning. Support Care Cancer 10(8):637\u2013646. https:\/\/doi.org\/10.1007\/s00520-002-0360-5","journal-title":"Support Care Cancer"},{"issue":"1","key":"9860_CR44","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1191\/0269216304pm837oa","volume":"18","author":"SA Murray","year":"2004","unstructured":"Murray SA, Kendall M, Boyd K, Worth A, Benton TF (2004) Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med 18(1):39\u201345. https:\/\/doi.org\/10.1191\/0269216304pm837oa","journal-title":"Palliat Med"},{"issue":"2","key":"9860_CR45","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1017\/s147895150606024x","volume":"4","author":"K Tamura","year":"2006","unstructured":"Tamura K, Ichihara K, Maetaki E, Takayama K, Tanisawa K, Ikenaga M (2006) Development of a spiritual pain assessment sheet for terminal cancer patients: targeting terminal cancer patients admitted to palliative care units in Japan. Palliat Support Care 4(2):179\u2013188. https:\/\/doi.org\/10.1017\/s147895150606024x","journal-title":"Palliat Support Care"},{"issue":"4","key":"9860_CR46","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/j.jpainsymman.2013.10.020","volume":"48","author":"L Selman","year":"2014","unstructured":"Selman L, Young T, Vermandere M, Stirling I, Leget C (2014) Research priorities in spiritual care: an international survey of palliative care researchers and clinicians. J Pain Symptom Manage 48(4):518\u2013531. https:\/\/doi.org\/10.1016\/j.jpainsymman.2013.10.020","journal-title":"J Pain Symptom Manage"},{"issue":"5","key":"9860_CR47","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1089\/jpm.2006.9.1106","volume":"9","author":"C Mako","year":"2006","unstructured":"Mako C, Galek K, Poppito SR (2006) Spiritual pain among patients with advanced cancer in palliative care. J Palliative Med 9(5):1106\u201313. https:\/\/doi.org\/10.1089\/jpm.2006.9.1106","journal-title":"J Palliative Med"},{"key":"9860_CR48","unstructured":"Catholic Health Association (CHA) (1993). Care of the dying: a Catholic perspective. Part IV: Theological, moral, and pastoral response--the transformation of suffering. Catholic Health Association. Health Prog 74(5):46\u201354"},{"issue":"4","key":"9860_CR49","doi-asserted-by":"publisher","first-page":"401","DOI":"10.21037\/apm.2019.03.04","volume":"8","author":"TS Beng","year":"2019","unstructured":"Beng TS, Yun LA, Yi LX, Yan LH, Peng NK, Kun LS et al (2019) The experiences of suffering of end-stage renal failure patients in Malaysia: a thematic analysis. Ann Palliat Med 8(4):401\u2013410. https:\/\/doi.org\/10.21037\/apm.2019.03.04","journal-title":"Ann Palliat Med"},{"key":"9860_CR50","doi-asserted-by":"publisher","unstructured":"Brown AE, Whitne SN, Duffy JD (2006) The physician\u2019s role in the assessment and treatment of spiritual distress at the end of life. Palliat Support Care. 29;4(1):81\u20136. https:\/\/doi.org\/10.1017\/s1478951506060093","DOI":"10.1017\/s1478951506060093"},{"issue":"1","key":"9860_CR51","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/1472-684X-12-35","volume":"12","author":"L Selman","year":"2013","unstructured":"Selman L, Simms V, Penfold S, Powell RA, Mwangi-Powell F, Downing J et al (2013) \u2019My dreams are shuttered down and it hurts lots\u2019-a qualitative study of palliative care needs and their management by HIV outpatient services in Kenya and Uganda. BMC Palliat Care 12(1):35. https:\/\/doi.org\/10.1186\/1472-684X-12-35","journal-title":"BMC Palliat Care"},{"issue":"7","key":"9860_CR52","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1177\/0269216315625860","volume":"30","author":"A Goodhead","year":"2016","unstructured":"Goodhead A, Speck P, Selman L (2016) \u201cI think you just learnt as you went along\u201d - Community clergy\u2019s experiences of and attitudes towards caring for dying people: A pilot study. Palliative Med 30(7):674\u2013683. https:\/\/doi.org\/10.1177\/0269216315625860","journal-title":"Palliative Med"},{"issue":"4","key":"9860_CR53","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1111\/scs.12569","volume":"32","author":"P Encarna\u00e7\u00e3o","year":"2018","unstructured":"Encarna\u00e7\u00e3o P, Oliveira CC, Martins T (2018) Psychometric properties of the suffering assessment questionnaire in adults with chronic diseases or life-threatening illness. Scand J Caring Sci 32(4):1279\u20131287. https:\/\/doi.org\/10.1111\/scs.12569","journal-title":"Scand J Caring Sci"},{"issue":"Suppl 1","key":"9860_CR54","first-page":"41","volume":"11","author":"L Balducci","year":"2010","unstructured":"Balducci L (2010) Beyond quality of life: the meaning of death and suffering in palliative care. Asian Pac J Cancer Prev 11(Suppl 1):41\u201344","journal-title":"Asian Pac J Cancer Prev"},{"issue":"1","key":"9860_CR55","first-page":"5","volume":"17","author":"AM Tordable","year":"2015","unstructured":"Tordable AM (2015) Biograf\u00eda de una enfermedad. El sufrimiento espiritual como diagn\u00f3stico enfermero. Enferm Oncol\u00f3gica 17(1):5\u201310","journal-title":"Enferm Oncol\u00f3gica"},{"key":"9860_CR56","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001642","author":"XJ Kwete","year":"2023","unstructured":"Kwete XJ, Kane K, Liu Y, Krakauer EL (2023) Frequency and duration of suffering of cervical cancer patients and caregivers: results from an international Delphi study. PLOS Glob Public Health. https:\/\/doi.org\/10.1371\/journal.pgph.0001642","journal-title":"PLOS Glob Public Health"},{"issue":"1","key":"9860_CR57","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1177\/10499091211011712","volume":"39","author":"S Bluck","year":"2022","unstructured":"Bluck S, Mroz EL, Wilkie DJ, Emanuel L, Handzo G, Fitchett G et al (2022) Quality of life for older cancer patients: relation of psychospiritual distress to meaning-making during dignity therapy. Am J Hosp Palliat Med 39(1):54\u201361. https:\/\/doi.org\/10.1177\/10499091211011712","journal-title":"Am J Hosp Palliat Med"},{"issue":"3","key":"9860_CR58","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1017\/s1478951506060354","volume":"4","author":"H Murata","year":"2006","unstructured":"Murata H, Morita T (2006) Conceptualization of psycho-existential suffering by the Japanese Task Force: The first step of a nationwide project. Palliat Support Care 4(3):279\u201385. https:\/\/doi.org\/10.1017\/s1478951506060354","journal-title":"Palliat Support Care"},{"issue":"6","key":"9860_CR59","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/00004650-200511000-00010","volume":"19","author":"LR Villagomeza","year":"2005","unstructured":"Villagomeza LR (2005) Spiritual distress in adult cancer patients. Holist Nurs Pract 19(6):285\u2013294. https:\/\/doi.org\/10.1097\/00004650-200511000-00010","journal-title":"Holist Nurs Pract"},{"issue":"2","key":"9860_CR60","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/j.1365-2648.2008.04869.x","volume":"65","author":"LB Agrimson","year":"2009","unstructured":"Agrimson LB, Taft LB (2009) Spiritual crisis: a concept analysis. J Adv Nurs. 65(2):454\u201361. https:\/\/doi.org\/10.1111\/j.1365-2648.2008.04869.x","journal-title":"J Adv Nurs."},{"key":"9860_CR61","unstructured":"Frankl V (2009) El hombre en busca del sentido \u00faltimo. El an\u00e1lisis existencial y la conciencia espiritual del ser humano. 5ta ed. Buenos Aires: Paid\u00f3s p. 11\u2013236"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-09860-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-025-09860-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-025-09860-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T03:00:12Z","timestamp":1758164412000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00520-025-09860-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,18]]},"references-count":61,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["9860"],"URL":"https:\/\/doi.org\/10.1007\/s00520-025-09860-5","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,18]]},"assertion":[{"value":"3 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"796"}}