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The FICA\u00a9 Spiritual History Tool, developed by Dr. Christina Puchalski, provides clinicians with a framework for addressing patients\u2019 spiritual histories. The aim of this study was to translate, culturally adapt, and apply the FICA\u00a9 Spiritual History Tool in a sample of Italian end-of-life cancer patients and to identify the spirituality-related themes that emerge. The cultural adaptation process included forward\u2013backward translations of the FICA\u00a9 Spiritual History Tool, followed by its application through in-person conversations. Of the 95 eligible participants, 80 terminally ill cancer patients (84%) were included. A thematic analysis of the responses was conducted. Findings indicated that spirituality can provide a source of support for many Italian patients coping with terminal cancer. Spirituality was most frequently reflected with the Catholic faith. Some participants reported not belonging to any specific religious community; instead, they primarily relied on the support received from family and friends. The Italian version of the FICA\u00a9 Spiritual History Tool is clear, understandable and focused on exploring spirituality and its relevance in end-of-life conversations. Healthcare providers (HCPs) should be informed about and encouraged to use this tool to gather essential information about their patients\u2019 spiritual history and perspectives, supporting personalized care beyond their physical illness.<\/jats:p>","DOI":"10.1007\/s10943-026-02614-5","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:48:01Z","timestamp":1772966881000},"page":"3681-3696","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cultural Adaptation and Preliminary Assessment of the Italian Version of the FICA\u00a9 Spiritual History Tool in the context of End-Of-Life Cancer Patients"],"prefix":"10.1007","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5728-9907","authenticated-orcid":false,"given":"Andrea","family":"Bovero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Scomazzon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7777-7643","authenticated-orcid":false,"given":"Irene","family":"Di Girolamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Lamannis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4532-7766","authenticated-orcid":false,"given":"Christina","family":"Puchalski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-7912","authenticated-orcid":false,"given":"Mario","family":"Cagna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7068-4734","authenticated-orcid":false,"given":"Francesca","family":"Cotardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"issue":"8","key":"2614_CR1","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1001\/jama.2022.11086","volume":"328","author":"TA Balboni","year":"2022","unstructured":"Balboni, T. 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