{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:10:52Z","timestamp":1789740652066,"version":"4.0.1"},"reference-count":69,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["89"],"abstract":"<jats:p>Background: Spiritual care (SC) is a component of person\u2011centered care in serious illness, yet most evidence derives from high\u2011income countries (HICs). Most patients with serious illness live in low\u2011 and middle\u2011income countries (LMICs), where religion and spirituality often play distinctive social, cultural, and clinical roles.\nMethods: We synthesized 46 LMIC studies drawn from the Balboni et al. [1] systematic review of 371 empirical studies on spirituality in serious illness. Eligible studies were conducted in at least one LMIC, used valid spirituality measures, included \u2265100 adult participants, and were rated as low or moderate risk of bias using adapted Cochrane criteria. We examined the role of spirituality in coping and outcomes, as well as the approaches used to assess and deliver SC across Asia, the Middle East and North Africa, sub\u2011Saharan Africa, and Latin America.\nResults: Across the 46 studies, higher spiritual well\u2011being and positive religious coping were consistently associated with better quality of life, lower psychological distress, and stronger family outcomes. Religious or spiritual struggle was associated with poorer mental health. SC was most often delivered by family members and faith communities rather than clinicians. Of the 46 studies, 38 (83%) used HIC\u2011developed measurement instruments. Locally developed instruments from Thailand, Iran, and Nigeria revealed culturally distinctive pathways to spiritual well\u2011being.\nConclusion: Across diverse LMIC settings, SC emerges as a generalizable yet locally inflected component of person\u2011centered serious\u2011illness care. We propose a both\/and measurement framework retaining validated global tools while integrating locally developed instruments. Health systems in LMICs should integrate SC competencies into clinical curricula while preserving partnerships with family and faith networks.<\/jats:p>","DOI":"10.5334\/aogh.5384","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:41:04Z","timestamp":1789738864000},"page":"98","source":"Crossref","is-referenced-by-count":0,"title":["Spiritual Care in Serious Illness: A Narrative Review of Low- and Middle-Income Country Evidence"],"prefix":"10.5334","volume":"92","author":[{"given":"Ryan","family":"Meachen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5600-7119","authenticated-orcid":false,"given":"Junita","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabbi","family":"Lall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy A.","family":"Balboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine S.","family":"Psimopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler J.","family":"VanderWeele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"Balboni TA, VanderWeele TJ, Doan\u2011Soares SD, et al. Spirituality in serious illness and health. JAMA. 2022;328(2):184\u2013189. doi:10.1001\/jama.2022.11086.","DOI":"10.1001\/jama.2022.11086"},{"key":"2","doi-asserted-by":"crossref","unstructured":"Puchalski C, Ferrell B, Virani R, et al. Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. J Palliat Med. 2009;12(10):885\u2013904. doi:10.1089\/jpm.2009.0142.","DOI":"10.1089\/jpm.2009.0142"},{"key":"3","doi-asserted-by":"crossref","unstructured":"Puchalski CM, Vitillo R, Hull SK, Reller N. Improving the spiritual dimension of whole person care: Reaching national and international consensus. J Palliat Med. 2014;17(6):642\u2013656. doi:10.1089\/jpm.2014.9427.","DOI":"10.1089\/jpm.2014.9427"},{"key":"4","doi-asserted-by":"crossref","unstructured":"Ferngren GB. Medicine and Religion: A Historical Introduction. Johns Hopkins University Press; 2014. doi:10.56021\/9781421412153.","DOI":"10.56021\/9781421412153"},{"key":"5","doi-asserted-by":"crossref","unstructured":"Levin J. Conflict and cooperation. In: Levin J, Post SG. eds. Religion and Medicine: A History of the Encounter Between Humanity\u2019s Two Greatest Institutions. Oxford University Press; 2020:1\u201117 doi:10.1093\/oso\/9780190867355.003.0001.","DOI":"10.1093\/oso\/9780190867355.003.0001"},{"key":"6","doi-asserted-by":"crossref","unstructured":"Oman D. Why Religion and Spirituality Matter for Public Health: Evidence, Implications, and Resources. Springer; 2018. doi:10.1007\/978-3-319-73966-3.","DOI":"10.1007\/978-3-319-73966-3"},{"key":"7","unstructured":"World Health Organization. World Health Organization strategy for engaging religious leaders, faith\u2011based organizations and faith communities in health emergencies. Published November 3, 2021. https:\/\/www.who.int\/publications\/i\/item\/9789240037205."},{"key":"8","doi-asserted-by":"crossref","unstructured":"Peng\u2011Keller S, Winiger F, Rauch R. The Spirit of Global Health: The World Health Organization and the \u2018Spiritual Dimension\u2019 of Health, 1946\u20132021. Oxford University Press; 2022. doi:10.1093\/oso\/9780192865502.001.0001.","DOI":"10.1093\/oso\/9780192865502.001.0001"},{"key":"9","unstructured":"Pew Research Center. A changing world: Global views on diversity, gender equality, family life and the importance of religion. Published April 22, 2019. https:\/\/www.pewresearch.org\/global\/2019\/04\/22\/a-changing-world-global-views-on-diversity-gender-equality-family-life-and-the-importance-of-religion\/."},{"key":"10","unstructured":"World Bank. World Bank country and lending groups. 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