them more of a sense of control and reassurance for the
future (Spilka et al. 1985, Fryback & Reinert 1999, Moser
et al. 2001).
The significance of ‘spiritual pain’ is increasingly of interest
in the field of palliative care. Spiritual pain derives from the
deep anxiety associated with the prospect of elimination of
one’s personal existence: it is the ‘loss of meaning and
purpose in life’ caused by the loss of self-integration.
Despite the increased attention being focussed on spirituality
and health, research reveals that physicians are often
reluctant to explore spiritual issues with their patients (King
& Bushwick 1994). Particularly in the field of palliative care,
there is a need to respond not only to physical suffering
(including pain), mental suffering (such as anxiety and
depression) and social problems (for example, economic
and family), but also to questions of the meaning and values
given to human existence and the spirituality associated with
such meanings (Fitchett et al. 1996). The spiritual dimension
of dying moves us beyond pain management to focus on
holistic healing (Bryson 2004).