Table 2.

Description of the final six group concept mapping clusters of understanding of spiritual care

Cluster	Summary-content
1. Spiritual care as a part ofhealthcare No of ideas: 24	SC is agrowing type of healthcare which goes beyond biophysical and social needs and relates to patients’ and relatives’ existential and spiritual needs. Health professionals (eg, nurses, chaplains, psychologists and medical doctors) often engage in interdisciplinary work with patients and relatives through dialogue about spiritual issues. SC is a particularly important aspect of rehabilitation, palliative care, and general practice.
2. Perceived significance No of ideas: 27	SC is an underprioritised aspect of healthcare and not perceived as relevant for all patients. It is also perceived as difficult to approach—especially in a secular country (eg, Denmark). It is a sphere of healthcare which, particularly in a multicultural and pluralistic context, calls for more attention: for example, in the fields of education, supervision and research. It is an area with the potential to relieve anxiety and suffering, and thereby support a holistic approach to healthcare.
3. The role of spirituality No of ideas: 23	Spirituality is an essential part of spiritual care. Spirituality may comprise both patients’ existential, spiritual and religious concerns into an existential frame of self-concept. It emphasizes the connection/relationship between an individual self (body, mind and spirit/soul) and that individual’s self-transcending experiences, meaning and not rarely also sacred entities like oracles, prophets, spirits and/or deities (ie, God). It is always embedded and understoodwithin and with regard to the prevailing culture.
4. Help and support No of ideas: 34	SC involves supporting and helping patients when they face existential/spiritual/religious crises in healthcare. This involves taking the time to explore the patients’ spiritual history and not just their medical history; supporting both patients and relatives through active listening, and using dialogue to explore their thoughts, feelings and outlook on life; and assisting patients in finding meaning and purpose in the things they value, and, if possible, gaining inner peace and well-being.
5. Quality in attitude and action No of ideas: 35	SC is attentive and respectful towards patients’ values and beliefs. Healthcare professionals achieve this by acknowledging and supporting patients’ personal dignity through empathic listening and by offering comfort, compassion, love and advice.
6. Relationship No of ideas: 49	SC requiresrelationships between healthcare professionals and patients that are characterised by empathy and trustworthiness. Healthcare professionals are aware of their responsibility for this relationship with the patient. The professional encounter should be grounded in a committed and compassionate relationship. SC takes place when healthcare professionals are fully present and engaged in exploring the patients’ resources, allowing periods of silence in conversation, or holding the hands of a patient in need of a hand to hold.

SC, spiritual care.