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Background: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits. Aim: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context. Design: We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis. Settings/participants: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland. Results: Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation. Conclusion: Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care. [ABSTRACT FROM AUTHOR]

The body of theoretical and empirical research led by chaplains and theologians between 2000 and 2018 is developing into a rich, diverse, and methodologically rigorous healthcare chaplaincy literature, which this review proposes to map. Online keyword and bibliographical searches and specialist recommendations yielded 199 relevant publications, which we analyzed in terms of methodology, topic, and results. On this basis, this article identifies and describes five key areas of the literature: chaplains' practices, spirituality, research, impact, and healthcare professionals' practices of spiritual care. The discussion further highlights that publications would benefit from greater conceptual clarity, common research standards, and more critical research designs. [ABSTRACT FROM AUTHOR]

As many hospitals lack standardized referral protocols for spiritual care, healthcare professionals' perceptions and preferences play an important role in their decisions to refer patients to chaplains. To better understand what motivates these professionals to refer patients and how they approach spiritual care, this article examines referral requests from twelve healthcare professionals to a chaplain at the Lausanne University Hospital Department of Physical and Rehabilitation Medicine. Comparative discourse analysis highlights that requests are largely driven by difficulties in patient-professional relationships. Yet, further interviews reveal that healthcare professionals construct spiritual care as a way to access patients' sense of identity and explore the meaning they give to their lives and experiences, for the benefit of both patients and professionals. The discussion considers how chaplains could help healthcare colleagues formulate referrals that accurately reflect patients' spiritual needs, thus improving the relevance and quality of spiritual care. [ABSTRACT FROM AUTHOR]

To make sense of the gap between the theory and practice of community-driven development (CDD), development scholars and practitioners have proposed that the success of interventions is relative to the reform-mindedness of local government officials. This article sheds some light on the good governance performances of local government officials as part of the CDD programme Kalahi in the province of Bohol, Philippines. It highlights that locally, mayors who styled themselves as reformists enjoyed heightened power and electoral victories. In parallel, the province experienced a pattern of 'growth with immiserisation' and persistent political clientelism wrapped in a discourse of pro-poor development. [ABSTRACT FROM AUTHOR]

The article talks about the need for general practitioners (GPs) to provide spiritual care in general practice. It looks at medical literature on the connection between spirituality and health. Other topics discussed in it include the models presented in literature on how GPs practice spiritual care, reforming primary care to include spiritual care, and proposes an embedded model of practice that includes spirituality along with holistic care.