Psychological and spiritual needs, dignity and compassion
Total pain and the psychosocial and spiritual domains of palliative care, screening with the Distress Thermometer and a spiritual history (FICA, HOPE), Chochinov's dignity model, the Patient Dignity Question and dignity therapy, compassion and compassion fatigue, carers, the desire to hasten death, and prolonged grief disorder.
Tier 1Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Total pain (Cicely Saunders): physical, psychological, social and spiritual suffering, each feeding the others. TG Palliative Care v5 asks for multidimensional assessment of pain and breathlessness.
- Every patient with a life-limiting illness should have their psychological, social, cultural and spiritual needs assessed and documented. This is the first standard of the National Palliative Care Standards (5th edition 2018) and an essential element of the 2023 National Consensus Statement on end-of-life care.
- Screen briefly (Distress Thermometer, a spiritual history), refer for specialist help when distress is complex, and keep asking as things change.
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Sources
- Therapeutic Guidelines: Palliative Care (eTG complete), version 5AU/NZTherapeutic Guidelines Limited, 2024 (version 5, December 2024; current at November 2026)
- National Palliative Care Standards, 5th editionAU/NZPalliative Care Australia, 2018 (with the 2022 standards for all health professionals and aged care services)
- National Consensus Statement: Essential elements for safe and high-quality end-of-life care (2nd edition)AU/NZAustralian Commission on Safety and Quality in Health Care, 2023
- Puchalski C et al. Improving the quality of spiritual care as a dimension of palliative care: the report of the Consensus Conference. J Palliat Med 2009;12:885-904Journal of Palliative Medicine, 2009
- Chochinov HM. Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care. BMJ 2007;335:184-187BMJ, 2007
- Chochinov HM et al. The patient dignity inventory: a novel way of measuring dignity-related distress in palliative care. J Pain Symptom Manage 2008;36:559-571Journal of Pain and Symptom Management, 2008
- Chochinov HM et al. Eliciting personhood within clinical practice: effects on patients, families, and health care providers. J Pain Symptom Manage 2015;49:974-980Journal of Pain and Symptom Management, 2015
- Chochinov HM. Revisiting the Patient Dignity Question: paying attention to personhood. J Palliat Med 2025;28:1433-1434Journal of Palliative Medicine, 2025
- Chochinov HM et al. Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial. Lancet Oncol 2011;12:753-762The Lancet Oncology, 2011
- Wulandari BT, Rochmawati E. Effectiveness of dignity therapy on well-being among patients under palliative care: a systematic review and meta-analysis. Int J Nurs Stud 2024;149:104624International Journal of Nursing Studies, 2024
- Breitbart W et al. Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. J Clin Oncol 2015;33:749-754Journal of Clinical Oncology, 2015
- Sinclair S et al. Measuring compassion in healthcare: a comprehensive and critical review. Patient 2017;10:389-405The Patient, 2017
- Last updated
- 14 November 2026
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