Spiritual Care Expectations Among Cancer and Noncancer Patients With Life-Threatening Illnesses

Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs. 8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs. 11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care. 6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses. The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes. " In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace. " However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index. 1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs. 11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care. 6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses. The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes. " In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace. " However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index. 1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care.6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs. 11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.Background Spirituality is a core element in holistic nursing care. Therefore, it is necessary to understand the spiritual care expectations of cancer and noncancer patients with life-threatening illnesses.The aim of this study was to identify the spiritual care expectations of vulnerable patients with life-threatening illnesses.This study uses both quantitative and qualitative approaches, and data were collected from 232 patients. For quantitative data, we used the Nurse Spiritual Therapeutics Scale (NSTS), which comprises 20 items. Qualitative data were collected using an open-ended question. Quantitative data were analyzed using descriptive statistics, independent t tests, 1-way analysis of variance, and item and factor analysis. Qualitative data were analyzed using content analysis.The mean score of spiritual care expectations ranged from 2.27 to 3.07. There was a significant difference in NSTS mean score between cancer and noncancer patients. In exploratory factor analysis, NSTS was extracted into 3 factors and items belonging to the 3 factors showed similarity between cancer and noncancer patients. Qualitative data using content analysis revealed the following 3 themes: "treat with respect," "religious support," and "comfort with presence." The 3 factors corresponded with 3 themes: factor I versus "treat with respect," factor II versus "religious ritual," and factor III versus "comfort with presence."Spiritual care expectations of cancer and non-cancer patients with life-threatening illnesses were identified and the findings provide valuable data regarding the expectations of patients' spiritual care.Our findings emphasize integrating patient-reported outcomes with spiritual care to stimulate patient-centered care, thus promoting holistic palliative or end-of-life care.Human beings are regarded to be biological, social, emotional, and spiritual beings. Emotional and spiritual needs have ranked second on the National Inpatient Priority Index.1,2 Spirituality is the essence of human existence, which includes immaterial aspects of human life, and should be considered a core element of holistic nursing care.3 It is also very important for understanding beliefs, attitudes, and healthy behaviors, especially those of vulnerable people. In vulnerable patients anticipating death, the provision of spiritual care is a valuable and essential aspect of palliative care.4 Therefore, spirituality, with its potential to add meaning and value to life, warrants consideration in patient support and care.5 On analyzing the evidence of the role of spirituality and its effects on the research published from January 2000 to April 2022 in the area of serious illness and health, it has been confirmed that care considering spirituality is a key factor in improving patient health outcomes and enabling patient-centered care. 6Systematic reviews or meta-analysis studies published in the last 10 years regarding spirituality, spiritual needs, and spiritual care have shown the need for a new perspective.7 According to the definition adopted by the Spiritual Care Reference Group of the European Association for Palliative Care, "spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose, and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred." Studies have shown that up to 80% to 90% of patients report spiritual needs.8-10 These studies consisted of effective health outcomes for caregivers and had the following considerations: "involvement and control," "patient-centered approach," and "positive outcomes." In addition, several previous studies have shown that patients may be willing to seek and express the meaning and purpose of their lives.6,11 To improve the quality of palliative care, it is necessary to assess the patients' expectations from their point of view to address spirituality in serious illnesses and health outcomes as part of person-centered and value-sensitive care.6Expectations are a major determinant of patient satisfaction in healthcare and are expressed as desires, wishes, and hopes.11 Survival and access to health services are patients' needs. Their expectations involve a desire for healthcare that considers their individuality and offers them social apparatuses.12Many studies on the spiritual needs of patients near the end of their life have been conducted in Korea. The range of spiritual needs among patients varied from "maintaining positive perspective," "loving others," "finding meaning," and "hope and peace." However, it has been reported that hospice palliative care teams (HPCTs) experience challenges in the spiritual care of patients as they lack understanding of human spirituality, time, and empathy; have difficulties in spiritual communication; and are exhausted because of busy work and education.13-15 To overcome this difference in perception between caregivers and care recipients, and to provide more effective spiritual care, an inquiry from a new perspective is required. Rather than simply thinking about the spiritual needs of the patients, it is necessary to investigate the expectations of the spiritual care patients want. Few studies have been conducted from this perspective.Nurses are expected to be helpful to patients. Patients expect to be helped, and they generally have unmet needs.11 Therefore, to meet spiritual care expectations effectively, it is necessary to understand them through open-ended questions, as well as quantitative tools. Fundamentally, research is required to identify the most efficient evaluation method. Based on a review of a previous study,16 we decided to use a mixed-methods approach, as it best fits our research questions and purposes. A mixed-method design provides pragmatic advantages when exploring complex research questions.17This study aimed to identify the spiritual care expectations of vulnerable cancer and noncancer patients with life-threatening illnesses and examine the nature of care they want to receive from HPCTs.