Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science


Health and Rehabilitation Sciences


Nouvet, Elysée A.


This exploratory qualitative study identified spiritual and psychosocial palliative care needs in one rural Eastern Ontario town, referred to as the pseudonym “Duffy’s Hill.” Six qualitative interviews with health care providers gathered insights, ideas, and stories related to the provision of spiritual and psychosocial palliative care in Duffy’s Hill. Participant responses were analyzed for shared values, beliefs, ideas, practices, and norms in providing this care to determine if the distinct needs observed could be attributed to cultural particularities in Duffy’s Hill. Results found that participants viewed Duffy’s Hill as distinct from urban contexts in nature of practice and challenges faced. Good spiritual and psychosocial care involved awareness of a tension associated with the terms “spiritual” and “religious,” attention to patients’ senses of place, and opportunity for patients to maintain, engage in, or heal interpersonal relationships. These results, though exploratory, suggest some level of shared culture in Duffy’s Hill.

Summary for Lay Audience

The initiation of palliative care—an area of health care offered to individuals facing life-threatening, terminal, or chronic illness—signifies a shift in priorities from curing an illness to maintaining quality of life for the patient receiving treatment. The Canadian Hospice Palliative Care Association states that good palliative care involves treatment of physical suffering through pain management and services to treat spiritual and psychosocial aspects of health. Despite this fact, very little research has been conducted in Canada exploring what it means to treat patients’ spiritual and psychosocial needs. These elements of care are particularly under-studied in rural areas. This thesis explores what spiritual and psychosocial needs exist for palliative care patients in one rural Ontario town (referred to in this thesis as “Duffy’s Hill”) by asking six health care providers about their experiences offering palliative care in this town. Participants shared that patients were not always comfortable discussing spirituality because they associated it with religion, and religious participation, though common in Duffy’s Hill, was not always viewed positively. Thus, offering good spiritual and psychosocial care in this town involves careful selection of words when discussing this care, and avoidance of the terms “spiritual” or “religious” unless the provider understands the patient’s definition of these terms. Good spiritual and psychosocial care in this context also includes/means helping patients connect with their senses of place, creating opportunities for them to feel like they are at home, as well as opportunities for patients to engage in meaningful relationships with people. These opportunities might involve reconciling with estranged family members. Health care providers face challenges finding adequate time to do this work well, knowing who to involve in spiritual and psychosocial care, providing spiritual and psychosocial care to patients who do not want it, providing culturally-relevant care to non-locals who travel to Duffy’s Hill for vacation, and in helping non-mobile patients access care. These elements and challenges demonstrate that, at some level, cultural norms, values, beliefs, and practices exist that suggest a shared “rural” culture in Duffy’s Hill that holds implications for spiritual and psychosocial palliative care provision.