Assessing Cultural, Religious, and Spiritual Confidence and Perceived Preparedness in Community Palliative and End-of-Life Care: A Service Evaluation.

Background

Cultural, religious, and spiritual (CRS) needs are central to holistic palliative and end-of-life care (PEoLC), yet the confidence and perceived preparedness of community and voluntary sector staff in addressing them remain underexplored. As PEoLC increasingly occurs in community settings, understanding staff preparedness for culturally and spiritually sensitive care is vital.

Objective

This service evaluation examined CRS perceived preparedness and confidence among staff across Leicester, Leicestershire, and Rutland (LLR), exploring perceived challenges and available resources.

Methods

A modified Confidence and Perceived preparedness in the CRS Care Survey was distributed to healthcare, hospice, charity, and community staff (May-August 2025). Likert scale data (n = 39) were analysed descriptively; qualitative responses underwent thematic analysis using Braun and Clarke's framework, which was co-produced with stakeholders.

Results

Staff placed high importance on CRS needs (cultural M = 4.48, SD = 0.61; religious/spiritual M = 4.66, SD = 0.53) but reported lower confidence in the organisational capacity to meet them (M = 3.15 and M = 3.05). Qualitative survey findings showed that staff recognised CRS needs as central to holistic, individualised care, emphasising proactive assessment and avoiding assumptions. Barriers included fear of causing offence, organisational constraints, and challenges in supporting families, alongside concerns about unmet needs. Participants highlighted reliance on informal resources and a clear need for accessible, lived-experience-based training and practical guidance. A prototype CRS resource toolkit, including lived-experience videos and guidance for supporting Muslim patients, was co-developed and reviewed by healthcare, community, and public contributors.

Conclusions

Staff commitment to CRS-sensitive PEoLC is strong, but practical tools and training are lacking. A virtual CRS toolkit could enhance confidence, communication, and culturally responsive care across multidisciplinary settings.