“Empty action: two heads are better than one”: Spiritual care provision for patients living with advanced cancer in Sub-Saharan Africa: A meta-synthesis

Purpose: This meta-synthesis seeks to explore spiritual care provision by healthcare professionals and spiritual leaders to patients with advanced cancer and their families in Sub–Saharan Africa. Methods: Studies were searched and retrieved from MEDLINE, EMBASE, PsycINFO, CINAHL, Global Health, Web of Science, and the Africa Index Medicus databases. The search was conducted on November 10, 2023 and repeated on October 18, 2024. This meta-synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statements. Two authors independently conducted the screening and data extraction process. Two authors independently assessed the quality of included studies using the Critical Appraisal Skill Programme Checklist for qualitative studies, and findings from the studies were analysed and synthesised thematically. Findings: Twelve studies were included in the meta-synthesis. The analysis yielded six themes: metaphysical causes of cancer illness, patients and carers’ spiritual concerns, pluralistic therapy and nature of spiritual care provision, spirituality/religiosity in coping, positive reframing and pathways towards reconciliation, and integration of spiritual care into routine cancer care pathways. Conclusion: Patients and families combine orthodox treatment and spiritual forms of healing. They would like to receive spiritual care from healthcare professionals and not relegate it entirely to their spiritual leaders and church members. Spiritual/religious leaders of patients and families are willing to collaborate with orthodox treatment in providing spiritual care. Incorporating spiritual care into primary healthcare and educational programs is significant to enhancing patients’ outcomes and healthcare delivery.