MAKASSAR, Indonesia April 16 2026/NMHEALTH/ – When a patient is diagnosed with end-stage breast cancer, medicine can only do so much. At some point, the goal shifts from curing the disease to easing the journey. In those final months, patients often need not another drug, but someone who can sit with them in their pain, acknowledge their fears, and support their sense of meaning and purpose. That is what spiritual care is all about. And according to a study at one of Indonesia’s leading cancer hospitals, many nurses are not yet equipped to provide it.
Researchers from Universitas Hasanuddin surveyed 24 nurses in the Oncology Department of Dr. Wahidin Sudirohusodo Hospital in Makassar using a validated tool called the Spiritual Care Competency Scale (SCCS). The scale assesses six areas: assessing and implementing spiritual care, professionalising that care, personal support and counselling, referrals, attitudes toward patients’ spirituality, and communication. The findings were striking: 50 percent of nurses scored in the ‘low competence’ category. Only 25 percent reached a high level.
The encouraging part: nurses scored highest in communication and attitude the warmth and compassion are already there. What is missing are formal skills, such as how to assess a patient’s spiritual needs or refer them to appropriate religious and counselling resources. The data also reveal a clear driver of this gap: training. Nurses who had attended chemotherapy training showed higher spiritual care competence, while those with no training at all were the most likely to score poorly.
Why does this matter beyond the hospital? Because spiritual care is not a luxury it is a proven component of quality healthcare. Patients who receive spiritual support experience less anxiety and depression, better social support, and longer survival periods. When spiritual needs go unmet, research shows that medical costs at the end of life increase two to three times. This is both a human and an economic problem.
This challenge connects directly to Sustainable Development Goal 3 (Good Health and Well-Being), which calls for universal access to quality health services including for patients at the end of life. Achieving SDG 3 means going beyond physical treatment to address the psychological and spiritual dimensions of care, especially for the most vulnerable. Nurses are on the front line of this mission.
The path forward is clear. Hospitals and nursing schools must integrate spiritual care into standard training and continuing professional development. Dr. Wahidin Sudirohusodo already has the foundation a palliative care programme and partnerships with religious leaders. The next step is ensuring every oncology nurse has both the heart and the competence to walk alongside a patient in life’s most difficult moments. Breast cancer does not end when treatment stops. The quality of a patient’s final days is shaped not only by medical skill, but by the human presence of those who care for them. Investing in nurses’ spiritual care competence is investing in dignity and every patient deserves that.
Reference:
DOI: Https://doi.org/10.1016/j.heliyon.2024.e28317
Contact:
Prof. Rini Rachmawaty, S.Kep., Ns., MN, PhD
0812 1391 6730
