Forgiveness facilitation in palliative care: a scoping review

OBJECTIVE: The objective of this review is to map the nature and extent of forgiveness facilitation intervention implemented and evaluated in palliative care contexts. INTRODUCTION: Spiritual beliefs often include reconciliation and forgiveness, which are critical to patients and families in palliative care. Forgiveness facilitation can represent a valuable response as a multidisciplinary and non-pharmacological intervention to reduce suffering. INCLUSION CRITERIA: Studies including palliative care patients aged 18 years or over and assisted by palliative care teams, including all healthcare professionals, chaplains, and volunteers, were included in this review. METHODS: This scoping review is based on JBI methodology. The search was conducted in June 2017 and updated in December 2018 using international databases and gray literature in English, Spanish, German, Italian, and Portuguese. RESULTS: A total of 23 articles were included in this review. The results suggest a growing interest in forgiveness facilitation in palliative care in different spiritual and religious traditions. Most studies are based on a psychological perspective. Several activities related to the intervention have been identified, but few details or characteristics are described. Social workers, nurses, doctors, and psychologists were most identified as healthcare staff involved in forgiveness facilitation. The outcomes related to the intervention are mental, physical, and relational well-being; quality of life, decision-making and communication; self-esteem and hope; depression, anger, and anxiety; and inner peace. CONCLUSIONS: Forgiveness facilitation is critical in palliative care and is grounded in a multidisciplinary approach, but further evidence is needed to inform clinical implementation. These results open new perspectives for research and training on palliative healthcare staff.