Hospice Volunteers’ Spiritual Care Training

A Discussion of Core Competencies and Course Aims


  • Margit Gratz University of Münster
  • Traugott Roser University of Münster
  • Piret Paal Hospizdienst Dasein




hospice, volunteer, spirituality, spiritual care, training, curriculum, competencies


AIM: A Germany-wide survey confirmed that there is a need for a spiritual care curriculum to o er assistance in arranging the spiritual care training for hospice volunteers. This article defines the aims of the course and its central themes in teaching spirituality to hospice volunteers. METHODS: An expert group interview was designed to define the core competencies and course aims. The thematic content analysis was applied to extract themes from the transcript and paraphrased into codes, which were grouped into thematically coherent categories. RESULTS: Spiritual care training for volunteers should cover the following themes and practical assignments: (1) definition of central concepts of spirituality and spiritual care; (2) meaning of belief systems; (3) spiritual needs and resources; (4) personal manner and ability to relate meaningfully; (5) referral to appropriate pastoral care/chaplains/spiritual advisors; (6) rituals and creativity in spiritual care; (7) voicing and acknowledging own spirituality; (8) facing and initiating spiritual encounters. Course aims were identified concerning knowledge, skills, and attitude. CONCLUSION: The findings frame the development of a spiritual care curriculum for hospice volunteers.

Author Biographies

Margit Gratz, University of Münster

Margit Gratz has experience as a hospice volunteer, coordinator and palliative care trainer. She works in the Department of Practical Theology at the University of Münster.

Traugott Roser, University of Münster

Traugott Roser has worked as a chaplain on a palliative care unit and as a palliative care trainer, and presently holds a professorship in practical theology at the University of Münster.

Piret Paal, Hospizdienst Dasein

Piret Paal is a medical anthropologist and trainer, involved in projects regarding patient-centred palliative care.


ALPHA – Ansprechstelle im Land Nordrhein-Westfalen zur Pflege Sterbender, Hospizarbeit und Angehörigenbegleitung (ed.) (2008). Schwerpunkt Spiritualität I. Münster: Hospiz-Dialog NRW. [Online] http://alpha-nrw.de/wp-content/uploads/2014/07/34hospiz-dialog-januar-200ss8.pdf [accessed 25 Jun 2016].

Alsheimer, M. (2012) “Rituale in der Begleitung entwickeln und gestalten”. In Palliative Geriatrie. Ein Handbuch für die interprofessionelle Praxis, ed. C. Fuchs, H. Gabriel, J. Raischl, H. Steil and U. Wohlleben, 230–37. Stuttgart: Kohlhammer.

Angelo, J., and R. Egan (2015) “Family Caregivers Voice Their Needs: A Photovoice Study”. Palliative and Supportive Care 13(3): 701–12. https://doi.org/10.1017/S1478951514000522

Anandarajah, G., Craigie, F., Hatch, R., Kliewer, S., L. Marchand, D. King, R. Hobbs and T. P. Daaleman (2010) “Toward Competency-based Curricula in Patient-centered Spiritual Care: Recommended Competencies for Family Medicine Resident Education”. Academic Medicine 85(12): 1897–1904. https://doi.org/10.1097/ACM.0b013e3181fa2dd1

Balboni, T. A., L. C. Vanderwerker, S. D. Block, M. E. Paulk, C. S. Lathan, J. R. Peteet and H. G. Prigerson (2007) “Religiousness and Spiritual Support Among Advanced Cancer Patients and Associations With End-of-Life Treatment Preferences and Quality of Life”. Journal of Clinical Oncology 25(5): 555–60. https://doi.org/10.1200/JCO.2006.07.9046

Balboni, M. J., A. Sullivan, A. C. Enzinger, Z. D. Epstein-Peterson, Y. D. Tseng, C. Mitchell, J. Niska, A. Zollfrank, T. J. VanderWeele and T. A. Balboni (2014) “Nurse and Physician Barriers to Spiritual Care Provision at the End of Life”. Journal of Pain and Symptom Management 48(3): 400–10. https://doi.org/10.1016/j.jpainsymman.2013.09.020

Begemann, V., and S. Seidel (2015) Nachhaltige Qualifizierung des Ehrenamtes in der ambulanten Hospizarbeit und Palliativversorgung in Niedersachsen. Ludwigsburg: der hospiz verlag.

Brown, M. V. (2011) “How They Cope: A Qualitative Study of the Coping Skills of Hospice Volunteers”. American Journal of Hospice and Palliative Medicine 28(6): 398–402. https://doi.org/10.1177/1049909110393946

Buser, K., V. E. Amelung and N. Schneider (2008) “German Community Pastors’ Contact with Palliative Care Patients and Collaboration with Health Care Professionals”. Journal of Social Work in End-of-Life & Palliative Care 4(2): 85–100. https://doi.org/10.1080/15524250802353926

Büssing, A., A. Janko, K. Baumann, N. C. Hvidt and A. Kopf (2013) “Spiritual Needs among Patients with Chronic Pain Diseases and Cancer Living in a Secular Society”. Pain Medicine 14: 1362–373. https://doi.org/10.1111/pme.12198

Büssing, A., and H. Koenig (2010) “Spiritual Needs of Patients with Chronic Diseases”. Religions 1: 18–27. https://doi.org/10.3390/rel1010018

Büssing, A., A. Michalsen, H.-J. Balzat, R.-A. Grünther, T. Ostermann, E. A. M. Neugebauer and P. F. Matthiesen (2009) “Are Spirituality and Religiosity Resources for Patients with Chronic Pain Conditions?” Pain Medicine 10(2): 327–39. https://doi.org/10.1111/j.1526-4637.2009.00572.x

Büssing, A., T. Ostermann and P. F. Matthiessen (2007) “Adaptive Coping and Spirituality as a Resource in Cancer Patients”. Breast Care 2(4): 195–202. https://doi.org/10.1159/000104172

Charbonnier, R. (2008) “Seelsorge in der Palliativversorgung”. Wege zum Menschen 60(6): 512–28. https://doi.org/10.13109/weme.2008.60.6.512

Claxton-Oldfield, S (2015) “Hospice Palliative Care Volunteers: The Benefits for Patients, Family Caregivers, and the Volunteers”. Palliative and Supportive Care 13(3): 809–13. https://doi.org/10.1017/S1478951514000674

Cobb, M., C. M. Puchalski and B. Rumbold (eds) (2012) Oxford Textbook of Spirituality in Healthcare. Oxford: Oxford University Press. https://doi.org/10.1093/med/9780199571390.001.0001

Diekmann, A. (2007) Empirische Sozialforschung. Grundlagen, Methoden, Anwendungen. Rein­bek: Rowohlt Verlag.

Epstein-Peterson, Z. D., A. J. Sullivan, A. C. Enzinger, K. M. Trevino, A. A. Zollfrank, M. J. Balboni, T. J. VanderWeele and T. A. Balboni (2015) “Examining Forms of Spiritual Care Provided in the Advanced Cancer Setting”. American Journal of Hospice & Palliative Medicine 32(7): 750–57. https://doi.org/10.1177/1049909114540318

Gamondi, C., P. Larkin and S. Payne (2013) “Core Competencies in Palliative Care: an EAPC White Paper on Palliative Care Education – Part 2”. European Journal of Palliative Care 20(3): 140–45.

GKV-Spitzenverband et al. (2016) Rahmenvereinbarung nach § 39a Abs. 2 Satz 8 SGB V zu den Voraussetzungen der Förderung sowie zu Inhalt, Qualität und Umfang der ambulanten Hospizarbeit vom 03.09.2002, i. d. F. vom 14.03.2016. https://tinyurl.com/kjkzv7s

Gratz, M., T. Roser, F. Kittelberger and P. Paal (2015) “Evaluierung eines Spiritual-Care-Curriculums für Hospizbegleiter”. Zeitschrift für Palliativmedizin 16(2): 57–64. https://doi.org/10.1055/s-0034-1387542

Gratz, M., and T. Roser (2016) Curriculum Spiritualität für ehrenamtliche Hospizbegleitung. Göttingen: Vandenhoeck & Ruprecht.

Gratz, M., P. Paal, M. Emmelmann and T. Roser (2016) “Spiritual Care in the Training of Hospice Volunteers in Germany”. Palliative & Supportive Care 14(5): 532–40. https://doi.org/10.1017/S1478951515001261

Hampton, D. M., D. E. Hollis, A. L. Dudley, J. Taylor and S. C. McMillan (2007) “Spiritual Needs of Persons with Advanced Cancer”. American Journal of Hospice & Palliative Medicine 24(1): 42–48. https://doi.org/10.1177/1049909106295773

Helfferich, C. (2005) Die Qualität qualitativer Daten. Manual für die Durchführung von qualitativen Interviews. Wiesbaden: Verlag für Sozialwissenschaften.

Heller, B. (2012) Wie Religionen mit dem Tod umgehen. Grundlagen für die interkulturelle Sterbebegleitung. Freiburg im Breisgau: Lambertus Verlag.

Henoch, I., S. Strang, M. Browall, E. Danielson and C. Melin-Johansson (2015) “Development of An Existential Support Training Program for Healthcare Professionals”. Palliative & Supportive Care 13(6): 1701–709. https://doi.org/10.1017/S1478951515000632

Hesse, M., H. G. Nehen, H. C. Müller-Busch and T. Roser (2014) Welche Rolle spielt Spiritualität in der Begleitung durch ehrenamtliche Hospizhelfer? Kongressbeitrag beim 10. Kongress der Deutschen Gesellschaft für Palliativmedizin. www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0034-1374154

Kalish, N. (2012) “Evidence-based Spiritual Care: a Literature Review”. Current Opinion in Supportive and Palliative Care 6(2): 242–46. https://doi.org/10.1097/SPC.0b013e328353811c

Koenig, M., and S. Trittler (n.d.) Germany: Religious Belonging and Religious Demography. Religious Diversification. www.eurel.info/spip.php?rubrique89&lang=en

Kruse, J. (2014) Qualitative Interviewforschung. Ein integrativer Ansatz. Unpublished manuscript.

Marie Curie Cancer Care (2003) Spiritual & Religious Care Competencies for Specialist Palliative Care. www.ahpcc.org.uk/wordpress/wp-content/uploads/2014/07/spiritcomp.pdf

Müller, M., and W. Heinemann (2015) Ehrenamtliche Sterbebegleitung: Handbuch mit Übungsmodulen für Ausbildende, 2nd edn. Göttingen: Vandenhoeck & Ruprecht.

Nolan, S. (2012) Spiritual Care at the End of Life. The Chaplain as a “Hopeful Presence”. London: Jessica Kingsley.

Nolan, S., P. Saltmarsh and C. Leget (2011) “Spiritual Care in Palliative Care: Working Towards an EAPC Task Force”. European Journal of Palliative Care 18(2): 86–89.

Owen-Still, S. (1985) “Spiritual Caregiving. A Philosophy for the Volunteer-intensive Hospice Program”. The American Journal of Hospice Care 2(2): 32–35. https://doi.org/10.1177/104990918500200208

Paal, P. (2014) “Implementing Spiritual Care at the End of Life: Germany”. European Journal of Palliative Care 21(2): 76–77.

Pabst, K., and L. Radbruch (2015) EAPC Survey: The Role and Motivation of Volunteers in Hospices and Palliative Care in Europe. https://tinyurl.com/mym4n8v

Parry, S. B. (1996) “The Quest for Competencies”. Training 33(7): 48–56.

Phelps, A. C., K. E. Lauderdale, S. Alcorn, J. Dillinger, M. T. Balboni, M. Van Wert, T. J. VanderWeele and T. A. Balboni (2012) “Addressing Spirituality Within the Care of Patients at the End of Life: Perspectives of Patients With Advanced Cancer, Oncologists, and Oncology Nurses”. Journal of Clinical Oncology 30(20): 2538–544. https://doi.org/10.1200/JCO.2011.40.3766

Planalp, S., and M. R. Trost (2008) “Communication Issues at the End of Life: Reports from Hospice Volunteers”. Health Communication 23(3): 222–33. https://doi.org/10.1080/10410230802055331

Puchalski, C. M. (2010) “Tradition, Heritage and Spirituality. Formal and Informal Spiritual Assessment”. Asian Pacific Journal of Cancer Prevention 11: 51–58.

Pujol, N., G. Jobin and S. Beloucif (2016) “‘Spiritual Care is Not the Hospital’s Business’: a Qualitative Study on the Perspectives of Patients about the Integration of Spirituality in Healthcare Settings”. Journal of Medical Ethics, in press. https://doi.org/10.1136/medethics-2016-103565

Romanoff, B. D., and B. E. Thompson (2006) “Meaning Construction in Palliative Care: The Use of Narrative, Ritual, and the Expressive Arts”. American Journal of Hospice and Palliative Medicine 23(4): 309–16. https://doi.org/10.1177/1049909106290246

Steinberg, S. M. (2011) “Cultural and Religious Aspects of Palliative Care”. International Journal of Critical Illness & Injury Science 1(2): 154–56. https://doi.org/10.4103/2229-5151.84804

Udo, C., C. Melin-Johansson, I. Henoch, B. Axelsson and E. Danielson (2014) “Surgical Nurses’ Attitudes towards Caring for Patients Dying of Cancer – a Pilot Study of An Educational Intervention on Existential Issues”. European Journal of Cancer Care 23(4): 426–40. https://doi.org/10.1111/ecc.12142

Vaismoradi, M,. J. Jones, H. Turunen and S. Snelgrove (2016) “Theme Development in Qualitative Content Analysis and Thematic Analysis”. Journal of Nursing Education and Practice 6(5): 100–10. https://doi.org/10.5430/jnep.v6n5p100

Vallurupalli, M., K. Lauderdale, M. J. Balboni, A. C. Phelps, S. D. Block, A. K. Ng, L. A. Kachnic, T. J. VanderWeele and T. A. Balboni (2012) “The Role of Spirituality and Religious Coping in the Quality of Life of Patients With Advanced Cancer Receiving Palliative Radiation Therapy”. The Journal of Supportive Oncology 10(2): 81–87. https://doi.org/10.1016/j.suponc.2011.09.003

Wilson, D. M., C. Justice, R. Thomas, S. Sheps, M. MacAdam and M. Brown (2005) “End-of-life Care Volunteers: a Systematic Review of the Literature”. Health Services Management Research 18(4): 244–57. https://doi.org/10.1258/095148405774518624

Winter-Pfändler, U., and K. J. Flannelly (2013) “Patients’ Expectations of Healthcare Chaplaincy: A Cross-Sectional Study in the German Part of Switzerland”. Journal of Religion and Health 52: 159–68. https://doi.org/10.1007/s10943-010-9451-7

Wittenberg-Lyles, E., K. Washington, G. Demiris, D. P. Oliver and S. Shaunfield (2014) “Understanding Social Support Burden Among Family Caregivers”. Health Communication 29(9): 901–10. https://doi.org/10.1080/10410236.2013.815111

Wittenberg-Lyles, E., G. Schneider and P. D. Oliver (2010) “Results from a National Hospice Volunteer Training Survey”. Journal of Palliative Medicine 13(3): 261–65. https://doi.org/10.1089/jpm.2009.0240

Worthington, D. L. (2008) “Communication Skills Training in a Hospice Volunteer Training Program”. Journal of Social Work in End-of-Life & Palliative Care 4(1): 17–37. https://doi.org/10.1080/15524250802072021

Yilmaz, M., and H. Gurler (2014) “The Efficacy of Integrating Spirituality into Undergraduate Nursing Curricula”. Nursing Ethics 21(8): 929–45. https://doi.org/10.1177/0969733014521096

Zollfrank, A. A., K. M. Trevino, W. Cadge, M. J. Balboni, M. M. Thiel, G. Fitchett, K. Gallivan, T. VanderWeele and T. A. Balboni (2015) “Teaching Health Care Providers to Provide Spiritual Care: a Pilot Study”. Journal of Palliative Medicine 18(5): 408–14. https://doi.org/10.1089/jpm.2014.0306



How to Cite

Gratz, M., Roser, T., & Paal, P. (2017). Hospice Volunteers’ Spiritual Care Training: A Discussion of Core Competencies and Course Aims. Health and Social Care Chaplaincy, 5(1), 55–72. https://doi.org/10.1558/hscc.31352

Most read articles by the same author(s)