Spiritual Care in the Treatment of Patients with Metastatic Cancer: A Qualitative Study Using the ©FICA Spiritual History Tool

Spirituality and religiosity (S/R) are recognized as integral dimensions of whole person health care, yet their influence in oncology remains underexplored in Brazil. This study aimed to validate the Brazilian Portuguese version of the ©FICA Spiritual History Tool and to investigate how spirituality and religion contribute to the treatment experiences of patients with metastatic cancer. A qualitative, exploratory, cross-sectional design was employed. The ©FICA tool was translated, culturally adapted, and back-translated, with expert committee review. Twenty inpatients with metastatic cancer receiving treatment at a tertiary oncology service in São Paulo, Brazil, participated. Data were collected using the ©FICA and a sociodemographic questionnaire, with interviews transcribed verbatim and analyzed through reflexive thematic analysis supported by MAXQDA software. Participants ranged in age from 21 to 85 years, with a predominance of women (N = 11 or 55%). Five thematic categories emerged: understanding and importance of spirituality and religiosity in confronting finitude; the role of support networks and social support; meanings and emotions in the oncological context; experiences and expectations regarding spiritual care; and coping strategies employed during treatment. The results highlight the relevance of spirituality and religiosity as sources of meaning-making, resilience, and spiritual as well as existential support, demonstrating their positive impact on patients’ ability to cope with advanced cancer. The ©FICA tool proved to be a valid and reliable instrument for spiritual assessment in Brazilian Portuguese, enabling healthcare professionals to integrate patients’ spiritual histories into comprehensive, multidimensional cancer care. Findings reinforce the importance of incorporating spiritual assessment into oncology practice to promote quality of life and holistic well-being.