This study sought to evaluate how a training program on spiritual care affected physicians’ confidence, self-reported practice, and attitudes in caring for terminally ill cancer patients who express meaninglessness in living. Questionnaires were distributed to participating physicians before and after the training program. A total of 30 physicians completed the program. Confidence and self-reported practice regarding communication with terminally ill cancer patients who express meaninglessness significantly improved after the training: effect size, 1.3 (P=0.0001) and 1.2 (P=0.0001), respectively. Moreover, physician-reported helplessness significantly decreased (effect size, 0.8; P=0.0001) and positive appraisal and willingness to participate in caring for terminally ill cancer patients experiencing meaninglessness significantly improved (effect size, 0.8, P=0.0001; effect size, 0.4, P=0.0001, respectively). Overall, 96–100% of the participating physicians reported the program was useful for understanding the concept of spiritual care and for learning a practical approach for caring for such patients.

The aim was to explore existential suffering n physicians caring for terminally ill cancer patients. We performed qualitative analyses of 30 physician-reported descriptions of the clinical experience of caring for terminally ill cancer patients. Analyses were conducted using descriptive phenomenology to clarify the meaning of physicians’ experiences, guided by the three dimensions of Murata’s human being model. In their descriptions, all physicians mentioned existential suffering related to incompetence, and three themes were identified: 1) physicians who focus on the limitations of what they can achieve with curative or palliative treatment feel a sense of incompetence; 2) physicians who focus on difficulties in caring for patients with existential suffering feel a sense of incompetence; and 3) physicians who focus on environmental factors, such as work overload and insufficient communication skills training, experience a sense of incompetence. Physicians experience a sense of incompetence when they face treatment limitations and/or difficulties in caring for patients with existential suffering.