Cultural Adaptation and Preliminary Assessment of the Italian Version of the FICA© Spiritual History Tool in the context of End-Of-Life Cancer Patients

Overview

This study examined the cultural adaptation and preliminary assessment of the Italian version of the FICA Spiritual History Tool in end-of-life cancer patients. The FICA framework, originally developed to facilitate systematic documentation of patients' spiritual histories, was translated and culturally adapted for use within an Italian healthcare context. The research addresses the recognized role of spiritual dimensions in palliative and end-of-life care, where such considerations are documented to correlate with improved quality of life and emotional well-being outcomes in terminally ill populations.

Methods and approach

The adaptation process employed standard forward-backward translation methodology to ensure linguistic and cultural equivalence of the FICA Spiritual History Tool. The adapted instrument was subsequently applied through in-person structured conversations with end-of-life cancer patients. A sample of 95 eligible participants was identified, with 80 terminally ill cancer patients (84% enrollment rate) completing the assessment. Thematic analysis was conducted on patient responses to identify emergent spirituality-related themes and patterns.

Key Findings

Analysis revealed that spirituality functioned as a significant support resource for Italian end-of-life cancer patients. Catholic faith representations predominated among spirituality expressions. A secondary but notable cohort of participants reported non-affiliation with formal religious communities, instead identifying family and social networks as primary sources of spiritual and emotional sustenance. The Italian adaptation demonstrated clarity and comprehensibility, with the instrument effectively eliciting patient perspectives on spiritual dimensions relevant to end-of-life contexts.

Implications

The Italian version of the FICA Spiritual History Tool represents a validated instrument for incorporation into clinical practice, enabling healthcare providers to systematically assess and document spiritual history as a component of comprehensive end-of-life care. Healthcare providers require explicit training and institutional support to integrate this assessment tool into routine practice. Implementation of structured spiritual history assessment aligns with person-centered care paradigms, facilitating individualized treatment planning that extends beyond biomedical dimensions to encompass patients' existential and spiritual concerns.