History, Culture and Traditions: The Silent Spaces in the Study of Spirituality at the End of Life

Recent increase in the number of studies on spirituality manifests growing recognition of the importance of spirituality, as well as mounting interest in studying spirituality in healthcare. Most studies on spirituality in end of life care focus on identifying specific features of spirituality and often represent an individualistic understanding of spirituality. They seldom engage in a historical–cultural exploration of the contextual meanings of those features of spirituality. This paper aims to demonstrate the absence of contextual factors in studying spirituality at the end of life and to highlight the growing recognition of the importance of history, culture and traditions as resources to enrich our understanding of spirituality. An exploration of the concept of spirituality, an overview of the trajectory of the study of spirituality and a review of existing methodological stances reveal the silent space in current approaches to understanding spirituality at the end of life. Recognition of the importance of these contextual factors in understanding spirituality is growing, which is yet to influence the conceptualization and the conduct of spirituality research. Contextual understandings of spirituality that incorporate insights from the history, culture and traditions of specific contexts can inform effective means for providing spiritual support in clinical practice.