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

Spirituality is widely recognized to play an important role in the experience of terminally ill cancer patients, and several studies have shown that spiritual dimensions in their care can significantly enhance their quality of life and emotional well-being. The FICA© Spiritual History Tool, developed by Dr. Christina Puchalski, provides clinicians with a framework for addressing patients' spiritual histories. The aim of this study was to translate, culturally adapt, and apply the FICA© Spiritual History Tool in a sample of Italian end-of-life cancer patients and to identify the spirituality-related themes that emerge. The cultural adaptation process included forward-backward translations of the FICA© Spiritual History Tool, followed by its application through in-person conversations. Of the 95 eligible participants, 80 terminally ill cancer patients (84%) were included. A thematic analysis of the responses was conducted. Findings indicated that spirituality can provide a source of support for many Italian patients coping with terminal cancer. Spirituality was most frequently reflected with the Catholic faith. Some participants reported not belonging to any specific religious community; instead, they primarily relied on the support received from family and friends. The Italian version of the FICA© Spiritual History Tool is clear, understandable and focused on exploring spirituality and its relevance in end-of-life conversations. Healthcare providers (HCPs) should be informed about and encouraged to use this tool to gather essential information about their patients' spiritual history and perspectives, supporting personalized care beyond their physical illness.