Spiritual care has a significant part to play in cancer treatment, according to new research from Otago University.
Lead author Dr Richard Egan said spiritual care wasn't just about visits from a Christian chaplain, and could make a difference.
"We've got more and more evidence from around the world that if the clinicians ask about and record spiritual beliefs, then this makes a difference to their care," he said.
"Not only does it make a difference in terms of patient satisfaction but it can make a difference to physical outcomes."
The report defined spirituality in a broad sense, beyond conventional religious practices.
"There's probably about 86 per cent of New Zealand who don't go to a church, temple or synagogue. And yet arguably they still have spiritual needs.
"And when you've got a serious illness like cancer, your life's turned upside down. Are you going to be able to work? Are you going to die?
"You start asking some of those big questions. We call it spiritual distress. There's some research that suggests that there are 40 to 60 per cent of people experience spiritual distress in this situation."
Twenty-four cancer survivors, along with their whanau and health workers, were invited to participate in the study.
The authors found those interviewed felt the need for spiritual care to be respected, normalised, and seamlessly integrated within the current health system.
Egan pointed to an exponential growth in research in the area of spirituality and healthcare. He said more than 5000 papers on the subject have been published in the last 20 years.
"While it sounds difficult to measure, the evidence is such that many jurisdictions are explicitly training and asking their staff to consider the spiritual domain."
Cancer Society medical director Dr Christopher Jackson said spirituality was an area of unmet need.
"It's clear that people have a lot of suffering and distress during the journey of their cancer experience from a range of conditions," he said. "That kind of psychological spiritual supportive care is excellent in pockets, but there are also gaps.
"Whilst some doctors and providers do very well, there are clearly people who are not having their needs met and a more thoughtful incorporation of spirituality, psychological and supportive care into the delivery of routine cancer care - there is clearly room to do that.
"It's something the Cancer Society is looking to develop and work further on as well."
The role of the traditional hospital chaplain has changed to respond to more broader forms of spirituality.
Sande Ramage - a "spiritual care co-ordinator" at the Palmerston North-based MidCentral District Health Board - said strategies were being developed to recognise spirituality beyond traditional churches.
"Increasingly in New Zealand, we're becoming less attached to Christianity and more religiously diverse. The greatest number of people kind of free float.
"So what we've tried to do is to help train staff around being able to recognise distress in this regard. And also to try and find the words around it for people, and encourage staff to have open-ended conversations."
The Otago University report recommended early training around spiritual care among health professionals - although Ramage recognised there were limits to what health workers could provide.
"We have a specialist/generalist model. So at the bedside we expect people to be understanding about spirituality, observing and maybe asking some questions.
"But when it gets to the dark side of the soul stuff - that might be the point where the staff will say 'I might not be the best person to talk to about this but we've got somebody on the team whose a really good listener'. That's the point of transition."
Egan noted training was already being introduced at medical schools across the country, and acknowledged the spiritual care which formed a part of Māori and Pacific, and palliative healthcare education. Yet he believed there was work to do in this area.
"It's building it into the structure of healthcare from policy down to practice. And we're a long way from doing that well."