Abstract
Summary of the paper
This intentional and thought-provoking paper by Asshiddiqi (2026) provides accessible insights into the evolving role of nurses as reflective practitioners, collaborative partners and leaders in addressing digital health literacy. Health fatalism is explored as a belief that outcomes are predetermined by external forces (Kulakçı-Altıntaş and Ayaz-Alkaya, 2024), exacerbated by intersecting digital, spiritual, cultural and relational factors (Asshiddiqi, 2026). Through a structured reflective practice, guided by Gibbs’ Reflective Cycle (Gibbs, 1988), a complex personal-professional dilemma is examined. Moving through stages of description, feeling, evaluation, analysis, conclusions and action plan (Gibbs, 1988), a potent exemplar of reflective practice is offered. By weaving together multiple ways of knowing – empirical, aesthetic, personal and ethical (Carper, 1978; Sherwood, 2024) – meaningful insights are generated around how nurses across settings can more fully embody our roles as partners in supporting holistic health.
A tripartite framework for addressing health fatalism is presented: (1) strengthening family/relational support, (2) practising spiritual-cultural sensitivity and (3) countering health disinformation. For each pillar, adaptable strategies are outlined to support patients as they navigate complex health decisions.
Finally, a call to action emphasises embedding reflective practice across nursing education, clinical practice and health policy. Educators are encouraged to position reflective practice as a core competency, alongside digital health literacy and ethical communication about disinformation. Clinical leaders are urged to create and protect spaces for reflection within practice environments. Policymakers and healthcare organisations are called to support training and consider regulatory approaches to improve the quality and trustworthiness of digital health information.
Overall, the paper offers a grounded example of the value of reflective practice. By providing both conceptual rationale and a concrete example, reflective practice is positioned as a rigorous, actionable approach to knowledge development in nursing that can transform challenging encounters into meaningful insight and improved care.
Connection to palliative care nursing research
Although palliative care can be delivered across the lifespan, it is often introduced late in the course of illness (Pask et al., 2025). Fatalism is particularly salient in palliative and end-of-life care, where cures are often unlikely. Therefore, hope is often reframed towards comfort, connection, meaning and the possibility of a ‘good death’ (Kirby et al., 2021; O'Brien, 2025). The idea that ‘health was in God’s hands’ (Asshiddiqi, 2026) may reflect maladaptive fatalism; however, in some circumstances, it could also reflect a spiritually grounded orientation that invites acceptance, meaning-making and intentional engagement with remaining time. The latter supports presence, relational connection and caring behaviours that honour the lives we inhabit.
Findings from Asshiddiqi (2026) align closely with core principles of palliative care. Integration of multiple ways of knowing is foundational (Carper, 1978; Sherwood, 2024), as clinicians must hold complex clinical, emotional and existential dimensions simultaneously (Parekh de Campos et al., 2022). Similarly, the ‘shift from an “expert” stance to a collaborative partnership’ (Asshiddiqi, 2026) resonates deeply with palliative nursing’s emphasis on trustworthiness, presence, shared decision-making, humility and relational care (Lazenby and Moore, 2025). Through shared vulnerability and mortality, therapeutic relationships may deepen, creating space to explore difficult topics, such as mortality, with honesty and compassion.
The paper’s discussion of spirituality and fatalism also reflects ongoing complexities within palliative care research. Prior studies consistently highlight the importance of spirituality in health decision-making (Gazaway et al., 2023; Watts et al., 2020), yet the relationship between spirituality and health behaviours remains nuanced and, at times, paradoxical. Although spirituality may empower health-promoting behaviours, like active self-management (Miller et al., 2024b, 2021; Zuniga et al., 2018), ‘passive’ spiritual beliefs (i.e. a fatalistic sense that, because a higher power is in control, there is no reason to engage) have been linked with lower engagement in health behaviours (Debnam et al., 2012). Higher spiritual well-being has been linked with lower pain-related catastrophising and reduced symptom burden (Miller et al., 2024b), highlighting its role in cognitively/emotionally shaping illness experiences. Importantly, core elements of spiritual care – presence, intentionality and compassion (Miller et al., 2023) – closely align with reflective practice, suggesting that reflection may support high-quality spiritual care across contexts.
The focus on digital health literacy is also highly relevant. Misconceptions about palliative care persist, particularly among groups with limited access to high-quality, culturally responsive, trustworthy information (Aker et al., 2024; Flieger et al., 2020). In a rapidly evolving digital landscape (e.g. social media and generative artificial intelligence), and with declining public trust in traditional health institutions, nurses are increasingly positioned as frontline advocates for health literacy. This emphasis is timely and essential, with implications across all areas of practice, including palliative and end-of-life care.
Finally, Asshiddiqi (2026) highlights the critical importance of supporting reflective practice. Prior research underscores the need for structured opportunities for providers to process and integrate experiences related to illness, suffering, death and spiritual/existential concerns (Miller et al., 2024a, 2025), yet institutional support remains inconsistent. Reflective practice may serve as a feasible individual-level strategy that nurses can integrate into routine care, yet should not replace ongoing advocacy efforts for protected time and institutional support.
Practical implications for palliative care and beyond
As digital health information grows increasingly complex, nurses are at the forefront of addressing misinformation and health fatalism. Asshiddiqi (2026) offers a practical framework integrating reflective practice, family/relational support, spiritual-cultural sensitivity and countering health disinformation. Reflective practice provides a structured approach for nurses to navigate complex encounters, enhancing critical thinking, ethical awareness and person-centred care (Sherwood, 2024). These insights not only are especially relevant in palliative care, where patients and families often face existential concerns and complex decisions without curative options (Miller et al., 2025; Parekh de Campos et al., 2022), but are also applicable across settings.
Implications also extend to nursing education and health policy. Embedding reflective practice, digital health literacy and spiritual-cultural sensitivity into curricula can better prepare nurses for evolving care demands. At the systems level, institutional support for reflective practice – such as protected time and debriefing – is essential, as is investment in trustworthy, accessible health information. Together, these strategies can support more informed, compassionate and equitable care.
