Date Presented 04/04/2025
A prayer tree was affixed to a window in each of the two intensive care unit waiting areas. Thematic analysis of paper notes left by visitors provided insight for OT to develop spiritual support strategies.
Primary Author and Speaker: Rachel Ashcraft
Additional Authors and Speakers: Hon Yuen
PURPOSE: Individuals may have an increased need for spiritual support when a loved one is in an intensive care unit (ICU) (Lalani et al., 2018). Spirituality is an important client factor that occupational therapy practitioners (OTPs) incorporate in their practice (American Occupational Therapy Association, 2020). However, there is a gap in the literature regarding ways for OTPs to support the spiritual needs of families and visitors of patients in an ICU. The purpose of this study was to explore the spiritual expressions of those visiting someone in the ICU.
DESIGN: A two-dimensional painted Prayer Tree was affixed to a window of the ICU waiting area. Visitors left sticky paper notes provided (n = 3,673) on the tree, which were collected between 2018 and 2023 from two ICUs.
METHOD: The notes left on the Prayer Tree were entered into an Excel spreadsheet. Notes were translated into English when needed. Thematic analysis of the written notes was conducted.
RESULTS: Seven themes were identified: healing, faith, love, thankfulness, encouragement, grief, and prayer of acknowledgement. The predominant spiritual expressions in the notes were prayers requesting healing by a higher power, faith, love, and thankfulness.
CONCLUSION: The number of notes left on the Prayer Tree indicates that many visitors chose to engage with the Prayer Tree. Themes of prayers expressed within this study align with similar prayer, hope and wishes themes in other related studies (Collins et al., 2018; Egerod et al., 2023). Findings from this study suggest that engagement with art provided through an inclusive environmental modification in the form of a Prayer Tree provide an avenue for visitors of patients in the ICU to express their spiritual needs.
IMPACT STATEMENT: An inclusive art installation, such as a Prayer Tree, to provide a needed outlet for families of patients in the ICU to express their spiritual needs may help OTPs to develop spiritual support strategies for this population.
References
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi. org/10.5014/ajot.2020.74S2001
Collins, A., Bhathal, D., Field, T., Larlee, R., Paje, R., & Young, D. (2018). Hope Tree: An Interactive Art Installation to Facilitate the Expression of Hope in a Hospice Setting [Article]. American Journal of Hospice and Palliative Medicine, 35(10), 1273–1279. https://doi.org/10.1177/1049909118767136
Egerod, I., Bargfeldt, E. H., & Kaldan, G. (2023). Ponderings, Pleas and Prayer: A Qualitative Content Analysis of Danish Hospital Chapel Guest Books. J Relig Health, 62(1), 172–193. https://doi.org/10.1007/s10943-022-01612-7
Lalani, N., Duggleby, W., & Olson, J. (2018). Spirituality among family caregivers in palliative care: an integrative literature review. Int J Palliat Nurs, 24(2), 80–91. https://doi.org/10.12968/ijpn.2018.24.2.80
