PP-9 Spiritual awakening experiences at the end of life: a concept analysis

Introduction Spiritual awakening in the context of end-of-life is a complex and multifactorial human phenomenon, characterized by profound transformations in consciousness and existential meaning. Aims Considering that spirituality is inherent to human beings, the study Aims were: to define the attributes of the concept of ‘spiritual awakening at the end of life’; to determine the antecedents and consequences of the concept; and to identify its empirical referents. To this end, the following research question was formulated: What evidence is available regarding the attributes, antecedents, consequences, and empirical referents of the concept of ‘spiritual awakening at the end of life’? Methods A conceptual analysis was conducted using the Walker and Avant (2019) method, consisting of eight sequential steps. A comprehensive review of the available literature was conducted for this purpose. The literature search was conducted in May 2025 in the PubMed, CINAHL, and Scopus databases, with no time restrictions. Results Twenty-one articles were included. The study analysis identified four interdependent domains of attributes: (1) sensory-perceptual (spatial-temporal changes and energetic sensations); (2) affective-cognitive (expanded awareness, serenity, and full presence); (3) relational (altruism, empathy, and forgiveness); and (4) transcendental (ego dissolution, fusion with the divine, and discovery of meaning). Antecedents include spiritual awareness and the existential matrix; consequents include spiritual serenity, inner freedom, personal growth, and the desire to leave a legacy. Conclusion Spiritual awakening is therefore understood as a profound transformation of consciousness and perception of reality, often associated with the approach of death and the search for meaning and purpose. It can occur gradually or suddenly, spontaneously or induced, and manifests in a state of peace, gratitude, and unconditional love. Understanding this phenomenon broadens the humanizing dimension of care and offers new perspectives for the personal and professional growth of caregivers, reinforcing spirituality as an essential pillar of end-of-life care. Reference Walker LO, Avant KC. Strategies for theory construction in nursing, 6th ed.; Pearson: New York, NY, USA, 2019.