Spirituality in Advanced Chronic Illness: The Lived Experience of Portuguese Patient–Caregiver Dyads

Background: Spirituality is recognized as an essential dimension of palliative care, contributing to adaptation to suffering, vulnerability, and disease progression. Research has predominantly focused on either patients or caregivers separately, while the understanding of spirituality from a dyadic perspective remains limited. This study aimed to understand the lived experience of spirituality in the everyday lives of dyads composed of people living with advanced chronic illness and their informal caregivers. Methods: A qualitative study based on Colaizzi’s descriptive phenomenology was conducted. Thirteen dyads (n = 26 participants), comprising individuals with advanced chronic illness and their informal caregivers, were recruited from a Local Health Unit in the Central Region of Portugal using purposive sampling. Data were collected through semi-structured interviews and analysed according to Colaizzi’s seven-step method. The study was reported in accordance with the SRQR checklist. Results: Three main themes emerged from the analysis: (1) Spiritual Struggle and Challenges to Faith, characterized by disbelief, spiritual struggle, fragile hope, and divergent faith experiences; (2) Between Fate, Uncertainty, and Personal Agency, reflecting different ways of making sense of illness through fatalism, acceptance of life’s unpredictability, and a sense of personal control; and (3) Sources of Meaning and Spiritual Well-Being, encompassing family, nature and silence, life review, and prayer as resources that promoted comfort, hope, and meaning. Conclusions: Spirituality emerged as a dynamic, relational, and multifaceted experience that shaped how dyads interpreted, coped with, and attributed meaning to advanced illness. The findings highlight the need for palliative care approaches that systematically incorporate the spiritual dimension of both patients and caregivers as a unit of care.