Australian Patient Preferences for Discussing Spiritual Issues in the Hospital Setting: An Exploratory Mixed Methods Study

Exploration of Roles and Contribution of Spiritual Care Practitioners in Mental Health: An Australian Study

Mental health is inherently multidimensional, requiring a holistic approach to intervention that integrates various aspects of an individual's well-being. Spirituality, a vital component of mental health, remains under addressed in Australian mental healthcare. Spiritual care practitioners may play a key role in addressing spiritual needs in mental healthcare; however, their roles and contributions in this context remain unexplored in the extant literature. Bridging this gap, this study explores the potential role of spiritual care practitioners within mental health context. Using a qualitative research approach, this study engaged eight experienced spiritual care practitioners working in various mental health settings across Australia (n = 8). Through reflexive thematic analysis, the study identified and examined the practitioners' perspectives on their roles and contributions. The findings were summarised in three overarching themes: (1)  Core values; (2) Unique contributions in mental health; and (3) Spiritual care practitioners in the mental health system. The study's findings suggest that by employing a person-centred approach, spiritual care practitioners can play a crucial role in mental health assessments and interventions. Their contributions include providing insights rooted in clients' unique spiritual beliefs, aiding in the discernment between spiritual experiences and psychopathological symptoms, advocating for clients' spiritual needs, and supporting the education of mental health professionals. The study also highlights the need for professional recognition of spiritual care practitioners and their greater integration within the mental health system.

How spirituality is understood in occupational therapy: A qualitative study

INTRODUCTION

Since the inception of occupational therapy, spirituality has been a unique component of practice. However, much of the professional discourse on how to define spirituality has originated internationally. This study aimed to explore how Australian occupational therapists interpret and understand spirituality in their practice.

METHODS

This study employed an interpretive phenomenological methodology and reflexive thematic analysis. Twenty-three individual interviews were conducted with Australian occupational therapists across various work and specialty contexts.

CONSUMER AND COMMUNITY INVOLVEMENT

Because the participants in this study were occupational therapists, the research design did not include input from consumers or the community.

FINDINGS

Three main themes emerged from this study: (i) definitions of spirituality were complex and often described a person's connection to meaning and purpose in life; (ii) human factors that supported addressing spirituality included therapist self-reflection and clinical experience, while therapist discomfort and specific client circumstances acted as barriers; and (iii) environmental factors that supported addressing spirituality included access to training and a supportive workplace, while barriers included cultural taboos, as well as time and funding limitations.

CONCLUSION

All occupational therapist participants acknowledged spirituality as the meaningful connection between one's inner self and the outer world, and for most participants, this included acknowledging the transcendent. Therapist skills that facilitated the integration of spirituality into practice included self-reflection and building rapport with clients, which therapists could control. However, factors like years of clinical experience were beyond their control. In terms of environmental factors, therapists could influence their access to spirituality training, but aspects like a supportive work environment were often outside their influence. Additionally, many therapists reported feeling uncomfortable discussing spirituality within what they considered to be a culturally closed local context. To help overcome these challenges, the occupational therapy profession could benefit from developing culturally sensitive spirituality resources, research, and training.

PLAIN LANGUAGE SUMMARY

Spirituality has always been a part of occupational therapy, but much of the talking about it comes from other countries. This study looked at how Australian occupational therapists see spirituality. We interviewed 23 occupational therapists from all different jobs. They all agreed that spirituality is about connecting a person's inner self with the world. While therapists could control things like self-reflection and building relationships with clients, their years of clinical experience was outside their control. Likewise, they may be able to look for further education, but a supportive work environment was often out of their hands. Many therapists also felt uncomfortable discussing spirituality in workplaces where it was not openly accepted. To face these challenges, the profession may need more resources, research, and training on spirituality in practice.

How are the Spiritual Resources and Needs of Mental Health Consumers Identified and Documented by Staff upon Admission to an Australian Mental Health Service? A Mixed Methods Study

This study investigated how the spiritual resources and needs of Australian mental health consumers are identified by staff during admission at an inner-city acute care hospital. A mixed-methods study was conducted incorporating an audit of medical records (n = 205), and a staff focus group (n = 6). The results revealed that information collected during admission is often limited to factors such as medical and social history. Although participants could identify benefits of asking about spirituality, reasons for not asking were also articulated. Staff training and better care planning were identified as two ways to improve awareness of patients' spiritual needs.

Spiritual care in palliative medicine: interactive, virtual workshop for specialists

BACKGROUND

Spiritual pain and distress are commonly unrecognised among patients receiving palliative care, yet engaging with a person's spirituality can allow healing to occur even amid suffering. Palliative care clinicians lack training in assessing and managing spiritual distress among patients.

OBJECTIVES

Development of a virtually delivered spirituality workshop to improve clinicians' understanding of their own spirituality and confidence in addressing the spiritual dimension of patients' experience.

METHOD

32 palliative care clinicians across Australia and New Zealand attended four 1.5-hour sessions across consecutive weeks, with additional pre-session and post-session written and audiovisual content. Participants completed a pre-post evaluation survey, rating their confidence in knowledge and skills relating to the provision of spiritual care.

RESULTS

All participants completed at least three of the four workshop sessions, and 19 responded to the pre-post evaluation survey. Confidence ratings across all skills significantly improved following the workshop. Most participants reported improved confidence in taking a spiritual history, assessing patients for spiritual issues and managing patients experiencing spiritual pain. All reported that they would recommend the workshop to a colleague, and most (11/19) felt virtual delivery of the workshop was appropriate for the content and activities.

CONCLUSIONS

Spirituality training can be safely and effectively delivered through a virtual workshop for palliative care clinicians. The training was highly valued and deepened participants' understanding of their own spirituality. Further exploration of how virtual and face-to-face learning can be combined may identify a flexible and engaging experience for learners.

Measurement of Spiritual Wellbeing in an Australian Hospital Population Using the Functional Assessment of Chronic Illness Therapy: Spiritual Wellbeing Scale (FACIT-Sp-12)

Spiritual wellbeing is known to be a predictor of increased patient coping in hospital settings. Therefore, access to a valid and reliable measure of spiritual wellbeing amongst general hospital patients is highly recommended. The aim of this study was to investigate the dimensionality, reliability, and validity of the Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing scale (FACIT-Sp-12) in a heterogeneous cohort of hospital patients. A cross-sectional survey was administered to 897 adult patients across six hospitals in Sydney, Australia. Confirmatory factor analysis for the three-factor FACIT-12-Sp indicated a poor fit, but after removal of Item 12, the three-factor FACIT-11-Sp presented a good fit to the data. Reliability testing indicated acceptable to good internal consistency. Validity was supported by statistically significant differences between patients who considered themselves 'both spiritual and religious' and 'not religious or spiritual'. While some caution should be taken when using the FACIT-Sp due to several limitations, nevertheless, in a general hospital population in Australia, the three-factor FACIT-11-Sp indicated good dimensionality, reliability, and validity.

"Not me!" a qualitative, vignette-based study of nurses' and physicians' reactions to spiritual distress on neuro-oncological units

PURPOSE

People with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.

METHODS

Neurospirit-DE is a qualitative vignette-based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.

RESULTS

A total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.

CONCLUSIONS

Most neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient's spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients' distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

Military Perspectives on the Provision of Spiritual Care in the Australian Defence Force: A Cross-Sectional Study

A module to explore perspectives on chaplaincy services was included in an online enterprise survey randomly distributed to members of the Australian Defence Force (ADF) during 2021. Up to eight questions were answered by 2783 active military personnel relating to their perception of chaplain activities and the impact of chaplaincy services. Of those military participants answering the question on religious status (n = 1116), a total of 71.6% (n = 799) of respondents identified as non-religious while 28.4% (n = 317) identified as holding a religious affiliation. Approximately 44.2% (n = 1230) of participants had sought support from a chaplain, of which 85.3% (n = 1049) found chaplaincy care to be satisfactory or very satisfactory. While the data suggest there is a lack of clarity around the multiple roles undertaken by chaplaincy, nevertheless respondents were just as likely to prefer chaplains for personal support (24.0%), as they were to seek help from non-chaplaincy personnel such as a non-ADF counsellor (23.2%), their workplace supervisor (23.1%) or a psychologist (21.8%). This evidence affirms that the spiritual care provided by military chaplaincy remains one of several preferred choices and thus a valued part of the holistic care provided by the ADF to support the health and wellbeing of its members.