Correlations among spiritual care competence, spiritual care perceptions and spiritual health of Chinese nurses: A cross-sectional correlational study

An Evolutionary Concept Analysis of Spiritual Competence in Nursing

AIMS

Clarify the concept of spiritual competence in the context of nursing through evidence-based extraction of attributes, antecedents and consequences.

DESIGN

Concept analysis.

METHODS

Rodgers' evolutionary method of concept analysis guided this analysis, and we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

RESULTS

An analysis of 45 studies clarified the concept of spiritual competence in the context of nursing. Spiritual competence in nursing is a dynamic process that, once initiated by nurses' spiritual awareness, promotes their spiritual well-being, their spiritual knowledge and skills and their sense of spiritual-care self-efficacy.

CONCLUSION

A comprehensive understanding and clear conceptual definition of the concept of spiritual competence in nursing will enable researchers to overcome barriers and foster nurses' development of spiritual competence to provide spiritual care in nursing.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

The clarified concept of spiritual competence in nursing can help to shape education and clinical-training programs for nurses in a way that supports their ability to provide spiritual care and promote patient well-being and positive health outcomes.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was essential to the conduct of this research.

Mediating Effect of Perceived Professional Benefit on the Relationship Between Spiritual Health and Spiritual Care Competence Among New Nurses: A Cross-Sectional Study

Objectives: This study aimed to examine the relationship between spiritual health and spiritual care competence among new nurses and explore the mediating role of perceived professional benefit in this relationship. Background: Spiritual care is an integral part of holistic nursing. The ability to deliver spiritual care to patients, known as spiritual care competence, is increasingly being recognized as a crucial occupational skill for nurses, particularly new nurses. Thus, understanding the level of spiritual care competence among new nurses and identifying the factors associated with it have become matters of priority. Methods: In the cross-sectional online study, 299 new nurses were selected using convenience sampling from 10 tertiary hospitals in prefecture-level cities, in Henan Province, China, from March to April 2021. Participants' sociodemographic characteristics, spiritual health, perceived professional benefit, and spiritual care competence were assessed. The mediation model was examined using Model 4 of the PROCESS macro for SPSS. Results: The results showed a positive correlation between spiritual health, perceived professional benefit, and spiritual care competence (both p < 0.01). Furthermore, spiritual health had a direct effect on spiritual care competence (effect = 0.187). The association between spiritual health and spiritual care competence was mediated by perceived professional benefit (effect = 0.382). Conclusion: Perceived professional benefit was a mediator in the link between spiritual health and spiritual care competence among new nurses. Implications for Nursing Management: This study's findings underscore the need to promote the spiritual care competence of new nurses in China. Healthcare managers can not only directly promote the spiritual care competence of new nurses by cultivating their spiritual health but also indirectly by enhancing their professional benefits.

A comparative study of nurses' competencies in integrating religion/spirituality into patient care

BACKGROUND

There is a need of research to evaluate and compare the competencies of nurses in integrating patients' religion and spirituality into nursing practice in various settings, including general and psychiatric hospitals. By understanding the competencies of nurses working in different environments, tailored spiritual care training programs can be developed to meet their specific needs. This study aimed to evaluate and compare the competencies of nurses in integrating patients' religion/spirituality into nursing practice in both a general and a psychiatric hospital.

METHODS

This cross-sectional descriptive-analytical study was conducted in two hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran. Quota sampling was used to select 200 nurses (100 nurses from each hospital) in 2023. The Religious/Spiritually Integrated Practice Assessment Scale (RSIPAS) was used to evaluate and compare nurses' competencies in integrating the religion/spirituality of patients into their nursing practice.

RESULTS

The study revealed that nurses' competencies in integrating patients' religion/spirituality into nursing practice were moderate in both general (122.39 ± 19.40) and psychiatric hospitals (110.82 ± 25.63). Nurses in the general hospital had significantly higher competency scores compared to those in the psychiatric hospital (t = 3.59, p = 0.001). The type of hospital, work experience, and the involvement of professionals in providing religion/spirituality care were significant predictors of nurses' competencies in integrating patients' religion/spirituality into clinical practice.

CONCLUSIONS

The moderate levels of competencies among nurses highlight the need for further education and training to effectively integrate patients' religion/spirituality into nursing across various healthcare settings. The type of hospital also influenced their competencies. Therefore, it is crucial for nurses, particularly those working in psychiatric hospitals, to receive training that is tailored to the specific needs, culture, and context of their respective healthcare environments. It is essential to conduct a baseline assessment of nurses' readiness and competencies before implementing appropriate training programs.

Spirituality and Factors Relevant to Spiritual Nursing-Care Needs Among Chinese Patients with Cancer

This study aimed to identify the factors associated with the spiritual nursing-care needs of adult Chinese cancer patients. A questionnaire survey was conducted and the 158 respondents in the total sample were classified into two groups based on the presence or absence of spiritual nursing-care needs. The group requiring spiritual nursing-care exhibited lower scores on the Meaning and Peace scales and higher scores on the Faith scale compared to the other group. The between-group difference was significant only in the case of Peace. The results indicated that the Peace score was the sole significant predictor of spiritual nursing-care needs (OR 0.83, 95% CI [0.74, 0.94]). These findings suggest that nurses should provide spiritual care to help foster Chinese patients' peace of mind.

Nurses' models of spiritual care: Predictors of spiritual care competence

OBJECTIVES

Previous studies have shown that nurses' spiritual care competence is related to characteristics of personal spirituality, training adequacy, and comfort, confidence, and frequency of provision of spiritual care. However, these studies assumed that all participants understood spiritual care in the same way, and used self-ratings of spiritual care competence, which are problematic. Our previous study found that spiritual care was understood in 4 qualitatively different ways that can be arranged in order of competence. This study aimed to re-examine the relationships between nurse characteristics and spiritual care competence, using spiritual care understanding as a proxy for competence.

METHODS

Data was collected from a convenience sample of nurses who completed an anonymous, online survey. The survey provided qualitative data about what spiritual care means for them. The survey also provided quantitative data regarding nurse characteristics. This study created sub-groups of nurses based on their understanding of spiritual care, and used the quantitative data to construct a profile of nurse characteristics for each sub-group. Kruskal-Wallis statistical tests determined whether nurse characteristics differed across the 4 sub-groups.

RESULTS

Spiritual care competence was not related to confidence or comfort in providing spiritual care. Relationships with spirituality, training adequacy, and frequency of provision of spiritual care were not linear; i.e., higher competence did not always correspond with higher scores of these characteristics.

SIGNIFICANCE OF RESULTS

The results raise concerns about the construct validity of using comfort and confidence as estimates of spiritual care competence. That the relationships between competence and spirituality, training adequacy, and frequency of spiritual care provision was not as linear as portrayed in extant literature, suggests that outcomes of training may depend on the type of spiritual care understanding subscribed to by training participants. The findings offer insights about how nurses could achieve high levels of spiritual care performance.

Spiritual Care[Givers] Competence in Palliative Care: A Scoping Review

To deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional's empowerment when delivering effective spiritual care to patients and families.

A Mixed-Method Study on the Assessment of Factors Influencing Nurses' Provision of Spiritual Care

The purpose of this study was to explore factors that influence nurses' beliefs about offering spiritual care.

STUDY DESIGN

A mixed-method study design, incorporating both quantitative (questionnaire) and qualitative research, was used for this study (focus group discussion).

METHODS

The questionnaires were completed by a convenience sample of nurses and their assistants working in two public hospitals. These questionnaires included the Greek versions of the FACIT-Sp-12, SCIPS, NEO-FFI, and the Spiritual Climate Scale, as well as a specially designed questionnaire to gather demographic, socioeconomic, and professional information about the study population (SCS). Three nurses and two nursing assistants who worked in public hospitals and were chosen through purposive sampling made up the sample for the qualitative study. In utilizing inductive content analysis methodology, a qualitative analysis was carried out.

RESULTS

Greek nurses frequently offer spiritual care to their patients, primarily existential spiritual care. It was discovered that the spiritual climate, the nurses' positive coherence, and their educational level all exert a favorable effect on total spiritual care. Three categories and seven subcategories were used to describe the participants' prior experiences with spiritual care.

CONCLUSIONS

Greek nurses frequently offer spiritual care to their patients, and both internal and external factors influence their attitudes in this regard.

Competence and perceptions of spiritual care among clinical nurses: A multicentre cross-sectional study

AIMS

To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors.

BACKGROUND

Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking.

DESIGN

Multicentre cross-sectional study.

METHODS

Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care-Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence.

RESULTS

In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care-related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence.

CONCLUSIONS

There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses.

RELEVANCE TO CLINICAL PRACTICE

The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training.

REPORTING METHOD

EQUATOR guidelines, STROBE checklist: cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

All participants were clinical nurses. Participants were informed they could withdraw from the study at any time.

Spiritual care needs and their attributes among Chinese inpatients with advanced breast cancer based on the Kano model: a descriptive cross-sectional study

BACKGROUND

Numerous previous research have established the need for spiritual care among patients with cancer globally. Nevertheless, there was limited research, primarily qualitative, on the spiritual care needs of Chinese inpatients with advanced breast cancer. Furthermore, the need for spiritual care was rarely explored using the Kano model. To better understand the spiritual care needs and attributes characteristics of inpatients with advanced breast cancer, this study examined the Kano model.

METHODS

A descriptive cross-sectional design study was conducted in the oncology departments of three tertiary grade-A hospitals in China from October 2022 to May 2023. To guarantee high-quality reporting of the study, the Strengthening the Reporting of Observational Studies in Epidemiology Checklist was used. Data on the demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale (NSTS), and the Kano model-based Nurse Spiritual Therapeutics Attributes Scale (K-NSTAs) were collected through convenience sampling. The Kano model, descriptive statistics, two independent samples t-tests, and one-way analysis of variance were used to analyze the data.

RESULTS

The overall score for spiritual care needs was 31.16 ± 7.85. The two dimensions with the highest average scores, "create a good atmosphere" (3.16 ± 0.95), and the lowest average scores, "help religious practice" (1.72 ± 0.73). The 12 items were distributed as follows: three attractive attributes were located in Reserving Area IV; five one-dimensional attributes were distributed as follows: three one-dimensional attributes were located in Predominance Area I, and two were found in Improving Area II; two must-be attributes were located in Improving Area II; and two indifference attributes were located in Secondary Improving Area III.

CONCLUSION

The Chinese inpatients with advanced breast cancer had a middle level of spiritual care needs, which need to be further improved. Spiritual care needs attributes were defined, sorted, categorized, and optimized accurately and perfectly by the Kano model. And "create a good atmosphere" and "share self-perception" were primarily one-dimensional and must-be attributes. In contrast, the items in the dimensions of "share self-perception" and "help thinking" were principally attractive attributes. Nursing administrators are advised to optimize attractive attributes and transform indifference attributes by consolidating must-be and one-dimensional attributes, which will enable them to take targeted spiritual care measures based on each patient's characteristics and unique personality traits.

Nurses' perceptions and competencies about spirituality and spiritual care: A systematic review and meta-analysis

OBJECTIVE

To identify and synthesize nurses' perceptions of spirituality and spiritual care and their spiritual care competencies.

DESIGN

A systematic review and meta-analysis of observational studies.

DATA SOURCES

The electronic databases PubMed, EMBASE, Web of Science, CINAHL, ProQuest, Scopus, CNKI, and WANFANG were systematically searched from the inception of each database to April 19, 2023.

REVIEW METHODS

Two reviewers independently completed the selection of included studies and data extraction. The Agency for Healthcare Research and Quality (AHRQ) checklist was used to assess the methodological quality of the included studies. The study outcomes were meta-analyzed using STATA 15 software. Predefined subgroup analyses were conducted to explore differences in spiritual care competencies among nurses across religious affiliation and education levels.

RESULTS

Thirty-five cross-sectional studies conducted in 11 countries and territories met the inclusion criteria, with 17,786 participants. The meta-analysis revealed that the pooled mean scores for spirituality and spiritual care perceptions and spiritual care competencies were 3.62 (95 % CI: 3.41-3.83) and 3.46 (95 % CI: 3.28-3.63), respectively. Nurses with no religious affiliation had inferior spiritual care competencies (3.24) than nurses with religious affiliation (3.31); nurses with a master's degree or above had the greatest spiritual care competencies (3.59), while nurses with an associate's degree had the least (3.31).

CONCLUSION

Nurses' perceptions and competencies about spirituality and spiritual care were moderate, and both needed to be improved, especially among nurses with no religious affiliation and low education levels. Nursing educators and leaders need to emphasize both theory education in the spiritual dimension and dedication to training in spiritual care practice, as well as provide nurses with targeted teaching and training to improve their competency in addressing the spiritual needs of their patients.

The correlation between spiritual care competence and spiritual health among Iranian nurses

Background

Considering the importance of spiritual aspects of human beings, spiritual care provision is increasingly recognized as a major duty of healthcare providers, particularly nursing staff. Spiritual care competence is necessary for the nurses to be able to provide spiritual care, but the competence itself is associated with other variables. This study aimed to investigate if the spiritual care competence of nurses is related to their spiritual health.

Methods

A cross-sectional study was conducted with the participation of 172 practicing nurses in hospitals affiliated with Qom University of Medical Sciences, selected through stratified random sampling. Participants completed the Persian versions of the Spiritual Health Questionnaire (Amiri) and the Spiritual Care Competence Scale (Van Leeuwen). To examine the correlation between nurses’ spiritual health and spiritual care competence, a Spearman coefficient was used and a linear regression analysis was done to determine the predictability of the spiritual care competence of the nurses. The data were analyzed using SPSS v.23 and the significance level was set at 0.05.

Results

The participants showed a mean (SD) score of 108.93 (19.04) on spiritual care competence and 213.38 (16.49) on spiritual health. Spiritual care competence of nurses showed no significant relationship with demographic characteristics and their spiritual health had a significant relationship with gender only. Correlation analysis revealed a significant relationship between spiritual health and spiritual care competence and their subscales. Moreover, the linear regression analysis indicated that the nurses’ performance regarding spiritual health can predict their spiritual care competence.

Conclusion

The study revealed that the spiritual care competence of nurses is correlated with their spiritual health and performance as a subscale of spiritual health can predict their spiritual care competence. Thus, it can be concluded that the spiritual health of nurses is an important factor in providing spiritual care for patients and meeting their spiritual needs.

Psychometric Evaluation of the Spiritual Perspective Scale in Palliative Care Nurses in China

This study aimed to translate the Spiritual Perspectives Scale (SPS) into a Mandarin Chinese version (C-SPS) and evaluate its psychometric properties among 154 palliative care nurses from twelve community healthcare centres in Shanghai, China. Exploratory factor analysis suggested two factors (spiritually related activities and spiritual beliefs), accounting for 67.49% of the total variance. The Cronbach's α of the total C-SPS score was 0.89, and its split-half coefficient (Spearman-Brown reliability coefficient) was 0.72. The C-SPS showed consistently acceptable psychometric properties of reliability and validity. It can be used to evaluate the level of spiritual perspectives of nurses in China.