Midwifery to the soul while the body dies: spiritual care among hospice nurses

Spiritual Beliefs among Israeli Nurses and Social Workers: A Comparison Based on Their Involvement with the Dying

The purpose of the study was to compare spiritual beliefs and practices between nurses and health care social workers based on their involvement with dying patients. Exposure to the dying was identified by two indicators: the percentage of terminally ill patients in the provider's care and the work environment. On the basis of the literature, differences were expected between the two types of professionals and the three degrees of involvement with the dying. Nurses were expected to have a higher spiritual perspective than social workers; and health care providers with high involvement in care for the dying were expected to hold the highest levels of spiritual beliefs. Contrary to expectations, no differences in spirituality were found between nurses and social workers; both groups exhibited medium levels of spirituality. Furthermore, health care providers who were highly involved with dying patients had the lowest spiritual perspectives. Tentative explanations of these unexpected results are presented and discussed.

Israeli Oncology Nurses' Religiosity, Spiritual Well-Being, and Attitudes Toward Spiritual Care: A Path Analysis

PURPOSE/OBJECTIVES

To investigate the relationship among the antecedent factors of age, ethnicity, and education and the mediating variables of intrinsic religiosity, extrinsic religiosity, and spiritual well-being on Israeli oncology nurses' attitudes toward spiritual care.

DESIGN

A correlational, explanatory study.

SAMPLE

Members (N = 155) of the Israeli Oncology Nursing Society.

METHOD

Subjects completed a mailed research package. A path model guided the testing of the hypotheses.

MAIN RESEARCH VARIABLES

Spiritual well-being, intrinsic religiosity, extrinsic religiosity, age, ethnicity, and education.

RESULTS

Variables of interest accounted for a small but significant amount of the total variance in attitudes toward spiritual care. However, only spiritual well-being, extrinsic religiosity, and education demonstrated direct relationships with these attitudes. In addition, intrinsic and extrinsic religiosity, mediated through spiritual well-being, demonstrated indirect relationships with attitudes.

CONCLUSION

Nurses' attitudes toward spiritual care are influenced by their education, intrinsic and extrinsic religiosity, and spiritual well-being.

IMPLICATIONS FOR NURSING

Because spiritual well-being is a good predictor of nurses' positive attitudes toward spiritual care, nurses' spiritual well-being should be supported. In addition, nursing education needs to examine ways that may support more positive attitudes toward spiritual care. Future research also should be conducted on other nursing populations and across cultures and religious affiliations.

Oncology and nononcology nurses' spiritual well-being and attitudes toward spiritual care: a literature review

PURPOSE/OBJECTIVES

To review literature about oncology and nononcology nurses' attitudes toward spiritual care and the way that their spiritual well-being influences those attitudes.

DATA SOURCES

Published research and literature review articles, books, master's theses, and doctoral dissertations.

DATA SYNTHESIS

Spiritual considerations play an important part in the lives of patients with cancer. Therefore, nurses must not only examine their attitudes toward spiritual care but also identify variables that influence those attitudes. One of the major variables that may influence their attitudes is their own spiritual well-being.

CONCLUSIONS

A significant association exists between attitudes toward spiritual care and spiritual well-being in nurses who care for nononcology populations. However, little research examines oncology nurses' attitudes toward spiritual care and the way that their spiritual well-being affects those attitudes.

IMPLICATIONS FOR NURSING

Nurse researchers need to examine the spiritual dimension of oncology nurses and the way that this influences attitudes toward spiritual caregiving.

Teaching the Spiritual Dimension of Nursing Care: A Survey of U.S. Baccalaureate Nursing Programs

One hundred thirty-two randomly selected baccalaureate nursing programs in the Unites States responded to a survey exploring how the spiritual dimension of nursing care currently is being taught. The majority of programs included the concept of the spiritual dimension in curricula, but few programs had definitions of spirituality or spiritual nursing care. Content addressed most consistently by programs included assessment of spiritual needs, the needs of dying individuals, and the spiritual dimension as a component of holism or culture. There appeared to be a lack of clarity in the understanding of the concept of spirituality, as well as uncertainty about levels of faculty knowledge and comfort with teaching this topic.

Opinions and practices of medical rehabilitation professionals regarding prayer and meditation

OBJECTIVE

To assess the attitudes and practices of professionals in the field of physical medicine and rehabilitation (PM&R) regarding prayer and meditation.

DESIGN

A national mail survey that included questions about the use of a number of complementary and alternative therapies.

PARTICIPANTS

The survey was mailed to 7,479 physicians, nurses, physical therapists, and occupational therapists who specialize in PM&R, and 1221 (17%) returned completed surveys.

RESULTS

Although the majority of respondents endorsed prayer as a legitimate health care practice, there was greater belief in the benefits of meditation. Older respondents were more likely to recommend meditation to their patients and more likely to meditate themselves. Gender differences that were observed in opinions and practices are better interpreted as differences in professional specialty. In general, nurses and occupational therapists responded more positively toward meditation and prayer than did physicians and physical therapists. Personal use of a technique was the strongest predictor of professional behaviors. Attitude was a stronger predictor of professional use or referral for prayer than meditation, but correlations between attitude and behavior were generally weak for both techniques. Despite their acceptance of these techniques, the vast majority of rehabilitation professionals did not refer their patients for meditation or religious consultation.

CONCLUSIONS

Although there were significant relationships among beliefs, and personal and professional behaviors regarding these techniques, a large part of the variance in professional behaviors was not accounted for by age, gender, opinion, or personal behavior, indicating that other influences exert a stronger effect on professional practice decisions.

The spiritual care meanings of adults residing in the midwest

Only limited nursing knowledge exists as theoretical guidance for nurses in providing spiritual care. Using Leininger's theory of culture care diversity and universality, the purpose of this ethnonursing research study was to discover the embedded spiritual care meanings, expressions, lived experiences, and practices of adults residing in the Midwest and their perceptions of spiritual nursing care. Data were collected through interviews of 6 key and 12 general informants. Five universal spiritual themes were supported by the findings. Culture care modes were used to explicate spiritual knowledge that can be integrated into nursing practice.

God and the search for meaning among hospice caregivers

The purposes of this study were (1) to describe both religious and nonreligious appraisals of caregiving for a terminally ill patient and (2) to explore the relationship between these appraisals with situational outcomes, mental health outcomes, and spiritual health outcomes in the caregivers. Ninety-two caregivers completed a questionnaire consisting of religious and nonreligious appraisals, general and religious outcomes, depression, anxiety, and purpose in life. Caregivers who appraised their situation as part of God's plan or as a means of gaining strength or understanding from God reported positive outcomes while caregivers who viewed their situation as unjust, as unfair punishment from God, or as desertion from God had low scores on mental and spiritual health outcomes. Religious appraisals made a significant and unique contribution to the prediction of situational outcomes and mental and spiritual health outcomes above and beyond the effects of nonreligious appraisals.

Spiritual nursing interventions

Oncology, parish, and hospice nurses in the Midwest were surveyed to explore what nursing interventions they implement to enhance the spirituality of clients and how they learned about these interventions. Some 95 spiritual nursing interventions were identified and ranked according to frequency of implementation. The most frequently identified nursing interventions were referral, prayer, active listening, facilitation and validation of clients' feelings and thoughts, conveying acceptance, and instilling hope. The most frequently ranked implemented interventions were communication and religious nursing interventions. Only 15% of the participants indicated that they learned the most about spirituality and spiritual nursing interventions from basic and advanced nursing education combined. Findings support the need for increased emphasis of theoretical and clinical spiritual knowledge in nursing education and the development of a typology of spiritual nursing interventions to direct nurses in enhancing the spirituality of clients and implementing holistic nursing care.

The Sacred Circle: a conceptual framework for spiritual care in hospice

Hospice care has consistently recognized the need to integrate spiritual care into holistic plans of care for dying patients and their families. Designing and implementing spiritual care interventions can be potentially difficult for hospice practitioners who have not had specific training in theology or pastoral care. Matthew Fox, a theologian, has developed a model of spiritual development that utilizes an ecumenical, ethical framework that can be directly applied to the care of hospice patients and families. This model employs a Sacred Circle approach that begins with an emphasis upon the sense of awe and wonder (the Via Positiva), moves into the next cycle by recognizing problems and negative emotions (the Via Negativa), that then flows into the creative solutions to problems (the Via Creativa), which finally transforms the problem into a new level of understanding (the Via Transformativa).