Nurse Religiosity and Spiritual Care: An Online Survey

A survey regarding the role of UK dietitians in spiritual care

BACKGROUND

Users of dietetic services have unmet spiritual needs, although no study has yet explored dietitians' opinion, perceptions or experience of assessing spiritual needs and delivering spiritual care in clinical practice.

METHODS

A cross-sectional survey assessed the role of UK dietitians in spiritual care.

RESULTS

Thirty-seven practicing dietitians, with experience ranging from newly qualified to over 21 years of practice, took part in the survey containing open and closed questions. Almost half (49%) of dietitians said they always conducted spiritual assessments and most (57%) said they sometimes made a referral for spiritual concerns. When spiritual issues arose, dietitians were highly likely to listen well (score 4.6 out of 5) and encourage service users in their own (the service user) spiritual or religious practices (score 4 out of 5). However, the likelihood of taking the initiative and enquiring about religious and spiritual issues was lower (score <3 out of 5) in all areas of practice including end of life care. This may have been because confidence around spiritual care was also low (score 4.7 out of 10), uncertainty was high (score >3.5 out of 5) and there was a strong desire to receive training (>4 out of 5). Qualitative responses expanded further on these results suggesting that there was positive "intention" to provide spiritual care, but lack of training was a significant barrier (qualitative theme: "inadequacies"). The recognition of necessity but uncertainty of how to meet spiritual needs was also shown through qualitative findings to be a source of "emotional labour", particularly where there were conflicting beliefs between a dietitian and service user.

CONCLUSIONS

Although limited by a small sample size, these results provide new knowledge that spiritual care is considered an important part of the dietitians' role and that this is the case regardless of the dietitians own spiritual identity or religion. Dietitians would value training in spiritual care so that they can support service user needs more readily and confidently.

Repairing moral injury takes a team: what clinicians can learn from combat veterans

Moral injury results from the violation of deeply held moral commitments leading to emotional and existential distress. The phenomenon was initially described by psychologists and psychiatrists associated with the US Departments of Defense and Veterans Affairs but has since been applied more broadly. Although its application to healthcare preceded COVID-19, healthcare professionals have taken greater interest in moral injury since the pandemic's advent. They have much to learn from combat veterans, who have substantial experience in identifying and addressing moral injury-particularly its social dimensions. Veterans recognise that complex social factors lead to moral injury, and therefore a community approach is necessary for healing. We argue that similar attention must be given in healthcare, where a team-oriented and multidimensional approach is essential both for ameliorating the suffering faced by health professionals and for addressing the underlying causes that give rise to moral injury.

The effect of spiritual well-being on compassion fatigue among intensive care nurses: A descriptive study

OBJECTIVES

This study aimed to determine the effect of spiritual well-being of intensive care nurses on compassion fatigue.

METHODS

It is a descriptive study. The sample of the study was composed of 167 nurses who were working in the intensive care units of the hospitals in Turkey. Data were collected by using "Personal Information Form", "The Spiritual Well-Being Scale" and "The Compassion Fatigue-Short Scale" between July and October 2022. Descriptive statistics, t-tests, correlation, and simple regression analysis were used to analyse data.

FINDINGS

35% (n = 59) of the participants were between 22 and 27 years old; 73% (n = 122) were females; 67% (n = 112) had an undergraduate degree; 57% (n = 96) had an experience of 1 to 5 years in the intensive care. It was determined that intensive care nurses had a moderate level of compassion fatigue and a high level of spiritual well-being. Although especially the educational levels of the nurses contributed to their level of spiritual well-being, a younger age and being single and less experienced in the nursing profession and intensive care were identified as significant factors in determining compassion fatigue. Nurses' Spiritual Well-Being Scale mean score was 113.89 ± 15.50. The mean score of the Compassion Fatigue Scale was 60.15 ± 29.24. A positive correlation was found between the Spiritual Well-Being and the Compassion Fatigue Scales (ß = 0.358, p = 0.000).

CONCLUSIONS

Although intensive care nurses have a high level of spiritual well-being in general, they experience a moderate level of compassion fatigue. Younger and less experienced nurses should get more attention in intensive care units against compassion fatigue.

IMPLICATIONS FOR CLINICAL PRACTICE

Management of feelings of compassion can be a protective factor for compassion fatigue and can be used as a prevention strategy in the context of improving mental well-being among intensive care nurses. Awareness and knowledge of nurses on spiritual needs should be enhanced.

Pharmacy students' perceived barriers to spiritual care: A qualitative study

Background

Spiritual care (SC) is an important component of whole person care, a goal that many pharmacists embrace. Knowledge about barriers to incorporating SC in pharmacy practice may allow understanding of how to increase its provision.

Objectives

The objective of the study was to investigate pharmacy students' perceived personal and professional barriers to incorporating SC in pharmacy practice.

Methods

Second-year pharmacy students (n = 62) who attended a required class lecture on SC in healthcare responded to three open-ended questions that explored beliefs about SC in pharmacy practice. Students' responses were thematically analyzed using NVivo.

Results

Most (68%) of the students were female; 34% were Asian American. Students identified the following barriers to incorporating SC: limited or lack of time for SC, lack of supervisor and company support for SC, discordant pharmacist-patient spiritual beliefs, discomfort with talking about spirituality, lack of knowledge about spirituality and SC, personal factors, patient refusal of SC, fear of offending patients by discussing spirituality, and pharmacy environment.

Conclusion

Major barriers to SC include lack of time for SC, lack of supervisor and company support for SC, and discordant pharmacist-patient spiritual beliefs. Future studies should be conducted to investigate these and other barriers to SC in pharmacy practice.

Frequency of nurse-provided spiritual care: An international comparison

AIMS AND OBJECTIVES

To compare the frequency of nurse-provided spiritual care across diverse cultures.

BACKGROUND

Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement.

DESIGN

This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument.

METHODS

Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed.

RESULTS

Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics.

CONCLUSIONS

In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care.

RELEVANCE TO CLINICAL PRACTICE

Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.

Cultivating Students' Practice of Prayer with Patients

ABSTRACT

Educating prelicensure nurses about the positive outcomes of prayer can improve the potential for nurses to develop their skill and readiness to pray with or for patients as is appropriate and ethical. When nursing students learn to pray with their patients and families, the trusting component of the nurse-patient relationship becomes strengthened. As faculty and preceptors role-model praying with patients, students can begin to develop competency in providing spiritual care.

The Impact of US Nurses' Personal Religious and Spiritual Beliefs on Their Mental Well-Being and Burnout: A Path Analysis

This study addresses the gap in the literature regarding the impact of nurses' personal religious and spiritual beliefs on their mental well-being and burnout. A model of the association between these factors was tested based on surveys of 207 nurses located in southeastern USA and analyzed to determine the association between religion/spirituality, mental well-being, and burnout. A path analysis supported a model in which, through its positive impact on mental well-being, religion/spirituality was negatively associated with emotional exhaustion and depersonalization and positively associated with personal accomplishment.

Relationship between Compassion and Spiritual Care among Nurses in Turkey

The aim of this study was to determine the effect of the compassion level of nurses on the frequency of their provision of spiritual care therapeutics to patients. The research was conducted as a correlational descriptive study and included 253 nurses working in a university hospital in Turkey between October and December 2020. The data were collected via an online survey using psychometrically valid scales to assess the nurses' compassion and provision of spiritual care therapeutics. The nurses had a high compassion level and a medium level of spiritual care therapeutics. Compassion level explained 31% of the frequency of spiritual care therapeutics. As nurses' compassion levels increased, the frequency of their provision of spiritual care therapeutics to patients also increased.

Validation of the Nurse Spiritual Care Therapeutics Scale in Portuguese palliative care settings: a methodological study

BACKGROUND

Spirituality is a critical dimension in palliative care, but difficulties have been described in literature concerning the effective implementation and measuring of spiritual care.

AIM

To translate, adapt and validate the Nurse Spiritual Care Therapeutics Scale (NSCTS) in Portuguese palliative care settings.

METHODS

A methodological study was conducted. A final version of the questionnaire included the scale and was submitted to full psychometric testing using nurses working in Portuguese palliative care settings.

FINDINGS

A total of 88 nurses participated. The average age of the sample was 36.1 ± 8.93 years (range 23-60 years), and 92.0% were women. A Cronbach alpha value of 0.88; Kaiser-Meyer-Olkin measure of sampling adequacy 0.80; and Bartlett's Test of Sphericity were adequate. An exploratory factor analysis was conducted using principal axis factoring with an oblimin rotation that resulted in a three-factors solution.

CONCLUSION

The European Portuguese NSCTS questionnaire is a valid and reliable tool to assess the frequency of nurses' activities concerning spirituality in palliative care.

Testing the structural equation model of the influence of nurses' spiritual well-being and caring behaviour on their provision of spiritual care to patients

AIM

To test a proposed model that determined the effects of nurses' spiritual well-being and caring behaviour on their provision of spiritual care to patients.

BACKGROUND

The spiritual dimension of caring gained attention in the recent past as it is recognized to bring positive patient outcomes.

METHODS

A cross-sectional, descriptive, correlational design was used in the study. Data were collected from 300 registered nurses working in the hospitals in Pampanga, Philippines. Partial least square structural equation modelling was used to test the model.

RESULTS

Nurses had a high level of ideal and lived perspectives of spiritual well-being. They perceived their caring behaviour to be always manifested and occasionally engaged in spiritual activities that supported patient spirituality.

CONCLUSIONS

The structural equation model provided a feasible model that was either caring behaviour-laden spiritual well-being or spiritual well-being-infused caring behaviour.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing administrators may develop guidelines for practice within their institutions that are considerate of the proposed model. They may focus on caring behaviour-laden spiritual well-being model of nursing practice or spiritual well-being-infused caring behaviour model of nursing practice.

Perceived barriers to providing spiritual care among psychiatric mental health nurses

BACKGROUND

Although nurses typically view spiritual care as important, it is provided infrequently.

OBJECTIVES

This research investigated psychiatric mental health nurses' perceived barriers to providing spiritual care, and how these barriers were associated with frequency of spiritual care and demographic factors.

METHODS

This cross-sectional correlational study of 159 psychiatric mental health nurses used questionnaires to measure frequency of spiritual care and barriers to spiritual care.

RESULTS

The most frequent barriers to providing spiritual care were lack of education and fear of exacerbating psychiatric symptoms. Psychiatric mental health nurses provided spiritual care infrequently.

CONCLUSIONS

Nurses need education about providing spiritual care to those with psychiatric mental health needs.

Spiritual care interventions in nursing: an integrative literature review

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

Interprofessional Perspectives on Providing Spiritual Care for Patients With Lung Cancer in Outpatient Settings

PURPOSE

To explore palliative care and oncology clinicians' perspectives on current challenges and facilitating factors in meeting the spiritual needs of patients with lung cancer and family caregivers. This study was conducted in preparation for a community-based lung cancer palliative care intervention.

PARTICIPANTS & SETTING

19 oncology and palliative care clinicians in three outpatient Kaiser Permanente sites in southern California.

METHODOLOGIC APPROACH

This multisite qualitative study used focus group and key informant interviews. Data were analyzed using content analysis methodology, and a team approach was used to validate findings.

FINDINGS

Clinicians described facilitating factors (interprofessional team support, assessment of spiritual needs, clinician-provided spiritual support, and provision of culturally respectful spiritual care) and challenges (related to providing culturally respectful spiritual care by respecting the patients' spiritual and cultural beliefs in an open way and in advocating for the patients' wishes) they encountered when addressing patient and caregiver spiritual needs.

IMPLICATIONS FOR NURSING

This study demonstrated the need to provide nurses with practical tools, education, and a supportive environment to address patients' and family caregivers' spiritual concerns.