An Exploratory Study of Spirituality and Spiritual Care Among Malaysian Nurses

Spirituality, Religiosity, Caring Behavior, Spiritual Care, and Personalized Care Among Student Nurses: A Descriptive Correlational Study in the Philippines

This study sought to determine the student nurses' spirituality, religiosity, caring behavior, spiritual care, and personalized care. Further, it sought to determine the relationship between spirituality, religiosity, and caring behavior in student nurses' spiritual care and personalized care. The study used a descriptive correlational design using convenience sampling to collect data from 1248 student nurses in the Philippines from December 2023 to February 2024. We collected data using the Spirituality and Spiritual Care Scale rating scale and the Caring Behaviors Inventory. The study revealed that the mean scores of the students in their "spirituality" and "religiosity" were 4.08 (SD = 0.98) and 2.99 (SD = 1.26), respectively. Student nurses had sufficient confidence and skills in spiritual care, caring behavior, and personalized care. The students' age had a weak and negative association with the students' spirituality and religiosity. Students from University A had higher levels of spirituality and religiosity than students from University B, University C, and University D. Students in the 4th year level were more religious than 3rd year students. Students who had their last clinical exposure in the Admission and emergency room reported poorer caring behaviors than those who had previous clinical exposure in the Medical-surgical ward, Obstetrics and gynecology, Intensive Care Units, and Community. There is no significant relationship between a student nurse's spiritual care and caring behavior. This trend is similar to caring behavior and personalized care. The students' age predicts their personalized care.

The Relationship Between Religious Attitude, Compassion and Spiritual Care in Nursing Students: The Case of Türkiye

In the present descriptive study, we aimed to examine the relationship between the levels of religious attitude, compassion and spiritual care perception among nursing students. Data were obtained from 135 nursing students using the Socio-Demographic Diagnosis Form, the Ok-Religious Attitude Scale, the Compassion Scale, and the Spiritual Care-Giving Scale. The data were analyzed using the Kruskal-Wallis H test, the Spearman correlation test, and the Mann-Whitney U test. A positive correlation was found between the scores of the Ok-religious attitude scale and cognition sub-dimension, emotion sub-dimension, behavior sub-dimension, god sub-dimension and compassion scale and spiritual care-giving scale scores. Furthermore, we observed that some socio-demographic, and nursing profession and spiritual care characteristics of the students affected their religious attitudes, compassion and spiritual care perception. The sub-dimension scores of compassion and awareness of sharing among female students and the mindfulness scores of students with nuclear families were high. Our data suggest that the course contents for spiritual care, which is an integral part of holistic nursing care, should be included in the nursing curriculum. Moreover, we recommend that efforts be made to maintain a high level of compassion while considering the socio-demographics of the students and their opinions on the nursing profession. Finally, the data presented here has the potential to serve as a valuable resource for the development of novel approaches to the provision of spiritual care within nursing education programs.

The Relationship Between Meaning in Life, Life Satisfaction and Job Satisfaction with Religious Experience in the Life of Polish Nurses

This article examines the relationship between mental health dimensions such as meaning in life, life satisfaction, and job satisfaction, and the religious experience of God's presence and God's absence in the lives of Polish nurses with a bachelor and master's degree. The research was carried out in the city of Kraków, Poland. All nurses were brought up in Catholic families and declared themselves believing and practicing. The following research tools were used: the Meaning in Life Questionnaire, the Satisfaction with Life Scale, the Satisfaction with Job Scale, and the Intensity of Religious Experience Scale. Data analysis showed that the education level of Polish nurses does not significantly differentiate the analyzed variables. The correlation analysis showed that the strongest relationship was between satisfaction with life and satisfaction with job in the group of nurses with a bachelor's degree and nurses with a master's degree. The regression analysis showed that the strongest predictor of God's presence in the group of nurses with a bachelor's degree was satisfaction with job, and in the group of nurses with a master's degree it was satisfaction with life. The structural equation analysis revealed that the satisfaction with life plays an important and positive mediation role between the presence of the meaning in life and the search for the meaning in life, and the experience of God's presence and the experience of God's absence in the life of nurses.

Do spirituality and emotional intelligence improve the perception of the ability to provide care at the end of life? The role of knowledge and self-efficacy

OBJECTIVES

Spirituality, emotional intelligence, and palliative care (PC) knowledge have a positive and direct influence on self-efficacy and on perception of preparation and ability to provide end-of-life (EOL) care. The aim of this work is to propose a conceptual model that relates spirituality, emotional intelligence, PC knowledge, self-efficacy, and the preparation and ability to provide EOL care by doctors and nurses.

METHODS

Quantitative, exploratory, descriptive, and inferential study applied to doctors and nurses in a hospital in the north of Portugal, between May and July 2022. The data collection instrument includes a questionnaire. The relationships between latent variables were evaluated using structural equation models by the partial least squares method using the Smart PLS 3.0 software. It was obtained the previous authorization of the ethics committee.

RESULTS

The results (n = 380) indicate that self-efficacy, spirituality, and PC knowledge have a positive influence on the ability to provide EOL care. Emotional intelligence and spirituality have a direct and positive effect on self-efficacy. There is no direct influence of emotional intelligence on the ability to provide EOL care, but emotional intelligence has an indirect effect mediated by self-efficacy.

SIGNIFICANCE OF RESULTS

Spirituality, self-efficacy, and emotional intelligence are very important for the ability of doctors and nurses to provide EOL care. The identification of predictive factors of the ability to provide EOL care and the determination of the relationship between them can improve the provision of EOL care, reduction of health costs, timely and early referral of people to PC, and increase life quality.

Holistic nursing care practice and associated factors among nurses in public hospitals of Wolaita zone, South Ethiopia

BACKGROUND

Holistic nursing care is an approach to patient care that takes into account the physical, social, spiritual, and psychological needs of the patient. Providing holistic care has been found to be an effective way to prevent diseases and death, as well as improve the quality of healthcare provided to patients. However, despite its perceived benefits, many nurses lack experience with holistic care and only focus on patients' physical needs, treating them as biological machines while ignoring their spiritual, mental, and social needs. Therefore, this study aimed to assess the practice of holistic nursing care and its associated factors among nurses.

METHODS

A hospital-based cross-sectional study was conducted among 422 sampled Nurses working in public hospitals in Wolaita Zone. Systematic random sampling was applied to select the study participants. A self-administered, pretested questionnaire was used to collect the data. The collected data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Binary and multivariable logistic regression analyses were used to identify factors associated with holistic nursing care practice. Statistical significance was declared at a p-value less than 0.05. The strength of the association was indicated by the AOR and 95% CI.

RESULT

The study found that the overall practice of holistic nursing care was 21%. Nurses with a diploma in nursing (AOR: 0.28; 95% CI: 0.11, 0.71), nurses working in a hospital with no continuous in-service learning (AOR: 0.39; 95% CI: 0.20, 0.76), nurses with a poor relationship with patients (AOR: 0.31; 95% CI: 0.16, 0.58), and nurses with poor knowledge of holistic nursing care practice (AOR: 0.41; 95% CI: 0.21, 0.7) were factors associated with a lower likelihood of practicing holistic nursing care.

CONCLUSION

This study found that the practice of holistic nursing care among nurses working in public hospitals in the Wolaita Zone was low. Level of education, the unit of work, continuous in-service learning, the nurse-patient relationship, and the knowledge of nurses were factors associated with holistic nursing care. The provision of in-service training and the creation of trusting, positive relationships were suggested to improve the practice of holistic nursing care.

Evaluation of Midwives' Perceptions of Spirituality and Spiritual Care in Aydın, Turkey

Spirituality is an integral part of holistic care, but studies have revealed that the spiritual dimension of care is largely neglected in healthcare settings. This study evaluated midwives' perceptions of spirituality and spiritual care. The study is a cross-sectional design and was conducted from April 1 to June 30, 2018 in Aydın, Turkey. The research sample of the study contacted 101 midwives. The Spirituality and Spiritual Care Rating Scale were used to collect data. It was found that the midwives' perceptions of spirituality and spiritual care were affected by age, having children, family type, and working unit (p < 0.05).

Gender as a Moderator of Spirituality and Spiritual Care in ICU Nurses During COVID-19 Pandemic

Background

Earlier research has found that female healthcare providers often report greater spirituality and spiritual care than males. This would evoke attention toward factors contributing to such differences, particularly gender.

Aim

To examine the moderating effects of gender on the relationships between demographic characteristics of ICU nurses and their perceived spirituality and spiritual care.

Methods

A cross-sectional correlational design was used to recruit a national sample of 865 nurses working in ICUs in Jordan and providing care to patients diagnosed with COVID-19. Data were collected using a self-report bilingual version of Spirituality and Spiritual Care Rating Scale (SSC) and analysed using the SPSS software package.

Results

Social status, monthly income, and receiving previous courses or lecture training on spirituality and spiritual care were predictors of higher SSCRS scores. Working with COVID-19 patients was a positive predictor (B = 0.074, p = 0.023), suggesting that working with COVID-19 patients is more likely to have a higher level of SSC. Gender was a negative predictor (B = -0.066, p = 0.046), suggesting that female participants are likelier to have a lower SSC score.

Conclusion

Working with patients during the COVID-19 pandemic positively impacted nurses' perception of SCC, but female nurses had lower score than male nurses indicating the need for more emphasis on training female nurses and exploring further the areas in which they need more training and to be able to provide an effective SSC. A sustainable up-to-date training and in-service education programs responding to nurses' needs and emerged emergencies crisis need to be integrated into nursing quality of care policy development.

SPACEE Protocol: "Spiritual Care Competence" in PAlliative Care Education and PracticE: Mixed-Methods Research in the Development of Iberian Guidelines

Spiritual care requires understanding the spiritual experiences of patients and recognizing their resources and needs. Therefore, educators and practitioners should develop their knowledge and understanding in this regard. Spiritual care helps people overcome their anxieties, worries, and suffering; reduces stress; promotes healing; and encourages patients to find inner peace. To provide comprehensive and appropriate care while upholding human/ethical virtues, the spiritual dimension must be a priority. We aim to develop spiritual care competence guidelines for Palliative Care (PC) education and practice in Portugal and Spain. The study detailed in this protocol paper will include three phases. In phase I, the phenomenon will be characterized and divided into two tasks: (1) a concept analysis of "spiritual care competence"; and (2) a systematic review of interventions or strategies used to integrate spiritual care in PC education and practice. Phase II will entail a sequential explanatory approach (online survey and qualitative interviews) to deepen understanding of the perceptions and experiences of educators, practitioners, and patients/family carers regarding spiritual care in PC education and practice and generate ideas for the next steps. Phase III will comprise a multi-phased, consensus-based approach to identify priority areas of need as decided by a group of experts. Results will be used to produce guidelines for integrating spirituality and spiritual care competence within PC education and practice and synthesized in a white book for PC professionals. The value of this improved examination of spiritual care competence will ultimately depend on whether it can inform the development and implementation of tailored educational and PC services. The project will promote the 'spiritual care' imperative, helping practitioners and patients/family carers in their preparedness for End-of-Life care, as well as improving curricular practices in this domain.

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.

Exploring the Concept of Spiritual Sensitivity from the Perspectives of Healthcare Providers in Iran

Spiritual sensitivity (SS) is defined as attention to the available spiritual values in a conflicting situation and awareness of one's roles and responsibilities in that situation. It helps differentiate between the right and the wrong and leads to sound practice. This study explored the concept of SS from the perspectives of healthcare providers in Iran. This qualitative study was carried out in 2017-2019 using conventional content analysis. Twenty-two physicians, faculty members with clinical work experience, and healthcare providers were purposefully recruited. Data were collected using unstructured interviews and were analyzed using conventional content analysis. Participants' experiences of the concept of SS were grouped into three main themes, namely sense of value, spiritual growth and morale boosting, and SS as a motivator for purposeful service delivery. The findings of the present study will help healthcare managers develop programs for improving healthcare providers' spiritual sensitivity and also will help healthcare providers develop spirituality-based holistic care plans.

Spirituality and Religious Diversity in Nursing: A Scoping Review

Spirituality is a common theme in the field of healthcare research. This study aimed to examine nurses’ perceptions of spirituality in the context of the religious diversity of patients in pluri-religious settings. We performed a scoping review following the methodology on studies conducted between 2010 and 2020. We searched the following databases: CINAHL Plus, PubMed, and PsycINFO. For the identification of grey literature, the OpenGrey database was used. In total, 789 articles were reviewed. Of these, 16 met predetermined inclusion criteria. Two main overarching themes emerged from our inductive analysis: (a) the intertwining of spirituality and spiritual care in diverse religious landscapes and (b) obstacles impeding the inclusion of spiritual care in pluri-religious settings. According to our results, nurses consider that spirituality is interconnected with spiritual care for individuals from different religious backgrounds. Interpretations of spirituality in nursing practice vary widely, with spirituality and religiosity often shaped and influenced by culture and the experience of the professionals. Nurses attribute various meanings to spiritual care, most of which center on respecting personal, interpersonal, and relational aspects of religious and cultural beliefs and practices. Lack of education and specific skills, insufficient time, role ambiguity, and different religious beliefs were identified as hurdles to spiritual care. A poor work environment, a lack of patient privacy, including personal space, and a lack of compassion were also reported as deterrents to spiritual healing. More knowledge and training on different religions and spirituality are required to meet patients’ spiritual needs to better overcome these hurdles.

Spiritual care in Australian general practice nursing: An interpretive descriptive study

Spiritual care as an aspect of holistic or person-centered care has been well documented. Studies on spirituality and spiritual care in nursing have taken place in various countries and contexts. Studies about spiritual care from the nurse perspective in the primary healthcare setting of Australian General Practice are not evident. Using an interpretive description study design, data about views on spirituality, spiritual care experiences, and descriptions about any spiritual care provided were collected from eight practice nurses. Four themes were drawn from the findings: the personal importance of spirituality and spiritual care to nurses and patients, spiritual care as an aspect of person-centered care, spiritual care practices, and barriers and enablers to addressing spiritual needs. Participants identified that practice nurses require improved education about spirituality to adequately address spiritual needs as expressed by patients, as well as the tools to be able to provide spiritual care. They also identified that documentation templates used in general practice should include prompts to address spiritual and/or religious needs.

The Relationship Between Nursing Students' Perceptions of Spirituality and Spiritual Care and their Personal Values

This study involved a descriptive and correlational study to determine how nursing students at one university in Turkey perceive spiritual care. The data were collected through a personal information form, the Spiritual Care-Giving Scale and the Portrait Values Questionnaire. The data were analyzed using Pearson's Correlation Analysis and hierarchical regression analysis. There was a correlation between perceptions of personal values and spiritual care. It was observed that the values that predicted perception of spiritual care were the values of hedonism and tradition. Therefore, it is recommended to plan value-based training, especially on subjective concepts such as spiritual care and plan simulation-based training where students can measure the results of their behaviors and reactions in given scenarios.

Validity and reliability of the Spiritual Health Scale-Short Form for Turkish nursing students

OBJECTIVE

This study aimed at assessing the validity and reliability of the Turkish version of the Spiritual Health Scale-Short Form (SHS-SF).

METHODS

The methodological research was conducted with Turkish nursing students (n = 310). The sociodemographic question form and the SHS-SF were used as data collection instruments. The Content Validity Index, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analyses (CFA) were used for the validity of the scale, and Internal Consistency and Cronbach's Alpha reliability coefficient for its reliability.

RESULTS

The EFA revealed that five factors accounted for 66.49% of the variance. According to the CFA, the factor loadings for the 24-item scale ranged from 0.40 to 0.91. Goodness-of-fit indices were as follows: χ2/df = 2.39, RMSEA = 0.06, CFI = 0.92, TLI = 0.91, IFI = 0.92. The item-total correlation for the scale items ranged from 0.37 to 0.65. The alpha coefficient for the scale was 0.91.

SIGNIFICANCE OF RESULTS

It is important to identify the level of spiritual health of nurses and nursing students with a valid and reliable scale. The SHS-SF was found to be a reliable and valid scale for use in the Turkish language and culture. The scale can be used for evaluating spiritual health levels among Turkish nurses and nursing students. This will provide an opportunity for planning appropriate interventions to improve the spiritual health level of nurses and nursing students.

Spirituality in Daily Healthcare Provided in Brazil: Meanings and Practices of the Nursing Team

OBJECTIVE

to understand the meanings and practices related to spirituality experienced by Nursing teams in the daily care provided in Oncology.

METHODS

qualitative research, guided by the theory of Holistic Nursing by Myra Levine, conducted with members of the Nursing team at an Oncology hospital in Brazil. Data collection was carried out in 2018, through an interview guided by a semi-structured script. Data analysis was performed using Lawrence Bardin's Content Analysis technique.

RESULTS

two categories emerged: the first brought to light the meanings attributed to spirituality by the Nursing team and the second category presented the practices of spiritual care by Nursing personnel in their daily routine in Oncology, highlighting that professionals address spirituality with patients in different ways.

CONCLUSION

the approach to spirituality in Oncology care and in the professional training of Nursing personnel is essential, as a way of providing holistic and humanized care, thus strengthening the psycho-spiritual dimension in daily care.

Burnout and spirituality among nurses: A scoping review

OBJECTIVE

To investigate the relationship between spirituality / religiousness and Burnout Syndrome in nurses, as well as to examine the current evidence for spiritual/religious interventions to alleviate their symptoms.

DATA SOURCES

A scoping review was conducted using CINAHL, SCOPUS, Web of Science, Pubmed databases, and grey literature, between January and July 2020.

STUDY SELECTION

Two researchers performed the searches with a 95% agreement rate for the inclusion and exclusion of the studies. Both quantitative and qualitative studies published in peer-reviewed journals, using Spanish, Portuguese or English language were included. Restriction on publication date was not applied.

DATA EXTRACTION

A total of 1143 articles were identified and 18 were included in the final analysis. Quality assessment was performed, following CONSORT, STROBE, PRISMA and COREQ guidelines. Finally, the following data were extracted: authors, year, country, study design and sample characteristics, purpose of the study, and major findings.

DATA SYNTHESIS

The results of the present review show that spirituality / religiousness is a common strategy used by nurses when coping with stress and burnout. Most studies reveal that spiritual and religious beliefs are correlated with lower levels of burnout, exhaustion and depersonalization in different settings. Nevertheless, two studies have not found any relationship and one study has found worse outcomes.

CONCLUSIONS

There is a lack of experimental studies trying to examine if spiritual interventions could modify burnout levels in clinical practice. Health managers should be aware of the spirituality / religiousness of their nurses and provide the appropriate spiritual support.

Undergraduate Nursing Students' Spirituality and Perceived Ability to Provide Spiritual Care: A Mixed-Method Study

Study purpose: This study's purpose was to explore nursing students' spirituality and perceived ability to provide spiritual care. Design and methods: A convergent mixed method, cross-sectional design was used. A convenience sample included traditional nursing students in their second quarter (n = 53) and final quarter (n = 43) attending a faith-based university and accelerated final quarter nursing students (n = 45) attending a private secular university from two accredited nursing programs. Quantitative data were analyzed using a pairwise Spearman rank correlation and multivariate analysis of variance. Open-ended questions were analyzed using content analysis. Results: Quantitatively, as a student's spirituality increases, their perceived ability to provide spiritual care decreases. Qualitative findings revealed three categories: guidance to recognize spiritual needs, empathy and openness, and intertwined with religion. Conclusion: Quantitatively, nursing students reported their spirituality did not influence their perceived ability to provide spiritual care. Yet, qualitatively, students reported their spirituality assisted in their ability to provide spiritual care. However, students were unable to differentiate between spirituality and religion. Colleges of nursing need to ensure students learn the art of holistic nursing, which includes spirituality and religion along with opportunities to apply and reflect on their spirituality and perceived ability to provide spiritual care.

What is the practice of spiritual care? A critical discourse analysis of registered nurses' understanding of spirituality

Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non-denominational public hospital and a faith-based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study. Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers.

How Nurses Understand Spirituality and Spiritual Care: A Critical Synthesis

Aims: To discover how nurses understand spirituality and spiritual care and what affects nurses' understanding of these terms. Method: A literature search was conducted in CINAHL Plus, MEDLINE, and Google Scholar for research articles dated between 2010 and 2018 that were published in English. Using the Critical Appraisal Skills Program checklist for systematic reviews, nine articles met the inclusion criteria for this review. Most of these articles reported quantitative studies. Results: Although nurses recognize the importance of spirituality and spiritual care in nursing and have ascribed a diversity of meanings, there remains some confusion about what these terms mean. Several influences have been identified as shaping nurses understanding of spirituality and spiritual care, including education, nurses' own spirituality or religious beliefs, age, years of clinical experience, and place of employment. Conclusions: This review identifies the need for further studies using qualitative approaches to investigate how nurses' construct their understanding of spirituality and spiritual care and the dominant discourses nurses draw from to inform their understanding using qualitative approaches. Relevance to Clinical Practice: The insights gained by this review may be of value to nurse educators, managers, and policy makers in nursing education and the development of policies and practice guidelines.