Opinions, Knowledge and Attitudes Concerning "Spirituality, Religiosity and Health" Among Health Graduates in a Spanish University

Spiritual needs during COVID 19 pandemic in the perceptions of Spanish emergency critical care health professionals

OBJECTIVES

To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic.

METHODS

A qualitative investigation was carried out using in-depth interviews.

SETTING

Emergency and emergency and ICU health professionals from different regions of Spain.

FINDINGS

The sample consisted of 47 nursing and one nursing assistant. The qualitative analysis yielded four main themes that reflect the following categories: "the experience with spirituality in clinical practice"; "resources and barriers to provide spiritual care"; "the COVID pandemic and spiritual care" and "training in spiritual care". In addition, two subdeliveries were also obtained: "ethical dilemma" and "rituals of death".

CONCLUSIONS

The majority of emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients' spiritual needs. During the COVID-19 pandemic in Spain, professionals felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of health professionals is that more training and resources are needed on this topic.

IMPLICATIONS FOR CLINICAL PRACTICE

Health professionals in emergency intensive care must provide nursing care that meets the spiritual needs of their patients to improve care in crisis situations such as the one suffered by the COVID-19 pandemic. For this, emergency services professionals must work and participate in the development of measures to overcome certain barriers present in emergency services, such as lack of time, lack of training and misconceptions that make it difficult to approach emergency services these needs.

"More Spiritual Health Professionals Provide Different Care": A Qualitative Study in the Field of Mental Health

In recent years, there has been an exponential increase in studies demonstrating the positive effects of the religiosity/spirituality (R/S) approach on patients' physical and mental health. In mental health units, patients want professionals to be sensitive to their spiritual and/or religious needs, which is a fundamental aspect of a holistic approach to patients. Qualitative research with an exploratory and descriptive design with an ethnographic-phenomenological approach through in-depth interviews with sixteen professionals from Spanish mental health units. There is no consensus on the definition of spirituality; however, all of them believe that R/S has a positive influence on the health of patients in coping with illness. They believe that their own R/S may interfere with the professional-patient relationship and their attention to spiritual needs. Few professionals address these needs, citing limitations such as lack of time and lack of specific training in spiritual care. More research is needed on the spiritual care of mental health professionals to define the framework, professional training, and associated challenges in the spiritual care of patients.

How Does Confucianism Influence Health Behaviors, Health Outcomes and Medical Decisions? A Scoping Review

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description

Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!

The Role of Spirituality and Religiosity in Healthcare During the COVID-19 Pandemic: An Integrative Review of the Scientific Literature

The pandemic caused by the new coronavirus SARS-CoV-2 has been affecting populations globally since the end of 2019. Previous studies have indicated that spirituality in these times of crisis serves as a source of hope and well-being that helps people get through the day. This study investigated the role of spirituality and religiosity in healthcare during the COVID-19 pandemic. An integrative review of the scientific literature available on PubMed, Scopus, and Web of Science databases and a review of the gray literature in the Information System on Gray Literature in Europe (OpenGrey) were carried out. From a total of 1,338 articles searched; 25 articles were included in this review (22 quantitative observational, 2 qualitative and one randomized controlled trial). Our findings revealed the importance of including spirituality in clinical practice for both health professionals and patients. On the one hand, spirituality can be considered a good coping strategy used by healthcare professionals to promote mental health and well-being during the COVID-19 pandemic and resulting in greater patient satisfaction with the care given. On the other hand, addressing spiritual needs of individuals leads to a reduction in stress, anxiety, depression, and an increase in resilience and hope among patients.

Impact of an online spiritual care course on perceived competency in spiritual care of students in social and health care professions / Wirksamkeit eines Online-Spiritual Care-Seminars auf die wahrgenommene Spiritual Care-Kompetenz bei Studierenden in Sozial- und Gesundheitsberufen

This study examines the impact of an online spiritual care course on perceived spiritual care competency of students in social and health care professions. A quasi-experimental, pre-post-test study using questionnaires was conducted in Bavaria, Southern Germany, with a sample of 78 participants and 67 respondents in a comparison group. A repeated measures ANOVA was performed, with time and group as factors. Statistically significant increases were found in participants' perceived knowledge, skills, and attitudes concerning spiritual care, in different facets of spiritual care competency, in spiritual awareness, and in general self-efficacy (p < .05). Results suggest the effectiveness of online spiritual care training, which can help prepare future caregivers in providing holistic care.

Physicians' religious/spiritual characteristics and their behavior regarding religiosity and spirituality in clinical practice: A meta-analysis of individual participant data

BACKGROUND

Religiosity and/or spirituality (R/S) of physicians have been reported to inform behavior regarding religiosity and spirituality in clinical practice (R/S-B). Our aim was to study this association.

METHODS

Building upon a large international data pool of physician values we performed network and systematic literature searches using Google Scholar, Web of Science, Embase, Medline, and PsycInfo. Measures for R/S and R/S-B were selected for comparability with existing research. We performed a two-stage IPDMA using R/S coefficients from sample-wise multiple regression analyses as summary measures. We controlled for age, gender, and medical specialty. An additional sub-analysis compared psychiatrists to non-psychiatrists.

RESULTS

We found 11 eligible surveys from 8 countries (n = 3159). We found a positive association between R/S and R/S-B with an overall R/S coefficient of 0.65 (0.48-0.83). All samples revealed a positive association between R/S and R/S-B. Only 2 out of the 11 samples differed from the overall confidence interval. Psychiatrists had a higher degree of R/S-B, but associations with R/S did not differ compared to non-psychiatrists.

CONCLUSIONS

We confirmed a significant association between R/S and R/S-B in this study. Despite large cultural differences between samples, coefficients remained almost constant when controlling for confounders, indicating a cultural independent effect of R/S on R/S-B, which to our knowledge has not been documented before.Such interaction can constitute both facilitators and barriers for high quality health care and should be considered in all aspects of patient and relationship-centered medicine.

Health professionals' attitudes toward religiosity and spirituality: a NERSH Data Pool based on 23 surveys from six continents

Background

In order to facilitate better international and cross-cultural comparisons of health professionals (HPs) attitudes towards Religiosity and/or Spirituality (R/S) using individual participant data meta-analysis we updated the NERSH Data Pool.

Methods

We performed both a network search, a citation search and systematic literature searches to find new surveys.

Results

We found six new surveys (N=1,068), and the complete data pool ended up comprising 7,323 observations, including 4,070 females and 3,253 males. Most physicians (83%, N=3,700) believed that R/S had “some” influence on their patients’ health (CI95%) (81.8%–84.2%). Similarly, nurses (94%, N=1,020) shared such a belief (92.5%–95.5%). Across all samples 649 (16%; 14.9%–17.1%) physicians reported to have undergone formal R/S-training, compared with nurses where this was 264 (23%; 20.6%–25.4%).

Conclusions

Preliminary analysis indicates that HPs believe R/S to be important for patient health but lack formal R/S-training. Findings are discussed. We find the data pool suitable as a base for future cross-cultural comparisons using individual participant data meta-analysis.

Religiosity and spirituality in mental health: nurses' training, knowledge and practices

OBJECTIVE

to analyze nurses' training, knowledge and practices in the religiosity/spirituality interface in the context of Psychosocial Care Centers.

METHODS

a descriptive, exploratory, qualitative study, carried out in a metropolitan region of Ceará. Four nurses were interviewed, and the data were examined using the content analysis technique.

RESULTS

four categories emerged from analysis: Deficit in teaching religious and spiritual practices in higher education in nursing; View of the concept of religiosity and spirituality; Religiousness and spirituality as an integral part of the person; Reception of religious and spiritual practices as an aid to treatment.

FINAL CONSIDERATIONS

a deficit in nursing undergraduate teaching was identified concerning religiosity and spirituality. However, the interviewed professionals understand the importance of religious and spiritual dimensions in the therapeutic process, even though they do not accurately differentiate the concepts.

Spirituality in a Doctor's Practice: What Are the Issues?

Introduction: It is becoming increasingly important to address the spiritual dimension in the integral care of the people in order to adequately assist them in the processes of their illness and healing. Considering the spiritual dimension has an ethical basis because it attends to the values and spiritual needs of the person in clinical decision-making, as well as helping them cope with their illness. Doctors, although sensitive to this fact, approach spiritual care in clinical practice with little rigour due to certain facts, factors, and boundaries that are assessed in this review. Objective: To find out how doctors approach the spiritual dimension, describing its characteristics, the factors that influence it, and the limitations they encounter. Methodology: We conducted a review of the scientific literature to date in the PubMed, Scopus, and CINAHL databases of randomised and non-randomised controlled trials, observational studies, and qualitative studies written in Spanish, English, and Portuguese on the spiritual approach adopted by doctors in clinical practice. This review consisted of several phases: (i) the exclusion of duplicate records; (ii) the reading of titles and abstracts; (iii) the assessment of full articles and their methodological quality using the guidelines of the international Equator Network. Results: A total of 1414 publications were identified in the search, 373 of which were excluded for being off-topic or repeated in databases. Of the remaining 1041, 962 were excluded because they did not meet the inclusion criteria. After initial screening, 79 articles were selected, from which 17 were collected after reading the full text. A total of 8 studies were eligible for inclusion. There were three qualitative studies and five cross-sectional observational studies with sufficient methodological quality. The results showed the perspectives and principal characteristics identified by doctors in their approach to the spiritual dimension, with lack of training, a lack of time, and fear in addressing this dimension in the clinic the main findings. Conclusions: Although more and more scientific research is demonstrating the benefits of spiritual care in clinical practice and physicians are aware of it, efforts are needed to achieve true holistic care in which specific training in spiritual care plays a key role.

A Survey on the Integration of Spiritual Care in Medical Schools from the German-Speaking Faculties

OBJECTIVE

Teaching about spirituality and health is recommended by the American Association of Medical Colleges and partially implemented in some US medical schools as well as in some faculties of other countries. We systematically surveyed Medical School Associate Deans for Student Affairs (ADSAs) in three German-speaking countries, assessing both projects on and attitudes towards Spiritual Care (SC) and the extent to which it is addressed in undergraduate (UME), graduate (GME), and continuing (CME) medical education (in this article, UME is understood as the complete basic medical education equivalent to college and Medical School. GME refers to the time of residency).

METHODS

We executed a cross-sectional qualitative complete online-survey, addressing ADSAs of all accredited 46 medical schools in these countries. Anonymized responses could be analyzed from 25 (54.3%).

RESULTS

No faculty provides a mandatory course exclusively dedicated to SC. Fourteen medical schools have UME courses or contents on SC, and 9 incorporate SC in mandatory classes addressing other topics. While most of the respondents indicate that spirituality is important for (a) the patients for coping and (b) for health care in general and thus, support the teaching of SC in UME, only half of them indicate a need for an SC curriculum in UME. Even if funding and training support were available, only a few of the respondents would agree to provide more of the sparse curricular time.

CONCLUSION

A majority of the participating medical schools have curricular content on SC, predominantly in UME. However, most of the content is based on voluntary courses. Despite acknowledging its importance to patients, ADSAs and medical teachers are still reflecting on the divergences in patients' and doctors' spiritual orientations and its consequences for implementing spirituality into the medical education.