Creating conditions for good nursing by attending to the spiritual

Investigation of environmental ethics, spiritual health, and its relationship with environmental protection behaviors in nursing students

Objective

To investigate the relationship between environmental ethics, spiritual health, and environmental behavior among nursing students.

Methods

In this cross-sectional study, 200 iranian students from the Chabahar Nursing School were selected using a simple random sampling method. The data collection tool included a questionnaire on demographic information, knowledge, attitudes and behaviors towards the environment, environmental ethics, and spiritual health. Partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the conceptual framework in this study.

Results

The mean score for environmental ethics among nursing students was 65.73±10.61 out of 100. Most of the students (47%) had desirable environmental ethics. The knowledge structure (β=0.46) predicted attitude. The attitude structure also predicted environmental behavior (β=0.28) and spiritual health (β=0.31). Ultimately, the results showed that spiritual health and environmental ethics predict environmental behavior directly and indirectly (p<0.001).

Conclusion

Spiritual health and environmental ethics were strong predictors of environmental behavior. Therefore, it is necessary to take into account not only students' spiritual health but also their ethical behaviors to promote environmental protection behaviors in the future.

Association between spiritual care competency and perceived professional benefit among nurses: A cross-sectional study

AIMS

This study aimed to investigate the status quo of nurses' spiritual care competency and their relationship with perceived professional benefit.

BACKGROUND

Spiritual care has always been considered a vitally important part of holistic nursing. Understanding the spiritual care competency of nurses during the COVID-19 pandemic can help nursing managers understand the weak links in spiritual care practice and improve the quality of nursing service. As a positive emotional experience and cognitive evaluation of the profession, perceived professional benefit can serve to adjust work pressure, relieve job burnout, and promote an individual's overall growth. However, the relationship between perceived professional benefit among nurses and spiritual care competency remains unclear.

METHODS

A total of 372 nurses were recruited from 15 separate Chinese hospitals. An online questionnaire was used to assess nurses' sociodemographic, spiritual care competency, and perceived professional benefit. Statistical analyses were performed using Pearson's correlation analysis, t-test, analysis of variance (ANOVA), and multiple stepwise linear regression analysis.

RESULTS

The total mean score of spiritual care competency (99.43 ± 21.10) among nurses was found to be moderate. Nurses' spiritual care competency was positively correlated with perceived professional benefit (P < .01). The multiple stepwise linear regression model (n = 372) had an explained variance (R² = 0.218) and showed that perceived professional benefit and the manner of receiving spiritual training were the main influencing factors of nurses' spiritual care competency (P < .001).

CONCLUSION

The study findings indicated that nurses need to improve their spiritual care competency by improving their perceived professional benefit.

IMPLICATION FOR NURSING MANAGERS

Our study evaluated the spiritual care competency of nurses and explored the correlation between perceived professional benefit and spiritual care competency among nurses. The results of this study can help nursing managers to carry out relevant interventions, thus improving nurses' spiritual care competency and optimizing the quality of nursing.

Spiritual care provision to end-of-life patients: A systematic literature review

AIM

To develop an understanding of how nurses provide spiritual care to terminally ill patients in order to develop best practice.

BACKGROUND

Patients approaching the end of life (EoL) can experience suffering physically, emotionally, socially and spiritually. Nurses are responsible for assessing these needs and providing holistic care, yet are given little implementable, evidence-based guidance regarding spiritual care. Nurses internationally continue to express inadequacy in assessing and addressing the spiritual domain, resulting in spiritual care being neglected or relegated to the pastoral team.

DESIGN

Systematic literature review, following PRISMA guidelines.

METHODS

Nineteen electronic databases were systematically searched and papers screened. Quality was appraised using the Critical Appraisal Skills Programme qualitative checklist, and deductive thematic analysis, with a priori themes, was conducted. Results Eleven studies provided a tripartite understanding of spiritual caregiving within the a priori themes: Nursing Spirit (a spiritual holistic ethos); the Soul of Care (the nurse-patient relationship); and the Body of Care (nurse care delivery). Ten of the studies involved palliative care nurses.

CONCLUSION

Nurses who provide spiritual care operate from an integrated holistic worldview, which develops from personal spirituality, life experience and professional practice of working with the dying. This worldview, when combined with advanced communication skills, shapes a relational way of spiritual caregiving that extends warmth, love and acceptance, thus enabling a patient's spiritual needs to surface and be resolved.

RELEVANCE TO CLINICAL PRACTICE

Quality spiritual caregiving requires time for nurses to develop: the personal, spiritual and professional skills that enable spiritual needs to be identified and redressed; nurse-patient relationships that allow patients to disclose and co-process these needs. Supportive work environments underpin such care. Further research is required to define spiritual care across all settings, outside of hospice, and to develop guidance for those involved in EoL care delivery.

The Catalogue of Spiritual Care Instruments: A Scoping Review

Spiritual care has been a growing focus in international healthcare research over the last decades. The approaches to spiritual care are many and derive from many different medical fields and different cultural contexts and often remain unknown across healthcare areas. This points to a potential knowledge gap between existing instruments and the knowledge and use of them cross-disciplinarily and cross-culturally, and thus best practice insights are not sufficiently shared. This article contributes to the growing field of spiritual care by providing an overview of the various approaches (henceforth instruments) to assess patients’ spiritual needs in view of improving spiritual care. This was done through a scoping review method. The results of the review were collected and catalogued and presented here as ‘The Catalogue of Spiritual Care Instruments’. The included instruments derive from a wide range of geographical contexts and healthcare areas and are aimed at patients and healthcare professionals alike, clearly showing that spiritual care is a focus in healthcare internationally. However, it also shows the difficulties of defining spiritual care, the importance of local contexts, and the difficulties of cross-cultural validity. The catalogue contains 182 entries and is available as an interactive platform for the further development of spiritual care internationally.

Nurses Experiences in the Burn Unit: A Qualitative Research

Background:

Nurses form the largest group of burn care treatment team. They have valuable experiences regarding the care of burned patients that needs to be explored. Therefore, the present study was aimed to explain the experiences of nurses who work in the burn unit.

Materials and Methods:

This qualitative study was conducted in the burn units of Zabol and Zahedan Hospitals in 2018. Accordingly, the data were collected through a semi-structured deep interview with 16 nurses. Purposeful sampling method was used for data collection. The data were analyzed using a thematic analysis approach.

Results:

The data analysis ultimately led to the development of 4 themes and 16 sub-themes. The extracted themes included burden of burn unit, toil of burn unit as a deal with God, need for continuing the education program, and work-life imbalance.

Conclusions:

Nurses in burn unit experience many challenges that can affect their job and life, which require special attention of the authorities, their families, and other colleagues. For better patient care, there is a need for up-to-date facilities and training. The hospital managers should pay more attention to the nursing staff of the burn units through increasing staff number, changing the working units, and offering financial and motivational vacations.

Nurse Spiritual Care: Prevalence and Correlates

Many nurses embrace spiritual care as integral to holistic care. Evidence documenting the frequency of spiritual care provided in acute care settings, however, is sparse and weak. For this cross-sectional, correlational study, data were collected from N = 554 tertiary care nurses using the Nurse Spiritual Care Therapeutics Scale (NSCTS) measuring their self-reported spiritual care with patients/family members over the last 72 to 80 hours at work. While the most frequently endorsed practices centered on presence, listening, and spiritual assessment, the overall NSCTS score remained modest ( M = 37; SD = 12; possible range = 17-85). Several associations were found; 32.4% of the variance in frequency of spiritual care provision was explained by nurse perception that spiritual issues come up often in the work setting, high nurse spirituality score, not working in pediatrics, and having received education about spiritual care. Findings allow for benchmarking of nursing practices that have often been invisible.

The Importance of Spiritual Care in Nursing Practice

Purpose: Explore what spiritual care means to nurses who work in emergency care units. Design and Method: Nine nursing professionals from an emergency care unit at a private health institution affiliated with the Universidad de La Sabana participated in this descriptive qualitative study. Nonparticipant observation, field notes, and in-depth interviews with a question guide were used to collect the data, which were analyzed by means of content analysis. Results: Three themes and their corresponding subthemes were identified with respect to the significance of spiritual care: (1) interpretation of spiritual care, (2) the patient and the family in spiritual care, and (3) the role of the nurse in spiritual care. Conclusions: These findings provide a deeper understanding of spiritual care in terms of its significance. They also acknowledge its importance to nursing practice in emergency care units. The significance of spiritual care is based on theoretical, scientific, and humanistic points of reference (the discipline of nursing) that strengthen the therapeutic relationship between the patient/family–nurse dyad. The study also offers evidence for holistic nursing practice that requires theoretical-academic, administrative, and assistance support.

Discerning the healing path--how nurses assist patient spirituality in diverse health care settings

AIMS AND OBJECTIVES

To examine nurses' experiences in spiritual care in diverse clinical settings, preferably not palliative care.

BACKGROUND

Spirituality is part of holistic nursing care. The concept of spiritual literacy is introduced as the nurse's ability to read the spiritual signs of the human experience.

DESIGN

Classical grounded theory methodology with open and selective coding was used to identify the participants' main concern and the strategies they used to resolve it, and to develop a substantive grounded theory.

METHOD

Data were collected in 2008 and 2014 during eight focus group interviews with a total of 22 nurses recruited from a master's programme, postgraduate programmes and a local hospital. Data were analysed through constant comparison until the grounded theory emerged.

RESULTS

The participants' main concern was how to assist the patient to alleviation. The participants resolved this by Discerning the healing path, which comprises three stages: Tuning in on spirituality, Uncovering deep concerns and Facilitating the healing process. These three stages are accompanied all the way by the participants' Willingness to overcome own comfort zone and Building a trusting relationship.

CONCLUSION

Spirituality is of relevance for all areas of nursing care, not just dying patients or those in palliative care. Spirituality relates to the deep and important things in life and affects how patients face health issues. Nurses attend to spirituality in patients because the pain of the soul touches them and the calmness of spiritual peace amazes them.

RELEVANCE TO CLINICAL PRACTICE

The professional culture in the health care team socialises nurses into the workplace, and leaders need to pay close attention to how they can foster openness to spiritual matters. The personal and professional maturity of the nurse is fundamental to his or her willingness and ability to overcome own comfort zone.

Experiences of spirituality and spiritual values in the context of nursing - an integrative review

Spirituality is often mistakenly equated with religion but is in fact a far broader concept. The aim of this integrative review was to describe experiences of the positive impact of spirituality and spiritual values in the context of nursing. The analysis was guided by Whittemore and Knafl's integrative review method. The findings revealed seven themes: 'Being part of a greater wholeness', 'Togetherness - value based relationships', 'Developing inner strength', 'Ministering to patients', 'Maintaining one's sense of humanity', 'Viewing life as a gift evokes a desire to 'give back'' and 'Achieving closure - life goes on'. It is difficult to draw definite conclusions, as spirituality involves many perspectives on various levels of awareness. However, spirituality was considered more inclusive, fluid and personal. Furthermore, it emerged that spirituality and spiritual values in the context of nursing are closely intertwined with the concept of caring.