Opportunities for Enhanced Spirituality Relevant to Well Adults

A Qualitative Pilot Study of Spirituality in Long-term Recovery in Acquired Brain Injury

Increased spirituality occurring after acquired brain injury is a part of post traumatic growth (PTG). Participants were asked about their spirituality, and their responses were analyzed. Eighty-one percent exhibited a moderate spiritual impact on their recovery. Studies suggest that patients' spiritual needs are not being met, and chaplains are being underutilized. Trust and a sense of presence are essential to encouraging PTG, and, by fully utilizing the skills of our chaplain colleagues, could improve PTG.

Spiritual Perspectives of Nurses in the United States Relevant for Education and Practice

The purpose of the current study was to describe nurses’ spiritual perspectives as they relate to education and practice. A multiple triangulation research design encompassing a questionnaire and a descriptive qualitative content analysis were used with the purpose of capturing a more complete, holistic, and contextual description of nurses’ spiritual perspectives. Multiple triangulation included two data sources, two methodological approaches, and nine investigators. Using survey methods, Reed’s Spiritual Perspective Scale (SPS) was sent to 1,000 members of Sigma Theta Tau International Nursing Honor Society (STTI). Results support Reed’s premise that spirituality permeates one’s life. Regardless of gender, participants with a religious affiliation had significantly higher SPS scores than those without one. Nurses having a spiritual base use it in practice. Six themes emerged from the qualitative analysis: Nurses perceive spirituality as strength, guidance, connectedness, a belief system, as promoting health, and supporting practice. The integration of spirituality in nursing curriculums can facilitate spiritual care.

Roots and Wings

The overwhelming supply and demand for holistic health information and services suggest the need for integrative medical centers to offer experientially based educational programs. Seventeen individuals participated in a pilot of a 12-week multidisciplinary program titled Roots and Wings. Self-reported pre- and post measures were completed by 11 participants and indicated promising outcomes across the dimensions of physical, emotional, and spiritual health. Participants had a statistically significant decrease in physical and psychological symptoms and an increase in daily spiritual experiences. Statistically significant positive changes were also found for psychological attitudes and health locus of control in addition to indicators of behavior, satisfaction and attitudes relevant to the goals of Roots and Wings. The content of the program and the implications of these findings for nurse educators are discussed.

Men of Prayer: Spirituality of Men With Prostate Cancer

Spirituality plays a powerful role in cancer treatment and recovery; it has been identified by hospitalized patients as one of their top priorities of care. However, health care providers struggle to find ways to address the spirituality of their patients. The purposes of this study were to discover what spirituality means for men with prostate cancer and how it influences their treatment. Eleven men, ages 54 to 71, with prostate cancer were interviewed within several days following radical prostatectomy with bilateral lymph node staging. This grounded theory methodology generated three categories of spirituality: (a) praying, (b) receiving support, and (c) coping with cancer. The basic social process, coping with cancer, occurred in four phases: facing cancer, choosing treatment, trusting, and living day by day. These results were validated by four of the participants for truthfulness. The findings of this study provide holistic nurses with knowledge and a midrange theory of spirituality that can be usedin building a research-based practice.

A literature review of spirituality in coping with early-stage Alzheimer's disease

AIMS

This paper presents a literature review focusing on the use of spirituality in coping by older persons with early-stage Alzheimer's disease from their perspectives. The purpose of this literature review is to examine the existing body of knowledge about spirituality in coping with Alzheimer's disease and to apply a spiritual framework of coping in organizing the literature to identify themes and gaps in knowledge.

BACKGROUND

Despite the abundance of Alzheimer's disease research, little is known about how older persons with this devastating disease cope with the consequential losses. Maintaining a sense of normalcy and preserving self-worth are coping strategies reported by older persons with early-stage Alzheimer's disease. As spirituality is an effective coping resource for older persons with numerous psychological and personal losses in their lives, it may be an important coping resource for person with Alzheimer's disease.

METHOD

A literature search was conducted to find research published between 1990-2006 aimed at understanding spirituality in coping with early-stage Alzheimer's disease.

CONCLUSIONS

Six research studies were reviewed. Findings suggest that persons with early-stage Alzheimer's disease draw from their spirituality and faith to find meaning and courage in facing the challenges of cognitive losses. Furthermore, they are able to provide rich information about their spirituality and the psychosocial aspects of living with Alzheimer's disease. Limited empirical knowledge compels the need for future research to explore how spirituality is utilized in coping with early-stage Alzheimer's disease.

RELEVANCE TO CLINICAL PRACTICE

Enhancing persons' abilities to cope effectively with their diseases is an important goal of nursing care. Understanding how older persons with Alzheimer's disease cope with their memory loss is critical to the development of evidence-based interventions to minimize the stress of living with this disease.

Between spiritual wellbeing and spiritual distress: possible related factors in elderly patients with cancer

OBJECTIVE

this article describes the assessment of the spiritual wellbeing of elderly patients with cancer submitted to chemotherapy and possible predictive factors of the spiritual distress diagnosis.

METHODOLOGY

this is a methodological study for clinical validation of a nursing diagnosis, using interviews to assist in completing the form.

RESULTS

45 elderly patients participated in this study, Catholics, mostly female, diagnosed with breast cancer, average age of 70.3 years. The prevalence of spiritual distress was of 42%; 24.4% of the elderly patients were under anti-depressant medication. A significant association was noted between spiritual distress, anti-depressant medication and level of education; an increase (not significant) was acknowledged at the start of the treatment.

CONCLUSION

these results emphasize the relevance of clarifying this diagnosis and the responsibility of nurses to provide spiritual care to patients. Interventions should be planned appropriately every time a nursing diagnosis is identified as a complex answer and for which pharmacological treatment is not sufficient.

Spiritual coping in rehabilitation- a comparative study: part 2

Spiritual coping, which may or may not contain religiosity, may enhance adaptation of clients with chronic illness. Part 1 of this article (Baldacchino et al, 2013) presented the research methodology of this cross-sectional comparative study, which explored the spiritual coping of clients with chronic illness receiving rehabilitation services in Malta (n=44) (lower limb amputation: n=10, chronic heart disease: n=9, osteoarthritis in an institution: n=10 and in the community: n=15) and Norway (n=16) (post-hip/shoulder surgery: n=5; chronic heart disease: n=5; chronic pain: n=6). Data were collected from seven purposive samples by focus groups. Roy's adaptation model (1984) and Neuman's Systems Model (2010) guided the study. Part2 discusses the findings, which consist of one main spiritual coping theme and three sub-themes: 'adopting religious coping strategies, relationship with God, and time for reflection and counting one's blessings'. Commonalities were found in the findings except in one dimension, which was found only in the Malta group, that is, being supported by others with a similar condition. This difference may be a result of the environment in the rehabilitation centres, cultural, and geographical differences between the two countries. While considering the limitations of this study, recommendations are proposed to the rehabilitation and education sectors and further trans-cultural comparative longitudinal research with mixed method approach on various clients with acute, chronic and life-threatening illness.

Developing and testing a spiritual care questionnaire in the Iranian context

As most research exploring nurses' perceptions on the topic of spiritual care was conducted in Western countries, these findings may not be applicable in Iran because of cultural and health system differences. Therefore, a new survey instrument was developed for the Iranian context. The study was conducted in two steps: (1) development and validation of items for perception scale and (2) distribution of the questionnaire among nursing students to determine scale reliability and construct validity. The preliminary scale consisted of 50 items designed to measure the participants' perception of spiritual care. Construct validity of the scale was examined on the remaining 33 items. On interpretation of the items, the following four components were identified: (1) meeting patient as a being in meaning and hope, (2) meeting patient as a being in relationship, (3) meeting patient as a religious being, and (4) meeting patients as a being with autonomy. The results in this paper showed that preserving dignity in the nurses' practice meant getting involved in interpersonal caring relationships, with respect for the involved peoples' religious beliefs and their autonomy. Proper education and professionally led supervision with reflection on past and recent experiences may develop student nurses' and nurses' perceptions as well as their attitudes toward spiritual care and to achieve a realistic view of the profession.

Efficacy of different instruments for the identification of the nursing diagnosis spiritual distress

The study aims to identify the nursing diagnosis Spiritual distress in 120 patients with Chronic Renal Insufficiency, using different instruments, and to evaluate the effectiveness of these instruments in support of this identification. Data were collected separately by two nurses using a questionnaire containing sociodemographic information and the defining characteristics of Spiritual distress, as well as direct questioning to the patient regarding the presence of the diagnosis and the instruments: the Spirituality Rating Scale; Pinto and Pais-Ribeiro's Spirituality Scale; and the Spiritual Well-being Scale. The study found that 25.8% to 35.8% of the patients had the diagnosis. The diagnostic evaluation developed by the expert nurses presented no divergence between the two and obtained a perfect concordance coefficient (96.7%) with the opinion of the patient; this demonstrated substantial concordance with the Existential Well-being Sub-scale (83.3%) and with the Pinto e Pais-Ribeiro's Spirituality Scale (87.5%), which demonstrated their usefulness for diagnostic identification.

Facing existential realities: exploring barriers and challenges to spiritual nursing care

Although nurses of the past and present recognize the importance of spiritual care to health and healing, in practice and education, spiritual care dwells on the periphery of the profession. The purpose of this study was to gain a better understanding of the reasons behind this contradiction. Using the phenomenological approach, open-ended interviews were conducted with 29 individuals, including oncology nurses, patients and their families, chaplains, and hospital administrators. Their accounts reveal examples of how attitudes, beliefs, and practices of the larger organizational culture can shape the everyday lived experience of bedside nursing. Specifically, these influences tend to create a lived space that is uncaring, and a lived time that is "too tight." Moreover, lived body is experienced as an object for technical intervention, and lived other is experienced from a distance rather than "up close and personal." It was argued that, together, these existential experiences of lived time, space, body, and other create formidable barriers to spiritual nursing care.

Validação do diagnóstico de enfermagem Angústia Espiritual: análise por especialistas

OBJETIVO: Realizar a validação de conteúdo do diagnóstico de enfermagem Angústia espiritual. MÉTODOS: Utilizando o referencial metodológico proposto por Fehring, foi empregado um questionário semi-estruturado, respondido por uma amostra de 72 enfermeiros, para avaliação do título, definição e características definidoras do diagnóstico Angústia espiritual, bem como, sua disposição na Taxonomia II da North American Nursing Diagnosis Association. RESULTADOS: O melhor domínio para classificação do diagnóstico em estudo, segundo os enfermeiros peritos, é o Domínio 10; no entanto, suas classes requerem revisão. Espiritualidade prejudicada demonstrou ser um título adequado ao conceito investigado. A validação das características definidoras identificou sete delas como importantes indicadores clínicos do diagnóstico e apenas a característica não se interessa pela natureza foi considerada pouco relevante. O escore total do diagnóstico foi 0,72, sendo, portanto, considerado validado. CONCLUSÃO: Uma nova proposta apresentada ao fenômeno em estudo foi considerada pertinente. Este estudo pode oferecer subsídios para a validação clínica do diagnóstico investigado.

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.

The Provision of Spiritual Care by Registered Nurses on a Maternal—Infant Unit

Purpose: This study explores the spirituality, spiritual well-being (SWB), and spiritual care provision of registered nurses on a maternal—infant unit. Methods: Data collection instruments included a demographic and spiritual care form, Spiritual Perspective Scale (SPS), and Spiritual Well-Being Scale (SWBS) to address the study's research questions. Findings: Significant positive correlations were found between SPS and SWBS as well as religious well-being (RWB) and existential well-being (EWB; subscales of SWBS). Religious attendance was significantly correlated with SPS, SWBS, and RWB but not EWB. Frequency of spiritual assessment themes was first encounter and when needed, whereas reaching up and reaching out described their provision of spiritual care. Conclusion: The sample was highly spiritual, spiritually well, and provided varied spiritual care. Implications: More spiritual care research is needed. Content on providing spiritual care must be enhanced within nursing curriculums as well as with nurses in practice.

Spiritual Care Activities of Nurses Using Nursing Interventions Classification (NIC) Labels

PURPOSE

To describe the spiritual care activities of nurses as subsequently identified in the Nursing Interventions Classification (NIC) labels.

METHODS

Data were taken from a larger study that used a multiple triangulation research design to describe spiritual perspectives, interventions, and attitudes of 1,000 Sigma Theta Tau International members. Data analysis included descriptive and multivariate statistics for quantitative items, and content analysis for responses to questions.

FINDINGS

97 respondents reported providing 32 spiritual care activities. Ten NIC labels actually mapped the nurses' spiritual care activities.

CONCLUSIONS

Spiritual care activities involve a broad spectrum of interventions that may be unique to each patient. The 32 spiritual care activities described by the nurses provide new knowledge regarding core spiritual care activities. The use of NIC labels can facilitate documentation of spiritual care activities in diverse practice settings.

PRACTICE IMPLICATIONS

This study supports greater specificity in describing spiritual care interventions to a level that allows replication and advancement of knowledge.

Mapping the processes and qualities of spiritual nursing care

Although the importance of spiritual care is widely recognized in nursing theory, recent research suggests that it is rarely attended to in nursing practice. One explanation for this contradiction is the conceptual confusion that exists regarding the meaning of spiritual nursing care. To help unravel this confusion, in-depth open-ended interviews were conducted in an oncology care setting with 29 individuals representing the multiple perspectives of nurses, patients, family, and others. Phenomenological analysis of these interviews reveals that spiritual nursing care involves a complexity of social processes, of which developing caring relationships is core. For these social processes to work and for spiritual nursing care to be realized, the nurse must embody four essential human qualities: receptivity, humanity, competency, and positivity. Participants' descriptions of these processes and qualities not only offer clarity and understanding but also capture the diffuse and amorphous nature of spiritual nursing care.

Spiritual practice: a literature review related to spiritual health and health outcomes

Spirituality and the expression of spirituality have received renewed interest in both nursing and nonnursing literature over the last 20 years. Scholars in spirituality studies have contributed to the wealth of both qualitative and quantitative data that exist. Spiritual practices that facilitate spiritual health are embedded within many nursing interventions. The purpose of this review is to provide an overview of empirical and associated nursing literature on spiritual practices. Definitions of spirituality and spiritual health are included, and theoretical underpinnings of the empirical literature are discussed. Relation of spiritual practice as a health behavior is presented with implications for future research identified.

Do Pastoral Care Providers Recognize Nurses as Spiritual Care Providers?

This descriptive qualitative study was conducted to explicate pastoral care providers' perceptions of nurses as spiritual providers. Spirituality is especially meaningful in contemporary society as a whole with spiritual care an expectation of hospitalized patients. Spiritual care given by nurses is grounded in nursing's history, inherent in its philosophical framework, and supported by research and professional mandates. In hospitals today, the primary responsibility for the spiritual care of patients resides with pastoral care providers. Collaboration between pastoral care providers and nurses may improve patients' spiritual care outcomes. Before collaboration can occur, it is important to learn whether pastoral care providers recognize nurses as spiritual providers. Guided by qualitative research methods, participants were sought until data saturation occurred. This qualitative study consisted of 8 participants who were experienced, full-time pastoral care providers from general and religious-affiliated hospitals. Data were collected through audiotaped open-ended interviews, a demographic data form, and exploratory questions or probes. The analysis included concurrent data collection, constant examination of conceptual interactions, linkages, and the conditions under which they occurred. Themes emerged: quest, conscious response, and essence of caring. Pastoral care providers perceive nurses as spiritual providers. Few felt comfortable initiating collaboration. Study findings are not generalizable.

The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice

AIM

The aim of this study was to generate a deeper understanding of the factors and forces that may inhibit or advance the concepts of spirituality and spiritual care within both nursing and health care.

BACKGROUND

This manuscript presents a model that emerged from a qualitative study using grounded theory. Implementation and use of this model may assist all health care practitioners and organizations to advance the concepts of spirituality and spiritual care within their own sphere of practice. The model has been termed the principal components model because participants identified six components as being crucial to the advancement of spiritual health care.

DESIGN

Grounded theory was used meaning that there was concurrent data collection and analysis. Theoretical sampling was used to develop the emerging theory. These processes, along with data analysis, open, axial and theoretical coding led to the identification of a core category and the construction of the principal components model.

METHODS

Fifty-three participants (24 men and 29 women) were recruited and all consented to be interviewed. The sample included nurses (n=24), chaplains (n=7), a social worker (n=1), an occupational therapist (n=1), physiotherapists (n=2), patients (n=14) and the public (n=4). The investigation was conducted in three phases to substantiate the emerging theory and the development of the model.

RESULTS

The principal components model contained six components: individuality, inclusivity, integrated, inter/intra-disciplinary, innate and institution.

CONCLUSION

A great deal has been written on the concepts of spirituality and spiritual care. However, rhetoric alone will not remove some of the intrinsic and extrinsic barriers that are inhibiting the advancement of the spiritual dimension in terms of theory and practice.

RELEVANCE TO CLINICAL PRACTICE

An awareness of and adherence to the principal components model may assist nurses and health care professionals to engage with and overcome some of the structural, organizational, political and social variables that are impacting upon spiritual care.

Spiritual care in nursing: an overview of the research to date

AIMS

The paper gives an overview of nursing research papers published on spiritual care between 1983 and October 2005. It also provides pointers for the future direction of research in this emerging field.

BACKGROUND

Spiritual care of patients/clients is expected of nurses and is reflected in nursing codes of ethics, nurse education guidelines, policy documents and nursing guidance. Recent years have seen a proliferation in nursing research in this area, particularly in the UK and North America, and now in other European countries. It seemed timely, therefore, to review this published research.

METHOD

Included in the review were 47 original published nursing research papers identified from a CINAHL search and from a collection held by the author since 1983. Papers were sorted into five categories, a template to aid reviewing was produced and a short summary and critique of each paper was written.

CONCLUSIONS

Research on spirituality and health needs to move forward in a systematic and co-ordinated way.

RELEVANCE TO CLINICAL PRACTICE

Hopefully, the research summarized in this paper will be useful to clinicians and nurse educators as they strive to incorporate spiritual care within their practice. In turn patients/clients and their families should benefit from care which is more holistic and addresses their deepest concerns and needs.

To describe or prescribe: assumptions underlying a prescriptive nursing process approach to spiritual care

Increasing attention is being paid to spirituality in nursing practice. Much of the literature on spiritual care uses the nursing process to describe this aspect of care. However, the use of the nursing process in the area of spirituality may be problematic, depending upon the understandings of the nature and intent of this process. Is it primarily a descriptive process meant to make visible the nursing actions to provide spiritual support, or is it a prescriptive process meant to guide nursing actions for intervening in the spirituality of patients? A prescriptive nursing process approach implies influencing, and in some cases reframing, the spirituality of patients and thereby extends beyond general notions of spiritual support. In this paper we discuss four problematic assumptions that form the basis for a prescriptive approach to spiritual care. We conclude that this approach extends the nursing role beyond appropriate professional boundaries, making it ethically problematic.

Patientsʼ Perceptions of Spirituality and the Nurse as a Spiritual Care Provider

This qualitative study explored patients' perceptions of spirituality and of the nurse as a spiritual care provider. Semistructured interviews were conducted with 8 adults older than 21, who were living at home, and had been discharged from the hospital within the past 3 months having had at least a 5-day length of stay. Participants agreed that during their hospitalization, nurses were kind and caring but these behaviors were not perceived as spiritual care. Study findings suggest that patients do not perceive spiritual care within the role of nursing and therefore they did not share their spiritual concerns with nurses. Study findings are limited by sample size; however, implications for practice are that nurses need to be aware of a patient's spiritual needs to provide spiritual care.

Spirituality and treatment choices by South and East Asian women with serious mental illness

The purpose of this qualitative study is to investigate how South and East Asian immigrant women who have diagnoses of serious mental illness make treatment choices in relation to spirituality and to explore how gender, cultural beliefs, and spirituality intersect with the process of choice. The findings reveal that the process of spiritual choice includes three interrelated phases: (1) identifying contributing factors, (2) exploring spiritual resources and strategies, and (3) living with the choices. Variations among health beliefs and health care decisions are explained and services that women see as being helpful are identified.

Spirituality as a coping mechanism

Spirituality as a coping mechanism can be observed to be a powerful resource in the provision of comfort, peace, and resolution for patients confronted with critical illness. While the exact machinery of spirituality in adaptation and adjustment to illness is enigmatic, the complementary benefits are clearly illustrated in the analysis of recounted personal experiences. Analysis of interactions with patients living the experience of coping with critical illness provides nurses with a means of reflection and transformational learning which improves and preserves the spiritual heritage of nursing care.

Spirituality, rehabilitation, and aging: a literature review11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated

This focused review highlights the role of spirituality in rehabilitation. It is part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on spirituality, rehabilitation, aging, and research. OVERALL LEARNING OBJECTIVE: To identify the current state of knowledge regarding the relationships among rehabilitation, spirituality, and aging.

Developing a Plan for Pediatric Spiritual Care

During life-changing events, people turn to spirituality for comfort, hope, and relief. This article raises nurses' awareness of and intent to provide spiritual care for children and families as part of overall quality care. Essential nursing knowledge for the development of a plan of care that includes the child's spirituality, religion, and culture, developmental stage, age-appropriate spiritual care activities, and the needs of the family are presented.

Nurses Enhance Performance Through Prayer

Prayer can be empowering for performance enhancement. Researchers drew conclusions from a larger study that employed triangulation of research methods and a random sample of 1000 nurses to describe spiritual perspectives, interventions, and attitudes of nurses in the United States. This article describes the nurses' prayerful activities.