An understanding of spirituality and spiritual care among people from Chinese backgrounds: A grounded theory study

"A sign that I am not alone": A grounded theory-informed qualitative study on spirituality after suicide bereavement

Suicide bereavement is known to be highly distressing and to negatively affect the mental health of the bereaved. The role of religion and spirituality after suicide bereavement remains understudied. We aimed to specifically explore the role of spirituality after suicide bereavement by conducting a qualitative study through semi-structured interviews with fifteen people bereaved by suicide. The grounded theory-informed thematic analysis identified five main themes, namely "continuing bonds with the deceased," "lightening the burden," "grounded spirituality," "perceptual and conceptual shift" and "the movement of giving." For many participants, spirituality was a resource that facilitated the process of accepting their loss by offering a larger entity to which to hand over their suffering. Moreover, the continuing bonds with the deceased helped them to get through this ordeal. Our results can enable mental health professionals to better understand how spirituality can facilitate post-traumatic growth in people bereaved by suicide.

Effects of traditional Chinese culture-based bibliotherapy on the spiritual health of patients with liver cancer

BACKGROUND

Liver cancer is a serious global health problem and is associated with poor spiritual health. Bibliotherapy is beneficial in improving health outcomes in cancer patients, yet there is a lack of empirical evidence of its effect on the spiritual health of liver cancer patients in China. The study aimed to investigate the effects of bibliotherapy based on Chinese traditional culture on the spiritual health of patients with liver cancer in China. This study was approved by the Ethics Committee of Hunan Normal University School of Medicine and registered with the Chinese Clinical Trial Registry with the registration (No: 2021260), which registration in June 30th 2021.

METHODS

A total of 60 patients with liver cancer were divided into the intervention group (n = 30) and the control group (n = 30) through WeChat. The intervention group received bibliotherapy therapy based on traditional Chinese culture, while the control group received routine care. Spiritual health was assessed using the Spiritual Attitude and Involvement List (SAIL) and compared before and after the intervention between the two groups. The chi-square test and t-test were used to analyze the intervention effects.

RESULTS

The two groups were comparable in all baseline characteristics including the SAIL score. After 5 weeks of intervention, the score of SAIL increased significantly from 96.76 ± 15.08 to 106.93 ± 13.82 in the intervention group (t =  - 29.380, p < 0.001), while no significant difference in SAIL score was observed in the control group (from 95.27 ± 16.40 to 95.31 ± 16.24, t =  - 0.189, p = 0.852). Similar patterns were also observed in its three dimensions of connecting with oneself, connecting with the environment, and connecting with transcendence.

CONCLUSIONS

Our study showed that bibliotherapy based on traditional Chinese culture using the WeChat platform can greatly improve the spiritual health of patients with liver cancer and has the potential to be widely applied to cancer patients to improve their well-being.

Mediating role of spirituality on the relationships between posttraumatic stress and posttraumatic growth among patients with cancer: A cross-sectional study

Objective

This study explores the impact of posttraumatic stress (PTS) on posttraumatic growth (PTG) and verifies the mediating effect of spirituality among patients with cancer.

Methods

This study used a cross-sectional correlational design. This study surveyed 141 hospitalized patients over 20 years of age diagnosed with cancer. Participants were recruited by convenience sampling from a regional hospital in Taiwan. Data were collected from January to April 2021. Measurements included sociodemographic and disease-related information and data from the following self-report questionnaires: Posttraumatic Stress Reaction Index-Short Form, Posttraumatic Growth Inventory, and Spiritual Health Scale-Short Form. Structural equation modeling and bootstrapping were used to analyze the mediating effect of spiritual health on PTS and PTG.

Results

PTS and spirituality were negatively correlated, spirituality, and PTG were positively correlated, and PTS had no correlation with PTG. Spirituality fully presented a mediating role between PTS and PTG.

Conclusions

Patients' spirituality should be regarded as an important variable that can impact stress appraisal and improve the patient's PTG when a diagnosis of cancer is received. Assessing spiritual health at regular intervals and integrating spiritual care with clinical care could decrease PTS and improve PTG for patients with cancer.

Spiritual needs and their associated psychosocial factors among women with breast cancer: A cross-sectional study

AIMS

Guided by the biopsychosocial-spiritual model, this study aimed to evaluate the spiritual needs of Chinese women with breast cancer and explored factors associated with those spiritual needs.

DESIGN

This study has a cross-sectional design.

METHODS

This cross-sectional study involved 228 breast cancer patients in China, between May 2019 and July 2019. Data were collected using the general information form, the Spiritual Needs Scale, the Perceived Social Support Scale and the Hospital Anxiety and Depression Scale. Data were analysed by Spearman correlation analysis, univariate analysis and multiple linear regression, and a structural equation model (SEM) was constructed by maximum likelihood estimation.

RESULTS

There was a slightly higher average score for spiritual needs. Of the five dimensions of spiritual needs, those with the highest and lowest levels were 'meaning and purpose' and 'relationship with transcendence' respectively. Religion, time since confirmed diagnosis and education level were related to spiritual needs. The proposed model linking spiritual needs perceived social support, anxiety, and depression revealed a satisfactory fit to the data. Specifically, a higher level of social support predicted lower levels of anxiety and depression, which in turn predicted stronger spiritual needs.

CONCLUSIONS

The spiritual needs of breast cancer patients were associated with individual characteristics and psychosocial elements. Patients' spiritual needs should therefore be effectively evaluated, especially the needs of those who are not religious. Furthermore, comprehensive, needs-tailored interventions that incorporate spiritual, biological, psychological and social support should be formulated.

IMPACT

Nurses should become more aware of the spiritual needs of breast cancer patients, incorporate a spiritual focus into their care and develop comprehensive needs tailored to their characteristics as well as interventions based on biopsychosocial factors.

Spirituality and Spiritual Care among Ethnic Chinese Residing in England: Implications for Nursing

(1) Background: There is a lack of understanding of how spirituality is understood among ethnic Chinese living outside of China. The aim of this investigation was to gain insight into the meaning of spirituality and spiritual care among ethnic Chinese residing in England. (2) Methods: This study employed a grounded theory method. (3) Results: A core category called “seeking a meaningful life” emerged, comprising six categories: “motivation”, “support”, “maintaining standard values”, “achieving a meaningful life”, “relationships” and “perceptions of spirituality”. The core category included a three-stage process influenced by two factors: relationships with others and perceptions of spirituality. In motivated or supported situations of suffering and illness, ethnic Chinese usually follow principles of their Chinese tradition in seeking meaning for a satisfied spiritual life. This process is impacted by their relationships with others and view of spirituality. (4) Conclusions: Participants’ understanding of spirituality and spiritual care was related to seeking meaning and purpose in life. Nurses could incorporate the newly developed life meaning processes into their practice. This could be achieved by culturally explaining suffering and focusing on the significance of physical illness for Chinese people. This would ensure their spiritual care practice delivers culturally competent care for ethnic Chinese. Educators could also incorporate this process within their teaching materials so that this aspect of spiritual care is addressed for this specific group.

Association between attitude towards death and spiritual care competence of Chinese oncology nurses: a cross-sectional study

BACKGROUNDS

An understanding of the oncology nurse spiritual care competence would help nurse managers recognize weakness in spiritual practice and improve the quality of spiritual care. But the relationship between attitude towards death and spiritual care competence is unknown.

METHODS

We recruited 326 nurses from hospitals in Guangzhou, China. The nurses completed the Chinese Spiritual Care Competence Scale and the Chinese Death Attitude Profile-Revised questionnaires.

RESULTS

The total score of spiritual care competence was 61.62 ± 16.10. And the lowest score of attitude towards death was for escape acceptance, 2.64 ± 0.82. Factors associated with nurse spiritual care competence were work department, whether trained in spiritual care, approaching acceptance, and escaping acceptance of attitude towards death.

CONCLUSION

Nurses need to perfect their spiritual care competence and establish positive attitudes towards death.

Formação de enfermeiros e estratégias de ensino-aprendizagem sobre o tema da espiritualidade

RESUMO Objetivo investigar se e como o tema da espiritualidade foi abordado na formação de enfermeiros que atuam em cuidados paliativos. Método estudo qualitativo, realizado com 34 enfermeiros de um hospital de tratamento de câncer do Rio de Janeiro. Os dados foram coletados em 2019, por meio de entrevista semiestruturada. A análise foi lexical por meio do software Alceste. Resultados os enfermeiros reconhecem a necessidade de abordagem da espiritualidade no cuidado, mas as lacunas ou insuficiência de abordagem na formação dificultam sua aplicação na prática. Para supri-las, estratégias são aplicadas na educação permanente nos serviços. Conclusão e implicações para a prática o não preparo formal e técnico para a abordagem e oferta de cuidados à dimensão espiritual dos pacientes comprometem a realização do cuidado integral. A educação permanente mostrou ser a única possibilidade de preparar os enfermeiros para o cuidado a esta dimensão. Desvela-se a importância da abordagem da espiritualidade e os impactos para a saúde e o cuidado, mormente no campo dos cuidados paliativos, o que a torna transversal e necessária na formação profissional.