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

Spiritual Intelligence and Spiritual Care in Nursing Practice: A Bibliometric Review

Spiritual intelligence (SI) has recently gained traction in various fields, including nursing. Given the increasing emphasis on patient-centred care and the holistic well-being of patients and nurses, SI is particularly relevant in nursing practice. A bibliometric analysis of recent publications (2014-2024) in the field helps synthesise and evaluate the existing research on SI in the general field of nursing, identify literature gaps, suggest future research directions and raise awareness of the importance of SI in nursing practice. The present study reports bibliometric data (n = 461) from the Scopus database on SI, spiritual quotient and spiritual care in nursing and health care. The data are analysed using MS Excel and VOSviewer software. The publications' trend analysis revealed a significant increase in SI-related publications since 2015. The study presents top-cited articles. Journal of Religion and Health was found to be a prominent journal with the maximum number of publications, and Sage was found to be the top publisher of journals with articles on SI. Network visualisation reveals central figures such as Wilfred McSherry, Trove Giske, Elizabeth Johnston Taylor, Fiona Timmins, Silvia Caldeira and Linda Ross as key researchers in the field. The United States and Iran have the most substantial connections of authors publishing on SI. This study reveals an increasing interest in SI and care within nursing research, confirming its growing significance in the field. By reporting areas where research on SI in nursing remains underdeveloped, the study paves the way for the development of new or updated curricula in nursing programs. The study can guide faculty development initiatives by highlighting the importance of SI and providing resources for educators to incorporate these concepts into their teaching. This study presents specific research questions to address these knowledge gaps. Future studies which can address these questions will enrich nursing education and practice, leading to improved patient outcomes and enhanced nurse well-being using the full potential of SI in nursing practice.

Identifying and Addressing the Spiritual Needs of Older Adults in Care Facilities: Administrators of Chinese Nursing Homes Relate Their Perspectives

Addressing the spiritual needs of older adults is a central component of holistic service provision. Using a qualitative description design, this study identified: (1) common spiritual needs among Chinese nursing home residents, including the needs of residents with dementia, (2) the process staff use to identify these needs when residents are unable to verbalize them, and (3) the strategies staff implement to meet the identified needs. Semi-structured interviews were conducted with 21 nursing home administrators. Analysis produced five themes, including the need for older adults to express their faith, receive love and care, have contact with their children, interact with others, and participate in activities. For residents with dementia who are unable to verbalize their concerns, staff used two primary strategies to identify spiritual needs: careful observation and communication with family members. To address the identified spiritual needs, multiple strategies were offered including arranging clergy visits and personalizing care.

Vignettes as a novel research tool in spiritual care: A methods paper

AIMS

To discuss the construction and use of vignettes as a novel approach in spiritual care research and education.

DESIGN

Methods paper.

METHODS

In this methods paper, the authors introduce the use of vignettes in spiritual care research and provide insight into the construction of vignettes. The vignette presented was part of a study of neurosurgical nurses' attitudes and responses to the spiritual needs of neuro-oncology patients. The development process, consisting of four steps, is explained in this paper.

RESULTS

Using a vignette to explore nurses' attitudes towards spiritual care is an innovative way to understand what behaviours nurses consider appropriate in situations where the patient is seeking meaning and connection. Transparent description of the development process is crucial to ensure reproducibility.

CONCLUSION

The use of theoretically constructed and validated vignettes in spiritual care research is new. Vignettes used in surveys have the potential to elicit nurses' responses to patients' search for meaning and connectedness.

IMPLICATIONS

In order to investigate nurses' attitudes and behaviours towards patients' spiritual needs, carefully constructed and validated vignettes are valuable research tools.

IMPACT

Vignettes have proven to be a valuable research tool in the social and health sciences. So far, their use as a survey instrument in spiritual care research has not been investigated. Therefore, this method paper introduces vignettes as a novel approach to spiritual care research. Our findings contribute to the further development of vignettes in nursing science, as there are similarities with case development and simulation training in nursing education.

REPORTING METHOD

Reporting guideline is not applicable.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Instruments for assessing the spiritual needs of cancer patients: A systematic review of psychometric properties

AIMS AND OBJECTIVES

To identify available instruments for assessing cancer patients' spiritual needs and to examine their psychometric properties using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology.

BACKGROUND

Cancer patients frequently have significant spiritual needs. The nurse plays an integral role in assessing the patient's spiritual needs as part of providing holistic care. It is crucial to assess these needs using appropriate and reliable instruments.

DESIGN

A systematic review based on COSMIN methodology.

METHODS

Seven electronic databases (PubMed, EMBASE, CINAHL, Web of Science, ProQuest, CNKI and WANFANG) were systematically searched from inception until 14 February 2023. Two authors independently screened eligible literature, extracted data and evaluated methodological and psychometric quality. This systematic review was conducted following the PRISMA checklist.

RESULTS

Sixteen studies have reported 16 different versions of the instruments. None of the instruments were properly assessed for all psychometric properties, nor were measurement error, responsiveness and cross-cultural validity/measurement invariance reported. All of the instruments failed to meet the COSMIN quality criteria for content validity. The quality of evidence for structural validity and/or internal consistency in five instruments did not meet the COSMIN criteria. Eventually, five instruments were not recommended, and 11 were only weakly recommended.

CONCLUSION

Instruments to assess spiritual needs exhibited limited reliability and validity. The Spiritual Care Needs Scale is provisionally recommended for research and clinical settings, but its limitations regarding content validity and cross-cultural application must be considered in practice. Future research should further revise the content of available instruments and comprehensively and correctly test their psychometric properties.

RELEVANCE TO CLINICAL PRACTICE

The review findings will provide evidence for healthcare professionals to select instruments for recognising spiritual needs in cancer patients.

NO PATIENT OR PUBLIC CONTRIBUTION

This study is a systematic review with no patient or public participation.

Strengths and challenges with spiritual care: Student feedback from the EPICC Spiritual Care Self-Assessment Tool

AIM

To explore qualitative data from students' self-reported competencies in spiritual care gathered during testing of a student self-assessment tool based on the EPICC Spiritual Care Education Standard.

DESIGN

Reflexive thematic analysis of qualitative data from a multinational study on validating a new self-assessment tool.

METHODS

The EPICC Spiritual Care Education Standard for competency in spiritual care was developed to enhance nurses' and midwives' ability to provide spiritual care by creating a baccalaureate education standard for spiritual care competencies. Spiritual care researchers then developed a self-assessment tool to raise student awareness of spirituality and track personal and professional growth in spiritual care competency. The EPICC Spiritual Care Competency Self-Assessment Tool, tested at eight universities in five countries, provided many opportunities for student comments, resulting in rich qualitative data presented here.

RESULTS

Themes related to strengths, weaknesses and areas for improvement. Identified strengths were similar across countries: caring attitudes, general knowledge of caring and compassion and good communication skills. Weaknesses/challenges touched on spirituality as overlooked in some cultures but part of life for others, complex questions were hard to understand, and self-assessment tools are common for some and rare for others. Areas for improvement included need for knowledge of religious and other deeply held beliefs and for greater spiritual assessment skills. Similarities across countries related to basic training in communication and compassionate care for nurses globally. Differences lay in the challenges and/or barriers for spiritual care and may relate to cultures within countries and/or university test sites.

RELEVANCE TO CLINICAL PRACTICE

The Tool raises awareness of spirituality among students and working nurses, providing an accessible way to self-check personal and professional growth in spiritual care competencies, which increases student and nurse capacity to become more knowledgeable and skilled in facilitating spiritual care, thus be role models for students at the intersection of spirituality and health.

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.

Relationship between Compassion and Spiritual Care among Nurses in Turkey

The aim of this study was to determine the effect of the compassion level of nurses on the frequency of their provision of spiritual care therapeutics to patients. The research was conducted as a correlational descriptive study and included 253 nurses working in a university hospital in Turkey between October and December 2020. The data were collected via an online survey using psychometrically valid scales to assess the nurses' compassion and provision of spiritual care therapeutics. The nurses had a high compassion level and a medium level of spiritual care therapeutics. Compassion level explained 31% of the frequency of spiritual care therapeutics. As nurses' compassion levels increased, the frequency of their provision of spiritual care therapeutics to patients also increased.

Making Time and Being Present: Spiritual Care Revisited

The COVID-19 pandemic has placed significant strain on home healthcare clinicians, shifting the focus of care to essential physical care needs. Spiritual care needs have always been present, but the pandemic has heightened recognition of the importance of spiritual care in home care. The goals of spiritual care include promoting physical healing, improving quality of life, and enhancing patient and family wellbeing. The use of a standardized spiritual assessment tool can increase provider awareness and patient expression of spiritual care needs. Spiritual care activities consist of obtaining a spiritual history, compassionate presence, mindful listening, interprofessional collaboration, and the provision of space for spiritual practices. This article provides a conceptual overview and strategies for application of spiritual care competencies.

Understanding Spiritual Care—Perspectives from Healthcare Professionals in a Norwegian Nursing Home

Nursing home professionals have reported that spiritual care is an unclear concept, and research suggests that healthcare professionals have a limited understanding of this dimension of care. The provision of spiritual care is well-investigated internationally, but research is sparse within Norway’s secularized society. This study investigated healthcare professionals’ understanding of spiritual care in one nursing home. Methods: Data were collected from individual interviews (N = 8) and one focus group (N = 5) of nursing home personnel; the study used qualitative content analysis and a hermeneutic methodology. Results: One central question emerged during the data analysis: what is spiritual care versus good care? This starting point resulted in four themes (1) caring for the whole person, (2) having a personal touch, (3) seeing the person behind the diagnosis, and (4) more than religiousness. Some healthcare professionals had not heard of spiritual care, and many were not aware of this in their daily work with older patients. Nevertheless, they facilitated and cared for the patient’s spiritual needs, but they did not address it as spiritual care. Other participants were familiar with the concept and understood spiritual care as an essential part of daily care. Conclusion: healthcare professionals’ understanding of spiritual care is broad and varied, including practical and non-verbal aspects. The results indicated a need for an open dialogue about spiritual needs and resources in clinical practice and the teaching of personnel about how to facilitate older people’s spirituality. Moreover, there is a need for more research into spiritual care and how it differs from the concept of good fundamental care.

Nursing Students' Perception Levels of Spirituality and Spiritual Care in Turkey

The present study was conducted to determine nursing students' perception levels of spirituality and spiritual care and the factors affecting these levels. The study was carried out in the nursing faculty of a university located in eastern Turkey between April and June 2019. The study population was made up of students studying within a department of nursing (n = 1250), and involved a sample size of 420 students, determined by power analysis. Data were obtained from an 'Introductory Information Form' that included students' sociodemographic characteristics and questions related to spiritual care and the Spirituality and Spiritual Care Rating Scale (SSCRS). Students scored, on average, 59.8 ± 9.7 on the SSCRS. Gender, year of undergraduate education, father's education level, knowledge of spiritual care, beliefs on the relationship between spiritual care and nursing care, and the ability to meet patients' spiritual needs were variables with an impact on the total SSCRS scores (p < 0.05). The findings show that spiritual care perception levels of nursing students were high.

Religious and spiritual support in the conception of nurses and families of critical patients: a cross-sectional study

OBJECTIVE

To assess the religious and spiritual support in critical care according to the conception of patients' family members and nurses.

METHOD

This is a quantitative cross-sectional study conducted with nurses and relatives of patients admitted to intensive care units. Sociodemographic data were collected and a questionnaire on religiosity and spirituality was applied to family members and the Spirituality and Spiritual Care Rating Scale to nurses. The results with p ≤ 0.05 were significant.

RESULTS

Sample consisted of intensive care nurses (n = 22) and family members (n = 61). Intensive care nurses stated that they can provide spiritual care (p = 0.03). Of the family members, 88.5% believed that religiosity and spirituality help in coping with difficult times, highlighting prayer as part of care for critically ill patients (p = 0.02).

CONCLUSION

Nurses and family members recognized religious/spiritual support as significant to the process of caring for critically ill patients, even though professional qualification is required for greater integration of this support in daily intensive care.

Comparing Nurses’ and Patients’ Comfort Level with Spiritual Assessment

This paper presents and compares similarities and differences between nurses’ and patients’ reports on comfort levels with spiritual assessment. Spiritual care is a part of nurses’ professional responsibilities; however, nurses continue to report that they are poorly prepared for this. There is limited research on patients’ expectations or perspectives on spiritual care. For the original mixed-method, two-phased study, a 21-item survey with 10 demographic variables, and some open-ended questions related to the comfort level of assessing/being assessed in the spiritual domain were distributed to 172 nurses and 157 hospitalised patients. SPSS was used to analyse and compare the results from nurses and patients; thematic analysis was used to examine the open-ended questions. Nurses reported a higher high degree of comfort with spiritual assessment than patients reported towards being assessed spiritually. Both nurses and patients saw respect and trust as key to building a relationship where open questions related to spirituality can be used as a helpful way to assess patients spiritually. Increased understanding of the best approach toward a patient must be based on the beliefs, values, and practices of that patient so that spiritual care can be individually tailored, and nurses can help patients move along the path to healing.

How Do Migrant Nursing Home Staff Relate to Religion in Their Work With Patients Who Are Approaching Death?

AIM

To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death.

METHOD AND THEORY

Individual in-depth interviews were conducted with 16 migrant health care workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a "thick description" of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of sign ificance.

FINDINGS

Religion held various meanings for the migrant health care workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants related to religion at work was therefore based on individual preferences and internalized practices.

CONCLUSION AND IMPLICATION FOR PRACTICE

Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being.

The development of a consensus-based spiritual care education standard for undergraduate nursing and midwifery students: An educational mixed methods study

AIMS

The aim of this study was to develop a consensus-based Spiritual Care Education Standard for undergraduate N/M students to use in undergraduate programmes.

DESIGN

Mixed methods were used consisting of qualitative and quantitative methods based on the principles of Delphi research.

METHODS

The sample consisted of a total of 58 (N = 58) participants from 21 European countries. Data collection was conducted from June 2017 - February 2019 and took place in facilitated iterative action learning cycles and online surveys. Data were analysed by descriptive statistics and qualitative analysis. Consensus was stated by >90% agreement.

RESULTS

The process resulted in an EPICC Spiritual Care Education Standard consisting of the following four spiritual care competences: Intrapersonal spirituality, Interpersonal spirituality, Spiritual care: assessment and planning, Spiritual care: intervention and evaluation. For every competence, learning outcomes were described in knowledge, skills and attitudes.

CONCLUSION

This Standard guides N/M spiritual care education, student assessment and research. It can be the starting point for discussing spiritual care competences in other healthcare professions. Follow-up research should focus on implementation of the standard and on assessment of students' spiritual competence.

IMPACT

The Standard guides curriculum and programme development. The Standard guides students in performing their learning process. The Standard provides a frame of reference for policy making and follow-up research.

Spiritual care interventions in nursing: an integrative literature review

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

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.

Nurse care for the hospitalized elderly's spiritual dimension

OBJECTIVE

to analyze the nurse care for the spiritual hospitalized elderly's dimension.

METHOD

a qualitative study, based on Jean Watson's Theory of Human Caring. The study included 17 nurses working in a geriatric center in Salvador City, Bahia State, Brazil. The collection of testimonies occurred between January and April of 2018, through an interview.

RESULTS

spiritual care were dialogue, encouragement and respect for religious activities, embracement, empathy. One of the obstacles to providing this care was the lack of preparation in accessing the elderly's spiritual dimension.

FINAL CONSIDERATIONS

spirituality is a dimension of human and holistic nursing care. Caring for the spirit contributes to foster transpersonal care. The difficulty may be in the lack of nurses' preparation. It is necessary that they cultivate and live their own spirituality, transmitting the understanding in each care relationship.

Spiritual Care Perspective of College Student-Athletes

Spirituality in healthcare has been researched in multiple healthcare professions; however, very little research has been done in athletic training, and no studies have investigated the athletes' perception. The purpose of our online survey study was to determine the perceptions of college student-athletes on spiritual care. Our participants included 268 collegiate student-athletes from both faith-based and non-faith-based institutions. Respondents agree that spirituality may affect treatment progress, addressing spiritual concerns of the athlete could result in a more positive outcome, and certified athletic trainers should have some basic skills and knowledge to support the spiritual needs of the athlete.

Talking about spiritual matters: First year nursing students' experiences of an assignment on spiritual conversations

BACKGROUND

Spiritual care is part of holistic nursing. However, nurses have reported that their education does not sufficiently prepare them for spiritual care in practice. Few studies have reported students' perspectives on how they acquire skills and knowledge in spiritual care.

AIM

The aim of the study was to explore how first year nursing students experienced a compulsory assignment that asked them to carry out a conversation with someone about spiritual aspects of nursing care and to reflect about it in relation to nursing.

DESIGN

The study was a qualitative content analysis of students' reflective logs.

METHODS

This research analysed the reflective logs of 385 (76%) first year nursing students from one religious and one secular university in Norway. The logs were written in response to an assignment based on Stoll's assessment guide, which asked them to carry out a conversation about spiritual aspects of nursing care.

RESULTS

Analysis yielded three main categories that characterised students' experience of this assignment: meeting oneself, beyond one's comfort zone and discovering the other.

CONCLUSIONS

Students brought few skills and little experience in spiritual care into their education, and they felt that spiritual care conversations were personal and outside of their comfort zone. It is challenging for nursing education to equip nursing students with the competence in spiritual care necessary to meet the standard set out by the International Council of Nursing.

Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses

Background and aim of the work:

Spiritual wellbeing has important implications for an individual’s health and wellbeing. Whilst the provision of spiritual care and assessment of spiritual needs is a vital part of the nurse’s role, literature suggests that nurses do not always engage in spiritual care with their patients or assess their spiritual needs. This review aims to ascertain wider reasons for this inconsistent spiritual care delivery by nurses to their patients.

Methods:

A review of the literature was conducted to identify instruments available relating to nursing professionals spiritual care and assessment.

Results:

14 measures relating to spiritual care and assessment were identified covering the key domains of: ‘Beliefs and values and attitudes around spiritual care,’ ‘Frequency of provision or extent to which they provide spiritual care or willingness,’ ‘Respondents’ level of knowledge around spirituality and spiritual care,’ ‘Ability to respond to spiritual pain,’ and ‘Multiple Domains: beliefs and attitudes around spirituality and spiritual care, amount of preparation, training and knowledge, spiritual care practices, perceived ability and comfort with provision and perceived barriers to provision.’

Conclusions:

A lack of standardisation in the conceptualisation and assessment of spiritual care causes challenges in reviewing, however several themes do emerge. In general student and qualified nurses are aware of the importance of providing spiritual care and are hindered by a lack of education about how best to implement such care. The religiosity of individual nurses or their training institutions seems to be of less importance than training in spiritual care interventions. (www.actabiomedica.it)

A View of Spirituality and Spiritual Care in a Sample of Spanish Nurses

The aim of this paper was to explore a select group of Spanish nurses’ views of spirituality and spiritual care. An exploratory design using both qualitative and quantitative methods was used in this study. The participants were nurses who were enrolled in a Master of Nursing Research. Data were collected via an open questionnaire. Furthermore, participants completed the Meaning in Life Scale (MiLS-Sp), whose results were analysed using quantitative methodology. The results that were obtained from the quantitative analyses reported a satisfactory mean score on nurses’ self-reported spirituality. Qualitative data were analysed using grounded theory procedures. Qualitative analysis showed two approaches to spirituality nurses’ views: (i) a clinical approach that influenced by the context of their clinical practice and (ii) an alternative approach where spirituality was viewed as a health resource, moving away from the biomedical model of nursing training. Nurses are sensitive to spirituality issues and acknowledge their importance to practice. Despite this, they view spirituality in a rather mechanistic way without changing their attitudes, competences and perspectives on healthcare.

Teaching Spiritual Care Within Nursing Education: A Holistic Approach

Student nurses are unprepared to meet the spiritual needs of patients, and are often uncomfortable addressing this. This article aims to describe the student perspective of spirituality in relation to the holistic care model. Findings from the study provide insight about preparing nursing students to deliver spiritual care in nursing practice.

Nurses' Perspectives on Spiritual Caregiving: Tending to the Sacred

This qualitative secondary analysis explored the narratives of 14 nurses from various practice settings. Data analysis identified that although nurses share responsibility for spiritual caregiving for their patients, the ability to provide this care is greatly influenced by intrinsic and the extrinsic factors. Spiritual caregiving was seen as both a discrete act that facilitated patients' spiritual practices and, in other situations, took the form of integrative spiritual caregiving that was part of the interpersonal connection in the nurse-patient relationship.

Integrating spiritual care into nursing education and practice: Strategies utilizing Open Journey Theory

Throughout nursing, spirituality is a recognized domain of patient care, but nurses feel ill prepared by their nursing education to provide care that is spiritual in nature to patients and their families. Incorporating spiritual care into nursing curricula is challenging in light of the amount of topics for healthcare learning. Open Journey Theory is based on the merging of two grounded theories, one teaching and one learning theory, and is the suggested framework for integrating spirituality and spiritual care across all levels of nursing education. Specially chosen readings (books, articles), activities (role-plays, discussion groups), and assignments (journaling, writing papers, giving reports) can be integrated into already existing courses. By utilizing the three stages of preparing, connecting, and reflecting to frame student learning, nurse educators can introduce and build on spiritual concepts from the simple to the complex over the course of the entire nursing program.

The Effects of Endotracheal Suctioning in the Pediatric Population: An Integrative Review

BACKGROUND

Critically ill pediatric patients with endotracheal tubes routinely receive endotracheal tube suctioning to clear secretions and ensure tube patency. This common practice can result in adverse effects.

OBJECTIVES

The aim of this study was to evaluate the research literature on the stressors of endotracheal suctioning and consequent effect on the pediatric patient.

METHODS

An integrative review was conducted using the Whittemore and Knafl modified framework for integrative reviews, and article selection was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram. A literature search was conducted via PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus. Selected articles were evaluated to present the current evidence on the stressors of endotracheal suctioning in the pediatric population.

RESULTS

This review includes 14 articles, with a total of 849 patients, ranging in age from premature neonates to 17 years of age. The available literature aligned into 3 categories: neurovascular effects, respiratory systems effects, and pain related to endotracheal tube suctioning. Pain was the most prevalent category, with half of the studies using endotracheal suctioning as a painful procedure to validate pain assessment tools rather than examining the effect of suctioning. A majority of the studies (67%) were conducted in the premature neonate population. Children with congenital cardiac or pulmonary defects, genetic syndromes, or neurological injuries were frequently excluded.

CONCLUSIONS

Literature regarding the effects of endotracheal suctioning in children is limited. There are many extrapersonal, interpersonal, and intrapersonal stressors associated with endotracheal suctioning that merit future research.

Spirituality in palliative care: experiences of an interdisciplinary team

Objective To understand the experience of spirituality in the daily routine of a palliative care interdisciplinary team. Method A qualitative study was conducted with an oncological palliative care team in southern Brazil. The data was collected through phenomenological interviews in 2014, and interpreted using a hermeneutic phenomenological approach. Results Six professionals participated in the study. Spiritually-related activities, such as prayer and providing comprehensive care, were useful therapeutic resources for offering comfort, survival with dignity and humanization of death, in addition to helping the team and patients understand the end-of-life process and search for meaning in the suffering caused by illness. Conclusion Spirituality on the part of professionals with patients imparted meaning to their palliative care work and facilitated the formation of bonds between teams, patients, and family members.

Psychometric Evaluation of the Filipino Versions of the Duke University Religion Index and the Spiritual Coping Strategies Scale in Filipino Hemodialysis Patients

This study evaluated the psychometric properties of the Filipino versions of the Duke University Religion Index (DUREL-F) and the Spiritual Coping Strategies scale (SCS-F) for hemodialysis (HD) patients in the Philippines. A convenient sample of 162 HD patients was included in this descriptive, cross-sectional study. The DUREL-F and SCS-F exhibited acceptable internal consistency and stability reliability, as well as excellent content and construct validity. The findings confirmed the soundness of the psychometric properties of the two scales. Thus, they can be used for timely and accurate assessment of religiosity and spiritual coping utilization among Filipino patients receiving HD.