What is the practice of spiritual care? A critical discourse analysis of registered nurses' understanding of spirituality

Deconstructing spiritual care: Discursive underpinnings within palliative care research

Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care.

The influence of spirituality on caregiver burden and quality of life in older adult informal caregivers

BACKGROUND

Caregiver burden (CB) reduces quality of life (QOL) and causes poor health outcomes. Spirituality impacts this relationship.

AIMS

To determine prevalence of CB and investigate relationships among CB, spirituality, and QOL in older U.S. adult informal caregivers (n = 754).

METHODS

This was a cross-sectional, descriptive secondary analysis of data from the 2020 Health and Retirement Study using GLM and SEM.

RESULTS

Caregiver mean age was 65.93 (SD=8.37). Caregivers were primarily female (n = 456, 54.0%), White (n = 500, 79.5%), and married (n = 469, 65.3%). Most caregivers had moderate CB (n = 369, 49.8%). Black caregivers who were spiritual (p=.031) and caregivers with a high school diploma/GED who were spiritual (p=.021) had lower CB. Lower CB was correlated with higher QOL (p=< 0.001). SEM depicting an influencing effect of spirituality revealed good model fit (NFI=0.988; IFI=0.993; TLI=0.983; PCFI=0.397, RMSEA=0.043; χ2=9.577, p=.048, DF=4) CONCLUSIONS: Fostering spirituality in older adult caregivers could reduce CB and improve QOL.

Spirituality and Religious Diversity in Nursing: A Scoping Review

Spirituality is a common theme in the field of healthcare research. This study aimed to examine nurses’ perceptions of spirituality in the context of the religious diversity of patients in pluri-religious settings. We performed a scoping review following the methodology on studies conducted between 2010 and 2020. We searched the following databases: CINAHL Plus, PubMed, and PsycINFO. For the identification of grey literature, the OpenGrey database was used. In total, 789 articles were reviewed. Of these, 16 met predetermined inclusion criteria. Two main overarching themes emerged from our inductive analysis: (a) the intertwining of spirituality and spiritual care in diverse religious landscapes and (b) obstacles impeding the inclusion of spiritual care in pluri-religious settings. According to our results, nurses consider that spirituality is interconnected with spiritual care for individuals from different religious backgrounds. Interpretations of spirituality in nursing practice vary widely, with spirituality and religiosity often shaped and influenced by culture and the experience of the professionals. Nurses attribute various meanings to spiritual care, most of which center on respecting personal, interpersonal, and relational aspects of religious and cultural beliefs and practices. Lack of education and specific skills, insufficient time, role ambiguity, and different religious beliefs were identified as hurdles to spiritual care. A poor work environment, a lack of patient privacy, including personal space, and a lack of compassion were also reported as deterrents to spiritual healing. More knowledge and training on different religions and spirituality are required to meet patients’ spiritual needs to better overcome these hurdles.