Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses

Self-Reported Religiosity and Spirituality of Registered Nurses in Virginia

ABSTRACT

The professional nurse cares for an increasingly diverse population, varying in ethnicity, culture, and faith beliefs that influence health and wellness. The moral obligation of the nurse to provide individualized, holistic care of clients includes spiritual care. Supported by the Agape Model of Nursing, nurses should understand their personal religiosity and its impact on the care they provide. The purpose of this study was to better understand the self-reported religiosity and spirituality of registered nurses licensed to practice in the Commonwealth of Virginia.

An Exploration of the Supportive Care Needs of Caribbean Families of Critically Ill Adults

ABSTRACT

Nurses care for patients of diverse cultures. Persons in and from the Caribbean region have specific needs and concerns related to the support they need when a family member is admitted to an intensive care unit (ICU). Nurses familiar with Caribbean patient culture can provide these family members with knowledgeable and culturally competent care. However, little research exists about the unique needs of this population. This pilot study explored the nursing support needs of adult Caribbean family members of patients in the ICU.

Exploring the relationship between spiritual care and patient advocacy of nurses from generations X, Y and Z working in intensive care clinics: A cross-sectional study

OBJECTIVE

To determine the relationship between spiritual care and patient advocacy across three generations of nurses working in intensive care units.

DESIGN

Cross-sectional survey.

METHODS

Data collection took place from July to August 2022 with 120 nurses in Turkey. Data collection tools included the Spiritual Caregiving Competency Scale, the Spirituality and Spiritual Care Assessment Scale, and the Patient Advocacy Scale for Nurses. Data on nurses' demographics were evaluated using descriptive statistical methods (number, percentage, mean, standard deviation). Independent sample t-test, one-way ANOVA, Pearson correlation, and linear multiple regression analysis were used to evaluate the relationships between variables, with results reported as 95% confidence intervals (CI).

RESULTS

More than half of the nurses were from Generation Y (39.2 %) and Generation Z (42.5 %). Generation Z's mean patient advocacy score (156.96 ± 23.16) was statistically significantly higher than Generation X's (139.32 ± 34.26). We determined that the spiritual competence scale communication sub-dimension score of Generation Y nurses working between 1-10 years was higher than that of Generation Z nurses. Additionally, as the patient advocacy scores of all generations increased, so did spiritual competence scores.

CONCLUSION

The study found differences in patient advocacy and spiritual care competencies between generations. Thus, we recommend organizing courses, seminars, and in-service training on patient advocacy and spiritual care for intensive care nurses.

IMPLICATIONS FOR CLINICAL PRACTICE

This study estimates nurses' spiritual care competencies and patient advocacy levels from different generations and sheds light on the literature to eliminate differences in care between generations in nursing practices that evolve and change over time. It is recommended that courses, seminars, in-service training, spiritual activities, and interactive meetings be organized to encourage the participation of intensive care nurses to minimize the differences in spiritual care and patient advocacy among all generations of intensive care nurses.

How nurses can apply spiritual care to improve the daily lives of people with learning disabilities and their families

BACKGROUND

Most UK nursing research into spirituality overlooks its daily application in certain specialties, notably learning disability nursing.

AIMS

Tz explore spirituality over the lifespans of people with learning disabilities and how spiritual care affects their quality of life. To provide practical examples for nurses on how to apply spiritual care in their daily practice.

METHODS

A literature review conducted between January 2002 and July 2022) following recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Thomas and Harden's (2008) approach to thematic synthesis was used to structure 10 full-text articles into three key themes.

FINDINGS

The three key themes were: the role of the nurse, the impacts on the individual, and family/carer perspectives.

CONCLUSION

The nursing role in using spiritual care encompasses care planning an individual's spiritual activities, facilitating time alone, nurturing values such as self-acceptance, building therapeutic relationships, and advocating for progression in existing social structures and legislation.

The effectiveness of spiritual care training on medical students' self-reported competencies: A quasi-experimental study

OBJECTIVES

To evaluate the effectiveness of spiritual care training on medical students' self-reported competencies.

METHODS

This is a quasi-experimental (controlled and non-randomized) study including 115 Brazilian medical students. Participants were enrolled into 2 groups: fourth-year students (n = 64) who received spiritual care training and sixth-year students (n = 51) who did not receive this training - control group (i.e., usual teaching). Participants answered a self-reported Spiritual Care Competence Scale. Comparisons between groups were performed and effect sizes were reported.

RESULTS

Providing a spiritual care training resulted in significantly higher self-reported scores for the dimensions of "Assessment" (d = 0.99), "Improvement of care" (d = 0.69), "Counseling (d = 0.88)," "Referral" (d = 0.75), and "Total Spiritual Care" (d = 1.044) as compared to the control group. Likewise, 21 out of 27 items of the Spiritual Care Competence Scale were significantly higher for the intervention group, presenting effect sizes (d) ranging between 0.428 and 1.032.

SIGNIFICANCE OF RESULTS

Medical students receiving spiritual care training showed greater self-reported competencies as compared to those in the usual teaching. These results reinforce the importance of promoting spirituality teaching in medical schools.

Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials

Objective

This study aimed to systematically review studies of meaning therapy on patients with cancer and to evaluate its effectiveness on spiritual outcomes, psychological outcomes, and quality of life (QOL).

Methods

A comprehensive literature search were performed in five international databases (PubMed, Embase, Web of Science, The Cochrane Library, and CINAHL) and four Chinese databases (CNKI, Wanfang Data, VIP, and CBM) from the inception to August 2023. The methodological quality of each included studies was evaluated by using the revised Cochrane risk-of-bias tool for randomized trials. The random-effects model or fixed-effects model was utilized for effect size analysis, and the standardized mean difference (SMD) or mean difference (MD) along with its corresponding 95% confidence interval (CI) was computed. Meta-analysis was conducted by using the RevMan software 5.4.1.

Results

Eight randomized controlled trials with 1251 participants were included in this review. Meta-analyses revealed that meaning therapy can significantly improve the spiritual outcomes including meaning in life (SMD = -0.48; 95% CI = -0.89 to -0.07; P = 0.02), hopelessness (SMD = -0.30; 95% CI = -0.51 to -0.09; P = 0.005), self-esteem (MD = -2.74; 95% CI = -4.17 to -1.32; P = 0.0002) and spiritual well-being (MD = -3.32; 95% CI = -5.63 to -1.01; P = 0.005), psychological outcomes including anxiety (MD = -0.66; 95% CI = -1.30 to -0.01; P = 0.05), depression (SMD = -0.37; 95% CI = -0.55 to -0.20; P < 0.0001), psychological distress (SMD = -0.35; 95% CI = -0.70 to -0.01; P = 0.04) and desire for hastened death (MD = -0.76; 95% CI = -1.47 to -0.05; P = 0.04), and QOL (SMD = -0.29; 95% CI = -0.50 to -0.09; P = 0.006) in patients with cancer.

Conclusions

Meaning therapy has positive effects on improving spirituality, psychological health, and QOL of patients with cancer. More high-quality randomized controlled trials with larger sample sizes are warranted to confirm the results of our review and to clarify the long-term effects of meaning therapy in the future.

Systematic review registration

PROSPERO (No. CRD42021278286).

The impact of a nursing spiritual care module on nursing competence: an experimental design

PURPOSE

This study aimed to assess the impact of the Nursing Spiritual Care Module on the competence of nurses in providing spiritual care in the context of Malaysia.

METHOD

This study employed an experimental design and involved a total of 122 nurses, with 59 in the experimental group and 63 in the control group. Participants were selected from palliative care wards associated with Hospital Universiti Sains Malaysia. Nurses in the experimental group underwent a two-week educational module on nursing spiritual care, while nurses in the control group attended a single lecture on spiritual care provided by the hospital.

RESULTS

The results indicated no significant differences in sociodemographic characteristics between the two groups. A significant difference in spiritual care competence within the intervention group and the control group over time (p-value = 0.001), between the two groups (p-value = 0.038), and in the interaction between time and group (p-value = 0.001).

CONCLUSION

The Nursing Spiritual Care Module is crucial in aiding nurses and healthcare professionals in cultivating the appropriate and wholesome attitudes and practices necessary to address the spiritual needs of patients.

Intensive Care Unit Nurses' Experience of Watson's Theory of Human Caring Caritas Process III: Developing Spiritual Self to Provide Spiritual Nursing Care

The purpose of this study was to explore intensive care unit (ICU) nurses' experience of developing spiritual self to meet the significant spiritual and existential needs of patients and their families. A qualitative descriptive method with directed content analysis guided by Watson's Theory of Human Caring was utilized. From a sample of 10 ICU nurses, 3 main themes were described. The themes articulate ICU nurses' experience of personal spiritual growth as influenced by their work environment and the need for continued development of spiritual self to support their clinical role.

Nurses' perceptions and competencies about spirituality and spiritual care: A systematic review and meta-analysis

OBJECTIVE

To identify and synthesize nurses' perceptions of spirituality and spiritual care and their spiritual care competencies.

DESIGN

A systematic review and meta-analysis of observational studies.

DATA SOURCES

The electronic databases PubMed, EMBASE, Web of Science, CINAHL, ProQuest, Scopus, CNKI, and WANFANG were systematically searched from the inception of each database to April 19, 2023.

REVIEW METHODS

Two reviewers independently completed the selection of included studies and data extraction. The Agency for Healthcare Research and Quality (AHRQ) checklist was used to assess the methodological quality of the included studies. The study outcomes were meta-analyzed using STATA 15 software. Predefined subgroup analyses were conducted to explore differences in spiritual care competencies among nurses across religious affiliation and education levels.

RESULTS

Thirty-five cross-sectional studies conducted in 11 countries and territories met the inclusion criteria, with 17,786 participants. The meta-analysis revealed that the pooled mean scores for spirituality and spiritual care perceptions and spiritual care competencies were 3.62 (95 % CI: 3.41-3.83) and 3.46 (95 % CI: 3.28-3.63), respectively. Nurses with no religious affiliation had inferior spiritual care competencies (3.24) than nurses with religious affiliation (3.31); nurses with a master's degree or above had the greatest spiritual care competencies (3.59), while nurses with an associate's degree had the least (3.31).

CONCLUSION

Nurses' perceptions and competencies about spirituality and spiritual care were moderate, and both needed to be improved, especially among nurses with no religious affiliation and low education levels. Nursing educators and leaders need to emphasize both theory education in the spiritual dimension and dedication to training in spiritual care practice, as well as provide nurses with targeted teaching and training to improve their competency in addressing the spiritual needs of their patients.

A structural equation modeling analysis of the effects of nurses' spirituality and spiritual care on professional quality of life

Spiritual care helps nurses establish a deeper connection with patients and meet their spiritual needs. Spiritual belief is thought to enable nurses to be more effective in their profession and positively affect their quality of life. This study aimed to investigate the effects of nurses' spirituality and spiritual care on quality of life. This study was designed as a descriptive cross-sectional study using structural equation modeling. A total of 221 nurses were included. Data were collected using the Professional Quality of Life Scale, and Spirituality and Spiritual Care Scale. The data were analyzed using descriptive statistics, correlational statistics, and structural equation modeling. Spirituality and spiritual care were negative predictors of burnout and positive predictors of compassion satisfaction. Spirituality and spiritual care decreased the level of burnout in nurses and significantly increased the level of compassion satisfaction. This study suggests raising nurse awareness of spirituality and spiritual care. Supporting nurses with professional training programs, including spiritual care, may benefit their quality of life.

Palliative care and spiritual care competency measurement among Turkish Nurses: A scale adaptation study

OBJECTIVES

This study aimed to conduct a Turkish validity and reliability study of the Palliative Care Spiritual Care Competency Scale.

METHODS

The sample of the study consisted of 354 nurses. In the first stage, the forward-backward translation method was used to develop the Turkish version of the Palliative Care Spiritual Care Competency Scale. The comprehensibility, purposefulness, cultural appropriateness, and discrimination of the scale items were evaluated with content validity. Confirmatory factor analysis (CFA) was applied to examine the construct validity of the scale. To evaluate the ability of the scale to give consistent results at different time intervals, the relationship between the scores obtained from the first and second applications was examined with the intraclass correlation coefficient (ICC). The reliability of the scale was evaluated with the Cronbach's alpha reliability coefficient and item-total score correlation coefficients.

RESULTS

The content validity index of the Palliative Care Spiritual Care Competency Scale was found to be 0.98 after expert opinion was obtained. The goodness-of-fit values of the scale were χ2/sd: 3.125; GFI: 0.915; AGFI: 0.875; IFI: 0.926; TLI: 0.905; CFI: 0.925; RMSEA: 0.078; SRMR: 0.054. As a result of CFA, some items were removed from the scale, and a Turkish version of the scale consisting of 14 items and three sub-dimensions was developed. The reliability of the scale over time was evaluated with the test-retest method, and it was found that the inter-response agreement was very good (ICC: 0.981; p < 0.001). The Cronbach's alpha reliability coefficient of the scale was 0.89 and the Cronbach's alpha reliability coefficient of the subscales ranged between 0.78 and 0.85.

SIGNIFICANCE OF RESULTS

It was determined that the Turkish version of the Palliative Care Spiritual Care Competency Scale is a short, easy-to-understand, and psychometrically sound measurement tool that can be safely applied to Turkish nurses.

The Knowledge, Practices, and Perceptions of Surgical Nurses Concerning Spirituality and Spiritual Care

PURPOSE

The purpose of this descriptive study was to describe the knowledge, practices and perceptions of nurses concerning spirituality and spiritual care.

DESIGN

A descriptive study.

METHODS

The study was performed with 142 surgical nurses working in three public hospitals in a city in Turkey. A "Personal Information Form" and the "Spirituality and Spiritual Care Grading Scale" were used for data collection. The data were analysed on SPSS 25.0 software.

FINDINGS

While 77.5% of the nurses reported having heard about the concepts of spirituality and spiritual care, 17.6% reported having received instruction concerning spirituality and spiritual care during their initial nursing education and 19.0% after graduation. In addition, 78.2% provided spiritual care in the clinics where they worked, 40.5% reported that patients were given religious support and 37.8% stated that patients were given the opportunity to be involved in their own care. The nurses' total mean spirituality and spiritual care grading scale score was 57.6±5.6. A statistically significant difference was determined in mean scale scores between nurses who had and had not heard about the concepts of spirituality and spiritual care (P=0.049) and between those who practiced and did not practice spiritual care in the clinics where they worked (P=0.018).

CONCLUSIONS

The majority of surgical nurses had heard about the concepts of spirituality and spiritual care but had not been exposed to them during their initial nursing education. However, the majority practiced spiritual care in their clinics, and their perception levels were above average.

Effects of a Meaning-Centered Spiritual Care Training Program for Hospice Palliative Care Teams in South Korea: A Nonrandomized Controlled Trial

BACKGROUND

Spiritual care is an essential part and a core component of quality palliative care, as identified by the World Health Organization. However, spiritual care training for hospice palliative care teams (HPCTs) is infrequent.

OBJECTIVE

The aim of this study was to investigate the effects of a meaning-centered spiritual care training program for HPCTs (McSCTP-HPCT).

METHODS

This study used a nonrandomized controlled design. The McSCTP-HPCT comprised 5 modules. The participants were HPCTs working in 15 national hospice institutions and were allocated to either the experimental group (n = 33) or the control group (n = 27) based on the participating institutions' preference. Three outcome variables were tested: spiritual care competency, spiritual care therapeutics, and compassion fatigue. Data were analyzed using descriptive statistics, χ 2 test, 1-way analysis of variance, and repeated-measures analysis of variance.

RESULTS

There was a significant difference in the interaction between measurement time and group assignment in spiritual care competency ( P = .002) and spiritual care therapeutics ( P = .038), whereas no significant difference was found for compassion fatigue ( P = .716).

CONCLUSION

The McSCTP-HPCT conducted in this study shows effectiveness in increasing the spiritual care competency and spiritual care therapeutics of HPCTs and may support the importance of spiritual care training.

IMPLICATIONS FOR PRACTICE

The McSCTP-HPCTs adds to the scientific evidence on spiritual care and has the capacity to improve the quality of care for patients with a life-threatening illness.

Perceived Barriers to Providing Spiritual Care in Palliative Care among Professionals: A Portuguese Cross-Sectional Study

Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.

Caring Spiritually: A Study on Spiritual Care Training in a Hospice Setting

Spiritual care can improve patients' physical and emotional well-being, but patients at the end of life often experience their spiritual needs are not being sufficiently met by the health care professionals. This is caused by barriers among health care professionals that stem from inadequate education on spiritual care and lack of self-reflection on spiritual topics. By participating in spiritual care training, health care professionals seem to gain the knowledge, confidence, and skills they need to care spiritually for patients. The aim of this study was to evaluate the effect and experiences of a training course in spiritual care for 30 nurses working at a Danish hospice. This was done by means of both a before-and-after questionnaire and focus group interviews. The course focused primarily on the nurses and their personal and collegial reflections on spiritual care, whereas increased spiritual care for patients seemed to be a secondary outcome of the course. There was a significant statistical correlation between the nurses' values and spirituality, and their confidence in being able to exercise spiritual care for patients. The training course facilitated spiritual empowerment, collegial spiritual care, and spiritual language among the nurses, which led to increased spiritual care for patients.

Benefits of Spiritual and Religious Support in the Pain Management of Cancer Patients: A Literature Scoping Review

Pain is one of the main symptoms of cancer and the most difficult to control due to its complexity as it can involve physical, psychological, social, and spiritual aspects. We proposed to summarize the scientific knowledge already published related to the influence of spirituality on pain therapy in cancer patients. Articles were searched in PubMed, SciELO, SciFinder, PsycInfo, and ScienceDirect databases using the following descriptors: "Spirituality," "Religion," "Religion," "Chronic Pain," "Pain Management" and "Cancer." A total of 68 articles were included and discussed. Most articles dealt with the influence of spirituality in palliative care, focussed on patient quality, and highlighted the importance of integrative oncology. Although few studies associated spirituality with chronic pain, most articles reported that spirituality could confer greater pain control.

The Relationship between Daily Spiritual Experiences and the Dimensions of Spiritual Care Competence in Nursing Students: The Dimension of Professionalization and Improvement of the Quality of Spiritual Care

Background

Daily spiritual experiences and spiritual care competence have positive health effects on patients and form an integral part of the nursing profession. This study was conducted to determine the relationship between daily spiritual experiences and the dimensions of spiritual care competence in nursing students.

Materials and Methods

This cross-sectional study was conducted on 401 nursing students in their last year of the program. The participants were selected from nursing schools in Tehran Province, Iran, in the academic year 2019-2020. The required data were extracted using a demographic information questionnaire, the Daily Spiritual Experiences Scale (DSES), and the Spiritual Care Competence Scale (SCCS). The collected data were analyzed in SPSS software at the significance level of 0.05.

Results

The mean (SD) of daily spiritual experiences and total spiritual care competence was 67.15 (16.33) and 101.77 (16.26), respectively. The personal support and patient counseling dimensions had the highest mean (SD) [22.10) 4.80)]. Among all these dimensions of spiritual care competence, only professionalization and improvement of the quality of spiritual care were predictors of the students' daily spiritual experiences (p < 0.05).

Conclusions

The professionalization dimension of spiritual care competence was identified as a predictor of daily spiritual experience in nursing students. Therefore, the researchers recommend the highlighting of this dimension in nursing programs to promote the students' spiritual care competence.

Developing and testing the EPICC Spiritual Care Competency Self-Assessment Tool for student nurses and midwives

AIMS AND OBJECTIVES

To develop and psychometrically test a self-assessment tool that measures undergraduate nursing and midwifery students' perceptions of spiritual care competence in health care practice.

BACKGROUND

Spiritual care is part of nurses/midwives' responsibility. There is a need to better benchmark students' competency development in spiritual care through their education. The EPICC Spiritual Care Education Standard served as groundwork for the development of the EPICC Spiritual Care Competency Self-Assessment Tool.

DESIGN

Cross sectional, mixed methods design. A STROBE checklist was used.

METHODS

The Tool (available in English, Dutch and Norwegian) was developed by an international group. It was tested between July-October 2020 with a convenience sample of 323 nursing/midwifery students at eight universities in five countries. The Tool was tested for validity using Kaiser-Meyer-Olkin (KMO) test, exploratory and confirmatory factor analysis, one-way ANOVA and independent samples t test. The reliability was tested by Cronbach's alpha coefficient. Qualitative data were analysed using thematic analysis.

RESULTS

The KMO test for sampling adequacy was 0.90. All, but two, items were related to the same factor. Cronbach's alpha coefficient for the Tool was 0.91. Students found the Tool easy to use, and they gained new insights by completing it. However, students felt that some questions were repetitive and took time to complete.

CONCLUSIONS

The Tool has construct and discriminant validity, and high internal consistency (is reliable). In addition, students found the Tool useful, especially in early stages of education.

RELEVANCE TO CLINICAL PRACTICE

The Tool affords student nurses and midwives the opportunity to self-evaluate their knowledge, skills and attitudes about spirituality and spiritual care. The Tool offers students, educators and preceptors in clinical practice a tangible way of discussing and evaluating spiritual care competency.

The Effects of a Scenario-Based Spiritual Care Course on Spiritual Care Competence among Clinical Nurses: A Quasi-Experimental Study

Across their lifespans, and in many clinical settings, patients have spiritual care needs. Many nurses lack competence related to providing spiritual care. Popular educational strategies, such as simulated educational programs and objective structured clinical examinations (OSCE), have not been widely adopted in nursing spiritual care education. The purpose of this study was to explore the effects of a scenario-based spiritual care course on spiritual care competence in nurses. This quasi-experimental study employed a repeated-measures pre-test/post-test design with assessments immediately before, immediately after, and 3 months post-intervention. Nurses providing direct patient care in diverse clinical settings were recruited from a large medical foundation in northern Taiwan. The intervention was a one day scenario-based spiritual care course and OSCE. The experimental group (n = 53) and controls (n = 85) were matched for their similar units, ages, working experience, and clinical ladder status. The Spiritual Care Competence Scale (SCCS), Spiritual Perspective Scale (SPS), Spiritual Care Perspective Scale-Revised (SCPS-R), and reflection logs were completed by both experimental and control groups. The Course Satisfaction Scale, OSCE Checklist, and Standardized Patient Feedback Scale (SPFS) were completed by the experimental group only. The experimental group had significantly higher SPS scores and self-evaluated SCCS scores, and lower SCPS-R scores (more positive spiritual perspectives), than controls at 3 months post-intervention. The experimental group showed significant within-subject effects at three time points on SPS scores, SCPS-R scores, and self-evaluated SCCS scores. Mean global performance of OSCE was 3.40 ± 0.91, and SP feedback indicated strengths and areas for improvement. In conclusion, the scenario-based spiritual care course effectively enhanced nurses' spiritual care competence, competence, and skills. Blended education techniques can therefore enhance nurses' ability to support patients with spiritual care needs.

Improving psychiatric nurses' competencies in spiritual care and integration of clients' religion/spirituality into mental healthcare: outcomes of an online spiritual care training program

BACKGROUND

Religion/spirituality (R/S), which is associated with individuals' well-being and psychological health, plays a significant role in most clients' lives in healthcare systems. Although clients in mental healthcare settings prefer their R/S to be employed in nursing care, R/S has neither been adequately integrated into mental healthcare nor discussed in the assessment and nursing interventions of mental healthcare. Evidence shows that most psychiatric nurses receive little or no training in spiritual care (SC) and are unable to integrate clients' R/S into mental healthcare. To address this gap, the present study aimed to investigate the effects of an online SC training program on psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare.

METHODS

This experimental study was conducted with nurses working in a psychiatric hospital affiliated with a large University of Medical Sciences in southeast Iran. Random sampling was performed and 95 nurses were assigned to the intervention (n = 50) and control (n = 45) groups. Online SC training was conducted for the intervention group in four sessions over four weeks. Data were collected using the Self-Assessment of Spiritual Care Competency and R/S Integrated Practice Assessment Scale before and one month after the training program.

RESULTS

There were no significant differences between the two groups before training (p > 0.05). After the training, nurses in the intervention group obtained significantly higher scores in competencies in SC and integration of clients' R/S into mental healthcare compared to the control group, with a considerable effect size (P < 0.05).

CONCLUSION

The online training program positively affected psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare. Since SC is a critical need for clients, specifically in mental healthcare settings, nurses must receive continuous education to provide SC to various clients.

The correlation between spiritual care competence and spiritual health among Iranian nurses

Background

Considering the importance of spiritual aspects of human beings, spiritual care provision is increasingly recognized as a major duty of healthcare providers, particularly nursing staff. Spiritual care competence is necessary for the nurses to be able to provide spiritual care, but the competence itself is associated with other variables. This study aimed to investigate if the spiritual care competence of nurses is related to their spiritual health.

Methods

A cross-sectional study was conducted with the participation of 172 practicing nurses in hospitals affiliated with Qom University of Medical Sciences, selected through stratified random sampling. Participants completed the Persian versions of the Spiritual Health Questionnaire (Amiri) and the Spiritual Care Competence Scale (Van Leeuwen). To examine the correlation between nurses’ spiritual health and spiritual care competence, a Spearman coefficient was used and a linear regression analysis was done to determine the predictability of the spiritual care competence of the nurses. The data were analyzed using SPSS v.23 and the significance level was set at 0.05.

Results

The participants showed a mean (SD) score of 108.93 (19.04) on spiritual care competence and 213.38 (16.49) on spiritual health. Spiritual care competence of nurses showed no significant relationship with demographic characteristics and their spiritual health had a significant relationship with gender only. Correlation analysis revealed a significant relationship between spiritual health and spiritual care competence and their subscales. Moreover, the linear regression analysis indicated that the nurses’ performance regarding spiritual health can predict their spiritual care competence.

Conclusion

The study revealed that the spiritual care competence of nurses is correlated with their spiritual health and performance as a subscale of spiritual health can predict their spiritual care competence. Thus, it can be concluded that the spiritual health of nurses is an important factor in providing spiritual care for patients and meeting their spiritual needs.

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.

Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review

AIMS AND OBJECTIVES

To map existing evidence about educational interventions or strategies in nursing and allied healthcare concerning students' and staffs' spiritual care provision.

BACKGROUND

Spiritual care is an important part of whole person care, but healthcare staff lack competence and awareness of spiritual issues in practice. To rectify this, it is important to identify what educational approaches are most helpful in supporting them to provide spiritual care.

DESIGN

A scoping review using the PRISMA-ScR checklist.

METHOD

Searches in the databases CINAHL, MEDLINE, ATLA and ERIC were conducted for papers spanning January 2009-May 2020. Search terms were related to spirituality, spiritual care, education and clinical teaching. Appraisal tools were used.

RESULTS

From the 2128 potentially relevant papers, 36 were included. The studies were from 15 different countries and involved nurses, physicians and other health-related professions, and both quantitative, qualitative and mixed methods were used. The results are presented in three themes: Understanding of spirituality, Strategies in educational settings, and Strategies in practice settings. The review points to great diversity in the content, lengths and setting of the educational interventions or strategies.

CONCLUSIONS

Courses in spiritual care should be implemented in curricula in both undergraduate and postgraduate education, and several studies suggest it should be mandatory. Courses should also be available for healthcare staff to raise awareness and to encourage the integration of spiritual care into their everyday practice. There is a need for greater consensus about how spirituality and spiritual care are described in healthcare settings.

RELEVANCE TO CLINICAL PRACTICE

Spiritual care must be included both in monodisciplinary and multidisciplinary educational settings. The main result of spiritual care courses is in building awareness of spiritual issues and self-awareness. To ensure the provision of spiritual care for patients in healthcare practices, continuing and multidisciplinary education is recommended.

Validity and reliability of the Spiritual Health Scale-Short Form for Turkish nursing students

OBJECTIVE

This study aimed at assessing the validity and reliability of the Turkish version of the Spiritual Health Scale-Short Form (SHS-SF).

METHODS

The methodological research was conducted with Turkish nursing students (n = 310). The sociodemographic question form and the SHS-SF were used as data collection instruments. The Content Validity Index, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analyses (CFA) were used for the validity of the scale, and Internal Consistency and Cronbach's Alpha reliability coefficient for its reliability.

RESULTS

The EFA revealed that five factors accounted for 66.49% of the variance. According to the CFA, the factor loadings for the 24-item scale ranged from 0.40 to 0.91. Goodness-of-fit indices were as follows: χ2/df = 2.39, RMSEA = 0.06, CFI = 0.92, TLI = 0.91, IFI = 0.92. The item-total correlation for the scale items ranged from 0.37 to 0.65. The alpha coefficient for the scale was 0.91.

SIGNIFICANCE OF RESULTS

It is important to identify the level of spiritual health of nurses and nursing students with a valid and reliable scale. The SHS-SF was found to be a reliable and valid scale for use in the Turkish language and culture. The scale can be used for evaluating spiritual health levels among Turkish nurses and nursing students. This will provide an opportunity for planning appropriate interventions to improve the spiritual health level of nurses and nursing students.

Spiritual Care Competences among Health Care Professionals in Pakistan: Findings from a Cross-Sectional Survey

Introduction: There is a gap in healthcare literature related to the spiritual competence of physicians and nurses practicing in South Asian Muslim communities. To fill that gap, the Spiritual Care Competence Questionnaire (SCCQ) was applied which was developed to address multi-professional spiritual care competences. Materials and Methods: A cross-sectional study among 294 health professionals (61% physicians, 17% nurses, and 22% other professions) in 10 hospitals in Punjab, Pakistan. Results: The highest scoring competences were “Dealing with patients/Communication competences”, while “Team Spirit” scored lowest. There were no gender related differences, but there were effects related to professions. “Team Spirit”, “Dealing with patients/Communication competences”, and “Empowerment competences” scored significantly higher in nurses as compared to physicians and other health care professionals, while there were no significant differences for their “Perception/Documentation competences”. These competences were not relevantly related to the intensity of their prayer/meditation activity. Conclusions: Health care professional from Punjab were preferred to tolerate the pain and the suffering of patients and their relatives rather than to talk about spiritual care issues. Their spiritual care competences were less developed. Thus, there is a clear need for further specific education and training of health professionals.

Towards a national strategy for the provision of spiritual care during major health disasters: A qualitative study

Background

Spirituality is beneficial to health. Evidence around the benefits of Spiritual care (SC) is advancing, and training is becoming part of healthcare professional development. As the COVID‐19 crisis showed, during major health disasters (MHDs), the demand for SC grows exponentially, while the burden of care and focus on preserving life often hamper its provision. Nonetheless, existing health emergency strategic frameworks lack preparedness for the provision of SC.

Aim

The aim of this study was to identify the components for a National Strategy (NS) for the provision of SC during MHDs.

Methods

Descriptive, cross‐sectional, qualitative phenomenological design based on individual, semi‐structured e‐interviews with nursing managers and National Health Service/volunteer chaplains based in England. Thematic analysis of 25 e‐interview data was performed based on a dialogic collaborative process.

Results and Discussion

Eleven themes were identified as components of the proposed NS. From these components, specific recommendations for practical actions are provided. An integrated framework approach and smart investments in resources, staff training and technologies should be led by the paradigm of culturally competent and compassionate care.

Conclusion

The need to have strategic frameworks, both national and local, that better equip a country healthcare sector to prevent, face, and recover from MHDs is paramount. Catering for the spiritual needs of the affected population should be a key aspect of any health emergency strategy to ensure the preservation of quality care.

Adequate provision of Spiritual care (SC) is more needed yet challenging during health disasters.

With the COVID‐19 crisis, SC strategic planning proved essential.

Collaboration, communities' inclusivity, and training are key strategic elements.

Governments investments should look at advanced technologies, and material and human resources.

Validity and reliability of the spiritual care competency scale for oncology nurses in Taiwan

Background

Nurses must have spiritual competence to provide holistic patient care. Therefore, the designed instrument to assess nurses’ competence could be a practical guide for health care professionals. This study aimed to evaluate the validity and reliability of the spiritual care competency scale (SCCS) for oncology nurses in Taiwan.

Methods

This study used a convenience sample from a regional teaching hospital in Taiwan from November 2017 to February 2019, who were asked to complete the SCCS. We employed scale-content validity index (S-CVI). Exploratory Factor Analysis (EFA) was also used to evaluate the structural factor of SCCS. Confirmatory Factor Analysis (CFA) verified the construct validity of SCCS scale for oncology nurses in Taiwan. Test–retest reliability were also measured in this study at 2-week interval.

Results

The average S-CVI of SCCS was 0.96. The EFA produced four factors of 27 items, such as professionalization, improving the quality of spiritual care, personal support, patient counseling and referral, attitude towards patient spirituality and communication, assessment, implementation providing and evaluation of spiritual care. Fitting the 27 items yielded an acceptable model fit; X²/df = 2.41, RMSEA = 0.08, GFI = 0.80, AGFI = 0.80, CFI = 0.92, IFI = 0.92, NFI = 0.90, RFI = 0.90, TLI = 0.91, SRMR = 0.06. Cronbach’s alpha values were between 0.93 and 0.95, and the total Cronbach’s alpha was 0.96. The intraclass correlation coefficient (ICC) scores were between 0.43 and 0.88.

Conclusions

The result of this study demonstrated satisfactory validity and reliability for the SCCS in the nursing field in Taiwan. Implications for practice in this study serves as a reference for effectively evaluating nursing competency in spiritual care.

Impact of an online spiritual care course on perceived competency in spiritual care of students in social and health care professions / Wirksamkeit eines Online-Spiritual Care-Seminars auf die wahrgenommene Spiritual Care-Kompetenz bei Studierenden in Sozial- und Gesundheitsberufen

This study examines the impact of an online spiritual care course on perceived spiritual care competency of students in social and health care professions. A quasi-experimental, pre-post-test study using questionnaires was conducted in Bavaria, Southern Germany, with a sample of 78 participants and 67 respondents in a comparison group. A repeated measures ANOVA was performed, with time and group as factors. Statistically significant increases were found in participants' perceived knowledge, skills, and attitudes concerning spiritual care, in different facets of spiritual care competency, in spiritual awareness, and in general self-efficacy (p < .05). Results suggest the effectiveness of online spiritual care training, which can help prepare future caregivers in providing holistic care.

Empowerment of nurses for integrating clients' religion/spirituality into clinical practice: outcomes of an online training program

Background

Integration of clients’ religion/spirituality (R/S) into nursing practice can have effective outcomes in clients’ health. In this regard, nurses’ lack of competency can disrupt this process and interfere with the treatment process. Limited studies examined the impact of training programs on nurses’ competency in spiritual care and integration of clients’ R/S into clinical practice. This study aimed to investigate the impact of an online training program on nurses’ empowerment for integrating clients’ R/S into clinical practice.

Methods

In the present interventional study, 80 nurses were selected by stratified sampling from two hospitals in the southeastern Iran. Nurses were randomly divided into the intervention (n = 40) and control (n = 40) groups. An online training program was performed for the intervention group in four 2-hour sessions during three weeks. Data were collected from all participants using the R/S Integrated Practice Assessment Scale (RSIPAS) before and one month after the intervention.

Results

Prior to the intervention, scores of integrating clients’ R/S into clinical practice were not significantly different between the intervention and control groups (t = 0.23, p = 0.81). However, after the training program, these scores increased significantly with a very large effect size compared to the control group (t = 4.31, p = 0.001). Although the control group scores improved significantly after the intervention compared to the pre-intervention stage, the effect size was very small (t = -2.55, p = 0.01).

Conclusions

The online training program had a positive effect on nurses’ competency for integrating clients’ R/S into clinical practice in the intervention group. Due to the importance of integrating clients’ R/S into clinical practice, nurses’ competency should be strengthened in this area. Managers are suggested to consider appropriate strategies in order to empower nurses in integrating clients’ R/S into clinical practice. Nurse educators can benefit from our experiences in application of online training programs in nursing schools.

Perceived professional competence in spiritual care and predictive role of spiritual intelligence in Iranian nursing students

AIM/OBJECTIVE

The aim of this study was to identify the relationship between perceived competence in spiritual care and spiritual intelligence among nursing students.

BACKGROUND

One of the most important duties of nurses is to pay attention to the spiritual needs of patients and provide them with proper spiritual care. Therefore, professional competence in this area is essential for nurses and nursing students. Also, spiritual intelligence is a factor influencing the caring behaviors of nurses.

DESIGN

A cross-sectional and correlational study SETTINGS/PARTICIPANTS: This study was included 510 undergraduate nursing students in two public faculties of nursing in Iran in the 2018-2019 academic year.

METHODS

The samples were selected using a census method. A demographic information questionnaire, the valid and reliable Iranian questionnaire of nurses' competencies in spiritual care and the spiritual intelligence self-report inventory (SISRI) were used to collect data.

RESULTS

A significant positive correlation was found between nursing students' competence in spiritual care and spiritual intelligence (p < 0.001, r = 0.26). No significant differences were found between the mean competence scores of spiritual care in terms of demographic characteristics. There were significant differences between the mean spiritual intelligence score in terms of age, marital status, history of clinical practice and academic year. The regression model indicated that for increased rates of spiritual intelligence, professional competence in spiritual care would rise as much as 0.39.

CONCLUSION

Spiritual intelligence can affect the competence of nursing students in providing spiritual care to patients. Therefore, to promote students' spiritual intelligence, appropriate plans with the aim of promoting the level of critical thinking and spiritual self-awareness are recommended.

An Online Competency-Based Spiritual Care Education Tool for Oncology Nurses

OBJECTIVE

The importance of spiritual care for the nursing profession has been long established. In many health care settings, including oncology, patients facing illness, suffering, and imminent death can struggle with existential questions of purpose and meaning-making. Recent research provided a competency-based educational framework to prepare nurses and nursing students to address these spiritual needs.

DATA SOURCES

This qualitative study evaluated the impact of the implementation of online educational tools across four nursing bachelor's programs to acquire competencies focused on addressing spiritual care needs.

CONCLUSION

Results showed that the tool added to the awareness of students and impacted among between students, teachers, and patient.

IMPLICATIONS FOR NURSING PRACTICE

The results underscored the need for structural and methodical implementation of technically challenging online tools because this impacts the feasibility and applicability of blended learning.

The Content, Teaching Methods and Effectiveness of Spiritual Care Training for Healthcare Professionals: A Mixed-Methods Systematic Review

CONTEXT

Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need.

OBJECTIVE

The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators.

METHODS

A mixed-methods systematic review was conducted. The search terms ('religio*' OR 'spiritual*' OR 'existenti*') were combined with ('educat*' OR 'train*' OR 'curricul*' OR 'program*'), AND ('care' OR 'therap*' OR 'treatment' OR 'competenc*'). Search terms were entered into the following data bases: PsycINFO, Medline, Cinahl and Web of Science. Findings were restricted to peer-reviewed studies published in English between January 2010 and February 2020.

RESULTS

Fifty-five studies were identified. The quality of studies was mixed. Programs encompassed a range of content and teaching methods. Reported outcomes included increased levels of competency across intrapersonal spirituality, interpersonal spirituality, and spiritual assessment and interventions. Identified barriers included competing healthcare priorities, negative perceptions of spirituality and spiritual care, resistance towards focusing on one's own spirituality, staff feeling inadequate, and the need for ongoing training. Facilitators included opportunities for reflection, involvement of chaplains, application of practical tools, opportunities for practice, online training, and managerial support.

CONCLUSIONS

Positive outcomes following spiritual care training were identified. Further research is needed to identify patient-related outcomes of staff training, and to examine how the benefits of such training can be maintained over time.

Spiritual Support During COVID-19 in England: A Scoping Study of Online Sources

Spiritual support is a key element of holistic care, and better healthcare professionals training and stronger strategic guidelines become urgent in light of health disasters and emergencies, such as the COVID-19 pandemic. To this end, the aim of this study was to explore spiritual support provision within mass and social media and the websites of spiritual leaders, institutions and NHS chaplaincy units during COVID-19 in England, between March and May 2020. A scoping review design informed by Levac and colleagues' five-staged framework was adopted, and adapted with a multi-strategy search to scope the different domains of online sources. Results revealed that spiritual support for dying patients, their families, health care staff, spiritual leaders and chaplains, had to be drastically reduced, both in quality and quantity, as well as being provided via different technological devices or domestic symbolic actions. No mention was found of a central strategy for the provision of spiritual support. This study points to the importance of developing centralized strategies to prepare healthcare systems and professionals in relation to spiritual support provision, both routinely and during health disasters and emergencies. Further research will have to explore innovative practices, in particular the role of digital technologies, in spiritual support provision.

Association between psychological capital and spiritual care competencies of clinical nurses: A multicentre cross-sectional study

AIMS

To investigate the status of spiritual care competencies among clinical nurses and their relationships with psychological capital.

BACKGROUND

Limited knowledge is about the influence of positive personal characteristics on nurses' spiritual care competencies.

METHODS

A multicentre cross-sectional study. A total of 1717 nurses were recruited from nine separate Chinese hospitals. Online questionnaires were delivered through a local nursing association to assess socio-demographics, spiritual care competencies and psychological capital of nurses.

RESULTS

Nurses had mild-to-moderate levels of spiritual care competencies and moderate levels of psychological capital. Psychological capital and its two metrics (self-efficacy and hope), spiritual care education, professional qualification and shift work were the main predictors of spiritual care competencies (each p < .05).

CONCLUSION

The findings of the study show a positive relationship between psychological capital and spiritual care competencies of clinical nurses. Strengthening nurses' psychological capital could improve their spiritual care competencies.

IMPLICATIONS FOR NURSING MANAGERS

Nurse managers and hospital administrators should better understand the value of psychological capital for nurses' capacity development. Effective interventions need to be implemented separately or combined with spiritual care education programmes to improve nurses' psychological capital and spiritual care competencies.

Spiritual Diversity, Spiritual Assessment, and Māori End-of-Life Perspectives: Attaining Ka Ea

The contemporary world is endowed with increasingly diverse spiritual and cultural perspectives, yet little is known about the spiritual concerns and spiritual resilience of Māori from Aotearoa New Zealand at the end of life. A context is provided for the value of spiritual assessment and identification of spiritual needs or concerns. Spiritual concerns and the desire to attain a state of ka ea (fulfillment, gratitude, or peace) may point to interventions, helping activities, or referrals that guide treatment. We reflect on qualitative findings from the 2017–2020 Pae Herenga study of 61 caregiving families, their helping professionals, and religious/spiritual leaders. We explore essential spiritual values and practices that support kaumātua (older tribal people) who have a life-limiting illness in achieving a sense of satisfaction and fulfilment at the end of life. Three themes emerged: the relational is spiritual, the need to live into the future, and value of spiritual end-of-life care. While some scholars have lamented the lack of culturally appropriate rapid assessment instruments, we suggest that a more open-ended assessment guide is better suited to understand key elements of spiritual diversity and spiritual concerns, particularly the spiritual strengths and resources that lead to well-being and even thriving at life’s end. Finally, learning about spiritual diversity can assist others to reconnect to lost meanings and regain a more holistic and centred view of life.

Care of the Spirit: Effects of an Interdisciplinary Undergraduate End-of-Life Course on Knowledge, Competence, and Response Empathy

The purpose of this pilot was to identify the effects of a 4-credit interdisciplinary undergraduate course focused on communication strategies to enhance spiritual care at the end of life. The course provided students with opportunities to enhance their ability to communicate empathically with individuals facing the end of life. Evidence-based content focused on ways to live each day with hope and gratitude, strengthen relationships, create a legacy, and find meaning and purpose in life and death. Narayanasamy's (1999) Actioning Spirituality and Spiritual Care Education and Training in Nursing model guided project development. The study used a prospective, pretest/posttest design. Participants included undergraduate students (n = 34) from nursing, premedicine, athletic training, business, economics, and religious studies at a Midwest liberal arts college. Statistically significant differences were found in students' attitudes toward and knowledge of spirituality/spiritual care (P < .0001, Cohen's d = 0.59), spiritual care competence (P < .0001, Cohen's d = 0.79), and level of response empathy through role play (P < .0001, Cohen's d = 0.92). Many students referred to this course as "life changing" and "healing." As our students go out into the community, they may intimately touch the lives and hearts of future patients, family, and friends who face the end of life with their compassionate words.