An investigation into the role of spirituality in nursing

The roles of chaplains in dispelling cancer myths in Nigeria: A narrative review

Background and Aims

The epidemiological burden of cancer in Africa, and Nigeria in particular, has been increasing significantly over the past few decades due to exposure to numerous risk factors as well as belief in various myths and misconceptions. Chaplains can play crucial roles in dispelling these myths and misconceptions about cancer among people. Therefore, this study seeks to review the epidemiological burden, risk factors, and myths relating to cancer and the roles of chaplains in dispelling cancer myths in Nigeria.

Methods

This paper is a narrative review that relied on secondary sources obtained through a thorough literature search of relevant articles on multiple electronic databases including PubMed, Google Scholar, and Web of Science. Published books, journal articles, and other published materials that were written in English were consulted in line with the objectives of this study. Both theoretical and empirical papers were used for this review.

Results

Cancers are associated with risk factors including exposure to chemicals, ultraviolet radiation, harmful tobacco and alcohol use, exposure to human papillomavirus (HPV), and these factors may vary with age, cultural beliefs (myths and misconceptions), and socioeconomic factors among others. Chaplains, however, have crucial roles to play in dispelling cancer myths in Nigeria. These roles include counseling, advocacy, education, and psycho-social support which may be limited by challenges such as spiritual ambiguity, inadequate training of healthcare providers and limited time/resources. These challenges can be addressed by training healthcare providers and incorporating chaplain practice in Nigerian healthcare.

Conclusion

The role of chaplains in dispelling cancer myths in Nigeria is crucial despite the numerous challenges. Hence, an urgent address of these challenges will be instrumental in ensuring effective chaplain practice in Nigeria.

The level of spiritual care competence of Polish nurses and the psychometric properties of the spiritual care competence scale (SCCS)

BACKGROUND

Providing effective spiritual nursing care requires development of professional competence which, when regularly evaluated, allows one to direct undergraduate and postgraduate nursing education in order to develop knowledge, skills and attitudes of nurses in the scope of spiritual care.

AIM

The aim of this study was to analyse the level of spiritual competence of professionally active nurses in Poland and, additionally, to analyse the psychometric properties of the Spiritual Care Competence Scale (SCCS).

METHODS

A cross-sectional study among Polish nurses (n = 343) was performed in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology guidelines.

RESULTS

An exploratory factor analysis identified five factors with 27 items explaining a total variance of 64.75%. Cronbach's alpha coefficient for the subscales ranged from 0.70 for 'Attitude toward the patient's spirituality' to 0.92 for 'Professionalisation and improving the quality of spiritual care'. Nurses reported a high level of spiritual competence (104.39 points) with better results in 'Attitude toward the patient's spirituality' and 'Communication, personal support and patient counselling' than in the 'Assessment and implementation of spiritual care', 'Professionalisation and improving the quality of spiritual care', and 'Referral, consultation and spiritual care'. Significant correlation was found between nurses' age, job seniority and spiritual competence, and between religiosity and spiritual competence.

CONCLUSIONS

The study showed satisfactory psychometric properties of the Polish version of the Spiritual Care Competence Scale, confirming its potential to measure the level of spiritual competence of nurses, both in education and research processes. SCCS-PL revealed five-factor structure with good internal consistency. The findings highlight the importance of providing professional education in respect of spiritual nursing care, especially in its practical dimension regarding skills development in which nurses obtained lower scores.

Content Analysis of the Meaning of Spiritual Care as Perceived by Nursing Students

Purpose

This study aimed to describe the meaning of spiritual care as perceived by nursing students.

Methods

This study used a descriptive research design, and the participants were 126 fourth-year nursing students from three nursing colleges. Data were collected from August to September 2019, and were analyzed using the content analysis method.

Results

Four themes of spiritual care with 15 sub-themes were extracted from the content analysis 1) "promoting spiritual well-being" (sub-themes "providing religious help", "caring for the patient as a spiritual being", and "presupposing human dignity regardless of religion"); 2) "taking place in actual nursing practice" (representative sub-themes "considering the perspective of the patient", "reducing suffering"); 3) "caring for the multifaceted needs of human beings" (representative sub-themes "providing physical, mental, and spiritual care", "caring for both the mental and physical health of the patient"), and 4) "growing together" (sub-themes "positively affecting patient well-being", "beginning with the nurse's self-transcendence").

Conclusion

These results suggest that nursing students consider spiritual care to be a highly positive and practical form of nursing care. However, because few students have been exposed to religion and spirituality, more systematic training should be provided.

End-of-Life Issues in the Era of the COVID-19 Pandemic

Purpose

The coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill and has exposed the lack of preparedness of most nations' health care systems. Even in usual times, palliative care has not received its fair share of recognition as an important component of patient care; instead, the emphasis is often placed on aggressive patient management. Now, with the entire medical community and decision-making committees focussed on intensive patient care, end-of-life care has taken a backseat.

Methods

This article is a brief communication.

Results

COVID 19 infection has been shown to lead to greater mortality and morbidity in patients with pre-existing illnesses such as hypertension, diabetes, renal failure, and cancer. Patients typically in need of end-of-life care, such as those with late-stage cancer or heart failure, are therefore at a higher risk of both contracting COVID-19 and suffering a more severe disease course. The strict nationwide lockdowns being imposed in most countries have deterred patients from seeking medical attention or hospice care. Every day new research is coming to light regarding COVID 19. This has helped significantly in creating awareness and limiting the spread of disease. However, misinformation is also rampant, leading to discrimination and mistreatment of infected patients.

Conclusion

This pandemic has been a terrifying ordeal for all and has exposed our entire population physically, psychologically, emotionally, and financially to unimaginable stresses. In the present scenario, EOL care is as much a necessity as intensive care and should be given at least a fraction of its importance.

Spirituality in nursing: A concept analysis

BACKGROUND

Spirituality has always been present in the history of nursing and continues to be a topic of nursing interest. Spirituality has ancient roots. The term 'spirituality' is interpreted as spirit and is translated as breath and soul, whereas spirituality (immateriality) is spiritual nature. Historically, the term spirituality is associated with the term religiosity, a definition that persists today, and often the two terms are used interchangeably. In the healthcare context, the construct is still.

OBJECTIVE

To clarify the concept of spirituality in nursing.

RESEARCH DESIGN

In this article spirituality was explored using Rodgers' evolutionary and inductive method of concept analysis.

PARTICIPANTS AND RESEARCH CONTEXT

For this analysis, a sample of 71 articles published in English, from 2008 to 2018 from PubMed/Medline, CINAHL Plus with full text, PsycINFO, SciELO databases were retrieved. It was also accomplished an empirical search of dictionaries and e-books.

ETHICAL CONSIDERATIONS

This study was conducted according to good scientific practice.

FINDINGS

It emerged that "spirituality" is a dynamic process and has a range of attributes. The cultural dimensions, the religious and spiritual traditions, the ethnic diversity and the influence of the historical and social contexts represent the societal and historical conditions ingrained in the Western thought that influence the emergence of spirituality as a concept. Antecedents, attributes and onsequences appeared to inform and strengthen one another over time. Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients and for work organizations.

An Exploratory Study of Spirituality and Spiritual Care Among Malaysian Nurses

The increasing evidence that spirituality is a critical component for promoting health and well-being has made spirituality more significant to nursing practice. However, although nurses' perceptions of spirituality have been studied in western countries, there has been little research on this topic in Southeast Asian countries where religions other than Christianity predominate. This study explores Malaysian nurses' perceptions of spirituality and spiritual care and examines associations between socio-demographics and their perceptions. The Malaysian Nurse Forum Facebook closed group was used for data collection with 208 completed the online survey. The participants considered that spirituality is a fundamental aspect of nursing. Nonetheless, half of the respondents were uncertain regarding the use of the spiritual dimension for individuals with no religious affiliation. Significant differences were found between educational levels in mean scores for spirituality and spiritual care. There was also a positive relationship between perception of spirituality and spiritual care among the respondents. Despite the positive perceptions of nurses of spirituality in nursing care, the vast majority of nurses felt that they required more education and training relating to spiritual aspects of care, delivered within the appropriate cultural context.

Evaluation of Health-Care Providers' Perception of Spiritual Care and the Obstacles to Its Implementation

Objective:

Cancer patients face many health challenges, including spiritual issues. Therefore, an awareness of health-care providers’ perspective on spiritual care provision is important. This study aimed to determine health-care providers’ perception of spiritual care and to examine the individual barriers to its implementation in cancer patients.

Methods:

The present descriptive study included 136 physicians and nurses. The Spiritual Care Survey was used as a research tool. Data were analyzed through descriptive statistics using IBM SPSS Statistics for Windows, version 20.0.

Results:

In this study, 70.6% of the participants considered spiritual care to be influential in the patients’ quality of life. However, 64.7% had received no spiritual care training, while 82.4% indicated a willingness to attend these courses. Regarding the obstacles to providing spiritual care, the highest and lowest scores, respectively, belonged to the lack of time and the person's reluctance to talk about spiritual issues.

Conclusions:

Spiritual care has not yet found its proper place in the care setting of Iran, and health-care team members do not have sufficient training to provide this kind of care despite their belief in its positive impact on patients’ quality of life.

Spiritual Nursing Care Education An Integrated Strategy for Teaching Students

The failure of nursing schools to integrate spiritual nursing care education into the curriculum has contributed to a lack in nurses' spiritual care ability. Developing, integrating, and testing a Spiritual Care Nursing Education strategy in an Associates of Science nursing program significantly increased the perceived spiritual care competence of student nurses. Utilizing a faculty team to develop learning activities to address critical spiritual care attributes offers a method to integrate spiritual nursing care content throughout the curriculum in ASN and BSN programs.

Atenção às necessidades espirituais na prática clínica de enfermeiros

Al considerar la integralidad del cuidado, es necesario que los enfermeros sistematicen el cuidado espiritual y propongan intervenciones en esta dimensión a sus pacientes. Objetivo: analizar la comprensión del enfermero acerca del cuidado espiritual y su experiencia en la promoción de este cuidado a los pacientes en la práctica clínica. Método: investigación descriptiva, con análisis cualitativo de los datos, desarrollada con 17 enfermeros. Se recolectaron los datos por medio de entrevistas semiestructuradas, analizadas mediante análisis de contenido cualitativo. Resultados: los enfermeros identificaron la necesidad de intervención en la dimensión espiritual de sus pacientes y consideraron importante atender a esta necesidad; sin embargo, ellos presentaron dificultades en brindar este cuidado. Falta de conocimiento y organización del proceso de trabajo fueron dificultades citadas para la no realización del cuidado espiritual y la priorización de los cuidados físicos. Se señala, aun, que el cuidado espiritual, cuando fue ofrecido, no fue sistematizado. Conclusión: esta investigación presenta potencial para despertar discusiones en cuanto a la formación del enfermero para el ofrecimiento del cuidado espiritual, además demuestra sus dificultades y facilidades para la ejecución de tal cuidado en la cotidianidad del trabajo de enfermería.

Defining the Meaning of Spirituality Through a Qualitative Case Study of Sheltered Homeless Women

The primary purpose of this case study was to assess the meaning of spirituality in a convenience sample of women located in an urban city in the southwest United States. The secondary purpose was to describe their lived experiences associated with spirituality. From these interviews five themes emerged: Belief in God or a Higher Power, Distinction Between Religion and Spirituality, Belief That There Is a Plan for Their Lives, Spirituality Providing Guidance for What Is Right/Wrong, and Belief That Their Lives Will Improve. These findings support the perceived fundamental importance of spirituality in the lives of homeless women. Nurses and other clinicians can use this information to develop interventions to help support women using spirituality practices and to help improve the outlook of homelessness for these women.

Meaning of spiritual care: Iranian nurses' experiences

Spiritual care is an essential component in nursing practice and strongly influenced by the sociocultural context. This article aimed to elucidate the meaning of nurses' experiences of giving spiritual care in southeast of Iran. A phenomenological hermeneutic approach influenced by Ricoeur was used. Eleven staff nurses who were currently working in the 3 major hospitals under the umbrella of the Kerman University of Medical Sciences were interviewed. The meaning of spiritual care was comprehensively understood as meeting patient as a unique being. This can be divided into 3 themes: meeting patient as a being in relationship, meeting patient as a cultural being, and meeting patient as a religious being. The results in this study suggest that education about spirituality and spiritual care should be included in the continuous and in-service education of registered nurses. Spiritual and cultural assessment criteria should be included in this education to improve the provision of holistic care.

Re-examining definitions of spirituality in nursing research

AIM

To discuss the definition of spirituality and its limitations for nursing research. It proposes a definition that will capture more accurately the role of spirituality in health outcomes.

BACKGROUND

Studies have increasingly examined spirituality in nursing research as a coping mechanism attenuating the negative impact of traumatic stress on mental health. Existing definitions of spirituality in nursing research include elements of positive emotional states (meaning, purpose, general well-being) which confound mental health outcomes.

DATA SOURCES

Medline and CINAHL databases were searched from 2007-2011 for research articles examining spirituality definitions and measures used by nurse researchers.

DISCUSSION

An analysis of the definitions of spirituality in nursing research reveals inconsistencies and confounding mental health concepts. The authors propose defining spirituality in the context of religious involvement when conducting research, while using a broader definition of spirituality when providing spiritual care. They argue such definition provides a more appropriate method of measuring this concept in research aimed at evaluating mental health outcomes while preserving the currently used patient-defined definition of spirituality when providing spiritual care.

NURSING IMPLICATIONS

A consistent definition of spirituality in nursing research evaluating mental health outcomes, distinct from 'spiritual care' in a clinical setting, is essential to avoid tautological results that are meaningless. Appropriate definitions will enable nursing researchers to more clearly identify resilience mechanisms and improved health outcomes in those exposed to traumatic stress.

CONCLUSION

A definition of spirituality that focuses on religious involvement provides a more uniform and consistent measure for evaluating mental health outcomes in nursing research.

Hope for the future: intensifying spirituality in the workplace

Healthy workplaces address various issues. Work focused on ergonomics addresses physical issues, satisfaction surveys reveal psychosocial issues; and other approaches address spirituality issues. Spirituality in the workplace contributes to holistic care and to the worth of the individual. Incorporating the concept of spirituality, in its broad sense, into the workplace enriches leadership practice and contributes to a holistic work environment. Spirituality is core to the servant leader approach to leadership and beneficial to other approaches. Followers benefit from a holistic approach to leadership; and some specific practices can exhibit the belief an organization holds related to the worth of the individual. Incorporating spirituality into an organization reflects the same values nursing holds for person-centered care, a view of integration of physical, psychological, and spiritual needs.

Administering a two-stage spiritual assessment in healthcare settings: a necessary component of ethical and effective care

AIM

This article delineates rationales for administering a spiritual assessment as a universal component of care.

BACKGROUND

The notion that nurses should identify and address patients' spiritual needs remains controversial, particularly in the UK where criticisms derived from secularization theory have appeared in the literature.

EVALUATION

To respond to these criticisms and to develop rationales supportive of spiritual assessment, I draw upon scholarship from a variety of disciplines including social work, sociology, and medicine.

KEY ISSUES

Five rationales are posited to support the concept of universal spiritual assessments: professional ethics, patient autonomy, knowledge of patients' worldviews, the identification of spiritual assets, and accrediting and governmental requirements. Criticisms based on secularization theory are discussed and analysed.

CONCLUSION

A two-stage spiritual assessment - consisting of a brief preliminary assessment followed, if necessary, by a comprehensive assessment - provides a mechanism to efficiently identify patients' spiritual needs.

IMPLICATIONS FOR NURSING MANAGEMENT

As key members of the healthcare team, nurse managers are ideally situated to ensure that all patients receive a spiritual assessment as a routine component of care. In so doing, they help ensure the provision of ethical and effective care to the diverse spiritual groups that will continue to populate the UK for the foreseeable future.

Nurse-patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients

BACKGROUND

Spiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients.

AIMS

This study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population.

DESIGN AND METHODS

A cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested.

RESULTS

The SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested.

CONCLUSION

Nurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients' health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers' interacting and communicating skills might facilitate patients' health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed.

LIMITATIONS

The SEM model tested comprised 20 variables, indicating a desirable sample size of n = 200, while the present effective sample was n = 187. Also, cross-sectional data do not allow making conclusion on the causality.

Spirituality and religiosity in the perspectives of nurses

Considering the human being as a unit composed of body, mind and spirit, it is important that nurses evaluate the need for spiritual intervention. This study aims to describe the understanding of nurses about the meaning of spirituality and religiosity at a hospital. This is an exploratory and qualitative research that was carried out with 17 nurses. Data were collected through semistructured interview and analyzed using content analysis. Results show that nurses identify the particularities involved in the concepts of spirituality and religiosity and recognize the link between them. The applicability of these terms in nurses' clinical practice is directly influenced by their own spirituality and religiosity, by their academic training and their fear of negative repercussions resulting from the direct approach of these issues with patients.

Spirituality and spiritual care from a Careful Nursing perspective

AIM

To provide a brief historical background of spirituality in nursing and describe spiritual care from the perspective of the Careful Nursing philosophy and professional practice model.

BACKGROUND

The previously overshadowed role of spirituality in modern nursing has re-emerged and been widely debated. Less attention has been given to how spiritual care is implemented in practice.

EVALUATION

Findings from historical research. Elaboration of a previously derived Careful Nursing concept and dimensions as a model of spiritual nursing practice values.

KEY ISSUES

In spite of the diversity of nurses' philosophical beliefs about spirituality, common ground can be found when these are translated into spiritual nursing practice values. Spiritual care in nursing is primarily expressed in the attitudes and actions of nursing practice guided by spiritual nursing values, particularly recognition of human dignity, kindness, compassion, calmness, tenderness, and nurses' caring for themselves and one another.

CONCLUSIONS

Spirituality is timelessly interwoven with nursing and health. Careful Nursing suggests a spiritual values model that could be useful in assisting nurses to reach a shared understanding of spirituality and a spiritual approach to nursing practice.

IMPLICATIONS FOR NURSING MANAGEMENT

Spiritual nursing values can be shared and developed in practical ways so that they become truly integrated into everyday nursing practice.

An examination of the sustainable adoption of whole-person care (WPC)

AIM

This study illustrates how King's theory of goal attainment was used to focus an examination of whole-person care (WPC) and to extend the range of knowledge needed for WPC and nursing practice.

BACKGROUND

Leadership implemented a faith-based innovation using continuing education for patient care that incorporates body-mind-spirit and eight principles called CREATION. Three questions arose: (1) Is there an evidence-based framework to determine whether the philosophy supports the discipline of nursing? (2) How extensive is the adoption and application of WPC? (3) Does the model make a difference in the context of nurse-patient interactions and outcomes in support of Magnet recognition criteria?

METHODS

Interpretative phenomenology was used and an interview protocol was developed to examine the adoption and movement toward a culture of WPC.

RESULTS

WPC was 'lived.' it is a relationship-oriented patient care model. However, except in direct patient care, the principles of creation were poorly diffused.

IMPLICATIONS FOR NURSING MANAGEMENT

These results contribute to nursing leadership's roles in fostering a workplace climate that enables the diffusion of innovative models of care. In addition, these results support the Institute of Medicine's call for nurses to take the lead in adopting innovations and provides leaders with actionable strategies.

Older Adults’ Spiritual Needs in Health Care Settings

Recognizing that spiritual needs often emerge in health care settings, the Joint Commission requires spiritual assessments in numerous organizations frequented by older adults. Given that many gerontological practitioners have received little training in identifying spiritual needs, a qualitative meta-synthesis ( N = 9 studies) was conducted to identify and describe older adults’ perceptions of their spiritual needs in health care settings. Five interrelated categories emerged: (a) spiritual practices; (b) relationship with God; (c) hope, meaning, and purpose; (d) interpersonal connection; and (e) professional staff interactions. The implications of the findings are discussed as they inform the spiritual assessment process.

Integrating spirituality into critical care: an APN perspective using Roy's adaptation model

Integration of the spiritual domain into the nursing plan of care positively influences health and wellness. Applying nursing theory to practice reinforces the advanced practice nurse's (APN's) responsibility to integrate spiritual care into the critical care environment. Indeed, all nurses have an obligation to integrate spiritual care because the focus of nursing care is beneficence. Moreover, the focus of APN care is not curing, but healing. Healing can be assisted by entering into the patient's suffering to help reconstruct life plans and facilitate realizing meaning from the despair of illness even while facing extreme adversity and death. This article describes spiritual care of the critically ill adult patient and the role that the APN must, can, and should take to assimilate spiritual care into care of these patients and their families.