A critical analysis of articles using a Gadamerian based research method

It is over 20 years since Michael Crotty's groundbreaking critique of phenomenological research in nursing. However, rather than entering into the acrimonious discussions that followed, we developed a research method that we believed translated Gadamer's philosophy into the world of empirical research. Fundamental to that work was our differentiation of hermeneutics from phenomenology. The aim of the present paper was to provide a critical analysis of the citations from publication in 2003 until the end of 2017. We identified 402 citations of which 362 were included. One hundred and sixty-three articles mentioned the article in passing, usually in a list of authors who had discussed hermeneutics. Sixteen citations misrepresented the method mainly claiming that we discussed a method for hermeneutic phenomenology (or phenomenological hermeneutics). Of the 117 citations that partially used the method, the main focus was the four steps of data analysis. Sixty studies used our method in totality although they derive from varying philosophical standpoints. Disappointingly, there has been little critique of our Gadamerian research method. For health disciplines to truly make progress in the academic stage, it is vital that we engage in with critique, some of which will come through open and honest reflexive engagement with our topics.

Spiritual care as a response to an exaptation: how evolutionary psychology informs the debate

This article has its origins in a 2013 proposal by the author that the concept of 'spiritual care' in clinical settings might fruitfully be grounded in the findings of the Cognitive Science of Religion (CSR). In a recent paper, John Paley rejects the central arguments and asserts his conviction that a model for 'spiritual care' cannot be derived from the insights of evolutionary psychology. In this article, the author employs a modified form of Fichtean dialectic to examine the contrasting positions and, via a process of analysis and synthesis, identify the key areas for further exploration and research. He concludes, first, that CSR in itself does not provide a sufficient theoretical justification for the notion and practice of 'spiritual care'; secondly, that any attempt to develop a general theory of spiritual care would need to pay closer attention to the role of historically situated religious communities; and finally, that these objections nevertheless do not amount to an argument against the attempt to provide spiritual care as part of person-centred care. Instead, a revised model is proposed which has the potential to provide testable predictions in this field.

"To cherish each day as it comes": a qualitative study of spirituality among persons receiving palliative care

PURPOSE

Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being.

METHODS

Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology.

RESULTS

Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith.

CONCLUSIONS

Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.

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.

Development and preliminary validation of a composite Spiritual Care-Giving Scale

BACKGROUND

Spiritual care is a central element of holistic nursing, but is not often made explicit in the theoretical and practical components of pre-registration nursing programmes. A composite scale will assist in identifying students' perceptions and issues to be addressed in curricula and practice settings.

OBJECTIVE

To develop and test the Spiritual Care-Giving Scale that measures student nurses' perceptions towards spirituality and spiritual care.

METHOD

Following a critical review of the literature, review by an expert panel and a pilot study, the SCGS, was administered to a convenience sample of final-year nursing students. Participants also completed the Spirituality and Spiritual Care Rating Scale and Student Survey of Spiritual Care to assess construct validity. Internal reliability was assessed using Cronbach's alpha and test-retest reliability was assessed at 1 week. Principal component analysis was used and the 68-item Spiritual Care-Giving Scale was reduced to 35-items.

RESULTS

745 (out of 1204) students completed the survey giving a 61.9% response rate. A 5-factor solution explaining 61.2% of the variance was supported. Cronbach's alpha of the 35-item scale was 0.86 and test-retest reliability was stable over time (r=0.811). Concurrent validity with the Spirituality and Spirituality Care Rating scale (r=0.587, p<0.01) and Student Survey of Spiritual Care (r=0.507, p≤0.01) showed significant correlation.

CONCLUSION

The Spiritual Care-Giving Scale was found to be a valid and reliable instrument for measuring the multifaceted perspectives of spirituality and spiritual care in practice by students. Further testing of this scale is required with other student populations and clinicians.