Does spirituality facilitate adjustment and resilience among individuals and families after SCI?

Exploring the Connections between Medical Rehabilitation, Faith and Spirituality

(1) Background: Patients who undergo a medical rehabilitation treatment are often facing a physical, emotional and spiritual crisis, mostly due to pain, loss of limb functionality, the memory of the pre-disease days or questions about their role and value in life. Most of the time, the physician does not have the ability to deal with these issues or to provide the expected responses. The aim of this study was to analyze the patient's perception on spirituality and faith while going through a medical rehabilitation program. (2) Methods: The current study included 173 patients treated in the Rehabilitation Department of the Clinical Rehabilitation Hospital in Cluj-Napoca, Romania. Of them, 91 comprised the study group and were assessed in 2023, while 82 comprised the control group and were assessed in 2007. All patients answered a 34-item questionnaire designed by the authors regarding the role of religion, spirituality and prayer in their post-disease life. (3) Results: The results show that 99% of the patients assessed believe in God, 80% pray every day, 50% have less pain after praying and 44% trust their priest the same as they trust their doctor. When comparing groups, results from 2023 show that more patients pray every day, while fewer are afraid of dying, think their disease is serious or wish for the medical team to pray with them, compared to 2007. (4) Conclusions: The physician should not neglect the faith of the patient and should use it to achieve a better rehabilitation outcome.

Spiritually grounded character: A latent profile analysis

Introduction

The relationship between personal spirituality and character strengths has not been adequately explored. We investigate this relationship in an adult sample via latent profile analysis.

Methods

Seven-hundred and sixty-three individuals aged 18 to 68years completed a survey of personal spirituality (e.g., Delaney Spirituality Scale), character strengths and virtues (e.g., VIA Inventory), flourishing (i.e., general wellbeing; PERMA Profiler), and various demographic variables (e.g., age, race, sexual orientation, yearly income, education level, religiosity, importance of spirituality and religion, and religious attendance). Latent profile analysis (LPA) was performed to identity profiles of individuals based on their reported levels personal spirituality and character strengths (i.e., VIA virtues).

Results

A best-fitting model consisting of four distinct, non-overlapping profiles emerged. In every profile, the degree of personal spirituality was consistently associated with strengths of character. Profiles that exhibited high levels of spirituality and character also reported greater levels of flourishing. Furthermore, profiles high in spirituality and character were associated with the observance of formal religion, report of high levels of spiritual and religious importance, and report of frequent attendance of religious services.

Discussion

These findings suggest that spirituality and character go hand in hand, that higher levels of the conjoint spirituality and character or "spiritually grounded character" correspond to greater wellbeing and may be generated or supported by a formal religious identification, practice, and community.

Relationship Between Spirituality, Religiosity, and General Life Satisfaction Among Canadians Living with Neurological Conditions in New Brunswick and Manitoba

This study assessed the association between religion and spirituality on general life satisfaction among a sample of community-dwelling Canadians with neurological conditions. The data represented responses from two provinces that participated in the national Canadian Community Health Survey-Annual Component (CCHS-2011). A weighted subsample (n = 4562) of respondents with neurological conditions from the provinces of New Brunswick and Manitoba was used. Multivariate logistic regression fitted the models using STATA version 14. Spiritual coping, self-perceived general, and mental health were found to be predictors of greater life satisfaction and quality of life. It may be beneficial to incorporate spiritual and religious needs in the circle of care for those living in the community with neurological conditions.

"Helping Somebody Else Has Helped Me Too": Resilience in Rural Women With Disabilities With Experiences of Interpersonal Violence

The concept of resilience, the ability to "bounce back," from adversity, can inform interpersonal violence interventions and victim assistance services. Unfortunately, though women with disabilities (WWD) experience high rates of all forms of violence and multiple layers of adversity, existing resilience research overlooks this populations' experiences, perspectives, and resilience strategies. The impairment, socially misperceived as a personal tragedy, precludes individuals with disabilities from being considered resilient; rather, they are designated almost universally as "at risk" or "vulnerable." This study aims to remedy this gap in understanding and scholarship. This qualitative study engaged 33 rural women with diverse disabilities who experienced violence to learn about how they cultivated resilience to support recovery and growth after experiencing abuse. Women described key personal qualities and supportive networks and services, such as internal drive, connectedness, dedication, healthy and helpful outlets, and an evolution of thoughts and behaviors. Counter to prevailing perceptions of WWD as dependent and helpless, women described how living with a disability honed strengths fundamental to their resilience. Women also described an "altruism born of suffering" wherein their experiences of violence contributed to a desire to give back and help others in difficult circumstances.Women's insights help to build a more comprehensive understanding of effective strategies and supports to bolster WWD's resilience. These findings inform interventions and promote approaches to build on women's strengths and resourcefulness.

Australian perspectives on spiritual care training in healthcare: A Delphi study

OBJECTIVE

The aim was to to establish core components of spiritual care training for healthcare professionals in Australia.

METHODS

This study used the Delphi technique to undertake a consensus exercise with spiritual care experts in the field of healthcare. Participant opinion was sought on (i) the most important components of spiritual care training; (ii) preferred teaching methods; (iii) clinical scenarios to address in spiritual care training; and (iv) current spiritual assessment and referral procedures.

RESULTS

Of the 107 participants who responded in the first round, 67 (62.6%) were female, 55 (51.4%) worked in pastoral care, and 84 (78.5%) selected Christian as their religious affiliation. The most highly ranked components of spiritual care training were "relationship between health and spirituality," followed by "definitions of spirituality and spiritual care." Consensus was not achieved on the item "comparative religions study/alternative spiritual beliefs." Preferred teaching methods include case studies, group discussion, role-plays and/or simulated learning, videos of personal stories, and self-directed learning. The most highly ranked clinical scenario to be addressed in spiritual care training was "screening for spiritual concerns for any patient or resident." When asked who should conduct an initial spiritual review with patients, consensus was achieved regarding all members of the healthcare team, with most nominating a chaplain or "whoever the patient feels comfortable with." It was considered important for spiritual care training to address one's own spirituality and self-care. Consensus was not achieved on which spiritual care assessment tools to incorporate in training.

SIGNIFICANCE OF RESULTS

This Delphi study revealed that spiritual care training for Australian healthcare professionals should emphasize the understanding of the role of spirituality and spiritual care in healthcare, include a range of delivery methods, and focus upon the incorporation of spiritual screening. Further work is required to identify how spiritual care screening should be conducted within an Australian healthcare setting.

Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

This study examined the mediating effect of resilience in the relationship between spirituality and self-management among older people with chronic obstructive pulmonary disease (COPD). The participants were 151 older people with COPD in four general hospitals in Jiangsu Province, China. Data were collected from September 2020 to May 2021 using a questionnaire developed by the investigator, the Function Assessment of Chronic Illness Therapy-Spiritual Scale (FACIT-SP-12), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and COPD Self-Management Scale (CSMS). One-way ANOVA and t-test were used to compare the level of self-management in patients with different sociodemographic and clinical characteristics. Partial correlation analysis was used to explore the correlation between spirituality, resilience, and self-management. Hierarchical multiple regression analyses were performed to examine the contribution of spirituality and resilience to the prediction of self-management. A bootstrapping test was implemented using the SPSS PROCESS macro to test the statistical significance of the mediating effect. There was a pairwise positive correlation between spirituality, resilience, and self-management. Resilience mediated the relationship between spirituality and self-management. These findings suggested that resilience interventions could be incorporated into future COPD self-management interventions to better improve self-management and health outcomes. Moreover, resilience should be an important component of healthy aging initiatives.

Perceived Consequences of Extended Social Isolation on Mental Well-Being: Narratives from Indonesian University Students during the COVID-19 Pandemic

Despite several recent studies reporting on young people's well-being during COVID-19, few large-scale qualitative studies have been carried out that capture the experiences of young people from low- and middle-income countries (LMICs) undergoing extended social restrictions. The challenges faced by young people from LMICs during COVID-19 are likely to be amplified by their countries' large populations, resource constraints, lack of access to health care, living conditions, socio-spatial contexts, and the pandemic's ramifications for communities. This study explored how youths perceived their well-being after being isolated for one-and-a-half years during the COVID-19 pandemic. Qualitative narrative research was employed as a method of inquiry. One-hundred and sixty-six university students in Jakarta, Indonesia, between the ages of 17 and 22 wrote reflective online essays on the consequences of extended pandemic isolation on their mental health. This data collection strategy offered an in-depth understanding of the phenomenon through the narratives of those who experienced it. Seven themes expressing the youths' perceived well-being were identified through inductive reflective thematic analysis: (1) the anguish of loneliness and estrangement; (2) a state of "brokenness" resulting from emotional agony and distress; (3) frustration, confusion, and anger; (4) the experience of conflicting emotions; (5) uncertainty about both the present and future; (6) a sense of purpose and fulfillment; and (7) turning to faith. The findings provide important insights into Indonesian youths' well-being following extended social restrictions following the outbreak. Their collective experiences can be used to inform policy and practice regarding the nature of support mechanisms required both during and following the pandemic, and in the future if such a situation were to occur again.

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.

Does being psychologically resilient assist in optimising physical outcomes from a spinal cord injury? Findings from a systematic scoping review

PURPOSE

To systematically search for current research on the role of resilience in the physical rehabilitation of SCI and describe the research to date.

MATERIALS AND METHODS

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) approach was used. Five databases were searched for papers published up to March 2020. The sample included adults who have sustained an SCI; outcomes included a physical rehabilitation outcome and a measure of psychological or personal resilience/resilience training.

RESULTS

The initial search found 2074 studies. 12 studies were included. Six suggest positive effects of resilience on physical functioning/recovery, six report resilience as not affecting physical functioning/recovery.

CONCLUSIONS

Resilience may positively affect physical outcomes; however, the relationship is under-researched and contrasting findings may be due to measurements and methods employed by research. Future research may distinguish between two sources of resilience following an SCI: prior resilient experiences, and resilience as a product of the injury. Individuals' past events that triggered resilient behaviour may be able to promote a resilient response to an SCI. Focussing on emotional coping may result in poorer outcomes than building a sense of control. Resilience training may affect psychosocial rehabilitation; it is difficult to establish if it would affect physical outcomes. A negative approach to an injury can have negative effects on functioning; when identifying patients for psychoeducational training, those with the presence of negative appraisals of their injury are most in need.IMPLICATIONS FOR REHABILITATIONResilience may positively affect physical outcomes; however, the relationship is under-researched.Individuals' past events that triggered resilient behaviour may be able to promote a resilient response to an SCI.Focussing on emotional coping may result in poorer outcomes than building a sense of control.When identifying patients for psychoeducational training, it may be those with the presence of negative appraisals of their injury that are most in need.

Spinal cord injury and aging: an exploration of the interrelatedness between key psychosocial factors contributing to the process of resilience

CONTEXT

Extant literature highlights how many individuals display resilient trajectories following spinal cord injury (SCI), exhibiting positive psychological adjustment. In the absence of a universal definition, it is agreed that resilience is demonstrated when individuals have better-than-projected outcomes when considering the level of adversity experienced. Previous research has focused on traits connected to vulnerability and maladaptive trajectories following SCI rather than the psychosocial factors that contribute to resilience, which can be cultivated over the lifetime. Individuals living with SCI are now aging and have lifespans paralleling that of the broader older adult population. Aging with SCI can result in a sequela of concomitant pathophysiologic conditions and social challenges, which can undermine resiliency.

OBJECTIVE

The purpose of the current commentary is to explore some of the psychosocial factors contributing to resilience within the context of aging with SCI.

METHODS

Commentary.

FINDINGS

Psychosocial factors contributing to resilience within the SCI population include self-efficacy, social supports, and spirituality. However, these factors are complex and their interconnectedness is not well-understood at the intersection of SCI and aging.

CONCLUSION

Understanding the complexities of the contributing psychosocial factors can allow for the development of targeted and innovative multi-pronged rehabilitative strategies that can support resilient trajectories across the lifetime. Future research should move towards the inclusion of additional psychosocial factors, adopting longitudinal research designs, and prudently selecting methods.

Identifying the components of spirituality affecting the resilience of nurses

AIM

To identify the components of spirituality that affect the resilience of nurses in the coronavirus service.

BACKGROUND

The nursing profession experiences a great deal of stress at work because of high concentration in the work. This leads to serious physical and psychological consequences that make their resilience challenging.

METHODS

The current study is descriptive qualitatively by type and inductive by approach. The study's statistical population consisted of nurses from the Iranian coronavirus service, and a sample of 11 nurses were selected using a teleological sampling method. An interview tool was used to collect qualitative data, and the thematic analysis technique was used to analyse interview data.

RESULTS

The main research issue was studied using the thematic analysis technique, and seven main themes were identified as the components of effective spirituality affecting the resilience of nurses in the coronavirus ward in Iran.

CONCLUSION

The results of data analysis showed that seven components affecting the resilience of nurses in the Corona ward are religious values, morality, self-awareness, patience and hope, wisdom, voluntary activities and the otherworld belief.

IMPLICATIONS FOR NURSING MANAGEMENT

The Nursing Ethics Code, which intended to supplement the guidelines on health ethics for all nurses in education, research, management, health and clinical services, focuses directly on the nurses' performance in patient care.

Developing a new behavioral framework for dementia care partner resilience (CP-R): A mixed research synthesis

BACKGROUND AND OBJECTIVES

Caring for a person living with dementia requires resilience, the capacity to recover and grow from challenging situations. Despite the increasing interest in assessing and promoting resilience for dementia care partners, behaviors that indicate this attribute are not well known. The goal of this study is to synthesize the literature to identify resilience-related behaviors and develop a new framework for future validation and intervention research.

RESEARCH DESIGN AND METHODS

We searched English-language peer-reviewed articles (January 1991 - June 2019) reporting qualitative or quantitative descriptions of resilience-related behaviors among dementia care partners. Thematic analysis was used to categorize behaviors into domains, identify the relationships among them, and generate a thematic map.

RESULTS

Sixteen articles were identified according to predefined inclusion criteria. Four domains emerged: (1) problem-response behaviors (problem-solving, problem-distancing); (2) self-growth behaviors (self-care activities, spiritual-related activities, and developing and maintaining meaningful social relationships); (3) help-related behaviors (help-seeking and help-receiving), and (4) learning-related behaviors (learning from others and reflection). Definitions of each domain, identification of corresponding behaviors, and formulation of Care Partner Resilience (CP-R) behavioral framework were informed by this mixed research synthesis and other relevant literature.

DISCUSSION AND IMPLICATIONS

The CP-R framework emerged as a result of a new focus on identifying and cultivating strengths instead of evaluating strain and burden. It serves as a useful foundation for understanding the impact of specific behaviors on dementia care partner resilience. Once validated, this framework will inform the development of future measures, research, interventions, and policies for dementia care partners.

Effectiveness of spiritual care training for rehabilitation professionals: An exploratory controlled trial

BACKGROUND: Spirituality may play an important role in neurorehabilitation, however research findings indicate that rehabilitation professionals do not feel well equipped to deliver spiritual care. OBJECTIVE: To evaluate a spiritual care training program for rehabilitation professionals. METHODS: An exploratory controlled trial was conducted. Participants enrolled in a two-module spiritual care training program. Spiritual care competency was measured with the Spiritual Care Competency Scale. Confidence and comfort levels were measured using the Spiritual Care Competency Scale domains. The Spirituality and Spiritual Care Rating Scale assessed participant attitudes and knowledge. Measures were administered three times: pre-program, post-program and six weeks follow-up. RESULTS: The training (n = 41) and control (n = 32) groups comprised rehabilitation professionals working in spinal cord or traumatic brain injury units. No between-group differences were observed on the study variables at the pre-program time point. Multilevel models found that levels of spiritual care competency, confidence, comfort, and ratings on existential spirituality increased significantly for the training group (versus control) post-program (p < 0.05) and these significant differences were maintained at follow-up. CONCLUSIONS: A brief spiritual care training program can be effective in increasing levels of self-reported competency, confidence and comfort in delivery of spiritual care for rehabilitation professionals.

Barriers and facilitators to work participation for persons with lower limb amputations in Bangladesh following prosthetic rehabilitation

BACKGROUND

Lower limb amputation due to workplace injury and motor vehicle accident is common in Bangladesh. Qualitative research may extend our understanding of how physical impairment and other factors, such as cultural norms, family roles and the built environment, facilitate or hinder work participation following lower limb amputation and prosthetic rehabilitation.

OBJECTIVES

The aim of this study was to explore the experience of people in Bangladesh following lower limb amputation and prosthetic rehabilitation to understand the facilitators and barriers to their work participation.

STUDY DESIGN

Qualitative interviews with thematic analysis.

METHODS

The Worker Role Interview was used to guide semi-structured interviews in a convenience sample of 10 adults living in Bangladesh following lower limb amputation and prosthetic rehabilitation. Interviews were interpreted, and the themes that emerged were evidenced with first-person quotes.

RESULTS

Barriers and facilitators to work participation were synthesised into the following themes: spirituality, attitudes, meaning of work, planning for work participation, traditional gender roles, social support, mobility aids, environmental challenges and ergonomic adaptations.

CONCLUSION

This qualitative approach identified barriers and facilitators to work participation, such as the role of spirituality and the effect of gender roles, that have not been well researched in this population. Being aware of their effects can help clinicians reduce barriers to work participation.

CLINICAL RELEVANCE

Greater awareness of the barriers and facilitators to work participation, such as the role of spirituality or the effect of gender roles, can assist clinicians to reduce barriers and help facilitate work participation for people living in Bangladesh following lower limb amputation and prosthetic rehabilitation.

"Spirituality is everybody's business": an exploration of the impact of spiritual care training upon the perceptions and practice of rehabilitation professionals

PURPOSE

This study explored the impact of a brief spiritual care training program upon the perceptions and self-reported practice of rehabilitation professionals working in traumatic injury.

METHODOLOGY AND METHODS

A qualitative study. Semi-structured interviews were held with staff from a rehabilitation hospital in Sydney, Australia, between six and eight weeks after participation in spiritual care training. A thematic analysis was conducted.

RESULTS

Of the 41 rehabilitation professionals who attended the training (1 h online, 1.5 h face to face), 16 agreed to be interviewed. The majority worked in spinal cord injury and were female. Half reported holding a Christian affiliation. One overarching theme and six sub-themes were identified from the qualitative data. The overarching theme was "spirituality is everybody's business". The six sub-themes were: (i) increased awareness of the nature of spirituality, (ii) realisation of the importance of spirituality to clients, (iii) a desire to keep spirituality on the radar, (iv) identifying barriers to providing spiritual care (v) incorporating spirituality into practice, and, (vi) recognising spirituality as personally meaningful.

CONCLUSIONS

A brief spiritual care training program can impact positively upon perceptions and practice of rehabilitation professionals. Ongoing training is needed to ensure that staff retain what was learnt. IMPLICATIONS FOR REHABILITATION Brief spiritual care training can impact positively upon rehabilitation professionals' perceptions of spirituality and lead to practice change in the delivery of spiritual care across many clinical disciplines. The stories of patients and family members are powerful staff education tools in spiritual care training. Client spirituality is an under recognised resource that staff can draw upon in supporting and enhancing the rehabilitation process.

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

BACKGROUND

Stroke is the leading cause of disability in Australia and the third-leading cause of disability worldwide and a significant burden on caregivers.

OBJECTIVE

To map the extent, range and nature of the literature investigating spirituality and resilience among family caregivers of survivors of stroke.

METHOD

A scoping review.

RESULTS

Six studies were identified, conducted in the United States, United Kingdom, China and Turkey. These included two quantitative, one experimental and three qualitative designs. No studies linked spirituality to resilience. For the qualitative studies, spirituality was the primary focus of one, and the secondary focus of two others. Qualitative data reflected the lived experience of caregivers drawing upon spirituality to help cope with the burden of caregiving. For the two quantitative studies, spirituality was measured as a secondary focus and showed no significant links between spirituality or adjustment in caregivers. The one experimental study comprised a psycho-educational intervention focused on building resilience, finding a significant increase in social support not reflected in a matched control group. Clinical implications suggested the need for strength-based interventions, including spiritual needs and religious beliefs of the family caregiver.

CONCLUSIONS

Spirituality and resilience following stroke are essential factors in caregiver adjustment following stroke. Further research with a focus on causality and the link between spirituality, resilience and adjustment in this population is needed.

Religiosity, Psychological Resilience, and Mental Health Among Breast Cancer Patients in Kingdom of Saudi Arabia

Objectives

This study aimed to investigate the correlations of religiosity and psychological resilience with mental health among cancer patients and to examine whether religiosity and psychological resilience can predict mental health.

Method

The sample consisted of 329 patients. Researchers applied Islamic Religiosity Scale, Wagnild and Young Resilience Scale, and the scale of Hospital Anxiety and Depression.

Results

The results showed that there are positive, statistically significant correlations between religiosity and psychological resilience, while there were negative, statistically significant correlations of religiosity and psychological resilience with mental health. And there are correlations between the alternative therapeutic interventions currently used to religiosity and psychological resilience, while there were no statistically significant correlations between alternative therapeutic interventions that the patient will use in the future to religiosity and psychological resilience. The results also revealed the possibility of predicting mental health through religiosity and psychological resilience.

Conclusion

These results emphasized the importance of increased religiosity and psychological resilience among cancer patients.

A predictive model of resilience among family caregivers supporting relatives with traumatic brain injury (TBI): A structural equation modelling approach

Constructs from positive psychology were employed to create an explicit model of caregiver resilience. Predictive and mediating relationships among resilience and related variables (personality, coping, self-efficacy, hope, social support) were then tested for their association with burden and psychological adjustment among family members caring for relatives with severe TBI. Family participants (n = 131) from six rehabilitation units from New South Wales and Queensland completed assessments which elicited explanatory (Eysenck Personality Questionnaire, Ways of Coping Questionnaire), mediating (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey), and caregiver outcome (Caregiver Burden Scale, Mental Health sub-Scale-SF36, General Health Questionnaire, and Positive and Negative Affect Scale) variables. Structural Equation Modeling (SEM) showed that resilience had a direct effect on positive affect in caregivers. Resilience also played a protective role in relation to two variables associated with caregiver vulnerability: an indirect association with caregiver burden mediated through social support; a direct effect on hope, which, in turn, was associated with positive mental health. Positive mental health then played a buffering role in relation to psychological distress and negative affect. Resilience, in combination with other psychological attributes, was associated with reduced morbidity among family caregivers after severe TBI.

A study of whether individual and dyadic relations between spirituality and resilience contribute to psychological adjustment among individuals with spinal cord injuries and their family members

Objective:

To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members.

Design:

Prospective cross-sectional observational data were analyzed by structural equation modelling.

Setting:

Inpatient and community services at one rehabilitation hospital.

Subjects:

Individual with spinal cord injury ( n = 50) and family member ( n = 50) dyads.

Interventions:

Standard rehabilitation, both inpatient and community.

Main measure(s):

Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale.

Results:

Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members.

Conclusion:

Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.

Religiousness/Spirituality, Resilience and Burnout in Employees of a Public Hospital in Brazil

The present study aimed to determine the relation between religiousness/spirituality (R/S), resilience and burnout in employees of a public hospital. A total of 57 participants were evaluated, and the R/S Brief Multidimensional Measure, Pesce and collaborators' resilience scale and Maslach Burnout Inventory were used. Most employees (91.2%) were females. It was observed that the burnout and resilience variables showed statistically significant differences in relation to R/S dimensions. The results identified an association between R/S, resilience and burnout, demonstrating that employees who are more religious and spiritualized have greater resilience and consequently are less often affected by burnout.

Spiritual Care in Nursing Practice in Veteran Health Care

Spiritual care is important in nursing practice, and spiritual well-being and spiritual care are associated with better health. Military veterans, a unique patient population, want spiritual care to cope with chronic conditions. It is unclear whether spiritual care is provided in veteran health care in the United States. This study used a qualitative descriptive method, guided by the Spiritual Care in Nursing Practice (SCNiP) theory, to describe spiritual care in nursing practice and facilitators/barriers in veteran health care. Individual interviews were conducted with 39 registered nurses (RNs) at a U.S. veteran health system. Findings were consistent with the SCNiP theory but revealed additional categorical attributes and processes as it applied to veteran health care. Facilitators that promoted spiritual care include nurse professionalism, collegial support, and available spiritual resources. Barriers included lack of time, task-oriented culture, unclear knowledge of accessing resources, and unclear organization policy in providing spiritual care. Findings further refined the theory.

The role of spirituality in spinal cord injury (SCI) rehabilitation: exploring health professional perspectives

STUDY DESIGN

Descriptive, qualitative study.

OBJECTIVES

To explore the perspectives of health professionals (HPs) regarding the role of spirituality in spinal cord injury (SCI) rehabilitation.

SETTING

Single centre rehabilitation hospital, NSW, Australia.

METHODS

Two focus groups (n = 12) were conducted with HPs (e.g., nursing, allied health, medical) working in SCI inpatient rehabilitation. A semi-structured interview was employed, consisting of questions about spirituality and its role in SCI rehabilitation. The groups were audio recorded and transcribed. An inductive thematic analysis was conducted.

RESULTS

Six themes were identified from the focus group data: (i) the meaning of spirituality; (ii) spirituality as a help; (iii) spirituality as a hindrance; (iv) how spirituality is indirectly addressed in practice; (v) perceived barriers to incorporating spirituality into practice; (vi) how spirituality can be better integrated into practice. HPs recognised that spirituality played an important role in the adjustment of many individuals and their families after SCI. However, spirituality was not proactively addressed during SCI rehabilitation, and most often arose during informal interactions with clients. Spirituality, and specifically religious belief, was perceived to sometimes raise difficulties for clients and staff. The use of physical space and a review of rehabilitation processes were suggested by HPs as two ways spirituality could be better incorporated into practice.

CONCLUSIONS

The findings of this study reveal that spiritual needs of clients and their family members during SCI rehabilitation are important and could be better addressed. A range of initiatives are proposed, including staff training and the use of standardised spiritual assessment tools.