Spiritual well-being among older adults

Measuring Spiritual Well-being using a numerical rating scale: Additional evidence of the validity of the Well-being Numerical Rating Scales (WB-NRSs)

The Well-being Numerical Rating Scales (WB-NRSs) can be used to assess rapidly and accurately different types of well-being. However, the spiritual well-being scale showed slightly weaker psychometric properties. This study aimed to further investigate its suitability in measuring spiritual well-being. Participants (N = 270, age: M = 32.98; SD = 15.64; 67% females) were administered a questionnaire including spiritual well-being, gratitude, compassionate love, and personality traits measures. A network analysis (based on correlations) was used to display graphically the pattern of relationships among the measured constructs (i.e. the nomological net). Results provided evidence that the scale measures spiritual well-being as defined in the literature, that is, a component distinct from faith and compassionate love, but connected to meaning in life, quality of relationships, personality traits, and gratitude. These findings confirm the WB-NRSs is a psychometrically sound and easy-to-use tool with clear benefits for both research and clinical assessment.

Meaning-in-life in nursing-home patients: a correlate with physical and emotional symptoms

AIMS AND OBJECTIVES

To investigate the prevalence of physical and emotional symptoms and the associations between symptoms and meaning-in-life in a cognitively intact nursing-home population.

BACKGROUND

Meaning has been found to be a strong individual predictor of successful ageing and life satisfaction as well as an important psychological variable that promotes well-being. Meaning serves as a mediating variable in both psychological and physical health.

DESIGN AND METHODS

The study employed a cross-sectional design. Data were collected in 2008 and 2009 using the QLQ-C15-PAL quality-of-life questionnaire, the purpose-in-life test and the Hospital Anxiety and Depression Scale. A total of 250 cognitively intact nursing-home patients who met the inclusion criteria were approached and 202 attended.

RESULTS

The prevalence of symptoms was fairly high, with fatigue (57%), pain (49%), constipation (43%) and dyspnoea (41%) as the most frequent physical symptoms, while 30% were depressed and 12% had anxiety. Significant correlations between meaning-in-life and symptom severity were displayed.

CONCLUSIONS

The level of symptom severity among cognitively intact nursing-home patients is high, requiring highly competent staff nurses. Meaning-in-life might be an important resource in relation to a patient's physical and emotional health and global well-being.

RELEVANCE TO CLINICAL PRACTICE

Facilitating patients' meaning-in-life might help reducing symptom severity and fostering quality of life in cognitively intact nursing-home patients. However, advancing staff nurses' competence in palliative care, symptom management and nurse-patient interaction is important for care quality and quality if life in nursing homes.

An exploration of the status of spiritual health among nursing students in Taiwan

OBJECTIVE

Few studies have investigated the spiritual health of nursing students. The purpose of this study was to examine spiritual health in a group of senior nursing students in Taiwan, and to explore the factors that influenced the spiritual health of the group.

METHOD

This was a cross-sectional study. A total of 1276 senior nursing students were selected using a probability-proportional-to-size (PPS) procedure, and were asked to complete a self-administrated questionnaire that included a spiritual health scale (SHS) and a demographic profile.

RESULTS

All study participants were female with an average age of 20.1 years, and most reported a religious affiliation and participation in religious activities. Their spiritual health was moderate; and generally the study metric "connection to others" was the highest factor, and the metric "religion attachment" was the lowest. Certain demographic characteristics, including age, education level, aboriginal characteristic, level of religious devotion, and family atmosphere were predictors of spiritual health.

CONCLUSION

Nursing educators should be aware of the impact of spiritual health on nursing students, and should consider developing spiritual and religious education programs to enhance students' spiritual health and to nurture their ability to supply spiritual nursing care for patients.

Spiritual assessment in African-Americans: a review of measures of spirituality used in health research

BACKGROUND

A number of instruments have been developed for investigating relationships between spirituality and health, and have been used to assess spirituality in African-Americans. Yet, the cultural appropriateness for African-Americans of these instruments has not been investigated to date.

OBJECTIVES

To evaluate the construct validity and reliability of spirituality measures used in health research from 1982 to 2005.

METHOD

Systematic review of the literature.

RESULTS

Thirty five studies and five measures of spirituality met the inclusion criteria. Most of the spirituality measures were developed in primarily Caucasian-American samples. African-Americans were represented in 71% of the studies (n = 25) using spirituality measures in health research. Distinct cultural attributes of African-American spirituality were omitted in most of the spirituality measures. Two studies were retrieved in which psychometric evaluation was conducted in entirely African-American samples.

DISCUSSION

Spirituality is a significant cultural experience and belief that influences the health behaviors of African-Americans. The lack of a culturally appropriate measure of African-American spirituality is a major limitation of studies investigating spirituality and health in this population. Development of a culturally appropriate and sensitive measure of spirituality in African-Americans is suggested to strengthen the quality of research in this area.

Spirituality and stress management in healthy adults

The purposes of this longitudinal, descriptive pilot study were to (a) test the acceptability and feasibility of a 6-week spiritual intervention; (b) determine the relationship between spirituality and stress; (c) explore the effects of the intervention on measures of perceived stress, spiritual perspective, and spiritual well-being; and (d) explore the meaning of spirituality. The sample consisted of 27 community-dwelling adults. Six categories emerged from the qualitative data as descriptors of the meaning and significance of spirituality. The survey data indicated that there were significant negative correlations between perceived stress and spiritual well-being at three time intervals, a significant decline in the levels of perceived stress, and a significant increase in spiritual perspective from the pretest to the 6-week follow-up. There were no significant changes in spiritual well-being. The intervention proved effective in reducing stress in this healthy adult sample.

Religiosity and depression in older people: evidence from underprivileged refugee and non-refugee communities in Lebanon

Religiosity is an important aspect of the life of older people, particularly in the Arab region where religiosity is an important part of daily social and political life. Studies have documented the relationship between religiosity and depression among older people, but none in the region. A total of 740 persons aged 60 + were interviewed in three poor urban areas of Lebanon, one of which was a Palestinian refugee camp. The questionnaire included five items on religiosity covering organizational and intrinsic religiosity. Depression was assessed using the 15-item Geriatric Depression Score (GDS-15). Depression was prevalent in 24% of the older persons interviewed with the highest proportion being from the Palestinian refugee camp (31%). Results suggest that only organizational religiosity was related to depression and this pattern was only significant among the refugee population. Religious practice is discussed as an indicator of social solidarity rather than an aspect of religiosity. Minority groups may rely on religious stratagems to cope with their distress more than other groups.

Psychometric Testing of the Social Support Survey on a Taiwanese Sample

BACKGROUND

The Medical Outcomes Study Social Support Survey (MOS-SS) is a multidimensional, self-administered instrument used to assess various functional dimensions of social support. Less is known regarding its value for a Chinese population.

OBJECTIVE

The aim of this study was to assess the psychometric properties of the MOS-SS on an adult sample in Taiwan.

METHODS

A total of 265 adult family caregivers of patients with cancer from four different hospitals in the north, middle, and south regions of Taiwan completed the MOS-SS.

RESULTS

In the original five-factor model, unsatisfactory item discriminant validity was found in almost half of the items; the item-own subscale correlation was lower than the item-other subscale correlation. A two-factor model accounting for 68.98% of the variance was found using exploratory factor analysis. The first factor (emotional support) accounted for 62.28% of the total variance, whereas the second factor (tangible support) accounted for 6.7%; the interfactor correlation was .71. The two-factor model seemed to have satisfactory reliability and validity and better discrimination between different subscales than did the original five-factor model.

DISCUSSION

Good reliability and validity were demonstrated in the MOS-SS when applied to an adult sample in Taiwan. A two-factor model, instead of a five-factor model as found in the Western countries, was found for this sample. Confirmation of the two-factor model and exploration of the two-factor model in related concepts are suggested for future studies.

The Influence of Growth on Spiritual Self-Care Agency in an Older Adult Population

This study investigated the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an older adult population. The purpose of this study was to identify the relationships among these concepts as well as the specific influence of spiritual growth, a component of health-promoting self-care behaviors, on self-care agency. The instruments used in this study included the Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practices Scale, and Exercise of Self-Care Agency Scale. A canonical correlation identified a significant variate having a correlation of .74 (p = .000) that accounted for 55% of the variance explained. The loading variables included spiritual growth, self-concept, initiative, and responsibility. The conclusion was made that spiritual growth influences older adults' self-care agency to a greater extent than self-care self-efficacy.

Treading lightly: spirituality issues in mental health nursing

Spirituality has been recognized as an important part of nursing practice since its early beginnings. However, debate continues about whether and how nurses and other mental health professionals should include spirituality within their daily work. This paper aims to contribute to the discussion of spirituality within mental health nursing, through considering findings from a Heideggerian phenomenological study conducted with six people with mental illness living in regional Australia. This study aimed to provide a greater understanding of the phenomenon of spirituality by answering a primary research question, 'What does spirituality mean for people with a mental illness?' Participants were interviewed and data analysed using an iterative approach. Findings emerged through multiple readings and meanings were gradually constructed from the data into themes. The themes describe that spirituality is experienced uniquely for the participants, and that spirituality became vitally important to them when they became mentally unwell. In addition, issues of interest to mental health nurses were raised but not completely addressed by the study. The issues relate to potential interactions about spirituality between nurses and their patients. Although participants wanted to discuss their experiences of spirituality with others, they raised concerns about whether their mental health care providers would be accepting of their beliefs. Spirituality was deemed to be a highly individual phenomenon; it could be experienced as a journey and it was life-sustaining. For these reasons, it is proposed that mental health professionals must be prepared to discuss patients' spiritual needs in the context of their health concerns.

Spirituality and Health: Perceptions of Older Women in a Rural Senior High Rise

The purpose of this study was to examine the essence of spirituality and health in older women living in a rural senior high-rise apartment building. The researchers used a phenomenological research design and interviewed 10 women 65 years of age and older. Data analysis using Colaizzi's (1978) method for analysis revealed three themes-health is functional and provides a sense of wholeness; the relationship with God or a higher power is a personal one; and death is a part of life. The three themes create an essential structure, which influences the way the participants live. These findings provide information for nurses on the spiritual needs of older women and how the experiences of living in a high rise affect spirituality and health.

Healthy aging for older women

Healthy aging is a multifaceted phenomenon, incorporating biological and psychosocial developmental factors. The population of older women is diverse in health, function, social context, and age. Health promotion strategies, therefore, should be customized accordingly to optimize the health of the varied subgroups of older women, according to their health trajectory and personal preferences. Research and evaluation of approaches to promote health among these subgroups is an important next step in understanding and influencing the health of older women.

Constructions of spirituality in contemporary nursing theory

BACKGROUND

The nursing literature on spirituality tends to agree that modern science is relatively powerless to address the loss of personal meaning experienced by people facing death, suffering and loss. As a remedy, the literature recommends addressing patients' spirituality. The typical analytical move is to distinguish spirituality from religion and consider it a part, dimension or property of the patient.

AIM AND METHOD

This paper uses discourse analysis to identify the formal properties of scientific and religious discourses and their social and political implications. The nursing literature is then investigated to detect the use of such discourses in constructing the object spirituality and to consider any implications for nursing as a social practice.

FINDINGS

Far from escaping science and religion, the literature constructs spirituality by means of scientific and religious discourses. These discourses have characteristic strengths and weaknesses that the nursing literature seems to miss. Accordingly, its use of religious discourse lacks coherence and depth, and risks merging human with transcendent authority. Its use of scientific discourse lacks precision and clarity and risks intensifying those features of modernity which contribute to a loss of personal meaning in the face of death, suffering and loss.

CONCLUSION

Nursing literature on spirituality raises important questions but is limited in its capacity to address them. This paper provides an alternative perspective. First, it draws on an analysis of the modern institutional environment and its existential dimension. Secondly, it applies discourse analysis to the task of helping people experiencing illness and injury. This approach respects the strengths and limitations of both scientific and religious discourses.