Competence and perceptions of spiritual care among clinical nurses: A multicentre cross-sectional study.

AIMS: To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors. BACKGROUND: Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking. DESIGN: Multicentre cross-sectional study. METHODS: Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care-Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence. RESULTS: In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care-related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence. CONCLUSIONS: There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses. RELEVANCE TO CLINICAL PRACTICE: The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training. REPORTING METHOD: EQUATOR guidelines, STROBE checklist: cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: All participants were clinical nurses. Participants were informed they could withdraw from the study at any time.

Spiritual Care Competencies and the Frequency of Spiritual Care Practices of Nurses in Turkey.

This descriptive study aimed at determining the spiritual care competencies and the frequency of spiritual care practices of nurses. A total of 119 nurses working in the palliative care unit, oncology services, and intensive care units of a state hospital in Turkey participated in the study. The data were collected by the  Participant Information Form, Spiritual Care Competence Scale, and Nurse Spiritual Care Therapeutics Scale. Spiritual care competencies of the nurses were found to be high; the frequency of spiritual care practices was determined as moderate. We found a positive correlation between the spiritual care competencies and the frequency of spiritual care practices of nurses. There was a significant difference between nurses' received spiritual care training status and their scale scores. In addition, nurses who believed that spiritual care was an important part of nursing care, and an important need of patients, had higher scale scores.

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 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.

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.

Correlations among spiritual care competence, spiritual care perceptions and spiritual health of Chinese nurses: A cross-sectional correlational study.

BACKGROUND: The significance of spiritual care competence among nurses has been emphasized across countries and cultures in many studies. However, there were few studies on correlations among spiritual care competence, spiritual care perceptions, and spiritual health of nurses in China. OBJECTIVE: To investigate spiritual care competence, spiritual care perceptions, and spiritual health, and examine the correlations among spiritual care competence, spiritual care perceptions and spiritual health, and the mediating role of spiritual health between other two variables of Chinese nurses. METHODS: A cross-sectional and correlational design was implemented, and the STROBE Checklist was used to report the study. A convenience sample of 2,181 nurses were selected from 17 hospitals in 3 provinces, China. Participants provided data on sociodemographic by completing the Chinese Version of the Spiritual Care Competence Scale, the Chinese Version of the Spiritual Care-Giving Scale, and the Spiritual Health Scale Short Form. Descriptive statistics, univariate, multiple linear regression, and Pearson correlation analysis were used to analyze data. RESULTS: The total scores of spiritual care competence, spiritual care perceptions, and spiritual health were 58.25 ± 16.21, 144.49 ± 16.87, and 84.88 ± 10.57, respectively, which both were moderate. Spiritual care competence was positively correlated with spiritual care perceptions (r = 0.653, p < 0.01) and spiritual health (r = 0.587, p < 0.01). And spiritual health played a mediating role between the other two variables (accounting for 35.6%). SIGNIFICANCE OF RESULTS: The spiritual care competence, spiritual care perceptions, and spiritual health of Chinese nurses need to be improved. It is recommended that nursing managers should pay attention to spiritual care education of nurses, and improve spiritual care perceptions and spiritual health in multiple ways, so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients in China.

Proposing a conceptual framework of spiritual care competence for Chinese nurses.

Spiritual care competence of nurses is crucial to satisfy the spiritual needs of the clients, but the dearth of conceptual frameworks has hindered the clarification of the construct, especially for nurses in the People's Republic of China. This article developed a 3*3*3 matrix framework to clarify the components of spiritual care competence for Chinese nurses through the synthesis of existing empirical and theoretical work, which includes three aspects (awareness, understanding, and application) on three levels (intrapersonal, interpersonal, and transpersonal) of three contents of spirituality (namely, worldview, connectedness, and transcendence). The proposed framework can be used as a model to promote spiritual care competence of nurses in China. Adoption of the framework to guide studies would allow for the design of interventions for the attainment of this competence.

Expert Discussion on Taking a Spiritual History.

This article elaborates on the hazards of spiritual history taking. It provides expert insights to consider before entering the field. In summer 2012, a group of spiritual care experts were invited to discuss the complexity of taking spiritual histories in a manner of hermeneutic circle. Thematic analysis was applied to define the emerging themes. The results demonstrate that taking a spiritual history is a complex and challenging task, requiring a number of personal qualities of the interviewer, such as 'being present', 'not only hearing, but listening', 'understanding the message beyond the words uttered', and 'picking up the words to respond'. To 'establish a link of sharing', the interviewer is expected 'to go beyond the ethical stance of neutrality'. The latter may cause several dilemmas, such as 'fear of causing more problems', 'not daring to take it further', and above all, 'being ambivalent about one's role'. Interviewer has to be careful in terms of the 'patient's vulnerability'. To avoid causing harm, it is essential to propose 'a follow-up contract' that allows responding to 'patient's yearning for genuine care'. These findings combined with available literature suggest that the quality of spiritual history taking will remain poor unless the health-care professionals revise the meaning of spirituality and the art of caring on individual level.

Spiritual Care[Givers] Competence in Palliative Care: A Scoping Review.

To deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional's empowerment when delivering effective spiritual care to patients and families.

Existential Needs in Mental Health - Who Cares? A Mixed Methods Study in Norway.

Mental health care that is open to patients' existential needs requires well-trained professionals who work in teams and use an open conceptualization of spirituality, religion and other meaning-making domains. Using a mixed methods approach, this article explores how professionals (n = 262) in secular Norway perceive obstacles and opportunities in existential care. The results show correlations between age group, personal religiosity, terminology and perceived expertise. Commitment is high, but collaboration with chaplains and team training are neglected.

SPACEE Protocol: "Spiritual Care Competence" in PAlliative Care Education and PracticE: Mixed-Methods Research in the Development of Iberian Guidelines.

Spiritual care requires understanding the spiritual experiences of patients and recognizing their resources and needs. Therefore, educators and practitioners should develop their knowledge and understanding in this regard. Spiritual care helps people overcome their anxieties, worries, and suffering; reduces stress; promotes healing; and encourages patients to find inner peace. To provide comprehensive and appropriate care while upholding human/ethical virtues, the spiritual dimension must be a priority. We aim to develop spiritual care competence guidelines for Palliative Care (PC) education and practice in Portugal and Spain. The study detailed in this protocol paper will include three phases. In phase I, the phenomenon will be characterized and divided into two tasks: (1) a concept analysis of "spiritual care competence"; and (2) a systematic review of interventions or strategies used to integrate spiritual care in PC education and practice. Phase II will entail a sequential explanatory approach (online survey and qualitative interviews) to deepen understanding of the perceptions and experiences of educators, practitioners, and patients/family carers regarding spiritual care in PC education and practice and generate ideas for the next steps. Phase III will comprise a multi-phased, consensus-based approach to identify priority areas of need as decided by a group of experts. Results will be used to produce guidelines for integrating spirituality and spiritual care competence within PC education and practice and synthesized in a white book for PC professionals. The value of this improved examination of spiritual care competence will ultimately depend on whether it can inform the development and implementation of tailored educational and PC services. The project will promote the 'spiritual care' imperative, helping practitioners and patients/family carers in their preparedness for End-of-Life care, as well as improving curricular practices in this domain.

Competencies of nursing students in the provision of spiritual care and the factors affecting spiritual caregiving.

PURPOSE: Nursing care is a holistic practice that contains biological, psychological, sociological, and spiritual elements. Spiritual care is also one of the core aspects of a holistic care approach, The provision of optimal spiritual care requires a good understanding of the issue by nurses. The present study determines the competencies of nursing students in spiritual care and the status of spiritual caregiving. DESIGN AND METHODS: The study has a descriptive, cross-sectional, and qualitative research method of answers to follow-up questions. The study was conducted with 468 nursing students who are 1-4 years in a BSN program in Turkey. Personal information form, semi-structured interview form, Spiritual Caregiving Scale, and Spiritual Care Competence Scale were used for the collection of data. FINDINGS: The average scores recorded by the participants in the Spiritual Caregiving and Spiritual Care Competence Scales were 145.60 ± 20.63 (the perception of spirituality and spiritual care is moderate-high) and 102.92 ± 15.67 (the competence of the nurse in spiritual care is moderate-high), respectively. It was found that nearly half of the respondent students had never heard of the concept of spiritual care, nor did they have any knowledge of such care, and almost none had undergone training in this subject. PRACTICE IMPLICATIONS: Important to add spiritual care to the nursing curriculum as a separate course or subject, and to raise awareness of students through applied teaching methods.

Nurses' Perceptions of Competence in Providing Spiritual Care.

PURPOSE: The study examined nurses' perception of competence in providing spiritual care. DESIGN OF STUDY: A descriptive correlational research design with a convenience sample was used. METHOD: Participates completed a demographic questionnaire and the Spiritual Care Competence Scale, which has six domains: assessment and implementation of spiritual care, professionalization and improving the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude toward the patient's spirituality, and communication. FINDINGS: The domain of communication had the most favorable perception among participants and the domain of professionalization and improving the quality of spiritual care had the least favorable perception. CONCLUSIONS: It is important for nurses to have the opportunity to gain knowledge regarding this significant component of holistic care.

Factors contributing to student nurses'/midwives' perceived competency in spiritual care.

BACKGROUND: The spiritual part of life is important to health, well-being and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. AIM: To explore factors contributing to undergraduate nurses'/midwives' perceived competency in giving spiritual care. DESIGN: A pilot cross-sectional, multinational, correlational survey design. METHOD: Questionnaires were completed by 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwives from six universities in four countries in 2010. Bivariate and multivariate analyses were performed. RESULTS: Differences between groups were small. Two factors were significantly related to perceived spiritual care competency: perception of spirituality/spiritual care and student's personal spirituality. Students reporting higher perceived competency viewed spirituality/spiritual care broadly, not just in religious terms. This association between perceived competency and perception of spirituality is a new finding not previously reported. Further results reinforce findings in the literature that own spirituality was a strong predictor of perceived ability to provide spiritual care, as students reporting higher perceived competency engaged in spiritual activities, were from secular universities and had previous healthcare experience. They were also religious, practised their faith/belief and scored highly on spiritual well-being and spiritual attitude/involvement. CONCLUSIONS: The challenge for nurse/midwifery educators is how they might enhance spiritual care competency in students who are not religious and how they might encourage students who hold a narrow view of spirituality/spiritual care to broaden their perspective to include the full range of spiritual concerns that patients/clients may encounter. Statistical models created predicted factors contributing to spiritual care competency to some extent but the picture is complex requiring further investigation involving a bigger and more diverse longitudinal sample.

Student nurses perceptions of spirituality and competence in delivering spiritual care: a European pilot study.

BACKGROUND: Spiritual care is expected of nurses, but it is not clear how undergraduates can achieve competency in spiritual care at point of registration as required by nursing/midwifery regulatory bodies. AIMS: To describe undergraduate nurses'/midwives' perceptions of spirituality/spiritual care, their perceived competence in delivering spiritual care, and to test out the proposed method and suitability of measures for a larger multinational follow-on study. DESIGN: Cross-sectional, multinational, descriptive survey design. METHODS: Author administered questionnaires were completed by 86% of the intended convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 European countries in 2010. RESULTS: Students held a broad view of spirituality/spiritual care and considered themselves to be marginally more competent than not in spiritual care. They were predominantly Christian and reported high levels of spiritual wellbeing and spiritual attitude and involvement. The proposed method and measures were appropriate and are being used in a follow-on study. CONCLUSIONS: The following are worthy of further investigation: whether the pilot study findings hold in student samples from more diverse cultural backgrounds; whether students' perceptions of spirituality can be broadened to include the full range of spiritual needs patients may encounter and whether their competence can be enhanced by education to better equip them to deliver spiritual care; identification of factors contributing to acquisition of spiritual caring skills and spiritual care competency.