Asiasiga i A'oga ma Nu'u: a child and adolescent post-tsunami intervention based on Indigenous Samoan values.

OBJECTIVE: To describe a community-based single-session group intervention designed to address psychosocial needs of Samoan young people following a tsunami. METHOD: This programme resulted from collaboration between Samoan therapists, Samoan Catholic pastoral care workers and non-Samoan mental health clinicians. Informed by Samoan concepts of self and wellbeing, it incorporated cultural and spiritual practices familiar to Samoan young people and their families as well as body-centred therapeutic techniques, the 'Tree of life' exercise and provision of a cooked meal. RESULTS: Following household visits to affected families in villages throughout southern and eastern Upolu and the island of Manono, the programme was devised and carried out in 11 villages with 1295 children participating. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders), young people, their families and community members. CONCLUSIONS: Interventions to address the psychological needs of Indigenous Pacific children and adolescents following a major disaster need to be embedded in the values of their communities. This paper describes an innovative programme based on Samoan values that was consistent with evidence-informed principles used to guide post-disaster responses.

Asiasiga: a Samoan intervention to address the immediate mental health needs of Samoan communities after a tsunami.

OBJECTIVE: To describe an Indigenous Samoan psychosocial intervention developed to address the mental health needs of affected communities in Samoa following a tsunami. METHOD: A partnership was established between Samoan therapists, Samoan Catholic pastoral workers and non-Samoan mental health clinicians, informed by Samoan concepts of self and wellbeing. The format developed for visits to significantly affected households was based on a Samoan cultural practice known as asiasiga and was carried out by pastoral workers, with daily group supervision and access to mental health professionals. RESULTS: Household visits were offered to affected families in villages throughout southern and eastern Upolu and the island of Manono. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders) and family leaders and members. CONCLUSIONS: Mental health responses to the needs of Indigenous Pacific communities following a disaster need to be embedded in the values of those communities. The Samoan practice of asiasiga contributed to the high degree of acceptability of this programme. Partnerships with churches, schools and other local organisations are likely to enhance acceptability and participation. More research is required on Indigenous Pacific post-disaster mental health programmes.

The Affordable Care Act and hospital chaplaincy: re-visioning spiritual care, re-valuing institutional wholeness.

This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.

Offering spiritual support to dying patients and their families through a chaplaincy service.

Despite its importance in end of life care, spiritual care is poorly addressed. This article presents the results of an innovative service in which nurses notify hospital chaplains of all patients placed on the Liverpool Care Pathway and the chaplains then visit to offer spiritual support to both patients and their carers. Nurses reported that the service was valuable not only for patients and their families but also for themselves and the whole clinical team. All nurses said they wanted the service to continue.

Spirituality. 2: Exploring how to address patients' spiritual needs in practice.

Although meeting patients' spiritual needs is important, many nurses are uncertain about what spiritual care involves and lack confidence in this area. This second article in a two part series on spirituality considers ways of addressing spiritual needs and provides an overview of the principles of assessment and implementation. Part 1 explored definitions of spirituality, the difference between religion and spirituality, and finding meaning in illness.

Exploring parish nurses' perspectives of parish nurse training.

BACKGROUND: Little research has explored parish nurses' perceptions of their preparation for their new role transition. This article studied role preparation from the perspective of practicing parish nurses. METHODS: A qualitative descriptive design used in-person interviews and open-ended questions. Interviews with practicing parish nurses within 2 years of attending a training course were transcribed and coded. Participants shared their perceptions of role preparation and the interventions that were most helpful in transitioning to the role of parish nurse. RESULTS: Participants identified some deficiencies in training that led to feelings of inadequacy in areas such as spirituality and community nursing knowledge. Lack of role models and inadequate practice hours were challenges for role transition. Group activities during training and peer support were cited as helpful interventions for the new parish nurse. CONCLUSION: The findings will help parish nurse educators to understand factors that affect role transition for parish nurses and contribute to the improvement of training models to support successful role transition.

Parish nurse-initiated interdisciplinary mobile health care delivery project.

Parish nurses and a school of pharmacy faculty collaborated on a mobile health project to bring screening and preventive services to low-income neighborhoods. Outcome measures indicated that older women were most likely to use these services. This project fostered a positive, trusting client-provider relationship that formed the basis of clients' motivation to make lifestyle changes. Future direction includes collaboration with an academic nursing center to expand services in chronic care management.

Providing coping assistance for women with behavioral interventions.

OBJECTIVE: To describe what parish nurses believe is essential to their practice and identify what nursing interventions they most frequently use. DESIGN: Descriptive cross sectional study. PARTICIPANTS: The International Parish Nurse Resource Center provided a list of nurses who completed the standardized core curriculum on parish nursing and were currently working in parish nurse roles in faith communities in the United States. METHODS: The Nursing Intervention Classification System Survey was mailed to 2,330 parish nurses with return envelopes. RESULTS: The 1,161 parish nurse respondents (50% return) resided in faith communities in 47 states and represented major religious denominations from Christian and non-Christian religious affiliations. Participants identified the most frequently used nursing interventions were in the behavioral domain and coping assistance system. CONCLUSIONS: Nurses working in faith communities are frequently using nursing interventions related to health promotion and coping assistance. The findings are valuable to all nurses in identifying strategies and collaborations for enhancing the well-being of women and their families. Improving quality of life through the collaborative support of community agencies, health care providers, and members of the faith community are integral to women's health.

Evidence for a new paradigm of the ministry of parish nursing practice using the nursing intervention classification system.

A national study of parish nurses used the Nursing Intervention Classification (NIC) Use Survey (3rd Ed.) to characterize parish nursing practice. The study categorized NIC interventions based on frequency of use by parish nurses. The majority of nursing interventions focused on the Behavioral Domain, which supports psychosocial functioning and facilitates lifestyle changes and the Coping Assistance Class, which includes spiritual support. Data provides evidence to further understand what parish nurses do in their daily practice, as well as clarifies the complexity and scope of this specialty practice. Findings confirm that parish nursing is a specialty nursing practice as well as a ministry. Objective descriptions of parish nurse practice, including the identification of the most commonly used parish nurse interventions, will assist in providing direction for defining the role of the parish nurse and providing a basis for reviewing the current content of parish nurse curriculum. The database, which uses a standardized nursing language, also provides evidence for a new paradigm of the ministry of parish nursing practice that is intelligible to other nurses, policy makers, and funders.

Collective knowledge sharing as a social justice strategy: the difference it made in a service project about preterm birth disparity.

Knowledge about how health disparities are created and sustained from those affected is needed. Collective knowledge sharing is one way to redefine and revalue dialogue and critique processes with the aim of promoting just relationships of knowledge production. This article describes how a community service project focused on using collective knowledge sharing as a social justice strategy with health ministry volunteers produced insights about preterm birth disparity issues. Project insights related to (1) the connection between faith and health, (2) the significance of family and congregational stories, and (3) the importance of praising assets in the context of disparity recognition.

Spiritual care as a dimension of holistic care: a relational interpretation.

This article reports on a phenomenological study undertaken to explore the meaning of spiritual care as described by a group of palliative care professionals. The research process was informed by van Manen's (1990) hermeneutic phenomenological approach. Eight palliative care professionals (nurses, complementary therapists and pastoral carers) were recruited from a community palliative care agency in Melbourne, Victoria, which provided home-based palliative care. All participants were female and came from diverse ethnic backgrounds. Data were collected by in-depth conversational interviews and were analyzed thematically. Two themes emerged: 'a living nexus between spiritual care, spirituality and holism' and 'a world of relationships'. The findings of the study point to the need for healthcare professionals to incorporate spiritual care guidelines into practice in order for palliative care to be truly representative of holistic health care.

Church and spirituality in the lives of the African American community.

The African American church is held in the highest esteem by most African Americans. Although the influence of the African American church has been underestimated by physicians and nurses, it could be pivotal in optimizing health status among African Americans. Because of this influence, health care practitioners, including nurses, are now recognizing the important role that the African American church plays in improving the health status of individuals in the African American community. This article illuminates the health and health care concerns of the African American community by considering the traditional lack of equal access for this population and the role that the church can play in not only offering church-based health care services but also improving the health status of church congregations. Future roles of the African American church for improved health status are also suggested.

Care of community-dwelling older adults by faith community nurses.

In this state-funded study of the impact of faith community nursing, 1,061 notes regarding 713 older adults were retrieved from 75 faith community nurses. Critical contacts were mapped using the Data, Interpretation, Action, Response, and Yield (DIARY) charting format. DIARY notes revealed that disabilities were seemingly avoided when reluctant older adults were coaxed to access care before their illnesses escalated. The nurses solicited help from blended networks, procured assistive devices, cued family members, made environments safe, reengaged those who were despairing, calmed those who were anxious, facilitated recovery aftercare, advocated for those who were neglected, and helped caregivers navigate end-of-life decisions.

Spirituality and secularization: nursing and the sociology of religion.

AIM: The concept of spirituality is much discussed in the UK nursing literature, despite the fact that Britain is one of the most secular countries in the world, and steadily becoming more so. Here, I pose the following question: given this increasing secularization, what accounts for the current interest in spirituality among UK nurses? BACKGROUND: The literature on spirituality in nursing has blossomed in the last 10 years, and various attempts have been made to define 'spirituality', 'spiritual need' and 'spiritual care'. Most definitions distinguish between 'spirituality' and 'religion', acknowledging that the latter is more institutional, and theologically more restrictive, than the former; and they suggest that spirituality is universal, something which (unlike religion) all human beings share. METHOD: I draw on the sociology of religion - neglected, for the most part, in the nursing literature - to establish two main points. Firstly, that the UK and the USA are at opposite ends of the religion/secularity spectrum, implying that it is a mistake to assimilate USA and UK sources. Secondly, that the concept of spirituality, as currently understood, is of very recent origin, and is still 'under construction', having become separated from its associations with Christian piety and mysticism only since the 1980s. CONCLUSIONS: The extension of spirituality into secular domains is part of a professionalization project in nursing, a claim to jurisdiction over a newly invented sphere of work. For the time being, it remains an academic project (in the UK) as it is not one with which many clinicians identify. Relevance to clinical practice. What counts as 'spiritual need' or 'spiritual care' may not be the same in both countries, and UK clinicians are unlikely to welcome the role of surrogate chaplain, which their USA colleagues are apparently willing to embrace.

Distress in patients with cancer: definition, assessment, and suggested interventions.

Distress in patients with cancer impacts their quality of life. The National Comprehensive Cancer Network (NCCN) created a distress thermometer and a problem checklist to aid in recognizing distress. The thermometer measures distress on a 0-10 scale, and the problem checklist identifies more specific etiologies of distress, such as practical, spiritual, physical, emotional, and family problems. Oncology nurses play a key role in the success of the distress-screening tool because they have the most patient contact. The NCCN guidelines suggest that patients complete the screening tools at each visit and clinicians review the outcome. NCCN has provided clinical pathways for treating the etiologies of distress using a multidisciplinary approach, including members from social work, pastoral services, mental health, and oncology.