Gender as a Moderator of Spirituality and Spiritual Care in ICU Nurses During COVID-19 Pandemic.

Background: Earlier research has found that female healthcare providers often report greater spirituality and spiritual care than males. This would evoke attention toward factors contributing to such differences, particularly gender. Aim: To examine the moderating effects of gender on the relationships between demographic characteristics of ICU nurses and their perceived spirituality and spiritual care. Methods: A cross-sectional correlational design was used to recruit a national sample of 865 nurses working in ICUs in Jordan and providing care to patients diagnosed with COVID-19. Data were collected using a self-report bilingual version of Spirituality and Spiritual Care Rating Scale (SSC) and analysed using the SPSS software package. Results: Social status, monthly income, and receiving previous courses or lecture training on spirituality and spiritual care were predictors of higher SSCRS scores. Working with COVID-19 patients was a positive predictor (B = 0.074, p = 0.023), suggesting that working with COVID-19 patients is more likely to have a higher level of SSC. Gender was a negative predictor (B = -0.066, p = 0.046), suggesting that female participants are likelier to have a lower SSC score. Conclusion: Working with patients during the COVID-19 pandemic positively impacted nurses' perception of SCC, but female nurses had lower score than male nurses indicating the need for more emphasis on training female nurses and exploring further the areas in which they need more training and to be able to provide an effective SSC. A sustainable up-to-date training and in-service education programs responding to nurses' needs and emerged emergencies crisis need to be integrated into nursing quality of care policy development.

Spirituality of Professional Pastoral Caregivers during the coven-19 Pandemic: Distress, Resources, and Consequences

The COVID-iota 9 pandemic has had an enormous impact on mental health in general and on care professionals in particular. Studies have shown that professional pasto-ral caregivers are challenged concerning stabilizing their mental health and coping with stress experiences. Spirituality, on the other hand, has been considered as a help-ful coping resource. This study examines professional pastoral caregivers in various contexts of hospitals, congregations, old people's homes or schools during the second lockdown in Germany. Results show the importance of spirituality as a resource, with an overall high centrality of religiosity, high daily spiritual experience and low spiritual dryness, but also reveal various stress factors with which pastoral caregivers have to deal. However, associations between work-related distress, spiritual dryness, centrality of religiosity and spiritual experience are displayed and discussed. Spiritual dryness correlates positively with work-related distress, whereas daily spiritual experience and centrality of religiosity correlates negatively. Possibilities of further support for those offering pastoral care during the pandemic and beyond are presented.

The Embedment of Palliative Care Services on a Neuro-Surgical Unit (CS359)

Outcomes: 1. A better understanding of the benefits of embedded palliative care into a neuro surgery unit at a large academic hospital 2. An understanding of the financial impact related to embedding a palliative care APC into the neuro surgery unit at a large academic hospital Problem: Palliative care needs of patients admitted to neurology ICUs are often unmet. Patients with palliative care needs identified were more likely to die in an ICU setting or be transferred to the floor with comfort measures only. These patients were noted to have a longer length of stay. Because of the known benefits of palliative care, specifically, with this vulnerable population of patients, there was a desire to increase the palliative care presence on the neuro surgical service. Intervention(s): One APC palliative care position specific to the neuro ICU team was created. Responsibilities included symptom management, family support, medical decision making, managing conflicts over care goals, and disposition planning. Outcome(s): Outcomes included involvement in interdisciplinary rounds, increased donor opportunities, and increased billing by 28% in 2021. There was a 46% increase in palliative care consults from 2020 to 2021 and an increase in percentage of DNR/DNI orders obtained during admission from 2020 to 2021. An increase in deaths during hospitalization with active palliative care consults on comfort care was noted. Statistics were collected specific to mortality, ICU LOS, diagnosis, COVID status, social work involvement, as well as spiritual care involvement. Conclusion(s): Patients are seen earlier in their hospitalization and their medical wishes are now widely known and discussed by all interdisciplinary team members. The need for the involvement of the APC in these cases has only solidified with increased exposure to the palliative care team as consults increase. Patients are benefitting from the quality care being provided that now better aligns with their personal medical goals. Implications for nursing: There are many vulnerable patient populations for whom palliative care could be just as impactful;additional research should be completed to investigate further. Palliative care embedded on an ICU improves collaboration and increases exposure and understanding of the intent of palliative care.Copyright © 2023

Reasons for Delay in Indian Women Presenting with Primary Stage III or IV Breast Cancer: An Observational Study

Background: Developing countries like India share higher burden of deaths due to breast cancer, despite having lower incidence than the west. Greater proportion of patients presenting with advanced stages of cancer is one of the reasons for this disparity. Since the factors leading to such delay have not been well studied in Indian patients, we decided to perform this study. Methodology: This was an observational study conducted from Jan 2021 to July 2022. Purposive Non-Random sampling was used and patients who had stage 3 or 4 breast cancer and were between 18-80 years of age were recruited. Interview was done on a one-to-one basis in a secluded area. Descriptive statistics were used, and chi-square was used to study the association of socio-demographic and clinical variables with the delay status of the breast cancer. Result(s): A total of 75 participants were enrolled in the study with mean age of 52.5 years and SD of 12.5 years. Out of these, 74 had lump as their first symptom. Only 14 of these 74 presented early i.e., within 3 months of onset of symptoms. Rest 60 participants presented late (more than 3 months after onset of symptoms). Between these two groups, difference in incidences of pregnancy associated lumps (0% in < 3 months vs 13.1% in >= 3 months, p=0.002), patients being afraid of treatment related complications (0% in < 3months vs 6.6% in >= 3 months, p=0.039) and their inability to decide because of lack of knowledge (0% in < 3months vs 6.6% in >= 3 months, p=0.039) were statistically significant. To our surprise, the thought that the lump was harmless and painless, embarrassment, limited access to healthcare and distance from the nearest healthcare facility, financial limitations, educational status, socio-economic status, family history of breast cancer, fear of mutilating surgeries and use of traditional medicine or spiritual care didn't have significant effect on whether the patients presented within or after 3 months of onset of symptoms. On the question of COVID pandemic related delay, only 16% of all patients cited this as an additional reason for delay and this was again, not different between the patients who presented within or after 3 months of onset of symptoms. Conclusion(s): Health promotion in terms of proper evaluation of pregnancy related lumps and awareness about the management options of breast cancer may help patients to present earlier to healthcare facilities and may help in improving breast cancer related outcomes in developing countries like India.

Quality of life of a group of Ecuadorian health professionals in covid-19

Introduction: Covid-19 was the cause of a pandemic that claimed thousands of human lives. The pandemic has caused health professionals mental health problems that influence emotional, psychological and social well-being, which affects the way they think, feel and act in daily life. Objective(s): To de-termine the quality of life of health personnel during the Co-vid-19 pandemic in public institutions in the city of Cuenca. Material(s) and Method(s): Descriptive, cross-sectional and observational study. The study sample was 338 health professionals belonging to the Ministry of Public Health of the Canton Cuenca, province of Azuay-Ecuador, doctors, nurses, dentists, psychologists, assistants and biochemists who work at differ-ent levels of care were included. Two WHOQOL surveys and the Lazarus and Folkman scale of coping modes were used, for the tabulation of the data the RStudio statistical program was used. Result(s): In the psychological domain, no significant destructuring was found in the personnel studied. In the field of health, it should be noted that the personnel studied reported the inability to carry out the activities they need and the diffi-culty in moving from one place to another. Conclusion(s): When investigating the relationship of health personnel with the envi-ronment, no statistically significant alteration was found, but it was evidenced that social support is a protective factor for the mental health of personnel.Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

American health care chaplains' narrative experiences serving during the COVID-19 pandemic: a phenomenological hermeneutical study.

The COVID-19 pandemic significantly impacted North American health care chaplains' modes of work and emotions. To capture the experiences of health care chaplains across the United States, 30 Board Certified (or eligible) chaplains were asked to keep a weekly narrative journal of their experiences and emotions during the pandemic from April of 2020 through June of 2020. Twenty-one chaplains submitted their journals for qualitative analysis, amounting to over 90,000 words of chaplain reflection containing rich, descriptive, and often personal stories of health care chaplains. Journals were analyzed using hermeneutic phenomenological methodology. The overarching patterns identified included: The World of Chaplaincy, Policies/Procedures/Visitation, Staff Care, Rituals, Chaplain Emotional Responses, Coping, and Racism. A significant finding was the resiliency and creativity of chaplains despite the rapid changes, uncertainty, and fear brought on by the pandemic. The results further suggest that journaling is a feasible and acceptable method in chaplaincy research.

Earbuds, smartphones, and music. Spiritual care and existential changes in COVID-19 times.

Rooted in a Durkheimian functionalist reading of religion, in this article, we present and discuss the results of a scoping study of on-line sources on the delivery of spiritual care during the COVID-19 pandemic in England. Spiritual care highlights the bond between healthcare and religion/spirituality, particularly within the growing paradigm of holistic and humane care. Spiritual care is also an area where the importance of the physical presence of receivers and providers is exceptionally important, as a classic anthropological understanding of the religious ritual would maintain. Three themes were found, which speak to changes brought about by the pandemic. These revolve around disembodiment, solitude, and technology in spiritual care, of religious and non-religious nature. A fourth theme encapsulates the ambivalence in the experience of spiritual care delivery, whereby distant and virtual care could only partially compensate for the impossibility of physical presence. On the one hand, we draw from anthropology of the ritual and phenomenology to make the case for the inalienability of intercorporeality in being there for the other. On the other hand, relying on digital religious studies and post-human theories, we argue for an opening up to new ways of conceptualising the body, being there, and being human.

COVID-19 and Religion: Pandemic Lessons and Legacies

The essay draws on a multiyear project to assess how religious communities worldwide experienced the COVID-19 pandemic and how they have in turn shaped responses to the pandemic. It focuses on religious public health responses, religious gatherings, and practices such as funerals, and the remarkable responses, especially at community level, offering social safety nets to people devastated by lockdowns and economic crises. Stigma, violence against specific groups, effects on women and children, and mental health are central challenges. The pandemic casts new light on contemporary forms of religious practice, community, mobilization, and engagement. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Spiritual care department leaders' response to racial reckoning in 2020 and 2021.

Ascension, one of the largest Roman Catholic healthcare systems, and Transforming Chaplaincy (TC) collaborated on a research project "Managing Spiritual Care (SC) Departments During the COVID-19 Pandemic: A Qualitative Study." Research participants included 22 leaders from Ascension and TC contacts. Four rounds of individual interviews were conducted from April, 2020 to February, 2021. After issues of race and racial reckoning following George Floyd's murder were brought up spontaneously in interviews, questions on how leaders responded to racial reckoning were added to the subsequent interviews. A secondary analysis examined responses from participants on racial reckoning from interviews 2-4. The objective of this study was to better understand how SC leaders understand their role in issues concerning justice, equity, and inclusion. This study utilized hermeneutic phenomenology methodology. Four phenomenological patterns emerged including: World of Racial Reckoning, Lack of Safety, Creating Safety, and Movement Toward Justice.

Hospital chaplains facing the pandemic. A qualitative study.

The article explores hospital chaplains perspective on the impact of the coronavirus pandemic on the provision of spiritual care in Poland. Semi-structured interviews with sixteen hospital chaplains providing spiritual care in hospitals during the COVID-19 pandemic were performed. Six main themes emerged during the interviews: chaplains' experience of the pandemic, chaplaincy during the outbreak, patients' needs, health professionals needs, social stigma and discriminatory behaviours against chaplains, and the importance of spiritual care during the crisis. Results indicate that although the COVID-19 crisis has limited the possibilities of providing spiritual care in hospitals and has changed its nature, it has positively impacted the visibility of hospital chaplaincy. It also underpins the contribution of hospital chaplains to modern healthcare practice and suggests that chaplains role as key healthcare workers should be further recognized and their integration into the healthcare system is required.

Examining Challenges to Palliative Care Services during the Covid-19 Pandemic, Focusing on Spiritual Care and Social Support: A Scoping Review

Background: This comprehensive scoping review examined and analyzed articles related to the topic of spiritual care challenges and mitigating interventions to challenges within palliative care during the COVID-19 pandemic.It then assessed the amount of knowledge relating to this topic in order to formulate recommendations for a reasonable direction for future research in the field of spiritual care within palliative care. Results: The research carried out in this scoping review found that spiritual care in the field of palliative care services is not only a topic that is currently being examined, but is more important than ever to explore thoroughly due to the vulnerabilities caused by the measures taken during the pandemic. Despite the importance of the topic, this scoping review found that spiritual care was not always a priority within palliative care services during pandemic times. Conclusion: In the future development palliative care, it is important to focus on appropriate staff training and consider providing basic training to all employees working with patients who are potentially approaching the end of life. Recommendations for future research in the field of spiritual care within palliative care should include the ethical use of IT technology and programs aimed at providing spiritual care services online. In the context of enhancing the provision of spiritual care, all members of the palliative and hospice care team should also continue to advocate for greater acceptance and promotion of spiritual care.

Spirituality of Professional Pastoral Caregivers during the COVID-19 Pandemic: Distress, Resources, and Consequences

The COVID-19 pandemic has had an enormous impact on mental health in general and on care professionals in particular. Studies have shown that professional pastoral caregivers are challenged concerning stabilizing their mental health and coping with stress experiences. Spirituality, on the other hand, has been considered as a helpful coping resource. This study examines professional pastoral caregivers in various contexts of hospitals, congregations, old people's homes or schools during the second lockdown in Germany. Results show the importance of spirituality as a resource, with an overall high centrality of religiosity, high daily spiritual experience and low spiritual dryness, but also reveal various stress factors with which pastoral caregivers have to deal. However, associations between work-related distress, spiritual dryness, centrality of religiosity and spiritual experience are displayed and discussed. Spiritual dryness correlates positively with work-related distress, whereas daily spiritual experience and centrality of religiosity correlates negatively. Possibilities of further support for those offering pastoral care during the pandemic and beyond are presented. Copyright © 2022 by Koninklijke Brill NV, Leiden.

COVID-19 and Religion: Pandemic Lessons and Legacies

The essay draws on a multiyear project to assess how religious communities worldwide experienced the COVID-19 pandemic and how they have in turn shaped responses to the pandemic. It focuses on religious public health responses, religious gatherings, and practices such as funerals, and the remarkable responses, especially at community level, offering social safety nets to people devastated by lockdowns and economic crises. Stigma, violence against specific groups, effects on women and children, and mental health are central challenges. The pandemic casts new light on contemporary forms of religious practice, community, mobilization, and engagement.

Resident physician outlook on death, dying and end-of-life care during the COVID-19 pandemic: effect of religion and burnout.

OBJECTIVES: Religion and spirituality are important aspects of many physicians and patients' lives and may impact their views of death and the way they interact with terminally ill patients, specifically comfort discussing end-of-life care and death and dying. This study explores the religious and spiritual beliefs of resident physicians, if they affect interactions with their patients and if burnout impedes this interaction. METHODS: A 28-item questionnaire was administered to residents and fellows at an urban academic hospital. RESULTS: 65 residents and fellows answered the survey. Religiosity but not spirituality correlated with reported comfort interacting with patients dealing with death or dying. Resident specialty, biological sex and spirituality were not associated with comfort and conversations about religion and end-of-life care. The majority (60%) reported that the pandemic has not affected how they speak to their patients about death and dying. Caring for a higher volume of terminally ill patients was not associated with high levels of burnout though 71% reported increased burnout due to COVID-19. CONCLUSION: Further research can be done to determine whether additional training or resources should be provided to resident physicians to cope with death and dying in the setting of a pandemic.

Tool for the assessment spiritual care after the COVID-19 pandemic: a sequential exploratory study.

Background: The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic. Materials and methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health. Results: Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p <0.001). Conclusion: Spiritual care tool is a valid and reliable tool, with 38 items to assess the spiritual care after the COVID-19 Pandemic.

Managing Spiritual Care Departments During the COVID-19 Pandemic: A Qualitative Study.

This qualitative study reports how 20 spiritual care leaders provided leadership in the early months of the COVID-19 pandemic. The patterns and themes that emerged centered around the changing world of chaplaincy, the administrative role of the leader, and the personal story of the leader. Spiritual care leaders demonstrated creativity with the potential to shape chaplaincy in positive ways, expanding the reach of spiritual care.

Perceived spiritual care competence and the related factors in nursing students during Covid-19 pandemic.

Background: Spirituality is defined as the way people experience, express, and seek meanings. It is a major concept in the field of nursing care. Nursing students who are trained and exposed to patients' spiritual care will be better able to take care of their patients' spiritual needs. Objectives: The study aimed to assess perceived spiritual care competence and the related factors in nursing students during the Covid-19 pandemic. Methods: This was a cross-sectional study. The participants were 191 undergraduate nursing students at Guilan University of Medical Sciences (GUMS) that were entered into the study from July 29 to December 21, 2021. The spiritual care competence scale was used to measure spiritual care competence in the participants. It is a 27-item questionnaire with six dimensions including assessing and implementing spiritual care, professionalism and improving the quality of spiritual care, personal support and patient counseling, referral to professionals, attitude towards patient's spirituality, and communication. Data was collected using the convenience sampling method. Data analysis was done by SPSS software version 16.0 using descriptive, bivariate, and multivariate methods. Results: The mean total score of spiritual care competency was 106.8 (SD = 13.4). The mean total score of spiritual care competency was significantly higher in the native students (P = 0.031) and the students with experience of jobs in hospitals (P = 0.037). Conclusion: The findings indicated an acceptable level of performance in nursing students in spiritual care during the Covid-19 pandemic.

Quality of death in cancer patients managed by gastroenterologists

Background: Care in hospitals is generally focused on prolonging life and may not adequately address the needs of dying patients. The incidence of oncologic diseases is rising, and efforts should be made to guarantee a better quality of death and dying. Aim: to evaluate the end-of-life care in patients with cancer under gastroenterologist care. Methods: Cross-sectional study including all in-patients with cancer who deceased in a Gastroenterology department in Portugal between 2012-2021. Demographic characteristics, clinical attitudes, therapeutic interventions and symptom control up to 6 months prior to the patient’s death were assessed. Results: We included 120 patients, 73% male, mean age 71±12.5 years. The most common cancers were hepatocellular carcinoma (35%), gastric cancer (16%), pancreatic cancer (15%) and cholangiocarcinoma (14%). One third of the patients had ECOG of 0-1 at admission and 77% (n=92) had advanced disease (stage IV or Barcelona Clinic Liver Cancer C/D). The median number of emergency consultations and hospitalizations in the 6 months before death was 2 (IQR 1-4). In their last month of life, the median time of hospitalization was 21.5 (IQR 12-25) days. It was documented the presence of an available caregiver in 56%(n=68) and spiritual support in only 2% (n=2) of the cases. One quarter of the patients experienced not adequately controlled pain and 72% received opioids. Palliative care consultation occurred in 60% (n=72) with a median time between that and death of 12 (IQR 3-18) days. Invasive procedures (diagnostic and therapeutic endoscopy, ERCP and EUS) were performed in half of the patients, achieving technical and clinical success in 62% (n=38) and 32% (n=19) of the cases, respectively. The mean time between those interventions and death was 12±10 days. The prognosis was discussed with the patient and family in 35% and 68% of the cases, respectively. At least 73% of the patients had visits at the end of life, which was negatively affected by the COVID-19 pandemic (p=0.022). Conclusions: In our cohort, we found a high hospitalization length of stay in the last month of life and high percentage of invasive treatments until shortly before dying. Thus, it is urgent to define and implement metrics of quality of death to prevent futile/potentially inappropriate treatment. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Association between spiritual care competency and perceived professional benefit among nurses: A cross-sectional study.

AIMS: This study aimed to investigate the status quo of nurses' spiritual care competency and their relationship with perceived professional benefit. BACKGROUND: Spiritual care has always been considered a vitally important part of holistic nursing. Understanding the spiritual care competency of nurses during the COVID-19 pandemic can help nursing managers understand the weak links in spiritual care practice and improve the quality of nursing service. As a positive emotional experience and cognitive evaluation of the profession, perceived professional benefit can serve to adjust work pressure, relieve job burnout and promote an individual's overall growth. However, the relationship between perceived professional benefit among nurses and spiritual care competency remains unclear. METHODS: A total of 372 nurses were recruited from 15 separate Chinese hospitals. An online questionnaire was used to assess nurses' sociodemographic, spiritual care competency and perceived professional benefit. Statistical analyses were performed using Pearson's correlation analysis, t test, analysis of variance (ANOVA) and multiple stepwise linear regression analysis. RESULTS: The total mean score of spiritual care competency (99.43 ± 21.10) among nurses was found to be moderate. Nurses' spiritual care competency was positively correlated with perceived professional benefit (P < .01). The multiple stepwise linear regression model (n = 372) had an explained variance (R2 = 0.218) and showed that perceived professional benefit and the manner of receiving spiritual training were the main influencing factors of nurses' spiritual care competency (P < .001). CONCLUSION: The study findings indicated that nurses need to improve their spiritual care competency by improving their perceived professional benefit. IMPLICATION FOR NURSING MANAGERS: Our study evaluated the spiritual care competency of nurses and explored the correlation between perceived professional benefit and spiritual care competency among nurses. The results of this study can help nursing managers to carry out relevant interventions, thus improving nurses' spiritual care competency and optimizing the quality of nursing.

Medical Acupuncture and Global Wellness

Physical and mental health challenges seem to be part of our daily living. To understand the latest consensus, I attended a symposium, June 30, 2021, advocating global health by using acupuncture and integrative medicine at the Lansdowne Resort for a Global Wellness Event, in Leesburg, Virginia. Group sound bathing and meditation were offered to the participants in a therapeutic session. This was to prepare our minds and bodies for the experience of this symposium. Do we wish to lead a revolution in the science of health—especially now—to maintain and thrive in the era of COVID-19? This was the main theme of this event. To understand COVID-19 better, experts were present who explained its biology and perhaps what might be expected in the future as this virus winds down or rebounds as variants.