Investigation of Nursing Students' Attitudes Towards Death and Their Perceptions of Spirituality and Spiritual Care.

Nurses are responsible for meeting the care needs of dying patients and their families, including their physical, psychological, emotional and spiritual assessment and care. The aim of this descriptive study was to investigate nursing students' attitudes towards death and their perceptions of spirituality and spiritual care. The study sample consisted of 237 second-, third- and fourth-grade nursing students. Data were collected using a "Personal Information Form", the "Spirituality and Spiritual Care Rating Scale (SSCRS)" and "Death Attitude Profile-Revised (DAP-R)". Number, percentage, mean, standard deviation and Spearman's correlation analysis were used for analysis. Participants stated that they had witnessed death before (73.8%), that spiritual care of dying patients and their families should be given special importance (93.7%) and that they feel incompetent in providing spiritual care (86.1%). Participants had a mean SSCRS score of 3.45 ± 0.43. They had the highest and lowest scores on the DAP-R subscales of "fear of death" (4.48 ± 0.83) and neutral acceptance (3.71 ± 1.21), respectively, indicating that they have a high fear of death and above average perceptions of spirituality and spiritual care. It is recommended that different teaching methods be integrated into the curriculum to help nursing students develop more positive attitudes towards death and improve their perceptions of spiritual care.

Do Perceptions of Spiritual Care Affect Attitudes Towards Care for Dying Patients in a Group of Turkish Nursing Students?

The present study was designed to determine the relation between attitudes to death and perceptions of spiritual care in nursing students. It is a descriptive study and included 290 fourth-year nursing students (intern students). Data were collected with a descriptive characteristics form, Frommelt Attitude Towards Care of the Dying Instrument and Spirituality and Spiritual Care Rating Scale. SPSS version 21 was used for data analysis. There was a significant positive relation between the mean scores for Spirituality and Spiritual Care Rating Scale and Frommelt Attitude Towards Care of the Dying Instrument. It can be recommended that courses about death and spiritual care should be offered and integrated into nursing curricula.

Patient Perceptions About the Role of Religion and Spirituality During Cancer Care.

We sought to assess the perspectives of cancer patients relative to their spiritual well-being, as well as examine the impact of religion/spirituality during cancer care. A mixed-methods concurrent embedded online survey design was used. While 86% of participants indicated a religious/spiritual belief, respondents also reported lower overall spiritual well-being than population norms (t(73) = - 5.30, p < 0.01). Open-ended responses revealed that 22% of participants desired the healthcare team to address the topic of religion/spirituality, but the majority preferred to discuss with a family member or friend (48%). Religion/spirituality might play a central role for a subset of patients across the cancer journey.

Negative Experiences in Childhood, Parental Style, and Resilience Among People Reporting Paranormal Experiences.

There are relatively few studies examining the parental style, childhood trauma, and paranormal experiences/beliefs; therefore, the aim of this study is to measure the dominant parental style of those who have experienced paranormal events and their correlation with negative events in childhood and resilience. Four questionnaires were administered to 644 participants. The results showed high frequency of experiences such as sense of presence, premonitory dreams, telepathy, mystical experiences, apparitions, and out-of-body experiences, among others. The results confirmed three hypotheses that predict a positive and significant correlation between the paranormal experiences in adult life and negative experiences in childhood, such as abuse and neglect. One possible interpretation is that "flexible" parental style is the more permissive ones (greater openness and sensitivity to capture alternative realities), in contrast to "rigid" parental style (whose perspectives generate restrictions to capitalize on the unconventional experiences of their children).

Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses.

BACKGROUND: Although spiritual care is a basic element of holistic nursing, nurses' spiritual care knowledge and abilities are often unable to satisfy patients' spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. DESIGN: A nonrandomized controlled trial. OBJECTIVE: To establish a spiritual care training protocol and verify its effectiveness. METHODS: This study recruited 92 nurses at a cancer treatment hospital in a single province via voluntary sign-up. The nurses were divided into two groups-the study group (45 people) and the control (wait-listed) group (47 people)-using a coin-toss method. The study group received one spiritual care group training session every six months based on their routine nursing education; this training chiefly consisted of lectures by experts, group interventions, clinical practice, and case sharing. The control group participated in monthly nursing education sessions organized by the hospital for 12 continuous months. RESULTS: After 12 months of intervention, the nurses in the study group had significantly higher overall spiritual health and spiritual care competency scores as well as significantly higher scores on all individual dimensions compared with those in the control group (P < 0.01). CONCLUSIONS: A spiritual care training protocol for nurses based on the concept of mutual growth with patients enhances nurses' spiritual well-being and spiritual care competencies.

Use of Complementary and Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-Boomers.

OBJECTIVES: To compare use of complementary and alternative medicine (CAM) across age cohorts. DESIGN: Secondary analysis of data from the Collaborative Psychiatric Epidemiology Surveys. PARTICIPANTS: Adults born in 1964 or earlier (N = 11,371). Over half (61.3%) are baby boomers and 53% are female. Seventy-five percent of the sample is white, 10.2% African American, 0.6% black Caribbean, 9.35% Latino, and 4.1% Asian. MEASUREMENTS: The dependent variable is a dichotomous variable indicating use of any CAM. The main predictor of interest is age cohort categorized as pre-boomers (those born in 1945 or earlier) and baby boomers (those born between 1946 and 1964). Covariates include the use of traditional service providers in the past 12 months and 12-month levels of mood, anxiety, and substance disorder. Disorders were assessed with the Diagnostic and Statistical Manual World Mental Health Composite International Diagnostic Interview. Logistic regression was used to test the association between use of CAM and age cohort. RESULTS: Baby boomers were more likely than pre-boomers to report using CAM for a mental disorder. Among identified CAM users, a higher proportion of baby boomers reported using most individual CAM modalities. Prayer and spiritual practices was the only CAM used by more pre-boomers. CONCLUSIONS: Age cohort plays a significant role in shaping individual healthcare behaviors and service use and may influence future trends in the use of CAM for behavioral health. Healthcare providers need to be aware of patient use of CAM and communicate with them about the pros and cons of alternative therapies.

Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study.

BACKGROUND: Sophisticated conventional medicine (CM) has brought significant advances to cancer prevention, detection, and treatment. However, many cancer patients still turn to complementary and alternative medicine (CAM) treatment. This study explored the prevalence, patterns, and perceived value of CAM among cancer patients. METHODS: This quantitative descriptive study was conducted between March 1, 2015, and July 31, 2015, among a cross-sectional, convenience sample of patients from the Oncology Department of San Fernando General Hospital in Trinidad and Tobago. Face-to-face interviews were conducted at the oncology clinic and treatment suite after obtaining informed consent. Data analysis included descriptive analysis, chi-square tests, and binary logistic regression analysis. RESULTS: The prevalence of CAM use among a sample of 350 cancer patients was 39.1% (39.6% for breast cancer, 44.4% for prostate cancer, 37% for ovarian cancer, and 38.7% for colon cancer patients). Herbs were the most common type of CAM used (93.4%), followed by spiritual therapy (73.7%). CAM use was more prevalent among females (68.6%), Indo-Trinidadians (63.5%), and patients aged 41-50 years (37.2%). The majority (70%-80%) rated CAM efficacy on perceived value. CAM was used mainly because of a desire to try anything that might help (67.6%), followed by it being congruent with the patients' beliefs (59.1%). Patients knew about CAM mainly through friends (69.3%) and family (69.3%). Most patients were generally satisfied (93.6%) and considered CAM helpful (89.8%), but the majority never informed their health care provider of CAM use (78.8%). Patients reported the simultaneous use of more than one type of CAM, without considering or knowing of possible side-effects. The perceived value of CAM included empowerment, control, cure, and improved quality of life. CAM use was associated with age, but no predictors of CAM use could be identified. CONCLUSION: Medicinal herbs and spiritual therapy are commonly used among cancer patients because of perceived benefits and satisfaction. CAM use is more prevalent among females, Indo-Trinidadians, and patients aged 41-50 years old. There are no useful predictors of CAM use. More than one type of CAM is commonly used simultaneously without disclosure to health care providers.

Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy Presenting for Care at a Comprehensive Cancer Center.

OBJECTIVE: We evaluated complementary and alternative medicine (CAM) practices among women presenting to a National Cancer Institute-designated Comprehensive Cancer Center with a gynecologic malignancy. METHODS: Women with a gynecologic malignancy who had consented to enrollment in our institutional prospective clinical registry between January 2003 and January 2014 and who had completed a questionnaire assessing sociodemographic characteristics, medical histories, quality of life, and CAM use were considered for analysis. RESULTS: Among the 2508 women identified, responses to questions on CAM use were provided by 534 (21.3%). The majority of CAM question respondents were white (93.5%) and older than 50 years (76%). Overall, 464 women (87% of CAM question respondents) used at least 1 CAM therapy during the previous 12 months. The most commonly used CAM categories were biologically based approaches (83.5%), mind and body interventions (30.6%), and manipulative and body-based therapies (18.8%). The most commonly used individual CAM therapies were vitamins and minerals (78%), herbal supplements (27.9%), spiritual healing and prayer (15.1%), and deep breathing relaxation exercises (13.1%). Complementary and alternative medicine use was greatest in age groups 20 to 30 years and older than 65 years and was more prevalent among those who were widowed (P < 0.005), retired (P = 0.02), and with a higher level of education (P < 0.01). There was no association with cancer type, race, or ethnicity. CONCLUSIONS: Complementary and alternative medicine use is common among women being treated for gynecologic malignancy. Given the potential interactions of some CAM modalities with conventional treatment and the possible benefits in controlling symptoms and improving quality of life, providers should discuss CAM with their patients.

Complementary and alternative medicine usage among cardiac patients: a descriptive study.

BACKGROUND: The use of complementary and alternative medicine (CAM) persists, despite the availability of conventional medicine (CM), modernisation, globalisation, technological advancement, and limited scientific evidence supporting CAM. People with cardiovascular diseases often use CAM, despite possible major adverse effects and lack of evidence supporting CAM claims. This study explored CAM use among cardiac patients, the types of CAM used, reasons and factors that influence its use, and the association between patient demographics and CAM use. METHODS: This cross-sectional quantitative study was conducted using quota sampling to survey 329 public clinic adult cardiac patients within the South-West Regional Health Authority (SWRHA) of Trinidad and Tobago. From 1 July 2012 to 31August 2012, each participant completed questionnaires, after consenting to participate. Data analysis included χ(2) tests and binary logistic regression. RESULTS: One hundred eighty-five (56.2%; standard error [SE] = 2.74%) patients used CAM. Herbal medicine was the most common CAM (85.9%; SE = 2.56%), followed by spiritual therapy/mind-body systems (61.6%; SE = 3.58%), physical therapy/body manipulation (13.5%; SE = 2.51%), alternative systems (8.1%; SE = 2.01%), and other methods (3.8%; SE = 1. 41%). The patients believed that CAM promotes health and wellness (79.5%; SE = 2.97%), assists in fighting illness (78.9%; SE = 3.00%), addresses the limitations of CM (69.2%; SE = 3.56%), alleviates symptoms (21.6%; SE = 6.51%), costs less than CM (21.6 %, SE = 3.03), and has fewer adverse/damaging effects than CM (29.7, SE =3.36), or they were disappointed with CM (12.4%, SE = 2.42). Ethnicity and religion were associated with CAM usage, but only ethnicity was a useful predictor of CAM use. CONCLUSIONS: Complementary and alternative medicine use was high among cardiac patients (56.2%, SE = 2.74%), and associated with ethnicity and religion. Friends, family, and perceived mode of action influenced a patient's use of CAM.

Spiritual AIM and the work of the chaplain: a model for assessing spiritual needs and outcomes in relationship.

OBJECTIVE: Distinguishing the unique contributions and roles of chaplains as members of healthcare teams requires the fundamental step of articulating and critically evaluating conceptual models that guide practice. However, there is a paucity of well-described spiritual assessment models. Even fewer of the extant models prescribe interventions and describe desired outcomes corresponding to spiritual assessments. METHOD: This article describes the development, theoretical underpinnings, and key components of one model, called the Spiritual Assessment and Intervention Model (Spiritual AIM). Three cases are presented that illustrate Spiritual AIM in practice. Spiritual AIM was developed over the past 20 years to address the limitations of existing models. The model evolved based in part on observing how different people respond to a health crisis and what kinds of spiritual needs appear to emerge most prominently during a health crisis. RESULTS: Spiritual AIM provides a conceptual framework for the chaplain to diagnose an individual's primary unmet spiritual need, devise and implement a plan for addressing this need through embodiment/relationship, and articulate and evaluate the desired and actual outcome of the intervention. Spiritual AIM's multidisciplinary theory is consistent with the goals of professional chaplaincy training and practice, which emphasize the integration of theology, recognition of interpersonal dynamics, cultural humility and competence, ethics, and theories of human development. SIGNIFICANCE OF RESULTS: Further conceptual and empirical work is needed to systematically refine, evaluate, and disseminate well-articulated spiritual assessment models such as Spiritual AIM. This foundational work is vital to advancing chaplaincy as a theoretically grounded and empirically rigorous healthcare profession.

Do spiritual patients want spiritual interventions?: A qualitative exploration of underserved cancer patients' perspectives on religion and spirituality.

OBJECTIVE: This study examines religion and spirituality among advanced cancer patients from an underserved, ethnically-diverse population by exploring patient conceptualizations of religion and spirituality, the role of religion and spirituality in coping with cancer, and patient interest in spiritual support. METHOD: Qualitative semi-structured interviews were conducted with patients who had participated in a study of a "mind-body" support group for patients with all cancer types. Analysis based on grounded theory was utilized to identify themes and theoretical constructs. RESULTS: With regard to patient conceptualizations of religion and spirituality, three categories emerged: (1) Spirituality is intertwined with organized religion; (2) Religion is one manifestation of the broader construct of spirituality; (3) Religion and spirituality are completely independent, with spirituality being desirable and religion not. Religion and spirituality played a central role in patients' coping with cancer, providing comfort, hope, and meaning. Patients diverged when it came to spiritual support, with some enthusiastic about interventions incorporating their spiritual values and others stating that they already get this support through religious communities. SIGNIFICANCE OF RESULTS: Spirituality plays a central role in the cancer experience of this underserved ethnically-diverse population. While spirituality seems to be a universal concern in advanced cancer patients, the meaning of spirituality differs across individuals, with some equating it with organized religion and others taking a more individualized approach. It is important that psychosocial interventions are developed to address this concern. Future research is needed to further explore the different ways that patients conceptualize spirituality and to develop spiritually-based treatments that are not "one size fits all."

Biographical similarities between spiritual healers and their clients in Germany - a qualitative study.

Spiritual healers in contemporary Germany comprise a heterogeneous and growing group, yet little data exists about them. Therefore, one aim of this study was to learn about which biographical aspects and events were important to the process of becoming a healer and which biographical aspects drove clients to consult a healer. The study was based on semi-structured interviews combined with participant observations. All data were recorded digitally, transcribed, entered into the software program MAXQDA and analysed subjected to Content Analysis. In total, 15 healers (nine male, six female) and 16 clients (13 female, three male) were included. According to the healers, a talent for healing can be inborn, inherited or developed through life experiences. Most of the healers experienced a crisis, which prompted their transformation to healers (the wounded healer type). A smaller group became healers mainly out of interest without going through crisis and by focusing on the spiritual attitude itself (the healer by interest type). The basis of healing is seen as a connection to a transcendent reality, which enables an open, loving and empathetic attitude. The experience of crises and illnesses and the importance of spirituality are major biographical similarities between healers and clients. Near-death experiences as an extreme form of crisis were reported from a few healers and clients. The connections between healing talents and crises, including a deepened exploration of near-death experiences and questions regarding inclining towards spirituality could be of interest in further studies.

Spiritual care of the child with cancer at the end of life: a concept analysis.

AIM: The aim of this paper is to report an analysis of the concept of spiritual care of a child with cancer at the end of life. BACKGROUND: Spirituality is a vital dimension of a child's experience at the end of life; providing comfort; support; and a sense of connection. Spiritual care is paramount to address the substantial spiritual distress that may develop. DESIGN: Rodgers' method of evolutionary concept analysis guided the review process. DATA SOURCES: The literature search was not limited by start date and literature through the end of 2012 was included. English, peer-reviewed texts in the databases CINAHL, ATLA and PubMed were included. METHODS: Critical analysis of the literature identified surrogate terms, related concepts, attributes, antecedents and consequences. RESULTS: The analysis identified six attributes: assessing spiritual needs; assisting the child to express feelings; guiding the child in strengthening relationships; helping the child to be remembered; assisting the child to find meaning; and aiding the child to find hope. Antecedents include existential questions and spiritual distress. Consequences include a peaceful death, spiritual growth, a relationship of trust and enhanced end-of-life care. CONCLUSION: Spiritual care is a vital aspect of holistic nursing care; however, gaps in knowledge and practice prevent children from receiving adequate spiritual care at the end of life. Nurses would benefit from increased awareness, skills and knowledge about spiritual care. Research is needed to identify interventions that exert the greatest effect on patient care outcomes.

Complementary and alternative medicine utilization by a sample of infertile couples in Jordan for infertility treatment: clinics-based survey.

BACKGROUND: Although there is little information available to quantify the use of complementary and alternative medicine (CAM), growing evidence suggests that CAM prevalence among patients seeking infertility treatment is increasing worldwide. There are many products available on the market and many infertile patients demand information about CAM from their health care providers. This paper investigates the prevalence of CAM use among infertile couples in Jordan. Additionally, trends and factors contributing to CAM use for infertility treatment among these couples have been evaluated. METHODS: A face-to-face questionnaire inquiring demographic information, use of CAM for medical conditions, in general, and types of CAM used for infertility treatment, in specific, was completed by one thousand twenty one infertile patients attending at two types of facilities; in vitro Fertilization (IVF) centers at both public and private hospitals and infertility private clinics. Both types of facilities were distributed in different areas of Amman, the capital city of Jordan. The study was conducted between May and August 2012. RESULTS: Our results show that CAM therapies for infertility treatment were encountered in 44.7% of the study sample. The vast majority of CAM users were females. The most commonly used CAM therapies were herbs and spiritual healing. A clear correlation between the use of CAM for infertility versus the use of CAM for other chronic medical conditions has been found. CONCLUSIONS: The prevalence of CAM use for infertility treatment in Jordan is relatively high, particularly among young females, well educated and with a low income, in consistence with the studies reported elsewhere. Herbs and spiritual healing are widely used among patients in adjunct to conventional medical interventions. As CAM use is prevalent among patients, there is a clear need for health providers to become more aware of this phenomenon and for further research in this field.

Perspectives on psychosocial and spiritual cancer support services in New Zealand.

In New Zealand, support services have been developed in response to patient need but are variable. The benefits of psycho-social-spiritual care in reducing distress and enhancing quality of life for people with cancer and their families are well established yet unmet needs continue to feature. This project aimed to examine how health care professionals assessed for psycho-social-spiritual distress and unmet need, decisions on appropriate support, and identification of barriers in the referral process. A mixed-methods approach was used for this research. The qualitative phase entailed semistructured interviews with health care professionals working in cancer care. The quantitative phase was an online survey of oncologists and nurses. Thematic analysis was carried out by performing a side-by-side analysis of both sets of data. Nurses were most likely to assess for psycho-social-spiritual need and to refer to support services. Despite a clear mandate to provide regular psycho-social-spiritual assessment, there is no consistency of assessment and referral across New Zealand. There are clearly unmet psycho-social-spiritual needs among people affected by cancer in New Zealand, with health care professionals in this study noting structural impediments to adequate supportive care. There is a mismatch between the importance placed on such care and the capacity that is currently available. The results of this study provide evidence that can be used to argue for improvements in the infrastructure, funding allocation and policy that would allow for better psycho-social-spiritual care within the challenging context of increasing numbers of those affected by cancer.

In search of healing between two worlds: the use of traditional and modern health services by older women in rural Bangladesh.

The objective of this study is to gain a deeper understanding of the use of traditional and modern medicine among older adult women living in rural Bangladesh. Factors are identified that guide the women's decisions about who to seek help from when they are ill. The findings provide evidence that, in spite of the availability of modern health care, traditional healers--faith-based and herbalists--are widely utilized. Reasons given for their choice of health care providers fall into two categories: belief in the effectiveness of the intervention and service delivery considerations. These data suggest that use of traditional healers persists among women in rural areas of Bangladesh and that health policy should be developed with an acknowledgment of these health practices.

TB questions, East Kwaio answers: community-based participatory research in a remote area of Solomon Islands.

INTRODUCTION: East Kwaio is a remote region on the island of Malaita, Solomon Islands. Atoifi Adventist Hospital (the Hospital) is the only hospital and tuberculosis (TB) services provider in the region. If people come to the Hospital with TB, they are usually admitted for the two-month intensive phase of treatment as there are no community-based TB services. Most people walk or travel by canoe to the Hospital as there are no roads. East Kwaio is known to have high rates of TB; however, it has a low case detection rate and low treatment completion. The aims of this study were to explore why people with TB, especially from the mountain areas, present to the Hospital so late in their illness or do not present at all. The study was part of a larger project to strengthen the research capacity of local health workers and community leaders, supported by visiting researchers from Australia. METHODS: Semi-structured interviews with TB patients, a focus group of key informants and direct interaction with a community with a history of TB were used to explore reasons why people present to the Hospital late in their TB illness. RESULTS: Four interviews and a focus group of 12 key informants were conducted and a mountain hamlet with a history of TB was visited. The results represent the data from the interviews and the focus group. The time delay in presenting to the Hospital from when participants first became unwell ranged between two and three years. In the mountain hamlet, two additional people with probable TB were seen who had not presented to the Hospital during illnesses of five and nine months. Reasons for delays included: seeking care from traditional healers; the challenge of accessing health services due to distance, cost and cultural issues different from the Hospital's worldview; social isolation when in hospital; and being old so not having long to live. Delays in diagnosis of people with TB will increase the risk of transmission to family and through hamlets and villages. This study has led to plans being developed to build a more culturally appropriate TB ward and community treatment program. CONCLUSIONS: The study has identified TB questions that need East Kwaio answers. It has shown that a small project can inform the development of important changes to TB services, such as the redevelopment and relocation of the TB ward. To enable TB control, the local health services need to develop an understanding of, and appropriately engage with, traditional beliefs that influence how people interact with Hospital TB treatment and management. This is the case even if the beliefs are based on a worldview different than that of the health service providers. Ongoing operational research is required into TB diagnosis and treatment services and the many factors that contribute to the high TB burden in this remote area.

Designing rites to re-enchant secularized society: new varieties of spiritualized therapy in contemporary Sweden.

Detraditionalization in late modernity in Western society has affected the domains of both traditional religion and clinical psychotherapy. Sweden, which is said to be one of the most secularized societies in the world, instead, has allowed the public domain to be colonized by new, spiritualized practices. Sold as therapy, the services of new spiritual leaders offer anti-stress techniques to prevent burnout, or leaders are trained to develop their leadership in coaching activities. New varieties of spiritualized therapy are rapidly increasing in contemporary Sweden, typical of which is to have added healing rhetoric to their agenda, such as "find your inner self" or "develop your inner potential." Four common denominators seem to guide these practices: self-appointed leaders, individual-centered rites, realization of one's Self, and intense emotions. We might also add a fifth aspect: profit. Rites have become a commodity and are sold as liberating practices for burnt-out souls or for people in pursuit of self-realization.

Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study.

BACKGROUND: Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement. METHODS: A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009. RESULTS: The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM. CONCLUSIONS: Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly.

Exploration of the Association Between Religious Affiliation and Attitude Toward Spiritual Care in Clinical Nurses.

BACKGROUND: Religion is an important cultural asset that is known to affect the thoughts, behaviors, and lifestyles of individuals. However, the impact of religious affiliation, religious activities, and religious beliefs on the attitudes of nurses toward providing spiritual care to their patients is an issue that has been inadequately explored. PURPOSES: The aim of this study was to explore the relationship between religion (including religious affiliation, religious activities, and religious beliefs) and attitude toward spiritual care in clinical nurses. METHODS: This study used a cross-sectional correlation study design. Six hundred nineteen nurses were included as participants. The measurements used included a questionnaire on religious affiliation, religious activities, and religious beliefs; the Spiritual Health Scale-Short Form; the Spiritual Care Attitude Scale; and a sociodemographic datasheet. The study employed hierarchical regression modeling to establish the relationships between the aspects and degrees of religious belief and practice as well as the attitudes of participants toward spiritual care. RESULTS: Most of the participants participated infrequently in religious activities. After controlling for demographic variables and spiritual health, religious belief was found to be an important factor impacting participants' attitudes toward providing spiritual care. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings indicate that religious belief is an important factor impacting the attitudes of nurses toward providing spiritual care and that the religious/spiritual beliefs of nurses may impact on their fitness to provide spiritual care to patients. Education on religion may be needed to improve the attitude of nurses toward providing spiritual care.