Should Healthcare Organizations Promote a Spiritually Healthy Work Environment?

Both personal spirituality/religiosity and perception of a spiritually respectful work climate are inversely related to burnout among nurses. In addition to briefly reviewing the empirical evidence that consistently supports these assertions, this essay offers some practical suggestions for how nurses can promote a spiritually healthy work environment.

Pharmacy students' perceived barriers to spiritual care: A qualitative study.

Background: Spiritual care (SC) is an important component of whole person care, a goal that many pharmacists embrace. Knowledge about barriers to incorporating SC in pharmacy practice may allow understanding of how to increase its provision. Objectives: The objective of the study was to investigate pharmacy students' perceived personal and professional barriers to incorporating SC in pharmacy practice. Methods: Second-year pharmacy students (n = 62) who attended a required class lecture on SC in healthcare responded to three open-ended questions that explored beliefs about SC in pharmacy practice. Students' responses were thematically analyzed using NVivo. Results: Most (68%) of the students were female; 34% were Asian American. Students identified the following barriers to incorporating SC: limited or lack of time for SC, lack of supervisor and company support for SC, discordant pharmacist-patient spiritual beliefs, discomfort with talking about spirituality, lack of knowledge about spirituality and SC, personal factors, patient refusal of SC, fear of offending patients by discussing spirituality, and pharmacy environment. Conclusion: Major barriers to SC include lack of time for SC, lack of supervisor and company support for SC, and discordant pharmacist-patient spiritual beliefs. Future studies should be conducted to investigate these and other barriers to SC in pharmacy practice.

Tragedy or transformation? Online survey of nurse spirituality during the COVID pandemic.

AIM: To describe positive and negative spiritual responses to providing COVID-related nursing care among nurses working in hospitals. BACKGROUND: The COVID pandemic has intensified and publicised the threats to nurse well-being. Absent from the recommendations for promoting nurse well-being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well-being. DESIGN: Cross-sectional, descriptive observational, mixed methods study. METHODS: Data were collected from 523 registered nurses employed in three Southern California hospitals during March-May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale-Short Form, Moral Injury Symptom Scale-Healthcare Professionals, Post-traumatic Growth Inventory and demographic and work-related items. STROBE guidelines for cross-sectional observational studies were observed. RESULTS: The mean for religious/spiritual struggles was 1.98 (range of 1-5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%-36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1-10); applying established criteria indicated it was troubling for at least 50%. The mean for post-traumatic growth was 4 (on a scale of 0-6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. CONCLUSION: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. RELEVANCE TO CLINICAL PRACTICE: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy-and allow spiritual transformation.

How Christian Nurses Respond to Patient Requests for Prayer: An Observational Study.

ABSTRACT: Nurse-provided spiritual care includes support of patient spiritual practices such as prayer. However, limited evidence exists about how nurses respond when a patient requests prayer. A subsample of nurses (n = 381) from a larger study responded to two open-ended questions in an online survey in response to a prayer scenario. Among these mostly Christian nurses, 97% indicated willingness to pray. Content analysis revealed a five-component structure for praying: Open, Set the Stage, Request, Wrap-up, Close. The structure provides a template for future research and nurse prayer in clinical contexts.

Social Empathy and Associated Factors Among Nurses: An Observational Study.

Integral to holistic "big picture" nursing care is an empathy that strives for social justice. Social empathy requires more than technical skills or even interpersonal empathy or other-focus; it also requires a perspective that appreciates the impact of social determinants and seeks action to address them. This study sought to measure social empathy and potentially associated demographic, personal, and work-related factors among nurses. This cross-sectional, observational study used online survey methods to collect data from 614 registered nurses employed in a faith-based health care system in the northwestern United States. Constructs measured included social empathy, social advocacy, self-compassion, emotional exhaustion, and trust/mistrust in God. Parametric statistical tests, including multiple logistic regression, allowed analyses. Findings indicated that social empathy was high in this sample. Younger nurses, those more inclined to advocate, those more self-compassionate, those less burned out, those working part-time (in contrast only with those working overtime), and those with at least a baccalaureate degree in nursing were more socially empathic. Findings highlight further rationale for creating healthy work environments that foster self-compassion and minimize burnout.

Frequency of nurse-provided spiritual care: An international comparison.

AIMS AND OBJECTIVES: To compare the frequency of nurse-provided spiritual care across diverse cultures. BACKGROUND: Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. DESIGN: This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. METHODS: Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed. RESULTS: Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. CONCLUSIONS: In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. RELEVANCE TO CLINICAL PRACTICE: Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.

Nurse Spiritual Care Therapeutics Scale: Validation Among Nurses Who Care for Patients With Life-Threatening Illnesses in South Korea.

Although clinical and empirical literature documents the variety of spiritual care interventions available to palliative care clinicians, the frequency with which they are provided is rarely and inadequately measured. Given the growing interest in implementing spiritual care across Asia, including South Korea, this study sought to cross-culturally validate the Korean version of the Nurse Spiritual Care Therapeutics Scale (NSCTS-K), a scale initially developed in the United States. The World Health Organization process for cross-cultural adaptation of scales and Polit and Yang's process for evaluating validation were implemented. With data from a sample of 252 Korean nurses providing care to patients with life-threatening illnesses, various statistical procedures for evaluating validity and reliability were applied during this cross-sectional, observational study. Exploratory factor analysis for the structural validity of the Korean scale generated 3 factors that accounted for 69.40% of the variance. The Cronbach α was 0.95. The NSCTS-K is one of the few scales available to determine the impact of nurse-provided spiritual care frequency on patient outcomes. Thus, this tool can quantify the frequency of spiritual care better and be used in quality improvement initiatives or palliative care research.

Validation of the Nurse Spiritual Care Therapeutics Scale in Portuguese palliative care settings: a methodological study.

BACKGROUND: Spirituality is a critical dimension in palliative care, but difficulties have been described in literature concerning the effective implementation and measuring of spiritual care. AIM: To translate, adapt and validate the Nurse Spiritual Care Therapeutics Scale (NSCTS) in Portuguese palliative care settings. METHODS: A methodological study was conducted. A final version of the questionnaire included the scale and was submitted to full psychometric testing using nurses working in Portuguese palliative care settings. FINDINGS: A total of 88 nurses participated. The average age of the sample was 36.1 ± 8.93 years (range 23-60 years), and 92.0% were women. A Cronbach alpha value of 0.88; Kaiser-Meyer-Olkin measure of sampling adequacy 0.80; and Bartlett's Test of Sphericity were adequate. An exploratory factor analysis was conducted using principal axis factoring with an oblimin rotation that resulted in a three-factors solution. CONCLUSION: The European Portuguese NSCTS questionnaire is a valid and reliable tool to assess the frequency of nurses' activities concerning spirituality in palliative care.

An online survey to describe pharmacy student spirituality and spiritual care perspectives.

INTRODUCTION: Little is known about student pharmacists' perspectives of spirituality and spiritual care (SC) in pharmacy education and practice. The purpose of this study was to examine student pharmacists' perspectives about spirituality and incorporating SC in pharmacy education and practice. METHODS: Student pharmacists were recruited from two private pharmacy schools in California, one religiously-affiliated and one non-religiously affiliated. A faculty member at each school invited student pharmacists via email or through Zoom (Zoom Video Communications) chat to complete the 37-item online survey through an embedded link. The investigator-designed survey was comprised of 22 items inquiring about spirituality and SC as well as several items assessing demographic and religious characteristics. RESULTS: Participants included 470 student pharmacists (87.2% response rate) who were 28.9 ± 5.7 years old on average. Half of the respondents (50.5%) attended the non-religiously affiliated university. Most of the respondents were female (67%), Christian (67.8%), spiritual (79.2%), and religious (75.2%). They "agreed" or "strongly agreed" that: "understanding patients' spiritual beliefs is an important part of pharmacy practice" (83%), "I would pray with my patients as a pharmacist" (54.8%), "it is appropriate for a pharmacist to have spiritual or religious conversations with patients" (52.9%), and "it is appropriate for a pharmacist to pray with and for patients who request it" (66.9%). These beliefs were positively correlated with self-reported religiosity and spirituality. CONCLUSIONS: Most students considered themselves spiritual and religious and felt that spirituality and learning about SC were important. The respondents' SC perspectives were associated with their religiosity and spirituality.

Perspectives about Spiritual Care in Pharmacy Practice: A Community-based Survey.

Background: Addressing religious and spiritual needs are important components of holistic healthcare. Little is known about the general public's perspectives about pharmacists providing spiritual care (SC). Objectives: To explore how community members perceive, experience, and desire pharmacist-provided SC. Method: IRB approval was obtained for this observational, cross-sectional study. Adults receiving COVID-19 vaccinations at an immunization clinic completed an investigator-designed 33-item online survey. The survey measured respondents' perspectives about and experiences with pharmacist-provided SC, as well as demographic characteristics. Results: Of the respondents (n = 261), 57% were female and 46% were Hispanic/Latino. Most (59%) agreed that their religion/spirituality would be important to them if they were ill; 64% also agreed that it would be helpful for a pharmacist to know about patients' religious/spiritual beliefs pertaining to their healthcare, and 60% agreed that pharmacists should provide SC to patients who request it. While 96% indicated that they had never talked to a pharmacist about a spiritual or religious matter related to their health or medication, 96% also indicated that no pharmacist had asked to pray with them. These results are contextualized perhaps by the finding that 76% reported having no professional relationship with a pharmacist. Conclusion: Respondents often reported an openness to receiving SC from pharmacists. Most respondents, however, had not received SC from a pharmacist. Future studies should be conducted to better understand patient preferences for pharmacist-provided SC.

Praying Online: Reflections and Suggestions for Nurse Educators.

ABSTRACT: This article presents reflections and suggestions for nurse educators in a Christian institution who want to pray with students while teaching online. Suggestions primarily relate to recording prayers for class, including avoiding the appearance of coercion; being clear that students' participation in the recorded prayer will have no effect on grades; placing prayer in recorded material at a consistent location (such as the beginning or the end) so students know when it is coming; being creative in offering varying ways to pray; being authentic; and inviting student participation.