Attitude towards Spirituality and Spiritual Care among Nurses of Bharatpur Hospital.

BACKGROUND: Understanding spirituality and spiritual care is a prerequisite for holistic care in nursing. Spirituality is an important dimension of human existence with a crucial role in health promotion. The objective of this study was to assess the level of attitude towards spirituality and spiritual care among nurses. METHODS: A cross-sectional analytical study design was used among 208 nurses to assess attitude toward spirituality and spiritual care among nurses of Bharatpur Hospital. A pretested semi-structured, self-administered questionnaire was used to collect data from the respondents. The instrument spirituality and spiritual care rating scales were used. Collected data were coded and entered in Microsoft office excel and SPSS version 22 was used for analysis. RESULTS: The finding of the study revealed that, out of 208 respondents, the majority (74.0%) of respondents were of age 20-29 years with a mean and SD of 28.2±5.510. Among all, 125(60.1%) respondents had a moderate attitude score of 32-62, 83(39.9%) had a high level of attitude score of 63-92, whereas 0.5% had a low level of attitude towards spirituality and spiritual care score (0-31).There is no statistically significant relationship between the level of attitude and socio-demographic variables. CONCLUSIONS: It is concluded that most of the respondents had a moderate level of attitude. In-service education and awareness on providing spiritual care among nurses needs to be focused.

Implementing spiritual care education into the teaching of palliative medicine: an outcome evaluation.

BACKGROUND: The concept of "total pain" plays an important role in palliative care; it means that pain is not solely experienced on a physical level, but also within a psychological, social and spiritual dimension. Understanding what spirituality entails, however, is a challenge for health care professionals, as is screening for the spiritual needs of patients. OBJECTIVE: This is a novel, interprofessional approach in teaching undergraduate medical students about spiritual care in the format of a seminar. The aim of this study is to assess if an increase in knowledge about spiritual care in the clinical context is achievable with this format. METHODS: In a mandatory seminar within the palliative care curriculum at our university, both a physician and a hospital chaplain teach strategies in symptom control from different perspectives (somatic domain - spiritual domain). For evaluation purposes of the content taught on the spiritual domain, we conducted a questionnaire consisting of two parts: specific outcome evaluation making use of the comparative self-assessment (CSA) gain and overall perception of the seminar using Likert scale. RESULTS: In total, 52 students participated. Regarding specific outcome evaluation, the greatest gain was achieved in the ability to define total pain (84.8%) and in realizing its relevance in clinical settings (77.4%). The lowest, but still fairly high improvement was achieved in the ability to identify patients who might benefit from spiritual counselling (60.9%). The learning benefits were all significant as confirmed by confidence intervals. Overall, students were satisfied with the structure of the seminar. The content was delivered clearly and comprehensibly reaching a mean score of 4.3 on Likert scale (4 = agree). The content was perceived as overall relevant to the later work in medicine (mean 4.3). Most students do not opt for a seminar solely revolving around spiritual care (mean 2.6). CONCLUSIONS: We conclude that implementing spiritual care education following an interprofessional approach into existing medical curricula, e.g. palliative medicine, is feasible and well perceived among medical students. Students do not wish for a seminar which solely revolves around spiritual care but prefer a close link to clinical practice and strategies.

Tribal Healing, Suicide, Ethical Issues, Cancer and Measuring Religiosity and Spirituality.

This issue of JORH considers the 'good, the bad and the ugly' of tribal or traditional healers, as well as articles relating to ethical challenges due to contemporary medicine and environmental issues. The concluding series on suicide (Part 2) is also finalized in this issue, as well as a number of research articles from multiple countries relating to cancer. Similar to previous issues, JORH once again adds to its increasing collection of articles relating to the empirical measurement of religion, spirituality and health. Readers are also reminded of the European Congress on Religion, Spirituality and Health (ECRSH) (Salzburg, Austria, May 2024), as well as the inaugural International Moral Injury and Wellbeing Conference (IMIWC) (Brisbane, Australia, September 2024).

Development of a conceptual framework for teaching-learning of spiritual care in nursing education.

BACKGROUND:  Conceptual frameworks are not only necessary for maintaining and preserving nursing knowledge through their unique contribution, but they also assist in the organisation and provision of complex nursing interventions. The lack of formal integration of spiritual care in health professions' education is blamed on the unavailability of guiding models among other challenges such as unavailability of relevant theories. OBJECTIVES:  The objective of this article was to describe the process followed to develop a conceptual framework as the basis for a practice theory for teaching-learning of spiritual care in nursing. METHOD:  An overall theory generative methodology was used. To develop the conceptual framework, conclusion statements deduced from empirical data using deductive and inductive strategies were applied. RESULTS:  The main concepts were identified, described, and classified. The relationship between concepts promoted synergy of the developed conceptual framework for teaching spiritual care in nursing. CONCLUSION:  The developed conceptual framework was founded on the notion that knowledge from different sources can provide a solid base in theory generation. Therefore, the concepts of the developed conceptual framework were not only related to what is 'ideal'; instead, their significance was underpinned by the created universal meanings for effective purposeful communication. Therefore, sources used to obtain data were critical in the development of the conceptual framework because they constituted different ways of perceiving and understanding the world.Contribution: The conceptual framework does not only guide nursing interventions but framework also provides a philosophical guide in meeting patient-centred diverse needs.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study.

PURPOSE: Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing. METHODS: This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences. RESULTS: Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan. CONCLUSIONS: This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Integrating Trauma-Informed Spiritual Care.

A call for a comprehensive practice that treats the whole person.

Spiritual care needs and their attributes among Chinese inpatients with advanced breast cancer based on the Kano model: a descriptive cross-sectional study.

BACKGROUND: Numerous previous research have established the need for spiritual care among patients with cancer globally. Nevertheless, there was limited research, primarily qualitative, on the spiritual care needs of Chinese inpatients with advanced breast cancer. Furthermore, the need for spiritual care was rarely explored using the Kano model. To better understand the spiritual care needs and attributes characteristics of inpatients with advanced breast cancer, this study examined the Kano model. METHODS: A descriptive cross-sectional design study was conducted in the oncology departments of three tertiary grade-A hospitals in China from October 2022 to May 2023. To guarantee high-quality reporting of the study, the Strengthening the Reporting of Observational Studies in Epidemiology Checklist was used. Data on the demographic characteristics questionnaire, the Nurse Spiritual Therapeutics Scale (NSTS), and the Kano model-based Nurse Spiritual Therapeutics Attributes Scale (K-NSTAs) were collected through convenience sampling. The Kano model, descriptive statistics, two independent samples t-tests, and one-way analysis of variance were used to analyze the data. RESULTS: The overall score for spiritual care needs was 31.16 ± 7.85. The two dimensions with the highest average scores, "create a good atmosphere" (3.16 ± 0.95), and the lowest average scores, "help religious practice" (1.72 ± 0.73). The 12 items were distributed as follows: three attractive attributes were located in Reserving Area IV; five one-dimensional attributes were distributed as follows: three one-dimensional attributes were located in Predominance Area I, and two were found in Improving Area II; two must-be attributes were located in Improving Area II; and two indifference attributes were located in Secondary Improving Area III. CONCLUSION: The Chinese inpatients with advanced breast cancer had a middle level of spiritual care needs, which need to be further improved. Spiritual care needs attributes were defined, sorted, categorized, and optimized accurately and perfectly by the Kano model. And "create a good atmosphere" and "share self-perception" were primarily one-dimensional and must-be attributes. In contrast, the items in the dimensions of "share self-perception" and "help thinking" were principally attractive attributes. Nursing administrators are advised to optimize attractive attributes and transform indifference attributes by consolidating must-be and one-dimensional attributes, which will enable them to take targeted spiritual care measures based on each patient's characteristics and unique personality traits.

A Comparative Analysis of Spiritual Care Needs Among Cancer Patients Receiving Home Care and Their Caregivers in Turkey.

This study was conducted to determine and compare the spiritual care needs of cancer patients and their caregivers. A comparative descriptive, cross-sectional design was employed in this study. The study comprised 102 patients who were registered in the hospital's home care unit, as well as their caregivers (total number = 204). The data were collected using a personal information form and the Spiritual Care Needs Inventory. The cancer patients had a mean age of 69.5 years, while their caregivers' mean age was 53.1 years. According to the results, the cancer patients needed more spiritual care than their caregivers (p < 0.01). Patients' spiritual care needs differed significantly by employment status (p < 0.05). However, gender, educational level, and marital status did not have a significant difference in the spiritual care needs of the patients and their caregivers (p > 0.05). Moderately positive and significant (p < 0.05) correlations between patients and their caregivers were found for the total Spiritual Care Needs Inventory scores (r = 0.449), the meaning and hope subscale (r = 0.378), and the caring and respect subscale (r = 0.546). It is important to evaluate the spiritual needs of patients with cancer and their caregivers. In this evaluation, it is essential to elicit the perspectives of cancer patients and their caregivers concerning spiritual needs and religion. Effective spiritual care for patients and their caregivers can only be provided if their beliefs and priorities are taken into consideration.

Spiritual care models of patients living with cancer in Taiwan.

BACKGROUND: Psychological, social and spiritual needs are often unmet during the care of patients with cancer in Taiwan. AIM: The purpose of this study was to confirm the spiritual care models including the spiritual distress symptoms (SDS), spiritual distress symptoms interventions (SDSI), and spiritual distress outcomes criteria (SDOC) of patients with cancer in the initial, relapse and terminal stages. METHOD: This cross-sectional survey collected data from 150 professional nurses about their perceptions of the SDS, SDSI and SDOC for patients with cancer. RESULTS: The significant total effects of SDS on SDOC by SDSI of the patients with cancer in the initial, relapse and terminal stages were found. Additionally, the direct effects of SDS on SDOC by SDSI of the patients with cancer from the initial, relapse to terminal stage were gradually enhanced. CONCLUSIONS: The relationship between spiritual distress symptoms, interventions and outcomes was significantly higher from the initial to relapse state until at the end of life, based on the perceptions of 150 professional nurses.

Experiential training course on spirituality for multidisciplinary palliative care teams in a hospital setting: a feasibility study.

BACKGROUND: There is widespread agreement about the importance of spiritual training programs (STPs) for healthcare professionals caring for cancer patients, and that reflecting on one's spirituality is the first step. Health professionals (HPs) working in hospitals must develop this dimension to guarantee the quality of life as well as spiritual and emotional support. In this paper, we propose a possible training format for hospital professionals and assess its implementation. METHODS: This is a phase 0-I study that follows the Medical Research Council (MRC) framework. The program was implemented for hospital palliative care specialists. The program included one theory lesson, three spiritual interactions, four pieces of reflective writing, and two individual follow-up sessions for each participant. The evaluation was performed quantitatively according to the MRC framework and qualitatively according to Moore's framework with data triangulation from interviews, reflective writings, and indicators. RESULTS: The program was implemented for palliative care physicians, nurses, psychologists, and bioethicists according to the plan, and the program components were highly appreciated by the participants. The results suggest the feasibility of a training course with some corrections, regarding both the components of the training and organizational issues. The qualitative analysis confirmed a shift in the meaning of the themes we identified. The trainees went from intrapersonal spirituality to interpersonal spirituality (engagement with the other person's spirituality, acknowledging their unique spiritual and cultural worldviews, beliefs, and practices), with colleagues, patients, and people close to them. The training had an impact on Moore's Level 3b. CONCLUSIONS: Spiritual training for hospital professionals working in palliative care is feasible. Having time dedicated to spirituality and the ongoing mentorship of spiritual care professionals were suggested as key elements. The next step is increasing awareness of spirituality from our hospital reality and creating a stable competent group (with nurses, chaplains, nuns, counselors, etc.) with the support of the management.

Spiritual care for older people living in the community: A scoping review.

BACKGROUND: The population of older people should be supported to enjoy optimal quality of life. Health professionals should consider a range of interventions that support the older population to maintain their quality of life. One such interventional approach involves spiritual care. OBJECTIVE: To explore what is known about spiritual care approaches for older people living in the community. METHODS: Scoping review informed by Joanna Briggs Institute guidelines. Eight electronic databases were searched: CINAHL, Ageline, PubMed, ProQuest Nursing & Allied Health, PsycINFO, Scopus, Garuda, and Neliti. The review included quantitative and qualitative primary peer-reviewed research studies focusing on spiritual care interventions for older people living in the community published between 2011 and 2021 in English or Bahasa Indonesia. The search was uploaded into an electronic citation manager and imported into Covidence for screening. RESULTS: A total of 29 studies were included in the review. While the studies were conducted in five continents, most were reported from the Asian continent. Five key issues based on the outcome of interventions were found namely psychological, physical, spiritual, multidisciplinary approach, and social connection. CONCLUSION: This scoping review identifies spiritual interventions conducted across many countries have been implemented for older people living in the community. Although there are review limitations and further research is needed, these spiritual interventions, both faith-based and non-faith-based, are identified as useful to support the well-being of older people.

Insights on spirituality and bereavement: A systematic review of qualitative studies.

AIM: To describe a synthesis of the experience related to the spirituality of those living a bereavement journey in primary qualitative studies. DESIGN: A systematic review of qualitative studies. DATA SOURCE: A systematic review was carried out in March 2019 and was updated in January 2023. Searching was accomplished by an online database, such as CINAHL, MEDLINE, PsycINFO, MedicLatina, LILACS, SciELO and Academic Search Complete. The search strategy did not consider a timeline as an eligibility criterion. The quality of the studies was assessed, and a thematic synthesis was performed in this review. METHODS: A systematic review of qualitative studies was conducted according to Saini and Shlonsky's methodology. REPORTING METHOD: PRISMA checklist. RESULTS: The review included 33 articles. Most of the studies were phenomenological and focused on parents' and family experiences of bereavement. Seven significant categories emerged, which match unmet spiritual needs during the grieving process. Two major categories were identified regarding the role of spirituality in bereavement: Spirituality as a process and spirituality as an outcome. CONCLUSION: In clinical practice, attention to spirituality and providing spiritual care is critical to guarantee a holistic approach for those experiencing bereavement. IMPLICATIONS: The findings of our study could foster awareness that healthcare professionals should include the spiritual dimension in their clinical practice to provide holistic care to individuals, enhancing the healing process in bereavement. NO PATIENT OR PUBLIC CONTRIBUTION: This is a systematic review.

The Role of Spirituality for Coping with Cancer and the Spiritual Care Needs of Women with Breast Cancer and their Family Caregivers in Turkey: A Qualitative Study.

This study aims at determining the spiritual care needs of women with breast cancer and their family caregivers, as well as the effect of spirituality on coping with this illness. This qualitative research utilized a phenomenological design. In-depth individual interviews were conducted with breast cancer women and family caregivers. A total of 26 participants (13 women with breast cancer and 13 family caregivers) were involved. The data were examined using inductive thematic analysis. Three main themes were identified: "Being diagnosed with breast cancer; its emotional and life-related impacts;" "Spirituality in fighting with cancer;" and "Caring period and needs". The results showed that the diagnosis and treatment of breast cancer have multifaceted effects on women and their family caregivers. Spirituality was found to be an essential factor in coping with cancer for women with cancer and their family caregivers. In addition, the results showed that women and family caregivers have some unmet spiritual care needs.

Ecospirituality and Health: A Systematic Review.

Environmental changes are affecting human health. A renewal of the way we understand and relate to the planet is needed. Ecospirituality brings together the terms spirituality and environment and is born as a means of solution to this dilemma. This systematic review aimed to find out the influence of ecospirituality on global health. A search of scientific literature was carried out in the main health science databases. A review was conducted to critically evaluate the studies that identified relevant ecospiritual aspects regarding health care for communities. After a systematic search and screening, and following specified methodological criteria, a total of 14 articles were selected in the review. The findings of the review suggest that a new perspective in our worldview such as ecospirituality will provide us with the necessary keys to improve health. To understand ecospirituality, we must keep in mind the indigenous way of life, which is the clear example to follow to achieve environmental health and global health. Ecospirituality leads to a healthier environment, and as this is directly related to health, there is also an improvement in global health.

The impact of a nursing spiritual care module on nursing competence: an experimental design.

PURPOSE: This study aimed to assess the impact of the Nursing Spiritual Care Module on the competence of nurses in providing spiritual care in the context of Malaysia. METHOD: This study employed an experimental design and involved a total of 122 nurses, with 59 in the experimental group and 63 in the control group. Participants were selected from palliative care wards associated with Hospital Universiti Sains Malaysia. Nurses in the experimental group underwent a two-week educational module on nursing spiritual care, while nurses in the control group attended a single lecture on spiritual care provided by the hospital. RESULTS: The results indicated no significant differences in sociodemographic characteristics between the two groups. A significant difference in spiritual care competence within the intervention group and the control group over time (p-value = 0.001), between the two groups (p-value = 0.038), and in the interaction between time and group (p-value = 0.001). CONCLUSION: The Nursing Spiritual Care Module is crucial in aiding nurses and healthcare professionals in cultivating the appropriate and wholesome attitudes and practices necessary to address the spiritual needs of patients.

The impact of spiritual care delivered by nurses on patients' comfort: A propensity score matched cohort utilizing electronic health record data.

BACKGROUND: Spiritual care has been associated with better health outcomes. Despite increasing evidence of the benefits of spiritual care for older patients coping with illness and aggressive treatment, the role of spirituality is not well understood and implemented. Nurses, as frontline holistic healthcare providers, are in a position to address patients' spiritual needs and support them in finding meaning in life. This study aimed to identify spiritual care by analyzing nursing data and to compare the psychological and physical comfort between older chronically ill patients who received spiritual care versus those who did not receive spiritual care. MATERIAL AND METHODS: A propensity score matched cohort utilizing nursing care plan data was used to construct balanced groups based on patient characteristics at admission. 45 older patients (≥65 years) with chronic illnesses received spiritual care with measured psychological or physical comfort and 90 matched controls. To ensure the robustness of our results, two sensitivity analyses were performed. Group comparisons were performed to assess the average treatment effect of spiritual care on psychological and physical comfort outcomes. RESULTS: The mean psychological comfort was 4.3 (SD = 0.5) for spiritual care receivers and 3.9 (SD = 0.9) for non-receivers. Regression analysis showed that spiritual care was associated with better psychological comfort (estimate = 0.479, std. error = 0.225, p = 0.041). While its effect on physical comfort was not statistically significant (estimate = -0.265, std. error = 0.234, p = 0.261). This study provides suggestive evidence of the positive impact of nurses' spiritual care in improving psychological comfort for older patients with chronic illnesses. CONCLUSION: Using interoperable nursing data, our findings suggest that spiritual care improves psychological comfort in older patients facing illness. This finding suggests that nurses may integrate spiritual care into their usual care to support patients experiencing distress.

Effect of a Spiritual Care Training Program to Build Knowledge, Competence, Confidence and Self-awareness Among Australian Health and Aged Care Staff: An Exploratory Study.

The aim of this study was to evaluate a new spiritual care training program with health and aged care staff. A four-module program was delivered to 44 participants at a large Catholic health and aged care provider in Australia. Pre, post and 6 week follow-up surveys were administered and included measures of spiritual care competency, confidence, perspectives of spirituality and spiritual care, spiritual well-being, and satisfaction. Paired sample t-tests showed total scores of participants' spiritual well-being, spiritual care competency and confidence significantly improved following the training and were largely maintained at follow-up. Perspectives on spirituality and spiritual care did not significantly change over time.

Military Perspectives on the Provision of Spiritual Care in the Australian Defence Force: A Cross-Sectional Study.

A module to explore perspectives on chaplaincy services was included in an online enterprise survey randomly distributed to members of the Australian Defence Force (ADF) during 2021. Up to eight questions were answered by 2783 active military personnel relating to their perception of chaplain activities and the impact of chaplaincy services. Of those military participants answering the question on religious status (n = 1116), a total of 71.6% (n = 799) of respondents identified as non-religious while 28.4% (n = 317) identified as holding a religious affiliation. Approximately 44.2% (n = 1230) of participants had sought support from a chaplain, of which 85.3% (n = 1049) found chaplaincy care to be satisfactory or very satisfactory. While the data suggest there is a lack of clarity around the multiple roles undertaken by chaplaincy, nevertheless respondents were just as likely to prefer chaplains for personal support (24.0%), as they were to seek help from non-chaplaincy personnel such as a non-ADF counsellor (23.2%), their workplace supervisor (23.1%) or a psychologist (21.8%). This evidence affirms that the spiritual care provided by military chaplaincy remains one of several preferred choices and thus a valued part of the holistic care provided by the ADF to support the health and wellbeing of its members.