Relationship Between Nurses’ End of Life Spiritual Care Knowledge and Attitudes With Religious Attitudes

Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n=180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n=50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59±10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.

This study aimed to explore the perception of Iranian nurses concerning spiritual care and to reveal any confronted barriers. Although the context of spiritual care is a substantial aspect of holistic care, the delivery of spiritual care has been problematic due to lack of nurses' understanding of this concept. Nurses' perceptions of spirituality and spiritual care directly influence their performance as well as their relationships with patients. This cross-sectional survey was conducted in 2013 with 259 nurses working in hospitals affiliated with Qazvin University of Medical Sciences, Iran. Data were collected using the Spirituality and Spiritual Care Rating Scale alongside qualitative open-ended questions. Descriptive and inferential statistics were used for the quantitative data and content analysis for the qualitative data. The overall average for spirituality and spiritual care was 2.84 (score range: 1-4), indicating a moderate mean score. A significant relationship was found between education level and spiritual care. The majority of participants believed that they did not receive enough training in this aspect of care. The main obstacles regarding delivering spiritual care included busy working schedules, insufficient knowledge regarding spiritual care, low motivation, diversity of patients' spiritual needs and feeling 'unqualified' to provide spiritual cares. Consistent with the previous studies, this study has demonstrated that nurses had low confidence to meet the spiritual needs of patients due to lack of knowledge and training in this regard. Iranian nurses' perception of spirituality and spiritual care is moderate, reflecting that they do not receive sufficient training regarding spiritual care. Despite the attention focused on spiritual care in clinical settings in Iran, there remains a significant gap in terms of meeting the spiritual needs of patients in nursing practice. This finding assists nursing clinicians, educators and policy makers to more effectively approach spiritual care as a beneficial component of holistic care. It is proposed that more emphasis is placed on integrating spirituality content into educational programmes to enable more effective clinical delivery. In addition, it would be beneficial to implement more widespread cultural assessment in order to further benefit spiritual care practices.

Introduction: Health is a multidimensional subject including physical, mental, social, and spiritual items. The nurses’ spirituality and provision of spiritual care are interrelated. Accordingly, this study aimed to determine the attitude toward spirituality and spiritual care among nurses, nursing faculty members, and nursing students. Methods: This cross-sectional and analytical study was conducted in 2018 at Jahrom University of Medical Sciences, Jahrom, Iran. The statistical population of the study included 500 nurses, nursing faculty members, and nursing students who were enrolled in the study using a census method. The study tools included a demographic information form, as well as a spirituality and spiritual care rating scale (SSCRS) with 23 questions in two basic sections: "spirituality" and "spiritual care". After obtaining informed consent from the individuals, the questionnaires were completed, and the data were analyzed using SPSS software (version 16). Results: In this study, 455 questionnaires were completed. In total, 62.2% of respondents were female and their mean age was 27.19±6.68 years. The mean total score of spirituality and spiritual care was obtained at 67±13.83. Moreover, 66.4% of participants achieved high levels of spirituality and spiritual care attitude. Attitude to spirituality and spiritual care were not significantly associated with age, gender, and clinical experiences (P>0.05). Conclusion: According to the Result of the present study, attitudes toward spirituality and spiritual care among nurses, nursing faculty members, and nursing students were desirable. Although a desirable attitude towards spirituality and spiritual care is the first step in paying attention to the spiritual needs of patients and providing spiritual care, it alone is not sufficient. If these concepts that are influenced by the cultural and religious background of society rather than by scientific and academic education, are neglected, learning will not meet the spiritual needs of all patients.

BackgroundSpiritual care is essential to nursing practice, contributing to holistic patient care. However, the relationship between nurses’ perceptions of spirituality and spiritual care with their engagement in spiritual care practices remains underexplored, particularly in Indonesia. Understanding this relationship is crucial for enhancing the quality of care provided to patients.ObjectiveThis study aimed to examine the correlation between nurses’ perceptions of spirituality and spiritual care with their spiritual care practices in Indonesia.MethodsA cross-sectional survey design was employed, involving a total of 300 nurses working in healthcare facilities across Indonesia. Data were collected via an online survey conducted from March to May 2024, using validated questionnaires: the Indonesian adaptation of the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Nurse Spiritual Care Therapeutic Scale (NSCTS). Spearman Rank Correlation was used to assess the relationship between nurses’ perceptions of spirituality and their engagement in spiritual care practices.ResultsThe study found that nurses held a positive perception of spirituality, with a mean score of 3.85 (SD = 0.41) regarding statements related to spirituality and spiritual care. However, they reported providing spiritual care only occasionally, with an average frequency of 3-6 times over a 72 to 80-hour work period. There was a significant positive correlation (r = 0.235, p <0.001) of nurses’ perception of spirituality and spiritual care with their engagement in spiritual care practices.ConclusionThe study highlights the need for targeted education and training to enhance nurses’ competencies in spiritual care practices. Addressing spiritual needs is vital for holistic patient care, and improving nurses’ perceptions and practices in this area can significantly benefit patient well-being.

Aim: A descriptive study was conducted to assess the perception of nursing students towards spiritual care in a selected college of nursing in Ernakulum District, Kerala. Background: In order for nursing education to prepare nurses for holistic patient care, it is critical that educators become more aware of the religious and spiritual dimensions in patient care and be able to provide adequate knowledge and skills for nurses to offer spiritually- based care in an ethical way. Furthermore, spiritual care is an essential component in the nursing context, as nurses have to care for patients who may often turn to the spiritual dimension to cope and heal. These aspects are important issues to be considered in planning what should be taught as part of spiritual care. Objectives: The objectives of this study were to assess the spirituality and perception towards spiritual care among nursing students and to assess the relationship between the same. Methods: A Descriptive analytical study was conducted among 129 BSc Nursing students studying in a Nursing College attached to a Medical College Hospital of South India. Convenience sampling technique was adopted for the study. Spirituality assessment scale and Nursing Spiritual Care Perspective Scale (NSCPS) were used to collect the data. Pilot study was conducted and the study was found to be feasible. Permission from the authorities was obtained and data collection was done. The data analysis was done using descriptive and inferential statistics and R software used for the analysis. Results: The study revealed that there was a statistically significant mild positive correlation between spirituality and nurse’s perception towards spiritual care (r=0.23, p and lt;0.01). Conclusion: Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients. Spirituality is an important aspect of holistic care. This study identified that there is a significant mild positive correlation between spirituality and spiritual care. The study found that nurses were very accepting of the need for spiritual care as part of their nursing role but that nursing education had not paid adequate attention to integrating this dimension into the nursing curriculum.

Introduction: Dental unit waterline system (DUWLS) decontamination is an important infection control in dental practice. This study aimed to determine knowledge and attitude towards DUWLS decontamination and its associated factors among undergraduate and postgraduate dental students in Universiti Sains Malaysia. Methods: A cross-sectional study was conducted using a validated questionnaire administered online using Google Forms to assess the knowledge and attitude of dental students towards DUWLS decontamination. Descriptive and inferential statistics using independent t-test, Pearson, and Spearman correlation were carried out using SPSS version 24.0. Results: A total of 169 dental students participated in the study, and the majority were female (71.6%) and Malay (59.2%). The mean (SD) age was 23.2 (0.93) and 34.4 (2.65), for the undergraduates and postgraduates, respectively. The mean (SD) knowledge scores for the undergraduates and postgraduates were 11.6 (4.23) and 18.0 (2.82), respectively, whereas the mean attitude scores were 51.3 (7.86) and 54.6 (4.74), respectively. The postgraduates had significantly higher mean knowledge and attitude scores than the undergraduates (p&lt;0.001). The significant factors associated with the undergraduates’ knowledge were received information and guidance and their personal experience in managing DUWLS (p&lt;0.05). However, only received information on DUWLS was significantly associated with the postgraduate’s knowledge score (p=0.011). Age factor had a significant association with the attitude score among the postgraduates (p=0.014). Conclusion: The knowledge regarding DUWLS decontamination was relatively moderate in both groups. However, both groups showed a favourable attitude towards DUWLS decontamination. Significantly higher knowledge and attitude scores were presented among the postgraduates than the undergraduates.

Introduction:The role of nurses working in critical care setup is one of the key members for optimal provision of the palliative care and end-of-life care (EOLC). This study aims to assess knowledge, attitude, practices, and perceived barriers regarding palliative and EOLC among critical care nurses.Methods:A cross-sectional study was conducted among 386 critical care nurses of a tertiary care center, selected through convenience sampling technique. Data related to knowledge, attitude, practices, and perceived barriers were collected using a standardized tool. The collected data were analyzed using SPSS version 24.Results:We observed that mean knowledge, attitude, and practice scores of critical care nurses were 9.83 ± 2.50 of 20, 104.91 ± 13.04 of 150, and 17.61 ± 4.36 of 27, respectively. One of the major barriers in providing palliative and EOLC was being called for attending to other newly admitted patients. The mean knowledge score of nurses was found to be significantly higher among female nurses (P = 0.016). Nurses who had additional training pertaining to palliative and EOLC had significantly higher mean knowledge (P = 0.001) and attitude scores (P = 0.02) than those who did not have such training. The mean practice (P = 0.02) and attitude score (P = 0.002) was significantly higher among postgraduate nurses as compared to nurses with lower qualification. The mean attitude score was significantly higher among nurses of lower age group (P = 0.04) along with a negative correlation of age of nurses with attitude (P = 0.01). Nurses' practice was positively correlated to the attitude (P = 0.001) and knowledge (P = 0.01).Conclusion:There is a considerable gap between critical care nurses' knowledge and practices, in spite of having a good attitude regarding palliative and EOLC. This necessitates the strengthening of both preservice and in-service education for nurses.

To determine factors associated with nurses' spiritual care competencies. Holistic nursing care includes biopsychosocial and spiritual care. However, nurses are limited by a lack of knowledge, time constraints and apprehension of assessing spiritual issues, which leaves them unable to assess and meet patients' spiritual needs. Thus, when patients experience spiritual distress, clinical nurses lose the opportunity to support spiritual growth and self-actualisation. In Taiwan, spiritual care, religion and culture are unique compared to those in other countries. Overall, factors associated with Taiwanese nurses' spiritual care competencies lack comprehensive exploration. This study adopted a descriptive correlational design using cross-sectional survey (see Appendix S1). Cluster sampling was used to select clinical nurses from fourteen units of a medical centre and a regional hospital. Data were collected from January-June 2018 with a 97.03% response rate. Clinical nurses completed a background questionnaire, spiritual care practice questionnaire, spirituality and spiritual care-related scales. Data were analysed using descriptive and linear regression. This report followed the STROBE checklist. Spiritual care competence ranged from 44-123 (mean 84.67±12.88; range 27-135). The majority of clinical nurses rated their spiritual care competence as moderate (64-98). The significant factors associated with nurses' spiritual care competence were education, religion, interest in spiritual care, having role models, past life events, barriers to providing spiritual care of the spiritual care practice score, and spiritual attitude and involvement score. The overall model was significant (p<.001) and accounted for 55.0% of variance (adjusted R2 =.488). Most clinical nurses have moderate spiritual care competence. Objective factors identified affect clinical nurses' spiritual care competencies. To improve nurses' spiritual care competencies, objective factors that affect clinical nurses' spiritual care competencies must be emphasised. Multiple strategies for enhancing nurses' own spiritual well-being can be provided via employee health promotion projects and activities, and promoting nurses' spirituality and spiritual care competencies can be explored in clinical settings through bedside teaching, situational simulation, objective structured clinical examinations and self-reflection.

Background and Purpose: Military nurses are exposed to various occupational stresses. Spirituality contributes to adaptation to critical situations and stresses. Spiritual care is an essential part of holistic care which in recent years has attracted the attention of health-related organizations. The aim of this study was to determine the attitude of military nurses, faculty members and military nursing students toward spirituality and spiritual care.Methods: In a cross-sectional descriptive study, 214 military nurses, faculty members and nursing students of Baqiyatallah University of Medical Sciences in Tehran were selected according to inclusion criteria by simple sampling method and completed the Spirituality and Spiritual Care Rating Scale [SSCR].Results: The mean score of attitude toward spirituality and spiritual care in clinical nurses was 69.4 [SD±12.6] in nursing professors 74.6 [SD±6.6] and in students 67.5] SD±4/11]. The majority of the research community was at a high and desirable level. [Between 63 and 92, which was the maximum score of the questionnaire].Conclusion: The results of this study showed that military nurses, faculty members and nursing students of Baqiyatallah University of Medical Sciences in Tehran have a positive attitude toward spirituality. They tend to provide spiritual care. Therefore, it is necessary to provide a suitable platform for providing spiritual care.

Background and aimSpiritual care is an important part of nursing practice that seems to provide comprehensive care to patients. Nursing manager’s attention to the spiritual dimension is one of the most important aspects affecting human health. Therefore, the aim of this study was to determine nursing managers’ attitude to spirituality and spiritual care in hospitals in Khorasan Razavi Province in 2016.MethodsIn this cross-sectional study, 110 management nurses (8 matrons, 37 supervisors and 65 head nurses) of hospitals in Khorasan Razavi Province (2016) were recruited for the study. Data were collected using a Spirituality & Spiritual Care Rating Scale (SSCRS) questionnaire in two parts, demographic information and questions related to the research objectives. Data were collected and analyzed using SPSS 16 software and doing descriptive (frequency, mean, standard deviation) and inferential statistics (independent-samples t-test, ANOVA) and considering levels of significance (p<0.05).ResultsThe results showed mean and standard deviation in management nursing attitude to spirituality (4.01±0.35) and spiritual care (4.03±0.78). The result showed significant differences between the attitude to spirituality and spiritual care and gender, age and work experience in nursing management (p<0.05).ConclusionsManagement nursing has high level attitude to spirituality and spiritual care. Therefore, providing the perfect platform to provide this care, and for nurses to implement it in hospitals is recommended.

An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks

Purpose: The aim of this study was to describe nursing educators’ perceptions of spirituality and spiritual care and their spiritual care competence, and to determine the relationship between them. Materials and Methods: This descriptive and cross-sectional study was conducted between Jun and September 2017. The sample was composed of 202 academicians from four universities. For data collection, the nursing academician information form, Spirituality and Spiritual Care Rating Scale, and the Spiritual Care Competency Scale were used. For data analysis, the descriptive statistics, the test of significant difference between two means, Pearson Correlation Analysis, the Mann Whitney U Test, and Kruskall Wallis Analysis were used. Results: The mean age of the academicians was 36.14 ± 8.91 years, and 96% were female. All stated that it was necessary to give spiritual care to patient individual and to provide education in spiritual care in nursing training. According to their statements, 68.8% of the academicians included the topic of spiritual care in their course content and 56.4% included nursing diagnoses relating to spiritual care in their lessons, but 44.6% did not use the related diagnoses when preparing students’ nursing care plans. A medium level positive correlation was found between item scores on two scales (r=0.404, p&lt;0.001). The mean two scales item scores of those with the academic status of assistant professor those who advised students on giving spiritual care to patients during clinical practice, and those who included spiritual care and nursing diagnoses regarding spiritual care in their course content were found to be statistically significantly higher (p&lt;0,05). Conclusion: It was concluded that nurse academicians who had active responsibilities for preparing and presenting educational content on spiritual care, which is a part of holistic care, had a broad view of spiritual care. A need was felt for developing both perceptions of competence in providing this care and perceptions of spirituality and spiritual care.

Background. Unani Tibb promotes holistic patient care, yet spirituality and spiritual care seem to be neglected in education. This theory-practice gap was previously highlighted in studies on Unani Tibb practitioners. The role of spirituality and spiritual care in Unani Tibb education in South Africa (SA) remains unclear. Objectives. To explore Unani Tibb students’ and educators’ perceptions and attitudes of spirituality and spiritual care in SA. Methods. A two-stage sequential explanatory mixed-method study was conducted. Quantitative data from stage 1 was obtained using a cross-sectional descriptive study followed by in-depth interviews for the qualitative study in stage 2. Stage 1 guided the interview questions in stage 2. Descriptive data analysis was performed for the quantitative study, followed by thematic analysis for the qualitative data. Results. A total of 18 (90%) participants took part in the quantitative study followed by 10 participants (50%) in the qualitative study. Three study findings emerged: i) a heightened level of spiritual awareness was recorded for this cohort despite the lack of spirituality and spiritual care content in the curriculum, ii) participants viewed spiritual care as integral to Unani Tibb philosophy, education and practice and iii) formal integration of spirituality and spiritual care concepts in Unani Tibb education was identified as a necessity to ensure the integrity of the holistic approach required by the profession. Conclusion. This study has implications across the health education sector and more specifically for Unani Tibb educators to consider the inclusion of spiritual care content in education programmes.

Spirituality is a necessary component of life. Spiritual care includes the activities necessary to meet the spiritual needs of clients. Nursing students must receive appropriate training to develop their abilities to provide spiritual care. This study explored student nurse perceptions of spirituality and spiritual care and related factors. We used a cross-sectional descriptive design and purposive sampling. Participants were senior nursing students of both genders from 22 schools. The Chinese version of a spirituality and spiritual scale was the research tool. A total of 239 participants returned the questionnaires, giving a response rate of 91.92%. Average participant age was 19.48 years; 45.61% reported no religion; 65.59% did not participate in religious activities; 94.56% reported having an interest in nursing; 52.72% were undecided about pursuing a nursing career; 3.35% did not want to be nurses; 46.44% had taken spirituality courses in school; 53.56% had taken spiritual care courses. Participants' overall perception of spirituality and spiritual care was "clear." This runs contrary to the idea that only religious people are spiritual and that non-religious nurses may be less able to tend to the spiritual needs of their patients. Participants who had taken spirituality or spiritual care courses had an interest in nursing and were willing to become nurses had, on average, significantly better spirituality knowledge and spiritual care attitudes than other participants. This study found that education, experience, career interest in nursing, and career choice affects nursing student perceptions of spirituality and spiritual care. We also found that this effect was independent of gender. Nursing students should be holistic care providers. Integrating spirituality and spiritual care into the standard nursing curriculum is recommended to improve nursing care quality.

This study explores the relationship between spirituality, perceptions of spiritual care, and hopelessness among elderly care technician students in Türkiye. Using a descriptive-correlational design, data were collected from 284 students through a sociodemographic form, the Spirituality and Spiritual Care Rating Scale (SSCRS), and the Beck Hopelessness Scale (BHS). The mean SSCRS score was 63.41 ± 8.76, indicating high spiritual sensitivity. Subscale scores were: Spirituality and Spiritual Care (26.58 ± 5.40), Religiosity (15.47 ± 1.83), and Individual Care (14.22 ± 2.88). The mean BHS score was 5.72 ± 4.86, reflecting low hopelessness. A weak negative correlation was found between spirituality and hopelessness. Despite students' limited ability to define the concepts of spirituality and spiritual care, their elevated scores on the Spirituality and Spiritual Care Rating Scale (SSCRS)-particularly within the 'Spirituality and Spiritual Care' and 'Religiosity' subscales-indicate a strong internalization of these values. This suggests that, although theoretical understanding is insufficient, students recognize the practical significance of spiritual care and perceive religiosity as an integral component of holistic care. Furthermore, the strong performance in the Religiosity subscale implies that students view spiritual care not only as psychological or emotional support but also as encompassing faith-based dimensions, such as prayer and religious practices. Integrating theoretical and practical spiritual care education into elderly care programs may help students combine faith-based values with professional skills, maintain hope, and improve care quality.