Suffering, Self, and Structures: Remarks for Buddhist-Christian Thought and Spiritual Care

The delivery of spiritual and religious care has received a high profile in national reports, guidelines and standards since the start of the millennium, yet there is, to date, no recognized definition of spirituality or spiritual care nor a validated assessment tool. This article suggests an alternative to the search for a definition and assessment tool, and seeks to set spiritual care in a practical context by offering a model for spiritual assessment and care based on the individual competence of all healthcare professionals to deliver spiritual and religious care. Through the evaluation of a pilot study to familiarize staff with the Spiritual and Religious Care Competencies for Specialist Palliative Care developed by Marie Curie Cancer Care, the authors conclude that competencies are a viable and crucial first step in 'earthing' spiritual care in practice, and evidencing this illusive area of care.

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.

This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment.

This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing to ascertain members' perceptions of spirituality and spiritual care. There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently, the area of spirituality has come under criticism bringing into question the role of the nurse with regard to the provision of spiritual care. A descriptive online survey was conducted with all Royal College of Nursing members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regard to this aspect of nursing practice. An online survey consisting of a five-part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale. Members were asked to complete the survey during a three-week period in March 2010. Overall, 4054 Royal College of Nursing members responded, making this probably the largest UK survey ascertaining nurses' perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach's alpha of 0·80 was obtained for the Spirituality and Spiritual Care Rating Scale. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing. The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension, the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients' spiritual needs.

The ethical basis of teaching spirituality and spiritual care: A survey of student nurses perceptions

Reviewed by: Black and Buddhist: What Buddhism Can Teach Us About Race, Resilience, Transformation, and Freedom ed. by Pamela Ayo Yetunde and Cheryl Giles, and: Buddhist-Christian Dialogue, U.S. Law, and Womanist Theology for Transgender Spiritual Care by Pamela Ayo Yetunde Carolyn Jones Medine BLACK AND BUDDHIST: WHAT BUDDHISM CAN TEACH US ABOUT RACE, RESILIENCE, TRANSFORMATION, AND FREEDOM. Edited by Pamela Ayo Yetunde and Cheryl Giles. Boulder, CO: Shambhala Press, 2020. xxxii and 189 pp. BUDDHIST-CHRISTIAN DIALOGUE, U.S. LAW, AND WOMANIST THEOLOGY FOR TRANSGENDER SPIRITUAL CARE. By Pamela Ayo Yetunde. New York: Palgrave Macmillan, 2020. ix and 144 pp. Pamela Ayo Yetunde and Cheryl Giles offer a variety of Black Buddhist voices in their co-edited volume, Black and Buddhist: What Buddhism Can Teach Us About Race, Resilience, Transformation, and Freedom. Yetunde extends this work in her single author volume, Buddhist-Christian Dialogue, U.S. Law, and Womanist Theology for Transgender Spiritual Care. In this review essay, I, first, will give brief information about the two authors and turn to each work, looking at key themes and insights they offer us about African American Buddhist practice, in general, and about pastoral care and chaplaincy. Finally, I would like to suggest the importance of these two works. the work of two lives Pamela Ayo Yetunde has emerged as an innovative voice in Black Buddhist Studies. Dr. Yetunde is a Buddhist chaplain, having trained at the Sati Center for Buddhist Studies, and pastoral counselor who has been active in hospice work, having founded the Zen Caregiving Project; she also co-founded the Center of the Heart and the Audre: Spiritual Care for Women with Cancer. She is a professor at United Theological Seminary of the Twin Cities and a faculty member at the Upaya Institute and Zen Center and a Community Dharma Leader in the Insight Meditation tradition. [End Page 327] She has written for Buddhadharma, Lion's Roar, and Tricycle: The Buddhist Review. In addition, she has a law degree and has written a book about women and finance. With other practitioners, she founded the Buddhist Justice Reporter: The George Floyd Trials (www.buddhistjustice.com). Yetunde brings all this to her intersectional work on Black Buddhists and on Buddhism and pastoral care, and her work is trailblazing, opening up conversations around race, gender, and religion in the books under review and in her 2018 work, Object Relations, Buddhism, and Relationality in Womanist Practical Theology, which includes interviews of African American lesbian Buddhist practitioners in the Theravada Insight Meditation tradition. Dr. Cheryl A. Giles is the Francis Greenwood Peabody Senior Lecture on Pastoral Care and Counseling at Harvard University. She is a member of the Buddhist Ministry Initiative. Her books include the co-edited pioneering work, The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work, which gathered voices from a variety of Buddhist lineages to explore contemplative care in hospital chaplaincy, prison ministry, college and military chaplaincy, and end-of-life care. Her Buddhist-Christian writings include "Self-Care for the Beloved Community" in The Christian Century (2016), which asks important questions about compassionate leadership and the preparation and resources needed for the work.1 Her work focuses on adolescent psychology, healthcare and African Americans, and contemplative care—providing spiritual, emotional, and pastoral support in a way that is informed by a "personal, consistent contemplative, or mediation practice"2—at the end of life. A practitioner of Tibetan meditation, she is a member of the Natural Dharma Fellowship. In "Beyond the Color Line: Cultivating Fearlessness in Contemplative Care" in The Arts of Contemplative Care, Giles confronting the racism present in Buddhism and, therefore, in care, asks us to cultivate fearlessness and to bring this to our meditation, to our work, and to our interactions. None of us will ever be perfect nor can we expect to live without fear. But we can aspire to be open to the unfolding present moment. We can help in this small way to make a real impact: we can vow to practice fearlessness every day for ourselves and others to alleviate suffering. We can stay true to a strong intention while opening to our own vulnerability and that of...

IntroductionThe rhetoric of Palliative Care encompasses physical, psychological, social and spiritual domains.1 However, this last element is often the most contentious in both definition and application2–4 and has often been...

Addressing spirituality within serious illness is a core dimension of palliative care delivery. However, spiritual care frequently lacks integration within the care of patients and families facing serious illness. This chapter discusses the integration of spiritual care into palliative care delivery. Requisite to this integration is a clear understanding of definitions and palliative care guidelines informing spiritual care provision. Furthermore, integration is informed and motivated by a large body of evidence showing how spiritual and religious factors frequently play salient roles in serious illness and influence palliative care outcomes. The integration of spiritual care into palliative care practice relies on a generalist–specialist model, within which all members of the interdisciplinary palliative care team are responsible for spiritual care provision. Non-spiritual care specialist members of the palliative care team are responsible for generalist spiritual care delivery, including taking spiritual histories and screening for spiritual needs. The care team also includes spiritual care specialists, typically board-certified chaplains, who provide in-depth spiritual care delivery to patients and families and aid the care team in understanding the spiritual and religious dimensions of care. Additionally, data regarding tested spiritual care interventions are discussed as potential tools palliative care teams can employ to improve patient care and outcomes. Finally, the integration of spiritual care into palliative care teams presents both opportunities and challenges that must be considered as efforts needed to foster more seamless spiritual care delivery within palliative care.

In the past 10 years spirituality and spiritual care have been much debated in professional healthcare literature, highlighting the need for a recognised definition of spiritual care to enable appropriate assessment of, and response to, spiritual issues. This accessible and highly relevant book surveys the numerous statements, guidelines and standards highlighted by these discussions, and equips healthcare professionals with the knowledge, skills and competence to provide the essence of spiritual care within their professional practice. Practical and evidence-based, this manual proves that delivery of good, professional spiritual care can build on intuitive human skills, and can be taught, learned, assessed and quantified. It gives readers the opportunity to move on from uncertainties about their role in the delivery of spiritual care by allowing them to asses and improve their understanding, skills and clinical practice in this area of care. Spiritual Care for Healthcare Professionals clearly grounds spiritual care in clinical practice. It is highly recommended for supporting academic study and encouraging healthcare practitioners to reflect on their practice and develop skills in spiritual assessment and care. Aimed at all healthcare professionals, it can be used by individual practitioners for continuing professional development as well as by academic staff developing educational programmes.

Introduction Spirituality is universal and is a major factor in the search for meaning in life. Spiritual care helps to overcome the fear of the unknown and anxiety related to distress or dying. The majority of healthcare providers do not feel competent or confident to deliver spiritual care. Currently there are gaps in spiritual care delivery, despite the availability of spiritual care services during patient’s and families’ imminent spiritual privations. Methods A written survey was conducted among the clinical nurses in the burn unit to identify the nurse’s perception regarding spiritual care. The survey was voluntary and anonymous. The survey contained six multiple choice questions and a comment section. (See Table 1) Results There was an 88% response rate (n=30) from all nurses (n=34) in the unit. While majority (90.3%) of staff felt spiritual care was an important component in the overall care, only 13.3% felt confident to provide the care. Among the survey participants, 77.4% agreed they had come across a time when they were not able to obtain spiritual care for their patient. Among the survey responders, 77.4% believed a nurse could be trained to deliver spiritual care in urgent situations to fill the gap in the absence of hospital chaplain. Finally, the nursing staff was asked if they would be interested in receiving education and 38.7% agreed they were interested in spiritual care education (Table 1). Conclusions Burn unit nurses reported spiritual care as an essential component for the holistic care of patients. However, nurses admit they lack confidence in providing spiritual care and agreed to the need for spiritual care education, with about a third of them being willing to obtain the education. As a result of this assessment, education will be provided to nurses in the burn unit as a pilot project. The overall goal is to educate the nurses throughout the facility who are interested in improving their spiritual care delivery. Applicability of Research to Practice Proper nursing education is needed to develop competency and confidence to provide spiritual care and minimize the gaps in spiritual care services during a patient’s imminent death or spiritual distress.

Editorial: Time as presence and opportunity: the key to spiritual care in contemporary nursing practice.

BackgroundSpiritual care is a core component of holistic palliative care assessment. Previous research has explored spiritual care from the perspectives of doctors and trained nurses within palliative care units. Healthcare...

The aim of this paper is to reveal the main nursing competencies for spiritual care, which emerged from data collecting from qualified nurses in Malta. For nurses to deliver spiritual care, they must be competent to provide care on a physical, mental, social and spiritual level. As spiritual care may be influenced by culture, this study explored the competencies for spiritual care from the Maltese nurses' perspective. A descriptive exploratory study investigated nurses' competencies in the delivery of spiritual care to patients with myocardial infarction. Data were collected by means of an open-ended questionnaire on qualified nurses (n=77) followed by an in-depth interview on a stratified random sample (n=14) of nurses from the same respondents. The four main nursing competencies identified were associated with the role of the nurse as a professional and as an individual person; delivery of spiritual care by the nursing process; nurses' communication with patients, inter-disciplinary team and clinical/educational organizations and safeguarding ethical issues in care. This study demonstrated the complexity of spiritual care, which requires nurses to increase their awareness of the uniqueness of each individual patient with regard to the connection between mind, body and spirit; the assessment of the spiritual status of patients during illness and the implementation of holistic care as recommended by the Nursing Code of Ethics. These findings will enable nurses to consider the importance of spiritual care, which may allow them to help empower patients find meaning and purpose during times of illness. More emphasis should be put on spiritual care in the pre- and postregistration education. Further research to translate these main competencies into specific competencies will guide spiritual care.

This paper outlines key developments, innovations, and milestones in the field of spirituality and spiritual care in nursing. A discursive paper. Nursing scholars have significantly influenced the profession and contributed to the development of nursing knowledge, particularly in the field of spirituality and spiritual care. Key research has focused on nurses' perceptions and attitudes toward spirituality, clarifying foundational spiritual concepts, and establishing a framework of core spiritual care competencies for the profession. Despite these advancements, significant gaps remain in nurses' knowledge, understanding, and experience in providing spiritual care. The development of agreed-upon spiritual care competencies at the European level offers important guidance for the profession, and educational initiatives are underway to support their integration. However, the field remains in an early stage of development, and further research is needed to embed spiritual care competencies into national and international nursing policy and practice. Moreover, continued research is also essential to inform and evaluate current educational programmes and nursing interventions, and to support the translation of evidence-based knowledge into effective spiritual care delivery. Spiritual support is proven to be an important consideration for many patients and families globally. Imbedding spiritual care education into both undergraduate and postgraduate nursing curricula is essential to prepare nurses to address the spiritual needs of patients in healthcare settings. Structured curricula that provide clear instructions on how to recognise, assess, and respond to spiritual concerns in clinical practice can enhance nurses' competence and confidence. Embedding spiritual care into education and training helps normalise spiritual care as a component of holistic nursing, supporting its inclusion in everyday care rather than treating it as an optional or marginal practice. Such educational integration has the potential to improve the consistency and quality of spiritual care across healthcare settings. Internationally there are evident gaps in the consistent provision of spiritual care to patients and their families. These are being addressed through conceptual clarity, the agreed-upon competencies, and enhanced educational initiatives. It is essential to continue to increase awareness among the nursing profession on the necessity of addressing spiritual care needs, within the context of cultural perspectives to ensure that value is placed on the significance of these issues on a global scale. There was no patient or publication contribution in this specific commentary.

Buddhist chaplaincy is a profession in which Buddhists with specialized training care for the spiritual needs of suffering individuals (careseekers), typically within non-religious settings such as hospitals, hospices, military, workplaces, or universities. Although the roots of spiritual care date back to the beginning of the Buddhist traditions, professionalized Buddhist chaplaincy is a very recent phenomenon. Despite some beginnings in the mid-20th century, most developments have occurred rapidly only within the 21st century. This contemporary movement is occurring in numerous places around the world, including North America, Europe, and Asia, covering a wide range of countries, cultures, and Buddhist traditions. The profession of chaplaincy was originally a Christian vocation but began expanding to serve the needs of multireligious careseekers and train caregivers of various religious backgrounds in the 20th century. Thus, while chaplaincy is now a profession open to all comers, including Buddhists, humanists, and atheists, many of the educational, training, and professional standards for certification or licensing are still normed against Christian expectations and legacy organizational structures, particularly in North America, Europe, and the British Commonwealth. In the countries where Buddhist chaplaincy is flourishing in the early 21st century, different groups are developing degree programs, training opportunities, and professional expectations that accord with their local regulatory bodies and other forms of existing chaplaincy certification. In Asian nations, Buddhists are stepping forward to build standards for providing spiritual care in the context of cultural institutions that are not typically religious (e.g., hospitals and schools). Diverse settings and differing requirements lead to distinctions between Buddhist chaplaincy in different countries. However, some of the core competencies for spiritual care are very consistent: compassion, listening, ritual proficiency, cultural understanding, and reflection. Buddhist and non-Buddhist chaplains alike agree to a fundamental skill set to care for people who are suffering in the various institutions where they work and volunteer. Distinctions between Buddhist and other forms of spiritual care are based on the care model employed, whether strictly co-religionist (i.e., Buddhists caring for Buddhists) or interfaith (i.e., Buddhists caring for all). In the latter case, professional chaplains (of any religion) are trained to provide spiritual care from the spiritual or religious worldview of the careseeker. As such, most Buddhist chaplains must possess basic knowledge and competency in many world religions. Nevertheless, Buddhist spiritual care may be distinct in its theory (Dharma based) and place more emphasis on mindfulness, meditation, and other contemplative techniques to benefit both careseekers and chaplains. Spiritual care that is “Dharma-based” means based on the teachings of the historical Buddha, Siddhartha Gautama, and/or the Buddhist traditions and teacher who followed after him. This includes a broad range of texts and teachings across the Buddhist world. As an emerging field, there is little literature on Buddhist chaplaincy, so it is currently somewhat difficult to say what theories and practices will come to dominate the profession.