Provision Of Spiritual Care Research Articles

Testing the structural equation model of the influence of nurses' spiritual well-being and caring behaviour on their provision of spiritual care to patients.

To test a proposed model that determined the effects of nurses' spiritual well-being and caring behaviour on their provision of spiritual care to patients. The spiritual dimension of caring gained attention in the recent past as it is recognized to bring positive patient outcomes. A cross-sectional, descriptive, correlational design was used in the study. Data were collected from 300 registered nurses working in the hospitals in Pampanga, Philippines. Partial least square structural equation modelling was used to test the model. Nurses had a high level of ideal and lived perspectives of spiritual well-being. They perceived their caring behaviour to be always manifested and occasionally engaged in spiritual activities that supported patient spirituality. The structural equation model provided a feasible model that was either caring behaviour-laden spiritual well-being or spiritual well-being-infused caring behaviour. Nursing administrators may develop guidelines for practice within their institutions that are considerate of the proposed model. They may focus on caring behaviour-laden spiritual well-being model of nursing practice or spiritual well-being-infused caring behaviour model of nursing practice.

What organizational and business models underlie the provision of spiritual care in healthcare organizations? An initial description and analysis

Two-thirds of American hospitals have chaplains. This article explores the organizational and business models that underlie how chaplains are integrated into hospitals. Based on interviews with 14 chaplain managers and the 11 healthcare executives to whom they report at 18 hospitals in 9 systems, we identify three central findings. First, there is significant variation in how spiritual care programs are staffed and integrated into their hospitals. Second, executives and chaplain managers see the value of chaplains in terms of their quality of care, reliability and responsivity to emergent patient and staff needs, and clinical training and experience working within a complex environment. Third, few departments rely on empirical data when making decisions about staffing, tending instead to default to the budgetary status quo. These findings provide the basis for a larger more systematic study.

Research Literature on the Intersection of Dementia, Spirituality, and Palliative Care: A Scoping Review

Dementia marks an increasingly prevalent terminal illness for which palliative care, including spiritual care, could improve quality of life. Research gaps exist in understanding the intersection of dementia, spirituality, and palliative care. Thus, we conducted the first scoping review examining the nature and breadth of peer-reviewed studies across these three topics. The scoping review followed methods from The Joanna Briggs Institute Reviewers’ Manual (2015). We developed a priori a scoping review protocol outlining the Population, Concept and Context for study, data sources, search strategy, inclusion/exclusion criteria, and procedure for screening, extracting, and analyzing data. The final sample consisted of 19 studies with the following themes: Characterizing Spiritual Needs, Preferences, and Resources; Characterizing Palliative or Spiritual Care; Predicting Provision of Spiritual Care; and Assessing Spiritual Care Interventions. Eighteen studies were published in the past decade, and eleven were based in Europe. The majority of studies focused on long-term care settings, grouped stages of dementia or did not specify dementia stage, and investigated interventions indirectly related to spiritual palliation. Many studies were limited in sample size and in generalizability / transferability and used less sophisticated research designs. Accordingly, research across dementia, spirituality, and palliative care needs to examine distinct stages of dementia; hospital-, home- and community-based settings; and formal spiritual care interventions (e.g., administered by chaplains) and needs to utilize rigorous study designs (e.g., randomized clinical trials). Such research could advance practice and policy that enhance quality of life for tens of millions of persons with dementia and their family members worldwide.

Digitale communicatie over existentiële vragen en spiritualiteit in het kader van persoonsgerichte zorg in het ziekenhuis

This article is about digital communication on existential and spiritual matters within person-centered care in hospitals. The explorative qualitative research aimed to get a deeper insight into the ways health care professionals (including spiritual care providers), can establish and then keep contact with patients when it is harder to have face-to-face conversations. In interviews and focus groups with stakeholders and experts, I have tried to find answers to the following research question: “Are there existing instruments in digital communication available, or is there a need to develop new tools, to use for personal communication on existential and spiritual matters when there is no possibility for face-to-face conversations?” The results of the research are diverse but consistent. Most of the respondents are opting for the use of the existing digital communication tools like Skype, WhatsApp etc. No particular mode was favoured. However, although digital communication is considered to be a good aid, face-to-face contact was nevertheless much more appreciated over digital means of communication. As a spin off there are ideas about possibilities to develop new ways of digital communication on the meaning of life and spirituality. In the article I also reflect on the impact of Covid-19 from a personal experience as a recent immigrant. We are living in extremely turbulent times. Ongoing turbulence might be the new normal. This all leads to a new question for future-proof spiritual care: “Can digital communication successfully replace traditional faceto- face communication in the realms of spiritual care? Or is also retaining more traditional face-to-face communication vitally important?”

A Survey of Hospice and Palliative Care Nurses' and Holistic Nurses' Perceptions of Spirituality and Spiritual Care.

The provision of spiritual care is referred to in professional practice guidelines and mandated in nurses' ethical codes. Still, a gap exists regarding essential training in spiritual conversation and assessment, leaving some health care providers feeling uncomfortable when assessing spiritual support needs. The purpose of this study was to assess hospice and palliative nurses' and holistic nurses' perceptions of spirituality and spiritual care. It was assumed that the standards of care for hospice and palliative nurses and holistic nurses stipulate that spiritualty is addressed within the framework of their specialties and provide education for spiritual care, thus making these nurses proficient in providing spiritual care. This exploratory, descriptive study utilized a web-based survey to measure perception of spirituality and spiritual care giving using a modified Spirituality and Spiritual Care Rating Scale. A convenience sample was recruited from members of the Hospice and Palliative Nurses Association and the American Holistic Nurses Association (n = 250). Descriptive statistics summarized data as well as qualitative analysis of written narratives. Content analysis of open-ended survey questions was used to identify themes until saturation. This study found that given adequate resources and education, nurses can be positioned to address the spiritual needs of patients and provide appropriate care. This study adds to an emerging body of evidence suggesting that training in spiritual care should be an important component of the foundational nursing curriculum.

Barriers to Addressing the Spiritual and Religious Needs of Patients and Families in the Intensive Care Unit: A Qualitative Study of Critical Care Physicians.

Though critical care physicians feel responsible to address spiritual and religious needs with patients and families, and feel comfortable in doing so, they rarely address these needs in practice. We seek to explore this discrepancy through a qualitative interview process among physicians in the intensive care unit (ICU). A qualitative research design was constructed using semi-structured interviews among 11 volunteer critical care physicians at a single institution in the Midwest. The physicians discussed barriers to addressing spiritual and religious needs in the ICU. A code book of themes was created and developed through a regular and iterative process involving 4 investigators. Data saturation was reached as no new themes emerged. Physicians reported feeling uncomfortable in addressing the spiritual needs of patients with different religious views. Physicians reported time limitations, and prioritized biomedical needs over spiritual needs. Many physicians delegate these conversations to more experienced spiritual care providers. Physicians cited uncertainty into how to access spiritual care services when they were desired. Additionally, physicians reported a lack of reminders to meet these needs, mentioning frequently the ICU bundle as one example. Barriers were identified among critical care physicians as to why spiritual and religious needs are rarely addressed. This may help inform institutions on how to better meet these needs in practice.

Palliative Care Consults in an Inpatient Setting for Patients With Amyotrophic Lateral Sclerosis.

Limited data about the frequency and outcomes of palliative care (PC) specialty consultations for patients with amyotrophic lateral sclerosis (ALS) are available. This study was a retrospective chart review. Patients with ALS admitted to 2 academic hospitals from 2013-2018 were included. We compared patients who were seen by an inpatient specialty PC service (PC group) with those who were not (NonPC group). Twenty-four patients met inclusion criteria (9 PC group, 15 NonPC group). Patients in both groups were similar in age and had been diagnosed for a similar amount of time before admission. In the PC group, 6 patients were seen by more than 1 PC multidisciplinary team member (physician, social worker, spiritual care provider, clinical nurse specialist). PC consultations were requested for goals of care (GOC) (n = 7), pain (n = 4), hospice information/referral (n = 2), dyspnea (n = 1), and excessive oral secretions (n = 1). GOC topics addressed for both groups were code status, treatment preferences (tracheostomy placement, percutaneous endoscopic gastrostomy placement, change to comfort care), prognostication, and hospice information/referral. Patients in the PC group were significantly more likely to be discharged with GOC (89%, p = 0.02) and completed advance care planning (ACP) documents (89%, p = 0.04) than patients in the NonPC group (32%; 47%). Despite reason for consultation, at least 1 symptom was addressed for every patient seen by PC specialists. Inpatient specialty PC consultation for patients with ALS leads to greater documentation of GOC and ACP by discharge. PC consultants participate in symptom management in patients with ALS during hospitalization.

Translation and Validation of the Spiritual Care Intervention-Provision Scale in the Greek Language.

Introduction Spiritual care is defined as activities and interventions that promote spiritual health and the spiritual dimension of quality of life. Empirical data indicate the importance that spiritual care provision has on nursing practice. The spiritual care intervention-provision (SCIP) scale was developed to assess the frequency of spiritual care intervention implemented by nurses. Currently, there are no validated scales for assessing spiritual care in the Greek language. Objective To adapt and validate the spiritual care intervention-provision scale in the Greek language. Methods A descriptive cross-sectional study was employed, in which 275 nurses working in two public hospitals participated. The SCIP scale underwent the process of cross-cultural adaptation and was evaluated by assessing its reliability and validity. Results The process resulted in a valid Greek version of the SCIPS, the internal consistency (Cronbach's α 0.887), reliability testing-retesting (r = 0.997, p < 0.001, and t = 0.387, p > 0.05), construct, and convergent validities were evaluated. Conclusion The Greek version of the spiritual care intervention-provision scale is a validated scale that can be used to examine spiritual care provision in Greek health services.

Toward an Integrative Model of Psychospiritual Therapy: Bringing Spirituality and Psychotherapy Together.

As a supervisor-educator for the Canadian Association of Spiritual Care, my primary task is to help developing spiritual care providers and psychospiritual therapists learn how to use psychotherapy within the field of spiritual care. The purpose of this essay is to share a psychospiritual model that I teach my students that helps them see how psychospiritual therapy is a form of spiritual practice that helps their clients experience healing from the sacred.

Factors influencing the self-perceived competencies in spiritual care of nurses in the long-term care facilities.

To identify key factors influencing institutional nurses' self-perceived competencies in spiritual care. In the past decade, interest in spiritual care has been increasing; however, in long-term care facilities, limited knowledge is available about nurses' competencies in spiritual care. The cross-sectional study was conducted with 202 nurses in 11 long-term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self-satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care.

Spiritual care provision to end-of-life patients: A systematic literature review.

To develop an understanding of how nurses provide spiritual care to terminally ill patients in order to develop best practice. Patients approaching the end of life (EoL) can experience suffering physically, emotionally, socially and spiritually. Nurses are responsible for assessing these needs and providing holistic care, yet are given little implementable, evidence-based guidance regarding spiritual care. Nurses internationally continue to express inadequacy in assessing and addressing the spiritual domain, resulting in spiritual care being neglected or relegated to the pastoral team. Systematic literature review, following PRISMA guidelines. Nineteen electronic databases were systematically searched and papers screened. Quality was appraised using the Critical Appraisal Skills Programme qualitative checklist, and deductive thematic analysis, with a priori themes, was conducted. Results Eleven studies provided a tripartite understanding of spiritual caregiving within the a priori themes: Nursing Spirit (a spiritual holistic ethos); the Soul of Care (the nurse-patient relationship); and the Body of Care (nurse care delivery). Ten of the studies involved palliative care nurses. Nurses who provide spiritual care operate from an integrated holistic worldview, which develops from personal spirituality, life experience and professional practice of working with the dying. This worldview, when combined with advanced communication skills, shapes a relational way of spiritual caregiving that extends warmth, love and acceptance, thus enabling a patient's spiritual needs to surface and be resolved. Quality spiritual caregiving requires time for nurses to develop: the personal, spiritual and professional skills that enable spiritual needs to be identified and redressed; nurse-patient relationships that allow patients to disclose and co-process these needs. Supportive work environments underpin such care. Further research is required to define spiritual care across all settings, outside of hospice, and to develop guidance for those involved in EoL care delivery.

COVID-19 Demands Theological Reflection: Buddhist, Muslim, and Christian Perspectives on the Present Pandemic

Abstract What are some ways that people from the Buddhist, Muslim and Christian faith traditions can reflect upon the coronavirus pandemic using a theological lens? How can Buddhist, Muslim and Christian practitioners respond in practical ways to the coronavirus pandemic, utilizing resources from their faith traditions? This contribution offers reflections on the worldwide suffering and challenges that the pandemic has caused from the perspectives of Buddhist, Muslim and Christian practitioners. Each writer offers practical resources and theological reflection from their vantage point as spiritual care providers and as people of faith.

Death and Grieving in a Changing Landscape : Facing the Death of a Loved One and Experiencing Grief during COVID-19

This article is a reflection of a palliative care chaplain’s experiences of supporting people through grief and loss during the COVID-19 pandemic. People have died without the support of loved ones present; funerals have been conducted in a very different manner to the usual practice; and many people’s experience of grief and bereavement has been challenging. The role of the chaplain is explored and discussed in relation to spiritual care provision. The author also acknowledges that the repercussions from COVID-19 have presented a challenge for many people who are grieving and experiencing bereavement.

How is spiritual care/pastoral care understood and provided in general hospitals in Victoria, Australia? – Staff perspectives

ABSTRACT There is strong movement worldwide towards the professionalisation of spiritual care in the healthcare system, accompanied by appropriate education pathways, defining of best-practice care models, and evidence-based practice. The aim of the study reported here was to explore the understanding and expectations of healthcare service staff, across the spectrum of staffing levels, in relation to the provision of spiritual care in their facility. It utilised semi-structured interviews with 32 staff members from three large metropolitan general hospitals in Victoria Australia. Interviews were audio-recorded, transcribed and thematically analysed. Overall, it was considered that spiritual care is an integral part of whole person care; more resources and in-house education of other staff are needed; and referral systems could be improved to better serve patient, family and staff spiritual care needs. Responses of clinical staff able to make referrals were compared with those of non-clinical staff who cannot make referrals. Spiritual care was regarded as important by all staff, but those who could make referrals were more likely to make specific improvement suggestions. Outcomes of this study are similar to others which have investigated these issues.

Perceptions and practices of spiritual care among hospice physicians and nurses in a Taiwanese tertiary hospital: a qualitative study

BackgroundSpiritual care is frequently cited as a key component of hospice care in Taiwanese healthcare and beyond. The aim of this research is to gauge physicians and nurses’ self-reported perspectives and clinical practices on the roles of their professions in addressing spiritual care in an inpatient palliative care unit in a tertiary hospital with Buddhist origins.MethodsWe performed semi-structured interviews with physicians and nurses working in hospice care over a year on their self-reported experiences in inpatient spiritual care. We utilized a directed approach to qualitative content analysis to identify themes emerging from interviews.ResultsMost participants identified as neither spiritual nor religious. Themes in defining spiritual care, spiritual distress, and spiritual care challenges included understanding patient values and beliefs, fear of the afterlife and repercussions of poor family relationships, difficulties in communication, the patient’s medical state, and a perceived lack of preparedness and time to deliver spiritual care.ConclusionsOur study suggests that Taiwanese physicians and nurses overall find spiritual care difficult to define in practice and base perceptions and practices of spiritual care largely on patient’s emotional and physical needs. Spiritual care is also burdened logistically by difficulties in navigating family and cultural dynamics, such as speaking openly about death. More research on spiritual care in Taiwan is needed to define the appropriate training, practice, and associated challenges in provision of spiritual care.

The relation between knowledge and attitudes with behavior of nurse in providing spiritual care

This study aims to determine the relationship of nurses' knowledge and attitudes with nurses' behavior in providing spiritual nursing care in the inpatient room at Citra Sari Husada Hospital, Karawang. This study used an analytic descriptive design with a cross-sectional approach with a population of 115 and the sample used was 85 people. Data were collected by distributing questionnaires. Questionnaires were used assess about nurses' knowledge, nurses' attitudes, and nurses' behavior in providing spiritual nursing care. The results of bivariate analysis found a relationship between knowledge and behavior of nurses in the provision of spiritual nursing care with p value 0.010 (α=0.05). But there is no relationship between attitudes with nurses' behavior in providing spiritual nursing care with p value 1.000 (α=0.05). Nurses' knowledge of nursing care can influence nurses' behavior in providing spiritual nursing care to patients.

Analysis of Spiritual Care Experiences of Acute-Care Hospital Nurses.

The purpose of this study was to analyze the experiences of acute care hospital nurses' on spiritual care with focus group interviews. Data were collected from 24 nurses recruited from one acute-care hospital in a southern province of Korea. Six focus groups were assembled considering age and religion. All interviews were recorded and transcribed. Data were analyzed using qualitative content analysis. Five categories with 14 sub-categories emerged: 1) ambiguous concept: confusing terms, an additional job; 2) assessment of spiritual care needs: looking for spiritual care needs, not recognizing spiritual care needs; 3) spiritual care practices: active spiritual care, passive spiritual care ; 4) outcomes of spiritual care: comfort of the recipient, comfort of the provider; and 5) barriers to spiritual care: fear of criticism from others, lack of education, lack of time, space constraints, and absence of a recording system. Participants perceived spiritual care as an uncertain concept. Some participants recognized it as a form of nursing care, and others did not. They practiced spiritual care in acute-care settings according to their personal perceptions of spiritual care. Therefore, in order to perform spiritual nursing in acute-care hospitals, it is a priority for nurses to recognize the concept of spiritual nursing accurately. It is also necessary to prepare a hospital environment suitable for the provision of spiritual care.

Chaplaincy and Spiritual Care Response to COVID-19: An Australian Case Study – The McKellar Centre

This article will consider a practitioner’s experience of the impact of COVID-19 on spiritual care within aged care at the McKellar Centre, Barwon Health, Victoria, Australia. Using Sulmasy’s (2002) paradigm, the provision of holistic care will be considered in terms of the physical, psychological, social and spiritual service variations that were necessary in order to continue to provide for the health and wellbeing of the most vulnerable in society – namely those in aged care. The WHO Spiritual Care Intervention codings (WHO, 2017) will be utilized to specifically explore the provision of spiritual care to assist the elderly requesting or needing religious/pastoral intervention. COVID-19 has radically shaped the environment of the McKellar Centre, however, the needs of elderly aged care residents must continue to be met, and this paper seeks to document how that process has been resolved in light of COVID-19. As pandemics are likely to reoccur, future issues for providing spiritual care from a distance, for the benefit of clients, their families, chaplains and health care organizations, will be noted. It must be acknowledged however, that the pandemic impact within Australia (and indeed much of the Oceania region) has been considerably less to that experienced by other regions of the world. Nevertheless, the preparatory and supportive response of spiritual care undertaken at the McKellar Centre speaks to a local response to an international crisis.

Religion, spirituality, and suicide risk in Iraq and Afghanistan era veterans.

United States military veterans experience disproportionate rates of suicide relative to the general population. Evidence suggests religion and spirituality may impact suicide risk, but less is known about which religious/spiritual factors are most salient. The present study sought to identify the religious/spiritual factors most associated with the likelihood of having experienced suicidal ideation and attempting suicide in a sample of recent veterans. Data were collected from 1002 Iraq/Afghanistan-era veterans (Mage = 37.68; 79.6% male; 54.1% non-Hispanic White) enrolled in the ongoing Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center multi-site Study of Post-Deployment Mental Health. In multiple regression models with stepwise deletion (p < .05), after controlling for depression and posttraumatic stress disorder (PTSD) diagnoses, independent variables that demonstrated a significant effect on suicidal ideation were perceived lack of control and problems with self-forgiveness. After controlling for age, PTSD diagnosis, and substance use problems, independent variables that demonstrated a significant effect on suicide attempt history were perceived as punishment by God and lack of meaning/purpose. Clinical screening for spiritual difficulties may improve detection of suicidality risk factors and refine treatment planning. Collaboration with spiritual care providers, such as chaplains, may enhance suicide prevention efforts.

Staff perceptions on the role and value of chaplains in first responder and military settings: A scoping review

Background&#x0D; Chaplains in first responder and military services support staff prior to, during and after critical incidents. Some studies have explored the role of chaplains in these settings predominantly in the military and from chaplains’ perspectives. However, few studies have explored the perspective of staff. This scoping review aims to map the literature on staff perceptions of the role and value of chaplains in first responder and military settings.&#x0D; &#x0D; Method&#x0D; A scoping review using the Arksey &amp; O’Malley (2003) and Joanna Briggs Institute Scoping Review Methodology was conducted. English language peer-reviewed and grey literature in CINAHL, PubMed, PsychINFO, ProQuest and Google Scholar from 2004-2019 was reviewed for inclusion. Records were included if they provided staff perspectives on the role and value of chaplains in first responder and military settings. The initial search identified 491 records after removal of duplicates. All titles and abstracts were then screened for relevance to the research question and 84 were selected for full-text review. Seven records were included in final review; five dissertations and two peer-reviewed articles. Five of these were from the military and two from the police. Data were extracted and thematically analysed to identify staff perceptions of the role, skills and attributes, and value of chaplains in first responder and military settings.&#x0D; &#x0D; Results &#x0D; Staff understood the role of chaplain to include the provision of spiritual and pastoral care and guidance and, in the case of police, providing scene support. Staff from all of the services identified requisite skills and attributes for chaplains such as being available, approachable and engaged; counselling; maintaining confidentiality and trust; being organisationally aware; and possessing distinct personality traits and knowledge of specialty content areas. The value chaplains brought to their services emerged from chaplains being trusted as a result of being proactively available for staff, families and bystanders for formal and informal conversation; organisational belonging and awareness resulting in enhanced staff satisfaction and retention; and promoting staff physical, mental, social and spiritual wellbeing.&#x0D; &#x0D; Conclusions&#x0D; Although military and police staff identified spiritual, psychological and social benefits to chaplains maintaining an active and visible role in their services, the small number of papers identified make generalisation of these findings to other first responder services problematic. Further research is therefore required to understand the impact of the chaplain’s role as part of the care team in first responder services.