Spiritual Assessment Tool Research Articles

“Not me!” a qualitative, vignette-based study of nurses’ and physicians’ reactions to spiritual distress on neuro-oncological units

PurposePeople with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. Consequently, neuro-oncological healthcare workers can be affected emotionally in a negative way. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.MethodsNeurospirit-DE is a qualitative vignette–based, multicenter, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive thematic analysis was used for data analysis.ResultsA total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted, and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.ConclusionsMost neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient’s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients’ distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement and training.

An Evaluation of the Uses of the HOPE Spiritual Assessment Tool: Preliminary Project Findings

An Evaluation of the Uses of the HOPE Spiritual Assessment Tool: Preliminary Project Findings

Self-Blame Attribution: Concept Analysis and Application to HPV-Related Cancers.

The attribution of self-blame for a negative physical health outcome can lead to further deterioration of one's mental and spiritual state. Using Walker and Avant's eight-step model for concept analysis, self-blame attribution is explored following the diagnosis of a human papillomavirus-related cancer in women. Conceptual case examples provide application of the concept to patient situations. Spiritual assessment tools for nurses caring for those who evidence self-blame are provided.

A Concept Analysis of Spiritual Self-Care in Hospice Team Members by Hybrid Model

Purpose: The study aimed to clarify the concept of spiritual self-care in hospice team members. Methods: To analyze the concept of spiritual self-care of hospice care team, the study was carried out using Schwartz-Barcott and Kim's hybrid model including theoretical, fieldwork and final analytic stages. In the theoretical stage, 'spirituality', 'spiritual well-being', 'spiritual health', 'spiritual care', and 'self-care' were set as search terms, and the resulting 107 related works of domestic and international literature were analyzed. In the field survey stage, data were collected from nurses and spiritual experts with more than 5 years of experience in spiritual self-care.Results: The concept of spiritual self-care is to realize the meaning and purpose of life while constantly maintaining relationships with oneself, neighbors, communities, and the absolute, utilize transcendence and internal resources, strengthen professional competence, maintain work-life balance, and achieve spiritual well-being. It was identified as a dynamic state to realize. The quality attributes of the concept of spiritual self-care were found to have 5 attributes and 15 indicators. Conclusion: The attributes and indicators derived through this study will be helpful in understanding the concept of hospice team members' spiritual self-care. In addition, as a way to continuously grow and train professional hospice team members, it can be used to develop a spiritual self-care assessment tool and an educational program to prevent burnout.

Testing reflective tools to support care home residents living with dementia with their spiritual needs

AbstractThe needs of older people with a ‘diverse’ cultural or faith background are not well represented in social care research in general, and particularly of those living in care homes where an estimated 70% of residents are living with dementia. Additionally, the spiritual needs of care home residents are often overlooked or misunderstood by care workers, resulting in a double lack of recognition. It is common for care workers to relate spirituality primarily to religion. This can be the case, but spirituality mainly reflects (the need for) a purpose and meaning in life. Evidence demonstrates that spirituality and religion can help reduce or stabilise cognitive disorders or enable people to develop coping strategies to help accept a cognitive disorder, maintain relationships, hope, and find meaning in their lives, thus improving their sense of wellbeing. Recent studies have highlighted the importance of creating dementia‐specific spiritual assessment tools and stakeholder training. This proposed study helps fill that gap.Pre‐liminary findings will be presented on a Reflective Spirituality Tool (RST) that is tested in care homes in England. Through interviews with care home residents living with dementia, their relatives/friends, care home staff, managers, and faith leaders, the RST will be re‐developed to ensure it reflects the diversity of people living in residential care. Furthermore, care home residents were asked to bring an artefact to their interview that represented a sense of peace, safety, or wellbeing to them. The artefacts were then photographed and collected in a ‘Gallery of Spiritualities’. These two tools aim to inform people involved in dementia care and reflect upon the diverse spiritual needs that care home residents have. Furthermore, the tools help inform care home managements, care home staff, nursing students and policy makers on how to improve spiritual care for people living with dementia in residential care.

Spiritual Intelligence among Blinds and Sighted Students in Palestine

Objectives: The study aimed to compare spiritual intelligence among blinds and sighted students in Palestine, while also investigating the influence of demographic variables such as gender, place of residence, educational level, and level of disability Methods: Employing a Comparative Descriptive methodology, the research utilized the Spiritual Intelligence assessment tool developed by King (2008), consisting of 47 items. The participants included 119 blind students and 60 sighted students in Palestine, all from the 8th and 9th grades, and they were chosen randomly. Results: The study demonstrated that the spiritual intelligence level among both groups (blinds and sighted) is high, also, there are significant statistical differences in spiritual intelligence level in both groups regarding sex (with a favor toward males), educational level (8th grade for blinds, and 9th grade for sighted), Level of disability (particularly among partially blind students), and place of residence (more pronounced in urban areas). Conclusions: In conclusion, the research emphasizes the significance of spiritual intelligence in both blind and sighted students in Palestine, shedding light on demographic factors that can influence its development. To foster a holistic educational experience, the study underscores the importance of integrating spiritual well-being into the educational framework, particularly for visually impaired students. This study recommended directing attention toward mental and spiritual well-being among blind students, aiding them in their academic journey. Additionally, the study suggests augmenting the curriculum with expanded vocabulary and concepts aimed at enhancing spiritual intelligence across all educational tiers.

Spiritual Intelligence among Blinds and Sighted Students in Palestine

Objectives: The study aimed to compare spiritual intelligence among blinds and sighted students in Palestine, while also investigating the influence of demographic variables such as gender, place of residence, educational level, and level of disability Methods: Employing a Comparative Descriptive methodology, the research utilized the Spiritual Intelligence assessment tool developed by King (2008), consisting of 47 items. The participants included 119 blind students and 60 sighted students in Palestine, all from the 8th and 9th grades, and they were chosen randomly. Results: The study demonstrated that the spiritual intelligence level among both groups (blinds and sighted) is high, also, there are significant statistical differences in spiritual intelligence level in both groups regarding sex (with a favor toward males), educational level (8th grade for blinds, and 9th grade for sighted), Level of disability (particularly among partially blind students), and place of residence (more pronounced in urban areas). Conclusions: In conclusion, the research emphasizes the significance of spiritual intelligence in both blind and sighted students in Palestine, shedding light on demographic factors that can influence its development. To foster a holistic educational experience, the study underscores the importance of integrating spiritual well-being into the educational framework, particularly for visually impaired students. This study recommended directing attention toward mental and spiritual well-being among blind students, aiding them in their academic journey. Additionally, the study suggests augmenting the curriculum with expanded vocabulary and concepts aimed at enhancing spiritual intelligence across all educational tiers.

Satisfaction Level Spiritual Care of Coronary Heart Disease Patients Using Spiritual Assessment Tool

with using application of Spiritual Assessment Tool. This type of research is descriptive analytic with cross sectional approach. results In this study, it is known that the age of the respondents is mostly in the age range of (>35 Year old age), which is as much as 81.8%. Most of the patient education is low education which is as much as 72.7%. Patient Satisfaction Spiritual Care in the pre-test is known to be mostly stated as not satisfied, as much as 68.2%, and in the post-test, Patient Satisfaction Spiritual Care experienced a change in that the patient stated that he was satisfied as much as 90.9%. In conclusion, spiritual care can increase patient satisfaction, especially coronary heart disease sufferers at Siti Khadijah Islamic Hospital, Palembang in 2023.

Spiritual Needs of Older Adults Living with Dementia: An Integrative Review.

Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore and Knafl method, this integrative review examined the literature from 2000 to 2022 on the spiritual care needs of PLwDs. We sought to identify characteristics of the spiritual needs of PLwDs and ways to address them. The ATLA Religion, CINAHL, PsycINFO, PubMed, and Socindex databases were used to search the literature, and 12 peer-reviewed articles met the inclusion criteria. Spiritual care needs varied across studies. Overall, findings support the importance of identifying PLwDs' religious and spiritual backgrounds to inform person-centered care. Spiritual needs were identified as verbal and non-verbal expressions related to past meaning and religious and spiritual background and were not consistently addressed in care. Providers reported observing spiritual distress in the mild stage prompting the need for spiritual care. There is a great need for dementia-specific spiritual assessment tools and spiritual care interventions to support spiritual well-being in dementia care. Spiritual care involves facilitating religious rituals and providing spiritual group therapy and religious and spiritual activities.

Building Spiritual Care Competency in Undergraduate Psychiatric Mental Health Nursing Students: A Quality Improvement Project.

Purpose: The spiritual care of patients is often overlooked in health care as many nurses are unprepared to provide competent, holistic care that addresses patients' spiritual needs. Since undergraduate academic instruction prepares nurses for practice, innovative strategies that train pre-licensure nurses to care for the spiritual needs of patients are essential. Design: A course needs assessment identified spiritual care as the most deficient competency for undergraduate psychiatric students. A three-phase quality improvement project designed to increase student awareness and practice of spiritual care included (a) development of a quality improvement plan, (b) implementation, and (c) outcome evaluation. Methods: Spiritual care was introduced into the Spring 2020 semester through didactic content and experiential practice. Additionally, an evidence-based spiritual assessment tool (i.e., HOPE questions) was integrated into the course to train students for use in clinical and simulation. Surveys were used to compare the 2019 and 2020 cohorts. Findings: Results showed a statistically significant increase in students' perception of spiritual care competency after project completion. Conclusions: Future implications include the use of similar methods to improve spiritual care competency for pre-licensure nursing students. Keywords: Spiritual care, undergraduate nurse, spiritual assessment.

Making Time and Being Present: Spiritual Care Revisited.

The COVID-19 pandemic has placed significant strain on home healthcare clinicians, shifting the focus of care to essential physical care needs. Spiritual care needs have always been present, but the pandemic has heightened recognition of the importance of spiritual care in home care. The goals of spiritual care include promoting physical healing, improving quality of life, and enhancing patient and family wellbeing. The use of a standardized spiritual assessment tool can increase provider awareness and patient expression of spiritual care needs. Spiritual care activities consist of obtaining a spiritual history, compassionate presence, mindful listening, interprofessional collaboration, and the provision of space for spiritual practices. This article provides a conceptual overview and strategies for application of spiritual care competencies.

Replika: Spiritual Enhancement Technology?

The potential spiritual impacts of AI are an under-researched ethics concern. In this theoretical essay, I introduce the established spiritual assessment tool, the Spiritual Assessment and Intervention Model (Spiritual AIM). Next, I discuss some existing and probable AI technologies, such as immersive tech and bots that have impacts on spiritual health, including the chat-bot Replika. The three core spiritual needs outlined in the Spiritual AIM are then engaged in relation to Replika—(1) meaning and direction, (2) self-worth/belonging to community, and (3) to love and be loved/reconciliation. These core spiritual needs are used to explore the potential impacts of the chat-bot Replika on human spiritual needs. I conclude that Replika may be helpful only as a supplement to address some spiritual needs but only if this chat-bot is not used to replace human contact and spiritual expertise.

Spiritual Healing: A Triple Scoping Review of the Impact of Spirituality on Burn Injuries, Wounds, and Critical Care.

Burn patients are unique because their recovery requires prolonged hospital admissions, often complicated by a myriad of medical and surgical complications as well as psychological and emotional challenges. Religion and spirituality have been linked to improved health outcomes in other medical fields. Our scoping review aimed to examine the available literature for evidence of the impact of spirituality on burns, complex wounds, and critical care to shed more light on the relationship between spirituality and the conditions treated by multidisciplinary burn center teams. We performed three systematic reviews to examine the relationship between spirituality and these conditions. Searches were performed using MeSH terms utilizing four databases (MEDLINE via PubMed, Embase, Cochrane, Web of Science, and Scopus). A systematic and independent title/abstract screening was carried out by two independent reviewers and a full-text review was followed. Our review demonstrated a clear lack of overlap between study outcomes and lack of objective spirituality measurements. Most articles primarily focused on psychological outcomes, such as stress or mental health, instead of objective measures such as wound size or scar formation. We found a trend toward better psychological outcomes in patients with more spirituality, either pre-existing or interventional. To increase comparability and uniformity of outcomes, future studies would benefit from utilizing standardized spiritual assessment tools and objective wound metrics.

Moving Beyond Spiritual Assessments: A Dynamic, Augustinian Approach to Spiritual Care of the Dying

ABSTRACT Spiritual assessment tools (SATs) have become fundamentally integrated into contemporary pastoral care, objectifying spirituality in a way that does little to appreciate its fluidity and dynamicity. In this paper, I use St. Augustine’s theology to argue that spirituality is dynamic and fluctuating, involving continuous movement and growth. To show that SATs cannot insightfully comprehend the spiritual experiences of the terminally ill, I first draw upon St. Augustine’s analysis of time, which accentuates that spirituality cannot be quantified. I then articulate St. Augustine’s account of divine deification, which shows that spirituality is comprised of incessant ascent and descent. I conclude by proposing a narrative chaplaincy approach that draws upon St. Augustine’s account of time and memory. By viewing spirituality through an Augustinian lens and implementing a dynamic narrative approach, chaplains can help instill a sense of peace in the terminally ill and cherish each patient’s fluid spiritual experiences.

The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients

This study was conducted to develop a scale to measure spiritual distress in cancer patients. A total of 69 preliminary items for the spiritual distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash's α coefficient. The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach's α was .91, and the coefficients of each subscale ranged from .78~.83. The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

Spiritual Experience in Dementia From the Health Care Provider Perspective: Implications for Intervention

Spiritual care seeks to counter negative outcomes from spiritual distress and is notably needed in dementia. Such care needs disease-appropriate customization. Employing “cognitive apprenticeship” theory’s focus on learning from contrast, we explored spiritual needs salient within dementia as related to other disease states; we aimed to inform future dementia-focused spiritual care design. Accordingly, we conducted semi-structured qualitative interviews with 24 providers who serve older adults inclusive of persons with dementia. We sampled participants purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about the nature of spiritual needs in dementia and stakeholders’ roles in addressing them. Hybrid inductive/deductive thematic analysis was employed. A thematic structure emerged with two themes: 1) spiritual experience in dementia compared to other medical conditions (sub-themes: the salience of (a) fear; (b) loss of self; (c) dementia’s progressive and incurable nature; (d) dementia’s impact on accessing faith); and 2) the need for spiritual intervention at the mild stage of dementia (sub-themes: (a) awareness in mild dementia and its influence on spiritual distress; (b) a window of opportunity). These findings pointed to possibilities for the “what” of spiritual needs and the “who” and “when” of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss early in the disease, and stakeholder training. Researchers should study the “how” of dementia-appropriate spiritual care given recipients’ cognitive and linguistic challenges. Conjointly, these efforts could promote the spiritual well-being of persons with dementia worldwide.

Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse-based education to increase understanding of the spiritual dimension in healthcare.

To examine the characteristics of spirituality as expressed by persons of colour living with serious illness. Spiritual, Religious and Existential Care, as specified in the National Consensus Project (NCP) Guidelines, is a core domain of palliative nursing. A constructionist approach to narrative analysis was used for this study and reported in accordance with the COREQ guideline. In-depth narrative interviews were conducted with 20 participants. These participants included persons of colour living with serious illness who were admitted to an acute-care hospital. Through a deductive coding approach, a codebook was created based on a broad definition of spirituality including: religion, self, family, community, nature and art/music/literature. The major themes expressed were religion, self and family. Subthemes of religion included increased faith, support of the church community and God's intervention in patients' lives. Subthemes of self included increased self-worth, self-awareness of one's place in the world and individualised transition to new meaning in life. Subthemes of family included family adding meaning and purpose to their lives, family as an important source of strength and support, wanting to regain their health to go back to caring for their families, and believing that their illness had brought their family closer together. The thematic analysis revealed a broader existential aspect of what brought value, meaning and purpose into their lives, despite their progressive physical illness. More research is needed to understand spiritual, religious or existential needs of persons of colour living with serious illness and how nurses can best support these needs. By understanding the components of spirituality, nurses can learn to recognise the signs of spiritual distress. This awareness also helps to know when a spiritual specialist is needed-either the patient's own spiritual guide(s) or the hospital chaplain. Nurses can also use spiritual assessment tools when performing a general assessment on the patient. By understanding the components of spirituality, nurses can learn to recognise the signs of spiritual distress. This awareness also helps to know when a spiritual specialist is needed-either the patient's own spiritual guide(s) or the hospital chaplain. Nurses can also use spiritual assessment tools when performing a general assessment on the patient.

The Spiritual Experience of Dementia From the Health Care Provider Perspective: Implications for Intervention.

Spiritual care aims to counter negative outcomes from spiritual distress and is beneficial to persons living with dementia. Such care needs dementia-appropriate customization. We explored the salient spiritual needs in dementia to inform future intervention development. Health care providers are well situated to observe the nature of spiritual needs across and within medical conditions. We conducted semistructured qualitative interviews with providers. We sampled purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about, for example, the nature of spiritual needs in dementia and stakeholders' roles in addressing them. Inductive/deductive thematic analysis was employed. 24 providers participated. The thematic structure consisted of 2 themes: (a) spiritual experience in dementia differs from that in other medical conditions (subthemes: fear, profound loss of self, progressive and incurable nature, and impacted ability to access faith) and (b) the need for spiritual intervention at the mild stage of dementia (subthemes: awareness in mild dementia and its influence on spiritual distress, and a window of opportunity). We learned about the potential "what" of spiritual needs and "who" and "when" of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss of self early in symptom progression, and stakeholder training. Researchers should study additionally the "how" of dementia-appropriate spiritual care. Conjointly, these efforts could promote spiritual well-being in persons living with dementia worldwide.

Australian perspectives on spiritual care training in healthcare: A Delphi study.

The aim was to to establish core components of spiritual care training for healthcare professionals in Australia. This study used the Delphi technique to undertake a consensus exercise with spiritual care experts in the field of healthcare. Participant opinion was sought on (i) the most important components of spiritual care training; (ii) preferred teaching methods; (iii) clinical scenarios to address in spiritual care training; and (iv) current spiritual assessment and referral procedures. Of the 107 participants who responded in the first round, 67 (62.6%) were female, 55 (51.4%) worked in pastoral care, and 84 (78.5%) selected Christian as their religious affiliation. The most highly ranked components of spiritual care training were "relationship between health and spirituality," followed by "definitions of spirituality and spiritual care." Consensus was not achieved on the item "comparative religions study/alternative spiritual beliefs." Preferred teaching methods include case studies, group discussion, role-plays and/or simulated learning, videos of personal stories, and self-directed learning. The most highly ranked clinical scenario to be addressed in spiritual care training was "screening for spiritual concerns for any patient or resident." When asked who should conduct an initial spiritual review with patients, consensus was achieved regarding all members of the healthcare team, with most nominating a chaplain or "whoever the patient feels comfortable with." It was considered important for spiritual care training to address one's own spirituality and self-care. Consensus was not achieved on which spiritual care assessment tools to incorporate in training. This Delphi study revealed that spiritual care training for Australian healthcare professionals should emphasize the understanding of the role of spirituality and spiritual care in healthcare, include a range of delivery methods, and focus upon the incorporation of spiritual screening. Further work is required to identify how spiritual care screening should be conducted within an Australian healthcare setting.

574 A Nurse Educational Program to Promote Spiritual Care Delivery: Development and Pilot Testing

Abstract Introduction Spiritual Care (SC) is crucial for the holistic care of patients. Findings from a needs assessment conducted on an 8-bed burn Intensive Care Unit (ICU) (n=34, 88% response rate) revealed 90.3% of nurses believed SC was important for the overall care of their patient, but only 13% felt confident to provide the religious care. Of the respondents, 77% had come across a time when they were unable to obtain SC for their patients. The survey revealed 39% were interested in obtaining education to enhance their provision of holistic care. Based on this data, we developed and pilot tested an innovative SC educational course to examine feasibility, learning, and preliminary outcomes. Methods The IRB-approved study involved a two-hour evidence-informed class developed by a burn nurse and chaplain. The course was offered on a voluntary basis for all nurses in the critical care division (5 units overall). The class consisted of PowerPoint presentation, case studies and practice utilizing spiritual care assessment tools. Data was collected before and after the class at one- and two-months post class completion. Results Participants (n=12) were mostly female (82%), Bachelors prepared (82%), affiliated as Christian (73%) and had not had spiritual education in the past (73%). Nurses also agreed the spiritual assessment tools were useful and they were confident using them. Mean total score for Nurses’ Spiritual Care Practice increased 14% over time. Practices with the largest increases included reading/offering spiritual writings to patients (67/57%) and documentation of meeting spiritual needs (40%). The Spiritual Care Perspective scale increased 7% overall with changes in the beliefs of SC being a significant part of Advanced Nursing Practice (ANP) (10% increase), the domain of APN includes SC (15% increase) and nurses should assist a patient in using his/her spiritual resources to cope with illness (9% increase). At 2-months post training, participants felt comfortable (4.25/5.0 and confident (4.0/5.0) providing SC. Conclusions SC is an essential element of holistic nursing practice that has become even more relevant in this pandemic year. Our 2-hour educational class was considered well organized, provided relevant education and tools for use, and increased nurses confidence, comfort, and documentation of providing SC to their patients.