Spiritual Care (spiritual + care)

Distribution by Scientific Domains

Selected Abstracts

Learning for holistic care: addressing practical wisdom (phronesis) and the spiritual sphere

Helen L. Leathard
Abstract Title.,Learning for holistic care: addressing practical wisdom (phronesis) and the spiritual sphere. Aim., This paper is a discussion of practical wisdom (phronesis) and spirituality in holistic caring and strategies to facilitate their application in nurse education. Background.,Phronesis, with its inherent spiritual qualities, is an established aspect of the persona of excellent clinical leaders. There is a strong case for recognizing the value of this characteristic in all nurses, and a strategy is required for engendering the development of phronesis during nurse education. Data sources., Electronic searches of Google Scholar and CINAHL were conducted for English language publications in the period 1996,2008. Search terms included combinations of phronesis, spirituality, health, education, pharmacology, medicines and medication education, holistic care and spiritual care. Selection of items for inclusion was based on their pertinence to the arguments being developed and their value as leads to earlier material. Discussion., The links between the attributes of effective clinical leaders and those required for holistic caring are explicated and related to phronesis, the acquisition of which involves spiritual development. An explanatory account of phronesis and its applicability to nursing leads to an explanation of how its spiritual aspects in particular might be incorporated into learning for holistic care. Reference to research in medicines-related education illustrates how the principles can be applied in nurse education. Conclusion., Nursing quality could be enhanced if adequate opportunities for acquiring phronesis through experiential learning were provided in nursing curricula. Phronesis and spiritual care could be incorporated into existing models of nursing care or new models devised to use these critical concepts. [source]

Religion and the secularisation of health care

John Paley
Aims and objectives., To assess the claim that conceptualisations of religion and spirituality should be grounded in theology, and acknowledge the global resurgence of religion. Background., Although there is widespread agreement in the nursing literature that ,spirituality' is a broader concept than ,religion,' and should be understood generically, this approximate consensus has occasionally been challenged. A recent paper by Barbara Pesut and colleagues argues that the generic view not only empties spirituality of powerful religious symbols and narratives, but underestimates the continuing social influence of religion, and its resurgence on a global scale. Accordingly, these authors suggest three principles for conceptualising spirituality and religion in health care, one of which is that conceptualisations should be grounded in philosophical and theological thinking, and should not ignore the global resurgence of religion. Method., Critical review. Conclusion., The Pesut principle privileges theology, disregarding other disciplines which theorise religion. Arguably, it privileges specifically Christian theology, the history of which suggests a politics of orthodoxy and an epistemology of authority and obedience. The global resurgence of religion is not, in fact, global, as the industrialised countries have experienced a marked shift towards secular-rational values; and the postindustrial phase of development is associated with self-expression values, which represent a challenge not merely to religious institutions (arguably an affirmation of ,spirituality') but to traditional elites and structures of all kinds. Finally, religion ,resurgent' is not an attractive model for health care, since many of its most obvious manifestations are incompatible with the ideology of health professionals. Relevance to clinical practice., In the secular societies of Europe, if not North America, there should be no expectation that nurses provide spiritual care. It is a requirement of the great separation between civil order and religion that the health services, as a public space, should remain thoroughly secular. [source]

A critical view of how nursing has defined spirituality

Janice Clarke
Aims., To offer a detailed discussion of the issue of ,lack of critique' in the literature on spirituality in nursing. The discussion will include the limited use of sources from theology and religious studies and the demand to separate spirituality and religion and will go on to examine the consequences of the resulting approach. The drive for unique knowledge to further professionalisation and the demands of inclusiveness are suggested as possible reasons for the development of the current model. The dangers and pitfalls of definition are explored. The paper suggests that theology could provide insights into explaining spirituality. Background., The last four decades have seen a proliferation of definitions of spirituality in the nursing literature. Recently, in response to their own concerns and prompts from outside the ,spirituality' community authors have suggested that we revisit this literature with a more critical stance. This paper is in response to that suggestion. During the course of a PhD supervised from a department of practical theology I have critically analysed the literature from several perspectives and this paper is one result of that review. Design., Literature review. Methods., Critical reflection on how spirituality has been defined. Conclusion., The lack of critique has produced a bias in the literature towards broad, generic, existential definitions which, together with the intentional divorce from religion and theology have led to definitions which have the tendency to result in a type of spiritual care which is indistinguishable from psychosocial care, hard to explain to patients and difficult to put into practice. Relevance to clinical practice., The acceptance of a diverse range of understandings of spirituality and a greater focus on practical ways of using it in nursing care are the direction the profession should be moving into. [source]

The effectiveness of an educational programme for nursing students on developing competence in the provision of spiritual care

René Van Leeuwen
Aim., To determine the effects of a course for nursing students on developing competence in spiritual care and the factors that might influence the effects. Background., Studies suggest that role preparation in nursing for spiritual care is poor. For the assessment of competence, few or no explicit competency framework or assessment tools seemed to be used. Design., Quasi-experimental crossover design (pre,post-test). Method., The subjects were students from Christian nursing schools in the Netherlands (n = 97). The intervention consisted of a course in spiritual care. Competencies were measured with an assessment tool, the Spiritual Care Competence Scale. Data were analysed by t -test procedures (paired-samples t -test). At T1 vignettes were added to assess the quality of the students' own analyses. These data were analysed by a Mann,Whitney test. Regression analyses were performed on the influence of student characteristics on the subscales of the assessment tool. Results., Ninety-seven students participated in this study. Analysis showed statistically significant changes in scores on three subscales of the Spiritual Care Competence Scale between groups (T1) and over time for the whole cohort of students on all subscales (T2). Clinical placement showed as a negative predictor for three subscales of the Spiritual Care Competence Scale. Experience in spiritual care and a holistic vision of nursing both showed as positive predictors on certain competencies. A statistically significant difference was observed between groups in the student analysis of a vignette with explicit spiritual content. Conclusions., The outcomes raise questions about the content of education in spiritual care, the measurement of competencies and the factors that influence competency development. Relevance to clinical practice., The results provide nurse educators with insight into the effects of education in spiritual care on students' competencies and help them consider a systematic place for spiritual care within the nursing curriculum. [source]

The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice

MPhil, McSherry Wilfred BSc
Aim., The aim of this study was to generate a deeper understanding of the factors and forces that may inhibit or advance the concepts of spirituality and spiritual care within both nursing and health care. Background., This manuscript presents a model that emerged from a qualitative study using grounded theory. Implementation and use of this model may assist all health care practitioners and organizations to advance the concepts of spirituality and spiritual care within their own sphere of practice. The model has been termed the principal components model because participants identified six components as being crucial to the advancement of spiritual health care. Design., Grounded theory was used meaning that there was concurrent data collection and analysis. Theoretical sampling was used to develop the emerging theory. These processes, along with data analysis, open, axial and theoretical coding led to the identification of a core category and the construction of the principal components model. Methods., Fifty-three participants (24 men and 29 women) were recruited and all consented to be interviewed. The sample included nurses (n = 24), chaplains (n = 7), a social worker (n = 1), an occupational therapist (n = 1), physiotherapists (n = 2), patients (n = 14) and the public (n = 4). The investigation was conducted in three phases to substantiate the emerging theory and the development of the model. Results., The principal components model contained six components: individuality, inclusivity, integrated, inter/intra-disciplinary, innate and institution. Conclusion., A great deal has been written on the concepts of spirituality and spiritual care. However, rhetoric alone will not remove some of the intrinsic and extrinsic barriers that are inhibiting the advancement of the spiritual dimension in terms of theory and practice. Relevance to clinical practice., An awareness of and adherence to the principal components model may assist nurses and health care professionals to engage with and overcome some of the structural, organizational, political and social variables that are impacting upon spiritual care. [source]

Identity and resistance: why spiritual care needs ,enemies'

John Swinton PhD
Aims., This paper explores certain key critiques of spirituality-in-nursing as they have been offered by people outside of the discipline. It argues that nurses have not taken seriously enough the recent criticism of the nature and role of spirituality in nursing. Not to listen to the ,enemies' of spirituality-in-nursing is to risk stagnation and a drift into obscurity. Background., The area of spirituality has become a growing field of interest for nurses and has produced a burgeoning body of research literature. Yet, whilst much has been written about the positive aspects of spirituality, nurses have offered almost no critique of the ways in which spirituality and spiritual care are understood, despite the fact that there are clearly certain key issues that require robust critique and thoughtful reflection. Almost all of the major criticisms of spirituality-in-nursing have come from people outside of the discipline of nursing. The paper argues that nurses need to listen carefully to the criticisms of spirituality and spiritual care offered by the ,enemies' of spiritual care in nursing. When listened to constructively, they highlight issues that are vital for the development and forward movement of this important area of nursing practice. Methods., Literature review and critical reflection on current critiques of spirituality in nursing practice. Conclusions., The paper concludes that nurses need to begin to develop spirituality as a specific field of enquiry with its own bodies of knowledge, methodologies, assumptions and core disciplines. Relevance to clinical practice., In listening to and taking seriously its ,enemies', nursing has the opportunity to establish spirituality as an important, creative and vibrant aspect of nursing practice that has the capacity to grow and respond constructively to its ,enemies', in ways that make whole-person-care a real possibility. [source]

The challenge of spiritual care in a multi-faith society experienced as a Christian nurse

ILTHE, Tonks N. Fawcett BSc
Background., Understanding the spiritual dimension of holistic nursing care is arguably regaining its centrality in the assessment of patient well being in whatever area of care. However it is argued that we are still far from having a universal agreement as to what is meant by the concept of spirituality. Aims and objectives., This paper aims to explore some of the definitions and models of spirituality and determine what is meant by spiritual needs. Taking the perspective of a Christian nurse, the potential tension between the nature of spiritual care and evidence-based professionalism is explored. Conclusion., The exploration reveals the challenges faced by a nurse who wishes to administer this spiritual care and holds a personal commitment to the Christian faith. Relevance to clinical practice., Acknowledging and debating the challenge of spiritual care is arguably the first step towards meeting optimally this need in our patients. The dilemma that may need to be further explored within the context of nursing care is how a nurse, holding and operating within one particular belief (e.g. Christianity) can offer the ideal of spiritual care to patients who hold other, quite different beliefs. [source]

A conversation on diverse perspectives of spirituality in nursing literature

Barbara Pesut PhD RN
Abstract, Spirituality has long been considered a dimension of holistic palliative care. However, conceptualizations of spirituality are in transition in the nursing literature. No longer rooted within religion, spirituality is increasingly being defined by the universal search for meaning, connectedness, energy, and transcendence. To be human is to be spiritual. Some have argued that the concept of spirituality in the nursing literature has become so generic that it is no longer meaningful. A conceptualization that attempts to be all-encompassing of what it means to live a human life has a tendency to render invisible the differences that make life meaningful. For palliative patients in particular, a generic approach may obscure and relativize the important values and beliefs that inform the critical questions that many patients grapple with at end of life. A different approach to conceptualizing spirituality can be achieved through the use of typologies. Rather than obscuring difference, categories are constructed to illuminate how spirituality is understood within a diverse society and how those understandings might influence patient,provider relationships. What follows in this article is a dialogue illustrating one typology of spirituality constructed from a review of selected nursing literature. The hypothetical narrator and three participants, representing the positions of theism, monism, and humanism, discuss their understandings of spirituality and religion, and how those understandings influence the intersections between nursing ontology, epistemology, and spiritual care. [source]

Nursing students' perceptions of the importance of caring behaviors

Zahra Khademian
Abstract Title.,Nursing students' perceptions of the importance of caring behaviours Aim., This paper is a report of a study to determine the nursing students' perceptions of the importance of caring behaviours. Background., Caring has been considered as the essence of nursing. It is believed that caring enhances patients' health and well-being and facilitates health promotion. Nursing education has an important role in educating the nurses with adequate caring abilities. Method., Ninety nursing students (response rate 75%) responded to a questionnaire consisting of 55 caring behaviours adapted from items on Caring Assessment Questionnaire (Care-Q). Behaviours were ranked on a 5-point Likert-type scale. The caring behaviours were categorized in seven subscales: ,accessibles', ,monitors and follows through', ,explains and facilitates', ,comforts', ,anticipates', ,trusting relationship' and ,spiritual care'. Data were collected in Iran in 2003. Findings., The students perceived ,monitors and follows through' (mean = 4·33, SD = 0·60) as the most and ,trusting relationship' (mean = 3·70, SD = 0·62) as the least important subscales. ,To give patient's treatments and medications on time' and ,to do voluntarily little things,' were the most and least important caring behaviours, respectively. ,Explains and facilitates' statistically and significantly correlated with age (r = 0·31, P = 0·003) and programme year (r = 0·28, P = 0·025). Gender had no statistically significant influence on students' perceptions of caring behaviours. Conclusion., Further research is needed, using longitudinal designs, to explore nursing students' perceptions of caring behaviours in different cultures, as well as evaluation studies of innovations in curriculum and teaching methods to improve learning in relation to cultural competence and caring concepts. [source]