|Year : 2020 | Volume
| Issue : 2 | Page : 100-103
Are the Nurses Competent to Give Spiritual Care?
KR Anoopa1, Annal Angeline2, Jimi Patrishia Jerome3
1 Principal, Bishop Benziger College of Nursing, Kollam, Kerala, India
2 Associate Professor cum HOD - Dept of OBG Nursing, Bishop Benziger College of Nursing, Kollam, Kerala, India
3 Bishop Benziger College of Nursing, Kollam, Kerala, India
|Date of Submission||06-Nov-2020|
|Date of Decision||24-Nov-2020|
|Date of Acceptance||26-Dec-2020|
|Date of Web Publication||08-Feb-2021|
Dr. K R Anoopa
Principal, Bishop Benziger College of Nursing, Kollam, Kerala
Source of Support: None, Conflict of Interest: None
Introduction: Spiritual care is an inseparable element of nursing. A descriptive study was conducted to assess the spiritual care competence of nurses working in the intensive care units. The objectives were to assess the spiritual care competence of nurses on six domains of spiritual care, namely assessment and implementation of spiritual care, attitude toward patient's spirituality, communication, personal support and patient counseling, referral, professionalization, and improving quality of spiritual care and to associate spiritual care competence with selected demographic variables. Materials and Methods: The study was conducted intensive care units of selected hospitals at Kollam. Fifty staff nurses were selected by purposive sampling technique. The collected data were analyzed using descriptive and inferential statistics. Results: The findings revealed that 74% of subjects reported moderate competence, 22% less competence, and 4% have adequate competence. Conclusion: The study provides evidence to guide the nurse educators and policymakers on the need to focus on preparing nurses to develop spiritual nursing care competence. Nurses' competence in spiritual care gives a holistic perspective to patient care. A well-planned training program gives more clarity to the concept of spiritual care and nurses' role in various domains of spiritual care for patients. Training programs can be planned for nurses and students on spiritual care, policy guidelines on spiritual care can be developed and implemented, which may help the nurses to enable their clients to find meaning in their experience during hospitalization.
Keywords: Competent, nurses, spiritual care
|How to cite this article:|
Anoopa K R, Angeline A, Jerome JP. Are the Nurses Competent to Give Spiritual Care?. Indian J Psy Nsg 2020;17:100-3
| Introduction|| |
Spiritual care is an inseparable element of nursing. Nurses must play a significant role in providing holistic care to patients. Nurses have identified the importance of enhancing patient's spiritual health and established nursing theories that support holistic nursing care with special mention to spiritual component. Formally spiritual care has been included in nursing curricula and nursing code, but nursing educational institutions devote little attention to the development of students in this domain of care. The result is unfamiliarity with spiritual care in the nursing profession and nurses being prepared for spiritual care.
Also accreditation agencies now mandate the inclusion of spiritual care as a part of holistic care. Nurses doubt that their own spiritual/religious believes may interfere with that of patients while providing spiritual care. Thus, nurses' awareness about their own spirituality and its relationship to caregiving is an important factor that may influence the spiritual care competence of nurses. Need for spiritual care, which is a significant element of holistic approach, can be identified for all patients, but it is found as a priority need among patients with chronic illness who needs long-term and rehabilitative care.
Accreditation standards currently include the criteria for assessing spiritual needs of patients. The Joint Commission on Accreditation of Healthcare Organization has identified in their standard, the right of patients for spiritual care and support. The North American Nursing Diagnosis Association, International 2005, gives three nursing diagnoses – spiritual distress risk for spiritual distress and readiness for enhanced spiritual well-being, which address spiritual needs/problems among patients.
Nurses often encounter people at crucial times in their life journey. In India, nurses are often confused about how to meet spiritual needs in a secular way. At times, there may be a conflict between nurses and patient's religious beliefs which may lead to a lack of understanding of the extent of spiritual needs of patients. Modernization and new technologies in the field of health care have made the current nursing practice fragmented than holistic. Researchers have confirmed that hospital patients rank spiritual care as a priority in their recovery and see adequate spiritual care as integral to overall satisfaction with care during hospitalization.
Nurses are commonly recognized for high visibility task which is needed in acute care settings, but competence in providing low visibility task in caring for patients in recovery and rehabilitation is the core of nursing care. Spiritual nursing care which has most of the component has low visibility like attentive listening, communication, empathy, reassurance, presence, thus becomes a significant component of nursing care, which may enhance spiritual well-being of the patient. A lack of preparedness in this significant aspect of care can affect the health and healing of patients.
- To assess spiritual care competence of nurses on six domains of spiritual care namely assessment and implementation of spiritual care, attitude toward patient's spirituality, communication, personal support and patient counseling, referral, professionalization, and improving quality of spiritual care
- To find the association between spiritual care competence with selected demographic variables.
| Materials and Methods|| |
The research approach used in this study was quantitative approach with descriptive design and the setting of the study was the intensive care units of Bishop Benziger Hospital at Kollam. The purposive sampling technique was used to select 50 staff nurses working in intensive care units of Bishop Benziger Hospital, Kollam. Formal permission was obtained from concerned authorities and informed consent was obtained from nurses and the data were collected on an individual basis using a tool which consisted of two sections such as demographic variables of nurses and spiritual care competence scale (SCCS, Van Leeuwen and Cusveller). SCCS is a characterized 27-item self-reporting questionnaire to assess the spiritual care competence of nurses and the data were analyzed using descriptive and inferential statistics like Chi-square.
| Results|| |
With regard to the age, the majority of the subject belongs to the age group of 31–40 years, whereas, 36% belongs to above 41 years and only 4% of the subject belongs to 20–30 years of age [Figure 1].
Out of 50 subjects, 44% are coming under 2–5 years of experience and 36% had more than 5 years of experience and only 22% had <2 years of experience [Figure 2].
|Figure 2: Distribution of subjects according to years of experience n = 50|
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Based on the distribution of subjects according to educational qualification, 70% of the subjects of the nurses had general nursing and midwifery program and only 30% were graduate nurses [Figure 3].
|Figure 3: Distribution of subjects according to educational qualification n = 50|
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Based on the distribution of subjects according to the level of competence, majority of the subjects (74%) reported moderate competence, 22% has less competence, and only 4% expressed adequate competence with a mean value of 71.82 (standard deviation: 6.2) [Figure 4].
|Figure 4: Distribution of subjects according to level of competence n = 50|
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The mean percentage score was obtained in domains of competence. Nurses reported less competence in domains like professionalization and improving quality of patient care (66%), personal support and patient counseling (62%), whereas 32% reported adequate competence in the domain of attitude toward patient's spirituality [Figure 5].
|Figure 5: Distribution of mean percentage of score obtained in domains of competence n = 50|
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[Table 1] shows that a significant association was found between the level of competence and selected demographic variables such as years of experience, marital status, and religion.
|Table 1: Association of level of competence with selected demographic variables (n=50)|
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Chi-square calculated with Yates correction calculation cell value <5 in the above [Table 1].
| Discussion|| |
The present study findings show that only 4% of the participants had an adequate level of spiritual competence. Nurses' competence in spiritual care gives a holistic perspective to patient care. A well-planned training program gives more clarity to the concept of spiritual care and nurses' role in various domains of spiritual care for patients. A study conducted by Burkhart L, William Schmidt has found a statistically significant increase in nursing students perceived ability in providing spiritual care, particularly in complex family clinical situations before and after a planned training program.
A qualitative study has explored the perceived impact of the study unit spiritual coping in illness and care on qualified nurses. Participants found the study unit as a resource for updating their knowledge on spirituality in care and increased self-awareness of their own spirituality and nursing care. They acknowledged their role as change agents to implement holistic care in collaboration with the multidisciplinary team. Recommendations were proposed to integrate the spiritual dimensions in education and patient care.
An article on the effectiveness of spiritual care interventions Tuck has reported that the stress response, quality of life, and outcome of a patient can be influenced through interventions. It also reported the potential effectiveness of the intervention for a variety of populations and clinical settings.
Research studies have observed that even nurses who have not been trained in spiritual care can provide spiritual support by incorporating, active listening to patient's spiritual concerns, observing for and facilitating adherence to their preferences, and providing a peaceful environment, in their daily practice.,,
The investigator had constrain of sample size and setting. Hence, the study finding cannot be generalized.
Implication of the study
Competence in spiritual care which can be incorporated into daily nursing care activities through adequate preparation of nurses may have long-term implication on the early recovery of patients and autonomy of nurses.
| Conclusion|| |
The study provides evidence to guide nurse educators and policymakers on the need to focus on preparing nurses to develop spiritual nursing care competence. Training programs can be planned for nurses and students on spiritual care, policy guidelines on spiritual care can be developed and implemented, which may help the nurses to enable their clients to find meaning in their experience during hospitalization.
We acknowledge Mr. Anoop J, Ex. Faculty member, of our institution for his valuable contribution to data collection.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]