Nurses' experiences assessing the spirituality of terminally ill patients in acute clinical practice
Abstract
Aim: To explore and describe how nurses define spirituality and incorporate spiritual care into their clinical practice. Method: A two-phase, mixed-methods, explanatory descriptive design was adopted. Sixteen nurses working in an acute medical ward completed a purpose-designed questionnaire. This was followed by unstructured focus group interviews. The data generated was analysed using a thematic coding process. Findings: Four themes were identified: understanding spirituality, assessment of spirituality, difficulties in meeting spiritual needs, and education. The exploration of the nurses’ experiences showed that they did not clearly define or recognize the concept of spirituality, but they did recognize an aspect of patient care that required a transition away from a technical to a humane response. Conclusion: Despite the lack of a clear definition of spirituality and application of an established spiritual assessment tool, nurses do assess spirituality and incorporate spiritual care into their clinical practice, even in acute care settings.
References
- (2008) Spiritual crisis: a concept analysis. J Adv Nurs 65(2): 454–61 Crossref, Medline, Google Scholar
- (2005) Spirituality and medicine: complementary perspectives. Spirituality Health Int 6(2): 71–80 Crossref, Google Scholar
- (2009) Mixed Methods Research for Nursing and the Health Sciences. Wiley-Blackwell, Oxford Crossref, Google Scholar
- (2008) Spiritual care: is it the nurse's role? Spirituality Health Int 9(4): 270–84 Crossref, Google Scholar
- (2008) Memoing in qualitative research. Probing data and processes. J Res Nurs 13(1): 68–75 Crossref, Google Scholar
- (2009) Data collection in mixed methods research. In: S AndrewEJ Halcomb eds. Mixed Methods Research for Nursing and the Health Sciences. Wiley-Blackwell, Oxford Crossref, Google Scholar
- (1998) Advanced Design in Nursing Research. 2 edn. Sage Publications, California Google Scholar
- (2008) An experiential theory of spiritual care in nursing practice. Qual Health Res 18(7): 928–38 Crossref, Medline, Google Scholar
- (2002) Spirituality: Living Our Connectedness. Delmar Thomson Learning, Albany, NY Google Scholar
- (2007) Understanding Nursing Research. Building An Evidenced-Based Practice. 4 edn. Saunders, St Louis, Missouri Google Scholar
- (1989) Spiritual Dimensions of Nursing Practice. Saunders, Philadelphia PA Google Scholar
- (1991) Spirituality: integral to quality care. Holist Nurs Pract 5(3): 67–76 Crossref, Google Scholar
- (2007) Designing and Conducting Mixed Methods Research. Sage Publications, Thousand Oaks, California Google Scholar
- (2004) Nursing the dying: essential elements in the care of terminally ill patients. Int Nurs Rev 51(3): 149–58 Crossref, Medline, Google Scholar
- (2005) A discussion of the concept of spirituality. Nurs Sci Q 18(2): 157–62 Crossref, Medline, Google Scholar
- (1997) The meaning of spirituality: a literature review. J Adv Nurs 26(6): 1183–8 Crossref, Medline, Google Scholar
- (2000) Spirituality and health: what we know, what we need to know. J Soc Clin Psychol 19(1): 102–16 Crossref, Google Scholar
- (2009) From rigour to trustworthiness: validating mixed methods. In: S Andrew,EJ Hal-comb, eds. Mixed Methods Research for Nursing and the Health Sciences. Wiley-Blackwell, Oxford Google Scholar
- (1996) Focus on spiritual well-being: harmonious inter-connectedmess of mind-body-spirit—use of the JAREL spiritual well-being scale. Geriatr Nurs 17(6): 262–6 Crossref, Medline, Google Scholar
- (1981) A silent conspiracy: coping with cancer patients on an acute surgical ward. J Adv Nurs 6(3): 221–9 Crossref, Medline, Google Scholar
- (2008) Concerns about measuring “spirituality” in research. J Nerv Ment Dis 196(5): 349–55 Crossref, Medline, Google Scholar
- (2003) Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. J Adv Nurs 44(1): 69–80 Crossref, Medline, Google Scholar
- (2010) Research Methods for Nursing and Healthcare. Pearson Education Limited, Harlow Google Scholar
- (1998) The concept of spirituality in nursing theories: differing world-views and extent of focus. J Adv Nurs 27(2): 294–303 Crossref, Medline, Google Scholar
- (2002) Dilemmas of spiritual assessment: considerations for nursing practice. J Adv Nurs 38(5): 479–88 Crossref, Medline, Google Scholar
- (1998) The debates emerging from the literature surrounding the concept of spirituality as applied to nursing. J Adv Nurs 27(4): 683–91 Crossref, Medline, Google Scholar
- (2008) A critical incident study of nurses' responses to the spiritual needs of their patients. J Adv Nurs 33(4): 446–55 Crossref, Google Scholar
- (2008) Spirituality in Nursing. Standing on Holy Ground. 3rd edn. MA Jones and Bartlett, Sudbury Google Scholar
- (1998) The Human Becoming School of Thought —A Perspective for Nurses and Other Health Professionals. Sage Publications, California Google Scholar
- (2006) To describe or prescribe: assumptions underlying a prescriptive nursing process approach to spiritual care. Nurs Inq 13(2): 127–34 Crossref, Medline, Google Scholar
- (2004) Nursing Research. Principles and Methods. 7th edn. Lippincott Williams and Wilkins, Philadelphia, PA Google Scholar
- (1992) An emerging paradigm for the investigation of spirituality in nursing. Res Nurs Health 15(5): 349–57 Crossref, Medline, Google Scholar
- (2003) Spirituality and the Practice of Healthcare. Palgrave, McMillan, Hampshire Google Scholar
- (1990) Nursing: Science of Unitary, Irreducible, Human Beings. National League for Nursing, New York Google Scholar
- (2001) Nurses' attitudes to terminally ill patients. J Adv Nurs 34(3): 338–45 Crossref, Medline, Google Scholar
- (2009) Principle-based concept analysis: recognition in the context of nurse-patient interactions. J Adv Nurs 65(9): 1965–75 Crossref, Medline, Google Scholar
- (2002) Towards clarification of the meaning of spirituality. J Adv Nurs 39(5): 500–9 Crossref, Medline, Google Scholar
- (2003) Nurses caring for the spirit: patients with cancer and family caregiver expectations. Oncol Nurs Forum 30(4): 585–90 Crossref, Medline, Google Scholar
- (2009) The validity and reliability of an instrument to assess nursing competencies in spiritual care. J Clin Nurs 18(20): 2857–69 Crossref, Medline, Google Scholar
- (2005) Clinical holistic medicine: the existential crisis—life crisis, stress and burnout. Scientific World Journal 5: 300–12 Crossref, Google Scholar
- (2005) Spiritual distress in adult cancer patients: toward conceptual clarity. Holist Nurs Pract 19(6): 285–94 Crossref, Medline, Google Scholar
- (2002) An Introduction to the Sociology of Health and Illness. Sage, London Crossref, Google Scholar



