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Patients in specialist mental healthcare services who are at risk of suicide may experience their struggles as existential in nature. Yet, research on meaning in life has been relatively scarce in suicidology. This qualitative study aimed to explore how patients at risk of suicide perceived their encounters with specialist healthcare professionals after a suicide attempt (SA), with special reference to meaning in life experiences. The study was conducted in specialised mental healthcare services in Norway. Data were collected via individual interviews with eight patients aged 20–75 years. Using a four-step procedure, the interviews were analysed by systematic text condensation. The participants understood their feelings of shame, self-contempt and challenging life experiences as contributing factors to their SA. They perceived that existential themes in relation to financial difficulties, shame and trauma were resolved, while issues associated with the SA, such as death, loss and beliefs, were given less attention. The participants were either ambivalent about continuing to live or wished to rebuild a meaningful life. Overall, their experiences of meaningfulness were hampered. Assisting patients with meaning in life experiences may help them alter their life interpretations and increase their ability to rebuild their lives as meaningful. The present study should be seen as a contribution to meaning-informed approaches in specialist mental healthcare services. More research is needed to equip healthcare personnel in their overall aims of preventing suicide and supporting patients at risk in their efforts to live a meaningful life Patients at risk of suicide and their meaning in life experiences

Background: The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic. Materials and methods: This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health. Results: Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p

As research has become part of chaplaincy, many chaplains become involved in research, often in the double-role of chaplain-researcher. Despite the increase of involvement in research, how conducting research benefits chaplains’ professional care for clients has not been studied. The present study aimed to describe how chaplains perceive the impact of participation in the Dutch Case Studies Project (CSP) on their professional expertise and positioning in theinstitution. A survey was distributed among participants of the CSP (N=50) and was completed by 48 participants. We found that participation in research contributed to the expertise of chaplains (e.g., its goal-orientation, the use of theory and method) and their positioning as they try to legitimate their profession. This study thus substantiates the presumption that chaplains’ engaging in research as chaplain-researcher contributes to the perceived improvement of the quality of chaplaincy care and its legitimation.

This study was carried out to determine the relationship between the spiritual orientation and psychological well-being levels of inpatients diagnosed with COVID-19 and the factors affecting the psychological well-being of patients. This cross-sectional study was conducted with 136 patients diagnosed with COVID-19 who were hospitalized in the COVID-19 clinics of a state hospital between May and July 2021 and volunteered to participate in the study. To collect the study data, the Personal Information Form, Spiritual Orientation Scale (SOS) and Psychological Well-Being Scale (PWBS) were used. There was a positive correlation between the mean scores obtained from the overall SOS and PWBS (r = .335, p < .001). Of the participants, those who were women, who were over 65-year-old patients, who were hospitalized for 8-14 days and who had chronic diseases had lower levels of psychological well-being. The inpatients with a diagnosis of COVID-19 had high levels of spirituality and psychological well-being. It was found that there is a relationship between the spiritual orientation and psychological well-being of inpatients hospitalized with the diagnosis of COVID-19. The fact that nurses take spirituality into account while providing care to patients diagnosed with COVID-19 may be effective in protecting their patients' mental health.

Aim: To explore how mental health professionals address spiritual care for outpatients in weekly multidisciplinary care meetings (MDM), and to explore the barriers and facilitators in the ways health professionals address spiritual care in those meetings. Method: Two teams of mental health professionals providing care for psychiatric outpatients are included. Qualitative data were collected from audio recordings of multidisciplinary meetings and from focus-group interviews afterwards. Data were analysed using ‘open coding’. Results: Spiritual care was not frequently addressed mostly due to the requirements of the health insurance reimbursement system. Aspects of spirituality addressed in these meetings pertained mainly to meaningful daily activities. Addressing spiritual care was facilitated, on the other hand, by a holistic focus on health and recovery-oriented care. Conclusion: In ambulatory mental healthcare spirituality is sparsely addressed and, when addressed, few aspects of spirituality come into view. Facilitating healthcare professionals’ awareness of their clinical perspective is an essential step to improve spiritual care for psychiatric outpatients.

Aims and objectives To develop and psychometrically test a self-assessment tool that measures undergraduate nursing and midwifery students’ perceptions of spiritual care competence in health care practice. Background Spiritual care is part of nurses/midwives’ responsibility. There is a need to better benchmark students’ competency development in spiritual care through their education. The EPICC Spiritual Care Education Standard served as groundwork for the development of the EPICC Spiritual Care Competency Self-Assessment Tool. Design Cross sectional, mixed methods design. A STROBE checklist was used. Methods The Tool (available in English, Dutch and Norwegian) was developed by an international group. It was tested between July–October 2020 with a convenience sample of 323 nursing/midwifery students at eight universities in five countries. The Tool was tested for validity using Kaiser–Meyer–Olkin (KMO) test, exploratory and confirmatory factor analysis, one-way ANOVA and independent samples t test. The reliability was tested by Cronbach's alpha coefficient. Qualitative data were analysed using thematic analysis. Results The KMO test for sampling adequacy was 0.90. All, but two, items were related to the same factor. Cronbach's alpha coefficient for the Tool was 0.91. Students found the Tool easy to use, and they gained new insights by completing it. However, students felt that some questions were repetitive and took time to complete. Conclusions The Tool has construct and discriminant validity, and high internal consistency (is reliable). In addition, students found the Tool useful, especially in early stages of education. Relevance to clinical practice The Tool affords student nurses and midwives the opportunity to self-evaluate their knowledge, skills and attitudes about spirituality and spiritual care. The Tool offers students, educators and preceptors in clinical practice a tangible way of discussing and evaluating spiritual care competency.

PURPOSE: Although there exists some literature on the psychosocial elements of health between patients with and without spiritual care, less information is available on hospital health outcomes. Hence, we aimed to describe and compare health care utilization and outcomes among medical oncology patients who received and did not receive spiritual care consultation during inpatient admission. METHODS: We conducted a retrospective chart review of medical oncology patients admitted to Yale New Haven Hospital between January 1, 2018, and December 31, 2020, to compare hospital outcomes between patients with and without spiritual care. RESULTS: Thirty-one thousand six hundred twenty-three patients were included, of whom 11,053 (35%) received a chaplain spiritual care visit and had a spiritual care note. Patients who received spiritual care were older and sicker. Readmission rates within 30 days were greater in the spiritual care group (OR = 1.07; P = .018). In addition, patients receiving spiritual care were at greater odds of increased length of stay (β = 4.92; P < .0001), intensive care unit admission (OR = 2.98; P < .0001), hospital death (OR = 1.46; P < .0001), and emergency department visit within 30 days of discharge (OR = 1.17; P < .0001). CONCLUSION: Patients who were older and sicker had greater spiritual care utilization than their younger and healthier counterparts. Spiritual care assessment of existential distress, complex grief, and faith-based support may be positively associated not only with patient care and quality of life but also with health care utilization and outcomes.

PURPOSE: The benefit of spiritual care for patients is well described, but little is known about the role of spiritual care in transgender and nonbinary patients recovering from gender affirming surgeries (GASs). METHODS: A single-center retrospective chart review was performed on patients who underwent GAS in 2017. Demographic information, surgery type, and chaplains' narrative notes were examined. RESULTS: A total of 145 chaplain visits were identified in 103 inpatient stays among 98 patients at the Mount Sinai Center for Transgender Medicine and Surgery in New York. Analysis was performed on narrative notes authored by a single chaplain, which included 132 visits among 78 transfeminine and 11 transmasculine patients. Fifty-four patients (61%) expressed gratitude for the chaplain visit and/or hospital experience overall. Seven patients (8%) described movement between religious denominations over the course of their lives, and 7 (8%) described supportive belief systems. Fifty-seven patients (64%) had a family member or friend present during the perioperative process, 13 (15%) described support systems, and 9 (10%) described supportive practices, activities, and/or coping methods. Twenty-one patients (24%) expressed concerns about current symptoms or the recovery process, and 32 (36%) received a prayer or blessing from the chaplain. Fifty-two patients (58%) consented to a follow-up call. CONCLUSION: Almost 50% of patients expressed gratitude for the chaplain's visit and more than half consented to a follow-up call from the chaplain, suggesting a chaplain can provide a welcome layer of support to postoperative GAS patients. The authors recommend integrating spiritual care into perioperative care.

There is an international movement towards integrated care. This systema- tized literature review studied healthcare chaplaincy spiritual care interventions that support adult mental health by integrating health and social care. Seventeen relevant studies were found. One analysed individual and family care in a general hospital. Twelve described one-to-one community-based interventions, of which ten concerned general practice healthcare centres. Four involved groups supporting mental health in hospitals or community-centres. Two studies used qualitative approaches, seven quantitative and eight mixed methods. The quality of evidence for the outcomes of interventions was examined. The review found that studies demonstrated shifts in healthcare professionals’ working practices anticipated by Paterson (2014), from hospital towards community bases, from treatment of individuals towards empowering ser- vice users to self-manage their health, and in mental health contexts from treatment of individuals towards care in groups.

Faith community nurses receive additional education in holistic health and intentional spiritual care, including self-caring. This study used an online survey to explore self-caring practices of faith community nurses and clinical nurses. Despite sample limitations, faith community nurses reported significantly higher levels of self-caring practices than clinical nurses.

Contains fulltext : 291198.pdf (Publisher’s version ) (Open Access) BACKGROUND: During the course of their disease, patients are, apart from suffering physical discomfort, also confronted with psychological, social, and spiritual challenges. However, healthcare professionals often lack the knowledge and skills to address the spiritual dimension and are in need of support for taking this responsibility. Spiritual caregivers are experts in spiritual care, but their contribution to the integration of this care by other healthcare professionals is largely unknown. OBJECTIVE: The aim of this study was to investigate how Dutch spiritual caregivers view their role in increasing the integration of spiritual care in daily healthcare practice as provided by other healthcare professionals in the Netherlands, and how they address this role. METHODS: An online survey was conducted from May until June 2021 among spiritual caregivers working in Dutch healthcare. Data were analysed using descriptive statistics. RESULTS: The majority of the 174 respondents answered that they already fulfil a role in the integration of spiritual care by, for example, providing education, coaching on the job, or participating in multidisciplinary consultation. However, the majority of respondents experienced barriers to their contribution, such as confusion of terminology and use of language while collaborating with other healthcare professionals and reluctance to share information. CONCLUSIONS: While spiritual caregivers realise having the potential to make important contributions to the further process of integration of spiritual care into the daily practice of other healthcare professionals, some practices and perceptions, especially from within their own discipline, may hamper this.

Spiritual care is a critical aspect of end-of-life care that is often undervalued and underaddressed by hospice health care teams. The purpose of this quality improvement project was to determine if the implementation of an evidence-based spiritual care protocol changed practices regarding the initial assessment of spiritual needs, frequency of reassessment of needs, the inclusion of spiritual interventions, and staff perspectives on spiritual care. The preimplementation and postimplementation data evaluation displayed increased compliance with spiritual needs assessment within 5 days of admission, increased reassessment intervals, an increase in the percentage of interactions that included spiritual interventions, and improved staff perspectives on spiritual care. The findings of the study support implementation of a spiritual care protocol in hospice patients.

Fear and anxiety can affect surgery outcomes. Spirituality is one of the basic aspects of human beings. This study determined the effect of spiritual care on the fear and anxiety of orthopaedic surgery candidates. A spiritual care programme was implemented for the experimental group. The results showed the spiritual care could reduce the anxiety and fear of orthopaedic surgery candidates. Therefore, nurses should pay more attention to spiritual care and receive the necessary training.

Context Spiritual care (SC) is central to palliative care. However, a mismatch between patients’ desire for SC and physicians’ SC provision remains. The shortage of specialty-trained palliative physicians, necessitates that all physicians provide primary palliative care, including SC. Although several quantitative studies explore physicians’ barriers to SC, few qualitative studies and no longitudinal studies exist. Objective To gain in-depth understanding of factors influencing physicians’ ability to provide SC over time. Methods A 20-year longitudinal, individual interview study. In study year-1, we interviewed all residents in a USA primary care residency (full study-group) regarding SC beliefs, experiences and skills. The longitudinal study-group (PGY1 subgroup) was interviewed again in study-years 3, 11, and 20. Interviews were audio-recorded and transcribed. Four researchers analyzed transcripts using a grounded theory approach. IRB approval was obtained. Results We analyzed 66 interviews from 34 physicians. Physicians had diverse personal spiritual beliefs. Seven themes emerged from both groups (response rate 89%): patients’ needs; practice setting; beliefs regarding physician's role; personal spiritual beliefs; SC training; life experiences (professional, personal); self-care and reflection. Longitudinal interviews revealed thematic evolution and interactions over 20-years: patients’ needs and physicians’ belief in whole-person care remained primary motivators; cross-cultural SC communication training diminished impact of personal spiritual beliefs and worries; life experiences enhanced SC skills; work environment helped or hindered SC provision; and spiritual self-care/reflection fostered patient-centered, compassionate SC. Conclusion Facilitating SC provision by nonpalliative care specialists is complex and may require both individual and systems level interventions fostering motivation, SC skill development, and supportive work environments.

The subject-matter of the paper involves issues related to the use of evidence from hearing a priest as a witness in jurisdiction tax proceedings by public administration bodies. The author emphasizes that pursuant to Article 193 point 3 of the Tax Ordinance Act priests of legally confirmed religions may not witness on facts that are subject to the seal of confession. However, other information obtained by the priest – under the broadly understood “spiritual care” – is not subject to the above absolute evidentiary prohibition. This is why the author brings in a de lege ferenda postulate to introduce to Article 195 point 3 of the Tax Ordinance Act, as modelled on i.a. the 1934 Tax Ordinance Act, the so-called “spiritual/pastoral confidentiality” which would relate to all information obtained by the clergy of legally confirmed beliefs from a faithful when performing their “pastoral functions”, but not stricte related to confession only.

Hospitalized persons want their spiritual needs addressed and discussed by the healthcare team, but medical providers and nurses lack the necessary training. Patients want chaplaincy care, but very few receive it, and little is known about utilization factors. To identify the population characteristics associated with the utilization of chaplaincy services, hospitalization data from March 2012 to July 2017 were analyzed (N = 15,242 patients). Religiously affiliated individuals and those with the most acute health needs were more likely to receive chaplaincy care and received more total care. Patient-centered healthcare models may need to evaluate strategic integration of spiritual care beyond reactive spiritual care provision.

Spiritual care remains a neglected dimension in the context of living in residential aged care facilities. Using a grounded theory methodology, in-depth interviews were conducted with 17 Nepalese a...

TARAMAPUBMED Our study was conducted to determine the spiritual care needs and death anxiety levels of individuals diagnosed with COVID-19. The population consisted of patients who were diagnosed with COVID-19 in Turkey. The mean total Spiritual Care Requirements Scale score of the participants was 67.05±26.30. The mean VAS for Death Anxiety score of the participants was 8.82±1.26. In our study, it was found that the patients diagnosed with COVID-19 had an increased need for spiritual care and high levels of anxiety about death.

Demographic changes in Australia have led to an increase in both religious diversity and the number of people who do not nominate a faith affiliation at hospital admission. Models of chaplaincy have shifted from clerical and largely male to an increasingly skilled and diverse spiritual care workforce appointed directly by health services. This study uses survey and in-depth interview methods at an inner-city Australian hospital to examine patient preferences for hospital chaplaincy provided by faith communities, and the importance of faith affiliation compared to other spiritual care provider characteristics. Survey results indicate that of 110 respondents, a high proportion (74%) prefer spiritual care to be provided by a person of the same faith. However, when considered relative to other characteristics, faith affiliation was not as important as kindness, listening skills and a non-judgmental attitude. Our findings have implications for workforce planning and educating. Further research in different settings and with different populations will make the findings more generalizable.

Background Spirituality is a fundamental dimension of our human nature that impacts on medical care and yet is relatively neglected by medical education courses in Australia. Aim This systematic review was conducted to assess the curriculum content currently used to develop medical student understanding of, and engagement with, spirituality in the context of patient care. Methods Studies published in English from 2010 to the review date were included in order to focus on the most recent curricula. Studies included medical students in undergraduate or postgraduate programs, doctors in resident training programs, and registrars. Interventions considered for inclusion were curriculum modules on communication skills in spirituality, spiritual needs assessments and holistic care planning. Six databases including PubMed, Scopus, PsycINFO, Embase, Medline, and CINAHL were searched electronically using the following keywords and MeSH search terms:- 'medical students', 'doctor', 'physician', 'spirituality', 'spiritual care', 'religion', 'education', 'history taking' and 'communication skills training' from 2010 to 2020. Results For 342 articles, three researchers screened the titles and abstracts; disagreements were resolved by discussion. Full-text articles were assessed for eligibility based on study and report characteristics: 17 papers were included in the analysis. Curriculum content of each study was reviewed. The following key features were employed frequently: chaplain shadowing, communications skills training, self-reflection, examining evidence and relationship building. Conclusion This review has determined the core content, aims and objectives to guide construction of spirituality curricula in Australian medical education. This article is protected by copyright. All rights reserved.

Although religiosity is a strong feature of Brazilian people, the integration of spirituality in palliative care (PC) has been a challenge for health care professionals. In order to evaluate the spiritual resources used by family members of patients in PC, this work presents the results of the research carried out with 50 family members. The Satisfaction with Life Scale, Centrality of Religiosity Scale, Spiritual/Religious Coping Scale, Religious and Spiritual Struggles Scale, and Attachment to God Inventory were applied. The prevalence of positive spiritual/religious coping was very high (76%) or high (6%). There was a strong correlation between positive spiritual/religious coping and centrality of religiosity (r = 0.805; SD = 0.87). There was a moderate negative correlation between the avoidant attachment to God and centrality of religiosity (r = -0.611; SD = 1.24) and positive spiritual/religious coping (r = -0.575; SD = 1.37). There was a moderate positive correlation between the anxious attachment to God and spiritual struggles (r = 0.515; SD = 0.76) and negative spiritual/religious coping (r = 0.555; SD = 0.616). These results suggest that spiritual/religious resources are present in family members of patients in PC. These resources have been mostly ignored by the multidisciplinary team. Findings provide an evidence base for training health care professionals to better integrate spirituality in PC settings.

The purpose of this article is to research han (an oppressed feeling in Korea) through spiritual approaches including self psychology. Han is an oppressive feeling in Korean society. This han, caused by splitting, can be a place for the beginning of healing. One can invest one’s instinctual energy in the right place in the feeble self, according to one’s deepest needs there, in that spot of fragility. Many Koreans have been suffering from a deceptive self-image and do not feel deserving of love or care because of the vicious han-ridden circle. If Koreans can attain healthy self-object experiences, they will no longer feel fragility in themselves

A mudança de papéis, as perdas e as transformações físicas que caracterizam o contexto da velhice levantam a pergunta sobre o papel da espiritualidade neste cenário. O estudo objetiva analisar o modo como residentes de Instituições de Longa Permanência para Pessoas Idosas (ILPIs) utilizam a espiritualidade como recurso para o enfrentamento (coping) do estresse e do sofrimento. A pesquisa foi realizada em 18 ILPIs da região Norte do Paraná, com 188 participantes. Trata-se de um estudo descritivo, com abordagem quantitativa com estudo de campo de corte transversal. Os dados foram coletados a partir da aplicação da Escala de Coping Espiritual Religioso (CER BREVE), da Escala da Centralidade da Religiosidade e questionário sociodemográfico. Os resultados apontam média da amostra do CER Positivo (M=4,14 e DP=0,78) e o CER Negativo (M=1,23 e DV=0,49). A amostra analisada (4,0 a 5,0) indica que a religiosidade é central na vida da pessoa idosa institucionalizada, considerada altamente religiosa. Conclui-se que as pessoas idosas reconhecem a importância da espiritualidade/religiosidade e se beneficiam dela para enfrentar os problemas e superá-los. Fornecer treinamento para o cuidado espiritual de pessoas idosas pode ser uma grande contribuição da Teologia a fim de promover melhores cuidados em ILPIs.

Purpose of review The purpose of this paper is (1) to provide insight in the palliative care needs of patients with COVID-19; (2) to highlight the challenges of COVID-19 for palliative care; and (3) to highlight developments in COVID-19 palliative care. Recent findings Patients with serious COVID-19 have palliative care needs in all domains: physical, psychological, social and spiritual. COVID-19 palliative care is confronted with many challenges, including: the uncertain prognosis, resource limitations, challenges regarding advance care planning, lack of guidance, limited multidisciplinary collaboration, need for remote communication, restrictions in family visits, and burden for clinicians. Palliative care responded with many developments: development of services; integration of palliative care with other services; tools to support advance care planning, (remote) communication with patients and families, or spiritual care; and care for team members. Summary Palliative care has an important role in this pandemic. Palliative care rapidly developed services and opportunities were found to support patients, families and clinicians. Further developments are warranted to face future demands of a pandemic, including integrated palliative care and education in palliative care skills across all specialties. Intervention studies are needed to enable evidence-based recommendations for palliative care in COVID-19.

The text deals with the experience of Czech hospital chaplains in 2020. Specifically, it concerns the period during the spring and autumn waves of the pandemic caused by the spread of the SARS-CoV-2 virus which leads to a viral disease known as covid-19. The article builds on data obtained through an online questionnaire and subsequent ten interviews with hospital chaplains. The results of the research are presented in four thematic blocks: chaplain and institutions, chaplain and staff, chaplain and patient, and the chaplain himself. Based on a qualitative analysis of the data, we conclude that the pandemic affected the self-concept of many chaplains. It mainly depended on their effectiveness, that is, the possibility of applying their skills, in the hospital during the pandemic. In many cases, the pandemic crisis has accelerated the development of relations with the institution and staff, for better or worse. The position of the chaplain in the hospital before the outbreak of the pandemic proved to be crucial. The work with patients themselves did not usually undergo a fundamental change; the chaplains often functioned here as a substitute for forbidden visits. At the end of the article, we present some practical recommendations resulting from our data.

Background: The provision of spiritual care is a key component of high-quality patient-centered care, particularly in the intensive care unit (ICU). However, the integration of spiritual care into the care of patients in the ICU is variable, especially at the end of life, which may be due in part to poor or incomplete provider knowledge of the work of chaplains. Objective: To characterize the care and services provided by chaplains to patients in an ICU at the end of life and/or their families. Design: A retrospective chart review was performed to identify all patients admitted over a three-month period to an ICU who had visits with a chaplain and an ICU course that ended in death, discharge to a palliative care facility or discharge to hospice. Subjects/setting: Twenty-five chaplains at a U.S. medical center. Measurements: Qualitative analysis was performed using directed content analysis on the notes written by the chaplains. Results: Qualitative analyses of the chaplain notes revealed four broad themes regarding the activities of chaplains in the ICU with respect to patients and families. These were that chaplains provide comfort to patients and family facing the end of life, provide prayers with a variety of purposes, assist in supporting family members through complex medical decision making, and provide connections to appropriate resources. Conclusions: Chaplains contribute to the care of patients in the ICU through a wide range of activities that demonstrate the unique intermediary and collaborative role chaplains can play within the health care team at the end of life in the ICU.

Military personnel deployed to war zones or assigned to other morally challenging military duties are likely to be exposed to potentially morally injurious events (PMIE) that may inflict a moral injury (MI). This qualitative study formed ‘Phase 1’ of a larger study into PMIEs experienced by Australian veterans and the potential pastoral/spiritual care role of chaplains. Two seminars were conducted that involved 10 veterans being interviewed and audio recorded about their deployment experiences to evaluate whether there was any evidence among Australian veterans of a PMIE. Narrative data analysis indicated that all participants had been exposed to, or were involved in, a PMIE of one kind or another. Seven key themes were identified from the analyzed qualitative data: (i) immoral acts, (ii) death and injury, (iii) betrayal, (iv) ethical dilemmas, (v) disproportionate violence, (vi) retribution and (vii) religious/spiritual issues. Given this preliminary PMIE evidence identified, there is a need for further research, as well as the development of a suitable moral injury assessment scale appropriate for Australian veterans. Furthermore, given the ethical, moral, and spiritual issues involved, the implementation of a rehabilitation program suitable for Australian veterans which can be provided by chaplains is also suggested—namely ‘Pastoral Narrative Disclosure.’ It is argued that moral injury needs to be recognized, not just as an issue affecting individual personnel and their families, but is also a community health, organizational and government responsibility.

Combat trauma experienced in a warzone can hamper the physical, mental, and spiritual health of military service members and Veterans for years afterward. Spiritual care for combat trauma is designed to help service members and Veterans find meaning and purpose in their experiences. One such spiritual care program is REBOOT Combat Recovery, a 12-week, Christian-based course led by trained volunteers across the country. An in-depth investigation of the REBOOT program is needed to advance knowledge of spiritual care for combat trauma and to assess the course in attendees��� own words. Semi-structured interviews were conducted with 40 course graduates. Experiences of the course were positive. Interviewees identified the program���s emphasis on peer fellowship, spirituality, and the roots of distress as reasons for its effectiveness (RQ1). The most helpful aspects of the program involved the hospitality and family focus; targets for improvement included maintaining fidelity to the curriculum and offering opportunities for continuity upon graduation (RQ2). Interviewees described a variety of ways the course affected their view of self, their relationship with God and others, and their perceptions of combat trauma (RQ3). These findings are valuable for enriching spiritual care, in general, and enhancing the REBOOT Combat Recovery program, in particular.

One of the essential non-pharmacological treatments for patients with chronic diseases are psychosocial supports and counselling services such as spiritual psychotherapy. Although several preliminary studies represent the effects of counselling and spiritual psychotherapy on anxiety in patients with chronic diseases, there are various contradictions among the findings. The present meta-analysis aimed to determine the effects of counselling and spiritual care programs on anxiety in patients with chronic diseases. For data collection, various databases were searched regarding no time limitation until May 2021, including SID, MagIran, Embase, ProQuest, Scopus, PubMed, and Web of Science (WoS) using Google Scholar search engine. Inclusion criteria were original research articles, interventional studies, and exclusion criteria were irrelevant assessments, systematic review and meta-analysis studies, case reports, letters to the editor, and duplicate papers. I2 test was used to calculate heterogeneity of studies, and the Egger’s test was applied to examine the publication bias. According to the inclusion criteria, 26 articles were selected among 612 initial papers with a sample size of 1040 individuals. The mean anxiety scores before and after the interventions were 33.02 ± 3.77 and 25.27 ± 3.66, respectively. The significant (P

Culturally appropriate spiritual care is increasingly recognised as a crucial component of spiritual care. As part of a larger study, we were interested in cultural and racial issues as experienced by spiritual carers in a hospice in Cape Town, South Africa. We conducted one-on-one interviews and focus group discussions with a cohort of spiritual care workers, who, being volunteers and relatively privileged South Africans, discussed their sensitivity to cultural issues, but also mentioned a host of political, racial and identity issues which profoundly affect their work. The data suggest that the concept of culturally appropriate care must be understood and acted on contextually. We note that the work of transformation of care cannot be separated from broader questions of social inequality and change.

Background and Objectives 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. Research Design and Methods 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. Results 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). Discussion and Implications 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.

During psychotherapy assessments clinicians may recognize that some of their injured and traumatized clients may be wrestling with issues related to a lack of forgiveness linked to Moral Injury (MI). This paper presents the Forgiveness Interview Protocol (FIP), a narrative therapy writing-process model for the treatment of Moral Injury, drawing upon the philosophical work of Margaret Holmgren: “Forgiveness and the Intrinsic Value of Persons” (1993) now linked to a variety of evidence-based psychological sources. The FIP utilizes three distinct theoretical and clinical disciplines to arrive at a semi-structured interview intended for mental health counseling, and religious and spiritual care.

Purpose Integrating spirituality into the patient care within a healthcare team, increases the ability to provide “holistic care” for cancer patients. The spiritual care experiences of different involved persons can be a guide for future planning. Therefore, this study aimed to explore the spiritual care experiences of hospitalized cancer patients, their family caregivers and healthcare team members in oncology settings. Methods This is a descriptive qualitative study which was conducted with 21 participants, who were selected by purposive sampling. Semi-structured interviews were used to collect the data. The data were analyzed with conventional content analysis method. Results Two themes of "systematic care" and "caring with paradoxical results" were extracted from the spiritual care experiences of our participants. Conclusions Spiritual care as professional, comprehensive, collaborative and artistic care should be provided in a multidisciplinary healthcare team for cancer patients. Otherwise, patients may experience deprivation of spiritual services and consequently, spiritual distress.

ZUSAMMENFASSUNG Hintergrund In Krisenzeiten wie der Covid-19-Pandemie hat das individuelle Coping für jeden Tumorpatienten eine besondere Bedeutung zur Bewältigung ihrer spezifischen Belastungen. Material und Methode Wir haben in zwei Projekten Daten zu Mental Health für Patienten mit Kopf-Hals-Karzinomen erfasst: WHO-5, SpREUK, Distress-Thermometer zu Belastung. Vor der Pandemie inkludierten wir 113 Patienten, während des 1. Lockdowns 84 Patienten und während des 2. Lockdowns 86 Patienten. Ergebnisse Wir sehen während des 1. Lockdowns im Trend eine Abnahme der allgemeinen Krankheitslast gegenüber der Zeit vor Covid-19. Lebenszufriedenheit steigt, Copingstrategien wie Sinnsuche, Vertrauen und Reflexion der eigenen Situation werden aktiviert. Im zweiten Lockdown lassen diese Entwicklungen wieder nach, wobei insbesondere das per se nicht sehr große religiöse Vertrauen geschwunden zu sein scheint. Schlussfolgerung Tumorpatienten können Krisensituationen durch Coping besser überwinden. Spiritual Care kann gezielt diese Copingmuster unterstützen.

Background: Although religion and spirituality are important to adults with cancer and their family caregivers, few studies have tested spiritual care interventions in the outpatient setting. Aim: To determine the feasibility, acceptability, and preliminary effects of chaplain-delivered, semi-structured spiritual care to adult outpatients with advanced cancer and their caregivers. Design: In this pre/post pilot intervention study, board-certified chaplains utilized the Spiritual Care Assessment and Intervention (SCAI) framework during 4 individual sessions. Surveys at baseline and at 1, 6, and 12 weeks post-intervention assessed spiritual well-being, quality of life, depression, anxiety, and religious coping. Setting/Participants: We enrolled U.S. adult outpatients with or without an eligible family caregiver. Eligible patients were at least 18 years old and at least 2 weeks post-diagnosis of incurable and advanced-stage lung or gastrointestinal (GI) cancer. Results: Of 82 eligible patients, 24 enrolled (29.3%); of 22 eligible caregivers, 18 enrolled (81.8%). Four planned chaplain visits were completed by 87.5% of patients and 77.8% of caregivers. All enrolled participants completed baseline surveys, and more than 75% completed follow-up surveys at 2 of 3 time points. More than 80% of patients and caregivers reported they would recommend the sessions to a friend or family member. Patients’ spiritual well-being improved significantly at all timepoints compared to baseline: 1-week post (p < .006), 6-weeks post (p < .001), and 12-weeks post (p < .004). Conclusions: Spiritual care through SCAI is feasible, acceptable, and shows promise in improving spiritual well-being and other important outcomes in advanced-stage cancer patients and family caregivers. Further investigation is warranted.

Context Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need. Objective The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators. Methods A mixed-methods systematic review was conducted. The search terms (‘religio*’ OR ‘spiritual*’ OR ‘existenti*’) were combined with (‘educat*’ OR ‘train*’ OR ‘curricul*’ OR ‘program*’), AND (‘care’ OR ‘therap*’ OR ‘treatment’ OR ‘competenc*’). Search terms were entered into the following data bases: PsycINFO, Medline, Cinahl and Web of Science. Findings were restricted to peer-reviewed studies published in English between January 2010 and February 2020. Results Fifty-five studies were identified. The quality of studies was mixed. Programs encompassed a range of content and teaching methods. Reported outcomes included increased levels of competency across intrapersonal spirituality, interpersonal spirituality, and spiritual assessment and interventions. Identified barriers included competing healthcare priorities, negative perceptions of spirituality and spiritual care, resistance towards focusing on one's own spirituality, staff feeling inadequate, and the need for ongoing training. Facilitators included opportunities for reflection, involvement of chaplains, application of practical tools, opportunities for practice, online training, and managerial support. Conclusions Positive outcomes following spiritual care training were identified. Further research is needed to identify patient-related outcomes of staff training, and to examine how the benefits of such training can be maintained over time.

BACKGROUND: The spread of coronavirus disease (COVID-19) has spread throughout the world and has created a level of fear, uncertainty that has an impact on several aspects of life including mental health. The rapid spread of the Corona Virus or COVID-19 throughout the world has damaged the order of life starting from the economy, social, politics, education, culture, religion and health. Various efforts have been made by the Indonesian government with social distancing or physical distancing, washing hands with soap and staying active at home. Conditions that change suddenly will make people unprepared to deal with it, especially in the psychological condition of the Indonesian people who experience a lot of anxiety. AIM: The purpose of this study was to analyze the effect of mindfulness meditation based on spiritual care on the level of community anxiety due to the COVID-19 pandemic. METHODS: This type of research uses experimental quantitative research using a randomized controlled trial research design. This research was conducted for 4 weeks in January-February 2021. The population of this study is the Surabaya community. The sampling technique used consecutive sampling technique and was divided into two groups, namely the intervention group as many as 61 respondents and the control group as many as 61 respondents. Data analysis used paired t test and independent t test with a significance value of p < 0.05. This research questionnaire uses the DASS 42 questionnaire has reliability 0.82 and the validity test gets the Cronbach alpha value is 0.85. RESULTS: The average level of anxiety before doing the spiritual care-based mindfulness meditation intervention in the intervention group was 17.28 (severe anxiety) and 17.18 in the control group (severe anxiety) with p = 1.000 which means there is no difference in the average level of anxiety whereas After being given the intervention, the average level of anxiety in the intervention group was 6.03 (normal anxiety) and 18.06 in the control group (severe anxiety) with p = 0.000, which means that there is a difference in the average level of anxiety in the intervention group and the control group after being given the intervention. CONCLUSION: Mindfulness meditation based on spiritual care can reduce people’s anxiety levels during the COVID-19 pandemic. © 2021 Siti Nur Hasina, Iis Noventi, P. H. Livana, Dodik Hartono.

Latar belakang : Kebutuhan dasar pasien meliputi kebutuhan fisik, psikologis, sosial dan spiritual. Kebutuhan spiritual diberikan kepada pasien di ruang ICU melalui layanan perawatan spiritual. Perawatan spiritual merupakan suatu praktik dan prosedur yang dilakukan oleh perawat pada pasien untuk memenuhi kebutuhan spiritual pasien melalui doa, shalat, dzikir etc. Tujuan: Penelitian ini bertujuan untuk menggali persepsi perawat tentang kebutuhan spiritual pasien. Metode: Metode yang digunakan dalam penelitian ini adalah dengan menggunakan eksplorasi deskriptif kualitatif. Hasil: Analisa data kualitatif menggunakan NVivo Plus Dua Belas menghasilkan tema kebutuhan spiritual pasien yang terdiri dari dua kategori yaitu pemberian dan pemenuhan. Kesimpulan: Kebutuhan spiritual merupakan kebutuhan dasar yang dibutuhkan oleh pasien di ruang ICU.

AIM To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics. DESIGN A cross-sectional survey was used. METHODS Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST. RESULTS Compared with patients having high PNST, patients with mild-moderate PNST experienced lower self-efficacy, hope, optimism, PsyCap and social/family well-being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well-being of patients with high PNST. CONCLUSION The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild-moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild-moderate PNST. IMPACT It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL.

Purpose: The study was conducted to examine the spirituality and spiritual care perceptions of nursing department students. Methods: The study was conducted in descriptive design with nursing students at a state university. Permission was obtained from the ethics committee, the institution, and the students before the study. The universe of the study consisted of all nursing students studying at the faculty, and the sample consisted of a total of 500 students who were willing to participate in the study. The data were collected with a questionnaire and with the Spirituality and Spiritual Care Detection Scale. The scores received from this scale were between 17 and 85, and high total scores suggest that the spirituality and spiritual care detection scale level is “good.” The data obtained in the study were evaluated with the Student t, one-way ANOVA, and Mann-Whitney U test. Results: It was determined that 66.2% of the students had knowledge about spiritual care, 27.4% received this knowledge from the school, and 60.2% met the need for spiritual care with worshiping. It was determined that the mean spirituality and spiritual care detection scale score of nursing students was 66.83 ± 5.01, and the mean spirituality and spiritual care detection scale score was statistically significant according to the grades (p < 0.05). It was also found that the students with an authoritarian family structure had lower mean spirituality and spiritual care detection scale scores than students with democratic and protective families. Conclusions and Recommendations: It was found that many nursing department students had knowledge on spirituality and spiritual care, the mean spirituality and spiritual care score was “good,” and that the family structure and the grade affected this situation. In this respect, it is recommended that students are supported and prepared for the clinic with topics including spirituality and spiritual care in nursing education.

The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In course applications, participants were required to submit goals to achieve and demonstrate institutional support. For the first ISPEC course, in July 2018, 48 clinician-chaplain teams attended. Following the 2½ day course, participants had access to online training modules for 1-year, ISPEC faculty mentoring support, and regular conference calls on goal implementation progress. Participants reported recognizing the importance of providing spiritual care and a new understanding of how collaborating as interprofessional teams enabled them to integrate this care into their home institution settings. In a mixed-methods evaluation survey completed 12 months after the ISPEC course, participants reported on the percentage of their goals completed, number and types of professionals they had educated in spiritual care, and personal confidence regarding spiritual care leadership skills. This data can serve as a model to guide other organizations striving to improve spiritual care, practiced collaboratively by clinicians and chaplains, as an essential aspect of overall QI efforts in palliative care.

This is a cross-sectional, descriptive and correlational study aiming to reveal the relationship of gratitude and coping styles with depression in caregivers of children with special needs. As a result of the study, which was conducted with 330 caregivers, it was determined that the caregivers' level of gratitude was high. In this study, it was found that the caregivers used mostly turning to religion, planning, positive reinterpretation, and instrumental social support as coping styles respectively. It was established that there was a significant correlation between caregivers' depression level and gender, education level, level of gratitude, focus on and venting of emotions, substance use, behavioural disengagement, positive reinterpretation, using emotional social support and planning coping styles. The depression disclosure level was found to be 17.8%. For holistic nursing care, the assessment of spiritual care and spiritual needs of caregivers is very important because of its positive effect on mental health.

The present study was conducted to determine the effect of spiritual care on the anxiety and depression levels of patients receiving hemodialysis treatment. The research was carried out between January and May 2019 in a training and research hospital hemodialysis unit in the Eastern Anatolian Region of Turkey. The research was completed with a total of 71 patients (33 experiments, 38 controls) who received hemodialysis treatment. Regarding in-group comparison, the difference between the mean scores of pre-test and post-test of the patients concerning the anxiety and depression in the experimental group was found to be statistically significant (p ? 0.05). It was determined that training for strengthening spirituality was effective in reducing the anxiety and depression levels of patients receiving hemodialysis treatment. It can be suggested that spiritual care should be used as a complementary method in health care practices to increase the effectiveness of the treatment. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. The authors thank the patients receiving hemodialysis treatment who participated in this study.

BackgroundThe significance of spiritual care needs among chronic diseases patients has been emphasized across countries and cultures in many studies. However, there were few studies on spiritual care needs among elderly patients with moderate-to-severe chronic heart failure (CHF) in China.ObjectiveTo investigate spiritual care needs and associated influencing factors among elderly patients with moderate-to-severe CHF, and to examine the relationships among spiritual care needs, self-perceived burden, symptom management self-efficacy, and perceived social support.MethodsA cross-sectional design was implemented, and the STROBE Checklist was used to report the study. A convenience sample of 474 elderly patients with moderate-to-severe CHF were selected from seven hospitals in Tianjin, China. The sociodemographic characteristics questionnaire, the Spiritual Needs Questionnaire Scale, the Self-Perceived Burden Scale, the Self-efficacy for Symptom Management Scale, and the Perceived Social Support Scale were used. Descriptive statistics, univariate, multiple linear regression, and Pearson's correlation analysis were used to analyze data.ResultsThe total score of spiritual care needs among 474 elderly patients with moderate-to-severe CHF was 37.95 ± 14.71, which was moderate. Religious belief, educational background, self-perceived burden, symptom management self-efficacy, and perceived social support were the main factors affecting spiritual care needs, and spiritual care needs were negatively correlated with self-perceived burden (r = −0.637, p < 0.01) and positively correlated with symptom management self-efficacy (r = 0.802, p < 0.01) and social support (r = 0.717, p < 0.01).Significance of resultsThe spiritual care needs of elderly patients with moderate-to-severe CHF were moderate, which were influenced by five factors. It is suggested that clinical nurses, families, and society should take targeted spiritual care measures to improve patients’ symptom management self-efficacy and perceived social support from many aspects, and reduce self-perceived burden to meet their spiritual care needs and improve the quality and satisfaction of spiritual care in nursing practice.