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With this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman—sometimes even critically so—and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This article presents the works of great Polish philosopher, Mieczysław Albert Krąpiec, whose creative output can be applied to professional nursing practice. Krąpiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krąpiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krąpiec: the theory of the person based on seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krąpiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all—not only selected—qualitative deficits of characteristics can be defined as holistic care in the nursing profession. [ABSTRACT FROM AUTHOR]

This paper presents a discourse analysis of publications of the Christian Reformed Church regarding its Rehoboth Mission near Gallup, New Mexico, among the Navajo. All issues of The Banner, Acts of Synod of the Christian Reformed Church, the Rehoboth Hospital Bulletin, and the Annual Report of the Rehoboth Mission from 1880 to the present were reviewed for references to health-care at Rehoboth from 1903 to 1943. Four religiously framed discourses were identified: discourses justifying provision of health-care at the mission, discourses of the Navajos as immature and potentially dangerous, needing to be civilized, discourses of cleanliness, and discourses of calling. This paper adds to a growing body of knowledge about religious frames within which nurses have practiced in North America. [ABSTRACT FROM AUTHOR]

In recent years, there has been increased interest in the role of religion in the reform of nursing during the mid-nineteenth century. However, less is known about how ‘party’ disputes between evangelicals and followers of the ‘Oxford Movement’ may have affected nursing. This study examines a proposal to create a nursing association for the Diocese of Lichfield in 1864, which leads to a public dispute concerning the ‘ecclesiastical’ nature of the organisation. Leading evangelicals in Derby campaigned against the idea of nurses belonging to a ‘sisterhood’. This resulted in two rival organisations being created in 1865. This paper reports upon the nature and origins of the dispute within the diocese, unsuccessful attempts to draw Florence Nightingale into the dispute and the relative success of the two institutions. The results of this research indicate that the importance of context and of place must be recognised when studying the history of nursing. This research is based mainly, upon newspaper reports, correspondence and miscellaneous sources, including biographies as there are few surviving records from the two organisations under scrutiny. [ABSTRACT FROM AUTHOR]

Aim. This paper is an exploration of the challenge of negotiating the highly personalized concept of spirituality within the public sphere of professional-patient interactions. Background. Spirituality has become increasingly prominent within the nursing discourse, and providing spiritual care is often positioned as an ethical obligation of care. However, bringing such a personal concept into the public domain of care creates some unique tensions and ethical risks. Discussion. Nurses bring three potentially competing identities to spiritual care encounters with patients. Firstly, they are professionals with a public trust in health promotion and restoration, including those areas that intersect with spiritual health. Secondly, they are citizens of a liberal society where non-judgmental pluralism as it relates to spirituality is enshrined. Thirdly, they are individuals who hold particular beliefs and values about spirituality. Each of these identities may result in particular, and potentially conflicting, approaches to spiritual care. Ultimately, the identity which nurses choose to adopt is often determined by how they view themselves in the spiritual care encounter, either as experts with legitimate authority to intervene in the spiritual lives of patients or as people in a shared relational encounter. Each of these approaches carries ethical risks, although the nature of these risks is different. Conclusion. The identities which nurses bring to spiritual care encounters have far-reaching implications for patient experiences in those encounters. Nurses who position themselves as experts run the risk of objectifying the spiritual, being experienced as coercive and transcending nursings' competence. The work of Martin Buber is presented as a model that, while acknowledging competing identities, sets forth a vision of spirituality and spiritual care based upon relational reciprocity. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private individualism. Second, I turn to the Jewish philosophies of Martin Buber and Emmanuel Levinas, and their advocacy for a kind of responsibility that precedes the constitution of individuality as this can provide a resource for action and practice circumventing liberal influenced empathy. I note critical reservations about direct and practical application of Levinasian ethics in nursing care, and turn to engaged Buddhist philosophies of interdependence—such as in Thich Nhat Hanh and the Dalai Lama—as a corrective. Third, I conclude by indicating ways interreligious radical responsibility can reorient us toward housekeeping habits of character and away from exceptional crisis management, noting specific examples and actions in health care, nursing education and nursing scholarship. [ABSTRACT FROM AUTHOR]

bash a. (2004) Journal of Clinical Nursing 13, 11–16 Spirituality: the emperor's new clothes? This paper explores the concept of ‘spirituality’ with reference to the Patients’ Charter that stipulates that a person's religious, spiritual and cultural needs should be respected at all times. The aim is to offer a critical analysis of what the word ‘spirituality’ may mean when used in the Patients’ Charter and to explore the implications of this for clinical practice. A critical discussion based on a literature review, examining in particular methodological presuppositions. The meaning of ‘spirituality’ in the Judaeo–Christian biblical traditions is explored. Some of the heuristic assumptions in contemporary research on ‘spirituality’ are examined. Philosophical (i.e. non-scientific) and scientific questions to do with ‘spirituality’ are disentangled. The paper concludes that: (i) ‘Spirituality’ is an elastic term not capable of universal definition as each person's spirituality is an individual matter for them and (ii) tools that are being developed for identifying a person's spirituality run the risk of making wrong presuppositions about what comprises spirituality. It is unlikely that tools can be developed that are widely applicable for identifying and assessing spirituality. [ABSTRACT FROM AUTHOR]

BACKGROUND: The nursing literature on spirituality tends to agree that modern science is relatively powerless to address the loss of personal meaning experienced by people facing death, suffering and loss. As a remedy, the literature recommends addressing patients' spirituality. The typical analytical move is to distinguish spirituality from religion and consider it a part, dimension or property of the patient. AIM AND METHOD: This paper uses discourse analysis to identify the formal properties of scientific and religious discourses and their social and political implications. The nursing literature is then investigated to detect the use of such discourses in constructing the object spirituality and to consider any implications for nursing as a social practice. FINDINGS: Far from escaping science and religion, the literature constructs spirituality by means of scientific and religious discourses. These discourses have characteristic strengths and weaknesses that the nursing literature seems to miss. Accordingly, its use of religious discourse lacks coherence and depth, and risks merging human with transcendent authority. Its use of scientific discourse lacks precision and clarity and risks intensifying those features of modernity which contribute to a loss of personal meaning in the face of death, suffering and loss. CONCLUSION: Nursing literature on spirituality raises important questions but is limited in its capacity to address them. This paper provides an alternative perspective. First, it draws on an analysis of the modern institutional environment and its existential dimension. Secondly, it applies discourse analysis to the task of helping people experiencing illness and injury. This approach respects the strengths and limitations of both scientific and religious discourses. [ABSTRACT FROM AUTHOR]

This paper offers an ideal type process which considers any patient, his intimates and hospital chaplain in the wider setting of personal care. It calls attention to an important aspect of patient care which offers a starting point from which to begin assessing the needs of any patient from a complementary perspective. The paper reveals two important consequences of the features of any patient situation for the structuring of whole patient care. The first is that the ill person can be susceptible to certain fundamental characteristics which bring him face-to-face with situations in which established practices display an insufficiency for providing mechanisms of adjustment. The second is that spiritual support can be a most important mechanism of adjustment to the aleatory and frustrating facts of these basic characteristics of the patient's existence. Also, it is not only that the ill person may have a need to be helped in this way, but that the appropriate general pattern of action in regard to the source of help is often related to evaluation by nursing and other health service personnel--who are inexpert in this field of care--of the general requirements of any patient situation. This evaluation may have important consequences regarding the completeness of patient care. [ABSTRACT FROM AUTHOR]

Nursing, with its socially embedded theory and practice, inevitably operates in the realm of power and politics. One of these political sites is that of religion, which to varying degrees continues to shape beliefs about health and illness, the delivery of healthcare services and the nurse–patient encounter. In this paper, I attempt to complicate nursing's views on religion and politics in healthcare, with the intent of thinking critically and philosophically about questions that arise at the intersection of religion, politics and nursing/healthcare. These questions include the following: What is the domain of religion and politics? How (non)religious are the contemporary societies in which nurses practice? What are the variations and implications of secularism? How is religion entangled with other intersecting social relations of power? How does a political reading of religion and politics matter to the concerns of nursing? [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non-naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. [ABSTRACT FROM AUTHOR]

koslander t. & arvidsson b. (2005) Journal of Advanced Nursing 51(6), 558–566 How the spiritual dimension is addressed in psychiatric patient–nurse relationships This paper reports a study describing nurses’ conceptions of how the spiritual dimension is addressed in psychiatric patient–nurse relationships. In psychiatric care, it is essential that patient–nurse relationships be built on a holistic view. In this context, nursing research shows that there is a lack of integration of the spiritual dimension. Twelve strategically selected psychiatric nurses were interviewed and analysed using a phenomenographic approach. The data were collected in 2003. The main findings were three descriptive categories: being a good carer, recognizing the spiritual dimension, and regarding the spiritual dimension as difficult to capture in patient–nurse relationships. The first descriptive category shows that nurses deal with spirituality by behaving as good carers. Those included in the second descriptive category reveal nurses who are aware of patients’ spiritual needs and who deal with these needs in different ways. The third descriptive category consists of conceptions revealing lack of knowledge of patients’ spiritual needs, both in abstract and real terms. Further research is needed to explore how patients describe their own spiritual needs, and how nursing staff can learn to be aware of and understand their own spirituality, thus enabling them to detect, discuss, clarify and deal with the concept of spirituality in patient–nurse relationships. [ABSTRACT FROM AUTHOR]

AIM: This paper aims to answer the question: What competencies do professional nurses need to provide spiritual care? BACKGROUND: Nursing literature from The Netherlands shows little clarity on the qualities that nurses require to provide spiritual care. Although the international literature provides some practical guidance, it is far from conclusive on the required qualities of nurses. METHOD: A qualitative literature review was conducted to draw together information from the nursing literature in order to formulate nursing competencies. A format developed for higher nursing education in The Netherlands was used; this consists of description of a general domain, specific competencies, vignettes, key focus and objectives. RESULTS: The resulting competency profile has three core domains (awareness and use of self, spiritual dimensions of the nursing process, and assurance and quality of expertise) and six core competencies (handling one's own beliefs, addressing the subject, collecting information, discussing and planning, providing and evaluating, and, integrating into policy). DISCUSSION: Spirituality is a field in nursing that is still in its infancy. CONCLUSION: This literature review yields a competency profile that may help to structure future care, research and education in spiritual care by nurses. Implications of the work for future research and education are discussed. [ABSTRACT FROM AUTHOR]

Comments on Neil Henery's paper on constructions of spirituality in contemporary nursing theory. Risks inherent to the use of discourse analysis in studying spirituality; Criticism on the framing of the intellectual structure within which nursing theory is to be analyzed; Problem with Henery's treatment of specific texts.

Purpose: Unrelieved pain among hospitalized children is a common problem that affects all aspects of children's health and their quality of life. Cultural and language differences between nurses and patients have been shown to impact the quality and safety of nursing care and management for children with pain. The aim of this study was to identify the cultural factors, barriers, and facilitators impacting the assessment and management of children's pain by expatriate nurses in Saudi Arabia. Design and Methods: A qualitative descriptive design was employed in this study. A sample of 16 nurses was conveniently recruited and interviewed through face‐to‐face semistructured interviews. Each interview lasted between 30 and 60 min and was audio‐recorded. Content analysis was used to analyze the transcripts. Transcripts were carefully read, significant statements were highlighted, coded, categorized, and clustered thematically. Results: Three main themes were identified, namely, (I) low priority of children's pain, (II) culture and religious challenges, and (III) communication challenges. Practice Implications: Cultural and language differences described by expatriate nurses hindered their care of children with pain. A systematic education for expatriate nurses, children, and families is urgently needed to enhance inter/cross‐cultural understandings and improve childcare in Saudi Arabia. This study identifies the unique challenges faced by expatriate nurses in Saudi Arabia. The findings reveal how a lack of knowledge about cultural values and beliefs can lead to misunderstandings and conflicts between nurses, children, and families and can have an impact on childcare and pain. It also highlights the need to improve pain management practices in multicultural healthcare settings, similar to those of Saudi Arabia and neighboring Arab nations, and across the globe. [ABSTRACT FROM AUTHOR]

Evidence points toward the impact of nurses' personal views and knowledge about religion, religiosity, and spirituality on health care. This qualitative research investigates nurses' concepts of religion, religiosity, and spirituality and how they use these concepts in practice. Thirty‐four nurses were interviewed at a hospital in the state of São Paulo, Brazil. Content analysis was used to organize and code the results. Three main themes generated from the interviews were (i) religiosity/spirituality as an important dimension in life; (ii) notions of religiosity and spirituality; (iii) formal knowledge of the concept of religion, religiosity, and spirituality. The results indicate that religion, religiosity and spirituality should be incorporated into nurse training to improve the comprehension and competence of nurses in these areas of practice. It is recommended that to ensure holistic and person‐centered care, there must be constant reflection on these concepts. [ABSTRACT FROM AUTHOR]

Background: Grieving and death rituals vary widely across cultures and are often influenced by geographical regions, religions, and local norms. Nursing rituals reflect the forms of cultural behaviour that assist in communicating traditional knowledge and practices. They help nurses maintain social order through cohesion and interaction. Aim and objectives: Exploration of European and Middle Eastern intensive care nursing ceremonies and rituals surrounding care provided to patients after death has been carried out. The key question researchers asked was "Can you describe your practice of caring for a patient who has died?" Design: Prospective qualitative thematic analysis. Methods: This study used a prospective qualitative thematic analysis investigating nursing practice and rituals when caring for patients who have died in intensive care. The interviews were conducted face‐to‐face with nurses consenting to be interviewed for research purposes. During the interviews, researchers noted sentences and topics, which they later classified into categories and subcategories. The interview settings were international and national conferences, workshops, meetings, and seminars over a 2‐year period. Thematic analysis was performed. This analysis allowed the researchers to understand and make sense of collective meanings and experiences of participants. Results: A total of 23 interviews with critical care nurses from 16 countries in Europe and Middle East were conducted. Through reflective and meaningful analytical interpretation, two main themes (with subthemes) emerged: sacredness and dignity. More similarities than differences among the nurses' experiences were found. Rituals included, opening a window, lighting a candle, blessing the deceased, and bereaving with the family. Conclusions: Post‐death ritual reflects local guidelines regulating the handling of the deceased body, culturally approved expressions of mourning, and acts to perform at specific times following death. Nursing rituals expressed here demonstrated the dignity, wherein nurses show towards the deceased and relationships between deceased and bereaved. Relevance to Clinical Practice: The investigators perceived nursing culture, beliefs, ceremonies, and rituals surrounding caring for patients who have died to be creative, spiritual, meaningful, and relevant for nurses. [ABSTRACT FROM AUTHOR]

Background: Understanding critically ill patients' experiences of nursing care is an important aspect that can improve quality of care in the intensive care unit. Aim: To elicit critically ill patients' experiences of nursing care in the adult intensive care units. Design: A qualitative descriptive design was utilized. Methods: Sixteen patients who had a predicted mortality risk of above 50% within the first 24 h of admission to the intensive care unit and had been discharged to the ward were purposively selected. The study was conducted at three academic affiliated, tertiary/quaternary specialist hospitals in South Africa. Individual semi‐structured interviews were conducted with the selected participants until a point of data saturation was reached. Data were analysed using a conventional content analysis technique (Hsieh and Shannon, 2005). Lincoln and Guba's criteria for ensuring the trustworthiness of qualitative research were applied. Findings: Four major themes emerged: 'being in someone's shoes', 'communication', 'presence' and 'religion and spirituality'. Conclusions: Even though some participants' responses reflected 'good' nursing care, the majority of the participants had negative experiences in relation to the nursing care they received while admitted in the selected intensive care units. Relevance to clinical practice: This study demonstrates critically ill patients' voices and preferences of intensive nursing care and describes some issues that require not only nurses' but also managerial improvements and interventions in order to ensure quality care and, eventually, patients' satisfaction with intensive nursing care. [ABSTRACT FROM AUTHOR]

The author comments on a study published in a 2009 issue of the "Journal of Clinical Nursing" that examined the impact of nurses clothing on anxiety levels in hospitalised children in Iran. According to the author, the use of children's opinion is one of the important aspect of this study. She points out that the study provided insight into the hospital care of children in a country often not accessible to those reading English language journals. She notes the influence of a predominant religion on nursing practice, education and research.

For nurses of the nineteenth and early twentieth centuries, cleanliness was often seen as a virtue next to godliness. For missionary nurses, this analogy took on multiple meanings. This study focuses on discourses of cleanliness at one site of missionary nursing in the early twentieth century: the Rehoboth Mission and its hospital, which provided health-care to the Navajo in the southwestern USA from 1903 to 1965. Data sources included denominational publications, institutional records, correspondence, questionnaires and interviews of the Dutch-American missionary nurses who practiced at the Rehoboth Mission. Discourse analysis was conducted on references to cleanliness, hygiene and sanitation in these texts. Secondary discourses of embodiment in daily practice, initiation and assimilation, caring, ignorance, environmental factors and gendered work were identified and analyzed. The study interrogates the whiteness of the nurses' dominant culture and sheds light on nurses' relationships with normative discursive frames that reflect and perpetuate inequalities, discredit non-dominant practices, and leave little room for competing discourses. It also illustrates a blurring of religion and health-care, and the need for a reflective and informed stance as a basis for cultural competence. [ABSTRACT FROM AUTHOR]

Aim. The concept of spirituality is much discussed in the UK nursing literature, despite the fact that Britain is one of the most secular countries in the world, and steadily becoming more so. Here, I pose the following question: given this increasing secularization, what accounts for the current interest in spirituality among UK nurses? Background. The literature on spirituality in nursing has blossomed in the last 10 years, and various attempts have been made to define ‘spirituality’, ‘spiritual need’ and ‘spiritual care’. Most definitions distinguish between ‘spirituality’ and ‘religion’, acknowledging that the latter is more institutional, and theologically more restrictive, than the former; and they suggest that spirituality is universal, something which (unlike religion) all human beings share. Method. I draw on the sociology of religion – neglected, for the most part, in the nursing literature – to establish two main points. Firstly, that the UK and the USA are at opposite ends of the religion/secularity spectrum, implying that it is a mistake to assimilate USA and UK sources. Secondly, that the concept of spirituality, as currently understood, is of very recent origin, and is still ‘under construction’, having become separated from its associations with Christian piety and mysticism only since the 1980s. Conclusions. The extension of spirituality into secular domains is part of a professionalization project in nursing, a claim to jurisdiction over a newly invented sphere of work. For the time being, it remains an academic project (in the UK) as it is not one with which many clinicians identify. Relevance to clinical practice. What counts as ‘spiritual need’ or ‘spiritual care’ may not be the same in both countries, and UK clinicians are unlikely to welcome the role of surrogate chaplain, which their USA colleagues are apparently willing to embrace. [ABSTRACT FROM AUTHOR]

Maclaren j. (2004) Journal of Advanced Nursing 45(5), 457–464 A kaleidoscope of understandings: spiritual nursing in a multi-faith society Spirituality is an increasingly discussed topic in nursing. In some parts of the UK there is a policy requirement to establish policies of spiritual health care which are appropriate to a multi-cultural society. In the nursing literature, spirituality is discussed from religious and secular perspectives which seem impossible to reconcile into a coherent philosophy. To discuss the relationship of spirituality to nursing and to suggest how we can think about spirituality as nurses working in a society of many faiths and cultures. Spirituality can be thought of in relation to individual patients and nurses. It also has significance for the profession of nursing and for health care as a whole. The difficulty of defining spirituality is discussed, and it is suggested that a definition of ‘spiritual nursing’ may be more achievable. Different concepts of spirituality are compared, including religious and secular spirituality. The relationship between religion and spirituality is seen as potentially problematic, with some religions denying the existence of secular spirituality. Secular spirituality and New Age movements are non-religious but spiritually influential phenomena. The problem for nursing is how to reconcile the immense variety of approaches to spirituality. The concept of spirituality as a meta-narrative is considered, and a postmodern appreciation of pluralism is employed as a way of embracing different spiritual realities. Spiritual nursing can be an opportunity for nurses to enlarge their understanding of the human condition rather than a narrowly defined concept to be applied within a model of practice. [ABSTRACT FROM AUTHOR]

Background. Interest in the spiritual dimension of nursing has resulted in a proliferation of published research internationally that is very prescriptive, suggesting that nurses should be providing spiritual care. However, little research has been published that provides nurses with a potential framework for the assessment and subsequent delivery of spiritual care. It would appear that there is a consensus of opinion that nurses can and should be able to undertake an assessment of their patients' spiritual needs. However, such assumptions may be unfounded, inaccurate, misguided and potentially detrimental to patient care. Aim. This article explores the area of spiritual assessment, drawing on the international literature, highlighting potential dilemmas in conducting a spiritual assessment. A review of some of the currently available spiritual assessment tools is also undertaken. Design. A debate is presented based on the authors' experiences and opinions with regard to this aspect of care. The debate is informed by a review of the literature specifically addressing spiritual assessment. The authors use United Kingdom policy to illustrate drivers and provide a context for the debate. However the dilemmas presented and issues raised are of significance to a wider international audience. Conclusion. It is argued that the area of spiritual assessment needs careful consideration, both nationally and internationally, by those professionals involved in the provision of spiritual care so that potential dilemmas can be identified and reviewed. Such consideration may prevent the construction and subsequent use of inappropriate assessment tools within practice. The article incorporates some considerations for practice. [ABSTRACT FROM AUTHOR]

A response to Dawson’s critical analysis of ‘spirituality as “integrative energy”’ Dawson’s reply to ‘spirituality as integrative energy’, particularly his objection to the appropriation of energy as a conceptual descriptor, demonstrates a woefully inaccurate and grossly misleading interpretation of my work. The purpose of this response is to challenge Dawson’s assertion that such reformulation effectively strips spirituality of its historical meaning and to provide evidence of its appropriateness. I briefly consider the precepts underlying holism as a moral imperative for professional nursing, the traditional role of spirituality in health and illness, the rise of medical science and its eventual disjunction from metaphysics, and the his torical evolution of nursing. I also comment on the privileged nature of the nurse–client relationship and the social and moral obligation of nurses to engage in holistic practice. Finally, I suggest that the reconceptualization of spirituality as ‘integrative energy’ represents its dynamic, unifying nature and reassert my contention that ‘integrative energy’ is an entirely appropriate and eminently suitable definition of spirituality. [ABSTRACT FROM AUTHOR]

Although nursing has recognized spirituality as an important aspect of holistic patient care, exactly what spirituality means has remained rather amorphous. The purpose of this article is to present aspects of spirituality found in modern nurse theorists' ideas. These aspects are presented both in relation to reciprocal interaction or simultaneous action world-views and in relation to the extent of focus on the concept within the model or theory. This discussion will provide the researcher and practitioner with additional theoretical understanding on which to ground investigations and base practice. [ABSTRACT FROM AUTHOR]

Comments on the issue of spiritual nursing. Results of a survey on religious belief in Great Britain; Percentage of British people who believe in God; Importance of spirituality to wellbeing and healing; Significance of spiritual care and its healing effects upon patients and carers.

Presents updates on research and development in advanced nursing as of February 1999. Information on the awarding of the Trevor Clay Memorial Fund to researchers by the British Lung Foundation; Shared care management of patients awaiting coronary artery bypass surgery; Issues related to religion and the donation of organs in Asia.

Humanism has appeared intermittently in the nursing literature as a concept that can be used in understanding nursing. I return to the concept in response to noticing the term appearing in the context of health humanities, where it is loosely associated both with humanities and being humane. I review the usage and critiques of humanism in both nursing and medical literature and then re‐evaluate what the idea of humanism might hold for nursing, trying to avoid the traps of an over‐determination of the human subject, or dichotomizing nursing as art or science, technology or caring. I draw on writings on humanism primarily from Emmanuel Levinas and Edward Said to emphasize strands in humanism of obligation towards others and of critical discernment within history and culture directed towards democratic practices. I discuss in passing the strong association in the UK particularly between humanism and scientism as a note of caution about the plurality of the term humanism. I conclude that humanism is a tradition that does offer productive ways of thinking about nursing with the proviso that it ought to be treated carefully as a problematic tradition and not as a new essence for nursing. [ABSTRACT FROM AUTHOR]

Editorial. Tackles the concept of spirituality in nursing. Significance of the concept to the field of nursing; Problems with the application of the concept; Assessment of patients' spiritual needs.