Exploring the relationships between and among registered nurses' spiritual well-being, spiritual care perspectives, and their provision of spiritual care in acute care settings

Abstract

Despite acknowledgment that spiritual care is an essential aspect of holistic nursing care, nurses often feel ill-prepared for, uncomfortable with, and uncertain about providing spiritual care. Studies have indicated that nurses who have a strong sense of their own spiritual well-being and/or a positive perspective [attitude, value, belief] about spiritual care are more inclined to provide spiritual care to their patients. However there is a scarcity of such studies among acute care nurses. This descriptive correlational study aimed to explore relationships between and among acute care nurses’ spiritual well-being (SWB), spiritual care perspectives (SCP), and their provision of spiritual care (SC) to hospitalized patients. The Spiritual Variable of the Neuman System Model provided a suitable framework for this study. Data were collected electronically via Survey Monkey® over a six week period from a convenience sample of acute care nurses (n = 130) through the Academy of Medical-Surgical Nurses. The Spiritual Well-being Scale by Paloutizan and Ellison (1982), the Revised Spiritual Care Perspective Scale by Taylor (2004), the Spiritual Care in Practice Questionnaire by Vance (2001), and a demographic/work-related survey were utilized for data collection. Participants in this study were primarily Christian (33.8%), or Catholic (31.5%), female, (90.8%), Caucasian (73.1%), average age 46.05 years, with a Bachelor’s degree in Nursing as their highest educational qualification (61.5%). Most were employed in general medical-surgical units (63%) for an average of 14 years. Pearson’s r analyses revealed significant positive relationships between the dependent variable (provision of SC), and the two independent variables—nurses’ SWB ( r = .27, p = .002), and SCP (r =.63, p = .0001). These findings indicate that nurses who possess a sense of high SWB, and a positive SCP (attitude) are more likely to provide SC to patients in acute care settings. Spearman Rho tests showed moderate to strong positive correlations between and among the dependent variable and three demographic/work related variables, namely —commitment to personal spiritual practices (rs = .31, p = .0001), confidence in providing SC (rs = .45, p = .0001), and comfort in providing SC ( rs = .40, p = .0001) —signifying that nurses who were strongly committed to their spiritual care practices were also confident and comfortable in providing spiritual care and provided such care frequently to their patients in the acute care setting. Multiple regression analyses demonstrated that SCP was the best predictor of SC practices. The nurses’ SCP (attitude) was also shown to have a significant mediating effect between the other predictors and provision of SC. Participants in this study understood that SC may involve non-traditional activities such as active listening and quiet presence. Findings from this study provide evidence that the nurse’s SCP is a significant contributing factor to provision of SC among acute care nurses. There are implications and recommendations for further research studies, nursing education, clinical practice, and policy making.