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Sample records for providing spiritual care

  1. Self-reported frequency of nurse-provided spiritual care.

    Science.gov (United States)

    Taylor, Elizabeth Johnston; Mamier, Iris; Ricci-Allegra, Patricia; Foith, Joanne

    2017-06-01

    To describe how frequently RNs provide 17 spiritual care therapeutics (or interventions) during a 72-80h timeframe. Plagued by conceptual muddiness as well as weak methods, research quantifying the frequency of spiritual care is not only methodologically limited, but also sparse. Secondary analysis of data from four studies that used the Nurse Spiritual Care Therapeutics Scale (NSCTS). Data from US American RNs who responded to online surveys about spiritual care were analyzed. The four studies included intensive care unit nurses in Ohio (n=93), hospice and palliative care nurses across the US (n=104), nurses employed in a Christian health care system (n=554), and nurses responding to an invitation to participate found on a journal website (n=279). The NSCTS mean of 38 (with a range from 17 to 79 [of 85 possible]) suggested respondents include spiritual care therapeutics infrequently in their nursing care. Particularly concerning is the finding that 17-33% (depending on NSCTS item) never completed a spiritual screening during the timeframe. "Remaining present just to show caring" was the most frequent therapeutic (3.4 on a 5-point scale); those who practiced presence at least 12 times during the timeframe provided other spiritual care therapeutics more frequently than those who offered presence less frequently. Findings affirm previous research that suggests nurses provide spiritual care infrequently. These findings likely provide the strongest evidence yet for the need to improve spiritual care education and support for nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Nurse education and willingness to provide spiritual care.

    Science.gov (United States)

    Wu, Li-Fen; Tseng, Hui-Chen; Liao, Yu-Chen

    2016-03-01

    Spiritual care is a critical part of holistic care, and nurses require adequate preparation to address the spiritual needs of patients. However, nurses' willingness to provide such care has rarely been reported. Hence, nurses' education, and knowledge of spiritual care, as well as their willingness to provide it require further study. A convenience sample of 200 nurses participated in the study. Quantitative data were collected using a 21-item Spiritual Care Needs Inventory (content validity index=.87; Cronbach's alpha=.96). The majority of participants were female (96.5%, n=193) between 21 and 59years old (mean=35.1years). Moreover, the majority of participants had a Bachelor's degree (74.0%, n=148) and 1-36years of clinical experience (mean=12.13years). Regarding religious beliefs, 63 (31.5%) had no religious belief, and 93 (46.5%) did not engage in any religious activity. Overall, the nurses were willing to provide spiritual care, although only 25 (12.5%) felt that they had received adequate education. The findings of this study indicate the need for further educational preparation in spiritual care for nurses. Specifically, additional teaching materials are required that are more directly related to spiritual care. Greater emphasis should be placed on different subject areas in school-based education, continuing education, and self-learning education according to the needs of nurses. Since spiritual care education needs policy support, in-depth discussions should take place regarding the approach and cultural environment for providing spiritual care in future nursing courses. Moreover, further studies should investigate barriers in providing spiritual nursing care to patients and whether they are the results of a lack of relevant knowledge or other factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Relationship between Nurses' Spiritual Well-being and Nurses' perception of competence in providing spiritual care for patients

    OpenAIRE

    Ebrahimi, Hossein; Jafarabadi, Mohammad Asghari; Arshetnab, Hossein Namdar; Khanmiri, Soraya Golipoor

    2015-01-01

    Objective: As an important factor affecting human's health consequences, spiritual well-being has been the center of attention in recent years. According to literature, nurses' spiritual well-being affects how they provide spiritual care. This paper, thus, aims to find the relationship between nurses' spiritual well-being and their perception of their competence in providing spiritual care for patients in Tabriz Educational-Therapeutic centersMaterial and Methods: This is cross...

  4. Spiritual leadership and spiritual care in neonatology.

    Science.gov (United States)

    Caldeira, Sílvia; Hall, Jenny

    2012-12-01

    This article aims to explore spiritual care in the neonatal care environment in addition to highlighting the importance of spiritual leadership of a health team in that context. Neonatal care is an ethically demanding and stressful area of practice. Babies and families require spiritual needs to be recognized in the context of holistic care. Literature around spiritual leadership is explored to nurture workplace spirituality. Analysis of a range of sources provides a theoretical reflection on spiritual leadership and spiritual care in neonatal care settings. The literature identifies that the carers should consider carefully on how care given may affect the infant and family. Themes relating to the baby's and family's spiritual needs and those of the staff in this area are identified. Spiritual leadership by the manager will provide support to the staff and help spiritual need to be met in this area of practice. Spiritual needs should be acknowledged within neonatal care whether these are of babies, families or the team itself. Managers have responsibility to ensure that spiritual care is carried out for babies and their families and to care for the team as spiritual leaders. © 2012 Blackwell Publishing Ltd.

  5. Nursing students’ spiritual well-being, spirituality and spiritual care

    OpenAIRE

    Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; givari, Azam; Haghani, Hamid

    2014-01-01

    Background: Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-be...

  6. Spiritual care competence for contemporary nursing practice: A quantitative exploration of the guidance provided by fundamental nursing textbooks.

    Science.gov (United States)

    Timmins, Fiona; Neill, Freda; Murphy, Maryanne; Begley, Thelma; Sheaf, Greg

    2015-11-01

    Spirituality is receiving unprecedented attention in the nursing literature. Both the volume and scope of literature on the topic is expanding, and it is clear that this topic is of interest to nurses. There is consensus that the spiritual required by clients receiving health ought to be an integrated effort across the health care team. Although undergraduate nurses receive some education on the topic, this is ad hoc and inconsistent across universities. Textbooks are clearly a key resource in this area however the extent to which they form a comprehensive guide for nursing students and nurses is unclear. This study provides a hitherto unperformed analysis of core nursing textbooks to ascertain spirituality related content. 543 books were examined and this provides a range of useful information about inclusions and omissions in this field. Findings revealed that spirituality is not strongly portrayed as a component of holistic care and specific direction for the provision of spiritual care is lacking. Fundamental textbooks used by nurses and nursing students ought to inform and guide integrated spiritual care and reflect a more holistic approach to nursing care. The religious and/or spiritual needs of an increasingly diverse community need to be taken seriously within scholarly texts so that this commitment to individual clients' needs can be mirrored in practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Spirituality and spiritual care in Iran: nurses' perceptions and barriers.

    Science.gov (United States)

    Zakaria Kiaei, M; Salehi, A; Moosazadeh Nasrabadi, A; Whitehead, D; Azmal, M; Kalhor, R; Shah Bahrami, E

    2015-12-01

    This study aimed to explore the perception of Iranian nurses concerning spiritual care and to reveal any confronted barriers. Although the context of spiritual care is a substantial aspect of holistic care, the delivery of spiritual care has been problematic due to lack of nurses' understanding of this concept. Nurses' perceptions of spirituality and spiritual care directly influence their performance as well as their relationships with patients. This cross-sectional survey was conducted in 2013 with 259 nurses working in hospitals affiliated with Qazvin University of Medical Sciences, Iran. Data were collected using the Spirituality and Spiritual Care Rating Scale alongside qualitative open-ended questions. Descriptive and inferential statistics were used for the quantitative data and content analysis for the qualitative data. The overall average for spirituality and spiritual care was 2.84 (score range: 1-4), indicating a moderate mean score. A significant relationship was found between education level and spiritual care. The majority of participants believed that they did not receive enough training in this aspect of care. The main obstacles regarding delivering spiritual care included busy working schedules, insufficient knowledge regarding spiritual care, low motivation, diversity of patients' spiritual needs and feeling 'unqualified' to provide spiritual cares. Consistent with the previous studies, this study has demonstrated that nurses had low confidence to meet the spiritual needs of patients due to lack of knowledge and training in this regard. Iranian nurses' perception of spirituality and spiritual care is moderate, reflecting that they do not receive sufficient training regarding spiritual care. Despite the attention focused on spiritual care in clinical settings in Iran, there remains a significant gap in terms of meeting the spiritual needs of patients in nursing practice. This finding assists nursing clinicians, educators and policy makers to more

  8. Spiritual Experiences of Muslim Critical Care Nurses.

    Science.gov (United States)

    Bakir, Ercan; Samancioglu, Sevgin; Kilic, Serap Parlar

    2017-12-01

    The purpose of this study was to determine the experiences and perceptions of intensive care nurses (ICNs) about spirituality and spiritual care, as well as the effective factors, and increase the sensitivity to the subject. In this study, we examined spiritual experiences, using McSherry et al. (Int J Nurs Stud 39:723-734, 2002) Spirituality and spiritual care rating scale (SSCRS), among 145 ICNs. 44.8% of the nurses stated that they received spiritual care training and 64.1% provided spiritual care to their patients. ICNs had a total score average of 57.62 ± 12.00 in SSCRS. As a consequence, it was determined that intensive care nurses participating in the study had insufficient knowledge about spirituality and spiritual care, but only the nurses with sufficient knowledge provided the spiritual care to their patients.

  9. Palliative care and spirituality

    Directory of Open Access Journals (Sweden)

    Narayanasamy Aru

    2007-01-01

    Full Text Available Critical junctures in patients′ lives such as chronic illnesses and advanced diseases may leave the persons in a state of imbalance or disharmony of body, mind and spirit. With regard to spirituality and healing, there is a consensus in literature about the influence of spirituality on recovery and the ability to cope with and adjust to the varying and demanding states of health and illness. Empirical evidence suggests that spiritual support may act as an adjunct to the palliative care of those facing advanced diseases and end of life. In this article, the author draws from his empirical work on spirituality and culture to develop a discourse on palliative care and spirituality in both secular and non-secular settings. In doing so, this paper offers some understanding into the concept of spirituality, spiritual needs and spiritual care interventions in palliative care in terms of empirical evidence. Responding to spiritual needs could be challenging, but at the same time it could be rewarding to both healthcare practitioner (HCP and patient in that they may experience spiritual growth and development. Patients may derive great health benefits with improvements in their quality of life, resolutions and meaning and purpose in life. It is hoped that the strategies for spiritual support outlined in this paper serve as practical guidelines to HCPs for development of palliative care in South Asia.

  10. Filipino Nurses' Spirituality and Provision of Spiritual Nursing Care.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M; Achaso, Romeo H; Cachero, Geifsonne S; Mohammad, Mary Rose A

    2016-12-01

    This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment. © The Author(s) 2015.

  11. Nursing students' spiritual well-being, spirituality and spiritual care.

    Science.gov (United States)

    Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; Givari, Azam; Haghani, Hamid

    2014-05-01

    Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-being, spirituality, and spiritual care perspectives between the first and fourth year baccalaureate nursing students. This is a descriptive-comparative study that was carried out among 283 nursing students. All the students were Iranians studying in the universities of Iran, Tehran, and Shahid Beheshti medical sciences. They volunteered to participate in the study. There were 105 first year students and 178 fourth year students. The questionnaires used were on Spiritual Well-being (SWB) Scale, Spiritual Perspective Scale (SPS), and Nursing Spiritual Care Perspective Scale (NSCPS). The statistical analysis was performed using the SPSS software, version 10. The data were analyzed using descriptive statistics (distribution frequency, mean, and standard deviation). Mann-Whitney test was to compare each item and independent t-test to compare the mean values of two groups. Regarding spiritual well-being, there were no significant differences between the two groups. 98.8% of the first year students and 100% of the fourth year students were in the category of moderate spiritual well-being. Neither were there any significant differences between the two groups in spiritual perspective and spiritual care perspectives. The scores of fourth year nursing students were similar to those of first year students in spiritual well-being, spirituality, and spiritual care perspectives, though the fourth year students had already undergone 4-year nursing course. Including spiritual care in the curriculum of

  12. Nursing students’ spiritual well-being, spirituality and spiritual care

    Science.gov (United States)

    Abbasi, Mojgan; Farahani-Nia, Marhamat; Mehrdad, Neda; givari, Azam; Haghani, Hamid

    2014-01-01

    Background: Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-being, spirituality, and spiritual care perspectives between the first and fourth year baccalaureate nursing students. Materials and Methods: This is a descriptive–comparative study that was carried out among 283 nursing students. All the students were Iranians studying in the universities of Iran, Tehran, and Shahid Beheshti medical sciences. They volunteered to participate in the study. There were 105 first year students and 178 fourth year students. The questionnaires used were on Spiritual Well-being (SWB) Scale, Spiritual Perspective Scale (SPS), and Nursing Spiritual Care Perspective Scale (NSCPS). The statistical analysis was performed using the SPSS software, version 10. The data were analyzed using descriptive statistics (distribution frequency, mean, and standard deviation). Mann–Whitney test was to compare each item and independent t-test to compare the mean values of two groups. Results: Regarding spiritual well-being, there were no significant differences between the two groups. 98.8% of the first year students and 100% of the fourth year students were in the category of moderate spiritual well-being. Neither were there any significant differences between the two groups in spiritual perspective and spiritual care perspectives. Conclusions: The scores of fourth year nursing students were similar to those of first year students in spiritual well-being, spirituality, and spiritual care perspectives, though the fourth year students had already undergone 4-year

  13. How Community Clergy Provide Spiritual Care: Toward a Conceptual Framework for Clergy End-of-Life Education.

    Science.gov (United States)

    LeBaron, Virginia T; Smith, Patrick T; Quiñones, Rebecca; Nibecker, Callie; Sanders, Justin J; Timms, Richard; Shields, Alexandra E; Balboni, Tracy A; Balboni, Michael J

    2016-04-01

    Community-based clergy are highly engaged in helping terminally ill patients address spiritual concerns at the end of life (EOL). Despite playing a central role in EOL care, clergy report feeling ill-equipped to spiritually support patients in this context. Significant gaps exist in understanding how clergy beliefs and practices influence EOL care. The objective of this study was to propose a conceptual framework to guide EOL educational programming for community-based clergy. This was a qualitative, descriptive study. Clergy from varying spiritual backgrounds, geographical locations in the U.S., and race/ethnicities were recruited and asked about optimal spiritual care provided to patients at the EOL. Interviews were audio taped, transcribed, and analyzed following principles of grounded theory. A final set of themes and subthemes were identified through an iterative process of constant comparison. Participants also completed a survey regarding experiences ministering to the terminally ill. A total of 35 clergy participated in 14 individual interviews and two focus groups. Primary themes included Patient Struggles at EOL and Clergy Professional Identity in Ministering to the Terminally Ill. Patient Struggles at EOL focused on existential questions, practical concerns, and difficult emotions. Clergy Professional Identity in Ministering to the Terminally Ill was characterized by descriptions of Who Clergy Are ("Being"), What Clergy Do ("Doing"), and What Clergy Believe ("Believing"). "Being" was reflected primarily by manifestations of presence; "Doing" by subthemes of religious activities, spiritual support, meeting practical needs, and mistakes to avoid; "Believing" by subthemes of having a relationship with God, nurturing virtues, and eternal life. Survey results were congruent with interview and focus group findings. A conceptual framework informed by clergy perspectives of optimal spiritual care can guide EOL educational programming for clergy. Copyright

  14. Spiritual Care in the Intensive Care Unit: A Narrative Review.

    Science.gov (United States)

    Ho, Jim Q; Nguyen, Christopher D; Lopes, Richard; Ezeji-Okoye, Stephen C; Kuschner, Ware G

    2018-05-01

    Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.

  15. A Thematic Literature Review: The Importance of Providing Spiritual Care for End-of-Life Patients Who Have Experienced Transcendence Phenomena.

    Science.gov (United States)

    Broadhurst, Kathleen; Harrington, Ann

    2016-11-01

    The purpose of this review was to investigate within the literature the link between transcendent phenomena and peaceful death. The objectives were firstly to acknowledge the importance of such experiences and secondly to provide supportive spiritual care to dying patients. Information surrounding the aforementioned concepts is underreported in the literature. The following 4 key themes emerged: spiritual comfort; peaceful, calm death; spiritual transformation; and unfinished business The review established the importance of transcendence phenomena being accepted as spiritual experiences by health care professionals. Nevertheless, health care professionals were found to struggle with providing spiritual care to patients who have experienced them. Such phenomena are not uncommon and frequently result in peaceful death. Additionally, transcendence experiences of dying patients often provide comfort to the bereaved, assisting them in the grieving process. © The Author(s) 2015.

  16. The use of dreams in spiritual care.

    Science.gov (United States)

    Stranahan, Susan

    2011-01-01

    This paper explores the use of dreams in the context of pastoral care. Although many people dream and consider their dreams to hold some significant spiritual meaning, spiritual care providers have been reluctant to incorporate patients' dreams into the therapeutic conversation. Not every dream can be considered insightful, but probing the meaning of some dreams can enhance spiritual care practice. Hill's Cognitive-Experimental Dream Interpretation Model is applied in the current article as a useful framework for exploring dreams, gaining insight about spiritual problems, and developing a therapeutic plan of action. Bulkeley's criteria for dream interpretation were used to furnish safeguards against inappropriate application of dream interpretation to spiritual assessment and interventions.

  17. Cultural and spiritual considerations in palliative care.

    Science.gov (United States)

    Long, Carol O

    2011-10-01

    Culture is a fundamental part of one's being. Spirituality is integrated with culture and both play a significant role in a person's journey through life. Yet, culture and spirituality are often misunderstood and may not seem to be important in healthcare settings. For adults with cancer and their families, this cannot be ignored. This paper reviews The Purnell Model of Cultural Competence as a framework for considering culture and spirituality in healthcare and discusses the importance of acknowledging and incorporating practices that support culture and spirituality in healthcare settings. Examples of how to include cultural and spiritual care in palliative and end-of-life care in healthcare settings are provided.

  18. Spiritual care in Christian parish nursing.

    Science.gov (United States)

    van Dover, Leslie; Pfeiffer, Jane Bacon

    2007-01-01

    This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.

  19. Spirituality in childhood cancer care

    Directory of Open Access Journals (Sweden)

    Lima NN

    2013-10-01

    have been increasingly attentive to this dimension of care. However, it is necessary to improve their knowledge regarding the subject. The search highlighted that spirituality is considered a source of comfort and hope, contributing to a better acceptance of his/her chronic condition by the child with cancer, as well as by the family. Further up-to-date studies facing the subject are, thus, needed. It is also necessary to better train health care practitioners, so as to provide humanized care to the child with cancer. Keywords: spirituality, child, child psychology, neoplasms, cancer

  20. Secondary Traumatic Stress, Culture and Stigma: Barriers to Self-Initiated Care in the Military Mental Health and Spiritual Care Provider Populations

    Science.gov (United States)

    2012-04-01

    caregivers have been actively and productively engaged long before the attacks of 9/11, having provided mental health and spiritual care to military...Secondary Traumatic Stress or Simply Burnout ? Effect of Trauma Therapy on Mental Health Professionals,” Australian and New Zealand Journal of Psychiatry...24. 77 Ibid., 24. 78 Ben-Zeev et al., “DSM-V and the Stigma of Mental Illness ,” 319. 79 Britt et al., “The Stigma of Mental Health Problems in

  1. Nurse Religiosity and Spiritual Care: An Online Survey.

    Science.gov (United States)

    Taylor, Elizabeth Johnston; Gober-Park, Carla; Schoonover-Shoffner, Kathy; Mamier, Iris; Somaiya, Chintan K; Bahjri, Khaled

    2017-08-01

    This study measured the frequency of nurse-provided spiritual care and how it is associated with various facets of nurse religiosity. Data were collected using an online survey accessed from the home page of the Journal of Christian Nursing. The survey included the Nurse Spiritual Care Therapeutics Scale, six scales quantifying facets of religiosity, and demographic and work-related items. Respondents ( N = 358) indicated high religiosity yet reported neutral responses to items about sharing personal beliefs and tentativeness of belief. Findings suggested spiritual care was infrequent. Multivariate analysis showed prayer frequency, employer support of spiritual care, and non-White ethnicity were significantly associated with spiritual care frequency (adjusted R 2 = .10). Results not only provide an indication of spiritual care frequency but empirical encouragement for nurse managers to provide a supportive environment for spiritual care. Findings expose the reality that nurse religiosity is directly related, albeit weakly, to spiritual care frequency.

  2. Creating a spiritual tapestry: nurses' experiences of delivering spiritual care to patients in an Irish hospice.

    LENUS (Irish Health Repository)

    Bailey, Maria E

    2009-01-01

    This study aims to describe nurses\\' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. The resulting creation of a spiritual tapestry provided an overall theme. Nurses in this study were spiritually self-aware and placed a high value on the spiritual element of their caring role. Nurses described their individual understanding of spirituality and discussed how they recognized and addressed a patient\\'s spiritual needs. Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that \\'weaves\\' together care and compassion with skills and knowledge in their nursing practice.

  3. An Investigation of the Perceptions and Practices of Nursing Students Regarding Spirituality and Spiritual Care

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    Asli Kalkim

    2016-08-01

    Full Text Available The aim of this research was to determine Turkish nursing students’ knowledge, practices and perceptions of spirituality and spiritual care and to investigate the relationship between their perceptions and their demographics. This study was a descriptive survey conducted at a nursing school providing degree-level education in the city of Manisa, in the western part of Turkey. The sample of the study consisted of the 400 nursing students. A nursing student sociodemographic form, a form on nursing students’ knowledge and practices of spirituality and spiritual care, and the Spirituality and Spiritual Care Rating Scale were used to collect the data. Half of the students could meet patients’ or individuals’ spiritual needs, and the spiritual care that they gave was most frequently listening, empathy, and psychological support. The research findings were that nursing students’ perceptions of spirituality and spiritual care were “sufficiently” although not “very sufficiently” defined. Being female, being in the second year of education and seeing spiritual care education as necessary were determinants of their perceptions of spirituality and spiritual care.

  4. Spirituality in Cancer Care (PDQ)

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    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... help patients with spiritual needs during cancer care, medical staff will listen to the wishes of the ...

  5. The spiritual care meanings of adults residing in the midwest.

    Science.gov (United States)

    Sellers, S C

    2001-07-01

    Only limited nursing knowledge exists as theoretical guidance for nurses in providing spiritual care. Using Leininger's theory of culture care diversity and universality, the purpose of this ethnonursing research study was to discover the embedded spiritual care meanings, expressions, lived experiences, and practices of adults residing in the Midwest and their perceptions of spiritual nursing care. Data were collected through interviews of 6 key and 12 general informants. Five universal spiritual themes were supported by the findings. Culture care modes were used to explicate spiritual knowledge that can be integrated into nursing practice.

  6. [Spiritual Care of Patients With Depression].

    Science.gov (United States)

    Kao, Chia-Chan; Lin, Yu-Hua

    2018-06-01

    Spiritual care is a component of holistic care. Patients with depression often experience body-mind-spirit health problems and may suffer from spiritual crises, particularly during the acute stage of a diseases, due to low self-esteem, negative attitudes toward life goals, daily life issues, and beliefs caused by physical, psychological, and occupational dysfunctions. Nonetheless, psychical care is the main treatment for patients with depression. This paper focuses on patients with depression and addresses the concepts of spiritual needs and spiritual care, identifying the factors that influence spiritual needs, the essentials of spiritual intervention, and the health effects of spiritual intervention outcomes on patients with depression. Courses that teach practical spiritual interventions are recommended for nurses. These courses should address topics such as individual approaches, building trusting relationships, setting diverse goals for spiritual interventions based on disease stage, and spiritual interventions involving the body-mind-spiritual aspects for patients with depression.

  7. The impact of nurses' spiritual health on their attitudes toward spiritual care, professional commitment, and caring.

    Science.gov (United States)

    Chiang, Yi-Chien; Lee, Hsiang-Chun; Chu, Tsung-Lan; Han, Chin-Yen; Hsiao, Ya-Chu

    2016-01-01

    The personal spiritual health of nurses may play an important role in improving their attitudes toward spiritual care and their professional commitment and caring capabilities. The purpose of this study was to explore the impact of nurses' personal spiritual health on their attitudes toward spiritual care, professional commitment, and caring. A total of 619 clinical nurses were included in this cross-sectional survey. The measurements included the spiritual health scale-short form, the spiritual care attitude scale, the nurses' professional commitment scale, and the caring behaviors scale. Structural equation modeling was used to establish associations between the main research variables. The hypothetical model provided a good fit with the data. Nurses' spiritual health had a positive effect on nurses' professional commitment and caring. Nurses' attitudes toward spiritual care could therefore mediate their personal spiritual health, professional commitment, and caring. The findings indicated that nurses' personal spiritual health is an important value and belief system and can influence their attitudes toward spiritual care, professional commitment, and caring. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Nurses' Spirituality Improves Caring Behavior

    Science.gov (United States)

    Bakar, Abu; Nursalam; Adriani, Merryana; Kusnanto; Qomariah, Siti Nur; Hidayati, Laily; Pratiwi, Ika Nur; Ni'mah, Lailatun

    2017-01-01

    Caring is a behavior of giving holistic assistance to individuals. In fact, this important behavior still has not routinely performed in current nursing practice. Personality and sipirituality are important factors in forming one's caring behavior. Spirituality is a passion or impulse to perform noble action. The objective of this study was to…

  9. Spirituality in cancer care at the end of life.

    Science.gov (United States)

    Ferrell, Betty; Otis-Green, Shirley; Economou, Denice

    2013-01-01

    There is a compelling need to integrate spirituality into the provision of quality palliative care by oncology professionals. Patients and families report the importance of spiritual, existential, and religious concerns throughout the cancer trajectory. Leading palliative care organizations have developed guidelines that define spiritual care and offer recommendations to guide the delivery of spiritual services. There is growing recognition that all team members require the skills to provide generalist spiritual support. Attention to person-centered, family-focused oncology care requires the development of a health care environment that is prepared to support the religious, spiritual, and cultural practices preferred by patients and their families. These existential concerns become especially critical at end of life and following the death for family survivors. Oncology professionals require education to prepare them to appropriately screen, assess, refer, and/or intervene for spiritual distress.

  10. Iranian nurses' professional competence in spiritual care in 2014.

    Science.gov (United States)

    Adib-Hajbaghery, Mohsen; Zehtabchi, Samira; Fini, Ismail Azizi

    2017-06-01

    The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. This study aimed to evaluate Iranian nurses' perceived professional competence in spiritual care, the relationship between perceived competence and nurses' personal characteristics, and barriers to provide spiritual care. A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses' competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses' overall score of competence in spiritual care and receiving training on spiritual care, nurses' position, and the ward they worked in. Confirming the findings of the international literature, this study puts light on the situation of nurses' perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care.

  11. How core nursing textbooks inform holistic spiritual care.

    Science.gov (United States)

    2016-08-01

    National and international health and nursing guidelines recommend that staff attend to patients' spiritual and religious needs, which suggests that spiritual care is an important aspect of holistic care. However, many nurses lack knowledge of the subject, and it is unclear whether core textbooks provide the information they need.

  12. Developments in spiritual care education in German--speaking countries.

    Science.gov (United States)

    Paal, Piret; Roser, Traugott; Frick, Eckhard

    2014-06-05

    This article examines spiritual care training provided to healthcare professionals in Germany, Austria and Switzerland. The paper reveals the current extent of available training while defining the target group(s) and teaching aims. In addition to those, we will provide an analysis of delivered competencies, applied teaching and performance assessment methods. In 2013, an anonymous online survey was conducted among the members of the International Society for Health and Spiritual Care. The survey consisted of 10 questions and an open field for best practice advice. SPSS21 was used for statistical data analysis and the MAXQDA2007 for thematic content analysis. 33 participants participated in the survey. The main providers of spiritual care training are hospitals (36%, n = 18). 57% (n = 17) of spiritual care training forms part of palliative care education. 43% (n = 13) of spiritual care education is primarily bound to the Christian tradition. 36% (n = 11) of provided trainings have no direct association with any religious conviction. 64% (n = 19) of respondents admitted that they do not use any specific definition for spiritual care. 22% (n = 14) of available spiritual care education leads to some academic degree. 30% (n = 19) of training form part of an education programme leading to a formal qualification. Content analysis revealed that spiritual training for medical students, physicians in paediatrics, and chaplains take place only in the context of palliative care education. Courses provided for multidisciplinary team education may be part of palliative care training. Other themes, such as deep listening, compassionate presence, bedside spirituality or biographical work on the basis of logo-therapy, are discussed within the framework of spiritual care. Spiritual care is often approached as an integral part of grief management, communication/interaction training, palliative care, (medical) ethics, psychological or religious counselling

  13. Spirituality and spiritual care in in the context of nursing education in South Africa

    Directory of Open Access Journals (Sweden)

    Sandhya Chandramohan

    2015-12-01

    Full Text Available Background: In order for nursing education to prepare nurses for holistic patient care, it is critical that educators become more aware of the religious and spiritual dimensions in patien tcare and be able to provide adequate knowledge and skills for nurses to offer spiritually-basedc are in an ethical way. Furthermore, spiritual care is an essential component in the nursing context, as nurses have to care for patients who may often turn to the spiritual dimension to cope and heal. These aspects are important issues to be considered in planning what should be taught as part of spiritual care. Objectives: This paper presents findings from a study on nursing practitioners’ views on the role of spiritual care in nursing practice and whether current nursing education has integrated this dimension into teaching. Method: A descriptive survey using a cross-sectional design with 385 nurses was conducted between December 2012 and February 2013. Participants were recruited through multistage random sampling. Data analysis was undertaken using SSPS 0.20. Results: All the participants (n = 385 concurred that spiritual care was a salient component of holistic patient care. They however stated that the primary barriers to providing spiritual care related to uncertainty on how to provide this type of care, and a lack of educational preparedness for this role. Conclusion: The study found that nurses were very accepting of the need for spiritual care as part of their nursing role but that nursing education had not paid adequate attention to integrating this dimension into the nursing curriculum.

  14. Spiritual care perspectives of Danish Registered Nurses

    DEFF Research Database (Denmark)

    Christensen, Kirsten Haugaard; Turner, de Sales

    2008-01-01

    Spiritual care perspectives of Danish Nurses The purpose of this study was to explore how Danish registered nurses understand the phenomenon of spiritual care and how their understanding impacts on their interventions with their patients. Nurses are responsible for the provision of care which...... approach rooted in the philosophy of Gadamer was chosen as methodology. In-depth interviews were used as data collection tool, and six registered nurses who worked within hospital settings in Denmark were interviewed. The findings revealed that deep knowing of the patients were essential before nurses...... would engage in provision of spiritual care. The participants acknowledged that their understanding of spirituality influenced their provision of spiritual care, which was recognized as a challenge requiring the nurse’s initiative and courage. Spirituality was primarily understood as a patient’s private...

  15. Spiritual Nursing Care Education An Integrated Strategy for Teaching Students.

    Science.gov (United States)

    White, Donna M; Hand, Mikel

    The failure of nursing schools to integrate spiritual nursing care education into the curriculum has contributed to a lack in nurses' spiritual care ability. Developing, integrating, and testing a Spiritual Care Nursing Education strategy in an Associates of Science nursing program significantly increased the perceived spiritual care competence of student nurses. Utilizing a faculty team to develop learning activities to address critical spiritual care attributes offers a method to integrate spiritual nursing care content throughout the curriculum in ASN and BSN programs.

  16. Teaching spiritual care to nursing students:an integrated model.

    Science.gov (United States)

    Taylor, Elizabeth Johnston; Testerman, Nancy; Hart, Dynnette

    2014-01-01

    Graduating nurses are required to know how to support patient spiritual well-being, yet there is scant literature about how spiritual care is taught in undergraduate programs. Typically spiritual content only is sporadically included; the authors recommend intergrating spiritual can thoughout the nursing curriculum. This article describes how one Christian nursing school integrates spiritual care content, supports student spiritual well-being throughout the program, and evaluates spiritual care instruction at graduation.

  17. Spirituality and spiritual care: a descriptive survey of nursing practices in Turkey.

    Science.gov (United States)

    Akgün Şahin, Zümrüt; Kardaş Özdemir, Funda

    2016-08-01

    Nurses' spiritual care practices have been shown to affect patients' well-being, therefore understanding nurses' spiritual care perceptions and their practices. The aim of this paper is to investigate the nurses' views to practising spiritual care. A descriptive survey of 193 nurses was conducted at a general hospital in Turkey. Data was collected using a demographic questionnaire and The Spirituality and Spiritual Care Rating Scale (SSCRS). The findings of this study revealed that older nurses (pspiritual care (pspiritual care.

  18. Integration Between Mental Health-Care Providers and Traditional Spiritual Healers: Contextualising Islam in the Twenty-First Century.

    Science.gov (United States)

    Chowdhury, Nayeefa

    2016-10-01

    In the United Arab Emirates, neuropsychiatric disorders are estimated to contribute to one-fifth of the global burden of disease. Studies show that the UAE citizens' apathy towards seeking professional mental health services is associated with the 'religious viewpoints' on the issue, societal stigma, lack of awareness of mental health and lack of confidence in mental health-care providers. Mental health expenditures by the UAE government health ministry are not available exclusively. The majority of primary health-care doctors and nurses have not received official in-service training on mental health within the last 5 years. Efforts are to be made at deconstructing the position of mental illness and its treatments in the light of Islamic Jurisprudence; drafting culturally sensitive and relevant models of mental health care for Emirati citizens; liaising between Imams of mosques and professional mental health service providers; launching small-scale pilot programs in collaboration with specialist institutions; facilitating mentoring in line with Science, Technology, Engineering and Math (STEM) outreach programmes for senior school Emirati students concerning mental health; and promoting mental health awareness in the wider community through participation in events open to public.

  19. Experiences of patients with cancer and their nurses on the conditions of spiritual care and spiritual interventions in oncology units.

    Science.gov (United States)

    Rassouli, Maryam; Zamanzadeh, Vahid; Ghahramanian, Akram; Abbaszadeh, Abbas; Alavi-Majd, Hamid; Nikanfar, Alireza

    2015-01-01

    Although nurses acknowledge that spiritual care is part of their role, in reality, it is performed to a lesser extent. The purpose of the present study was to explore nurses' and patients' experiences about the conditions of spiritual care and spiritual interventions in the oncology units of Tabriz. This study was conducted with a qualitative conventional content analysis approach in the oncology units of hospitals in Tabriz. Data were collected through purposive sampling by conducting unstructured interviews with 10 patients and 7 nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Three categories emerged from the study: (1) "perceived barriers for providing spiritual care" including "lack of preparation for spiritual care," "time and space constraints," "unprofessional view," and "lack of support"; (2) "communication: A way for Strengthening spirituality despite the limitations" including "manifestation of spirituality in the appearances and communicative behaviors of nurses" and "communication: Transmission of spiritual energy"; and (3) "religion-related spiritual experiences" including "life events as divine will and divine exam," "death as reincarnation," "trust in God," "prayer/recourse to Holy Imams," and "acceptance of divine providence." Although nurses had little skills in assessing and responding to the patients' spiritual needs and did not have the organizational and clergymen's support in dealing with the spiritual distress of patients, they were the source of energy, joy, hope, and power for patients by showing empathy and compassion. The patients and nurses were using religious beliefs mentioned in Islam to strengthen the patients' spiritual dimension. According to the results, integration of spiritual care in the curriculum of nursing is recommended. Patients and nurses can benefit from organizational and clergymen's support to cope with spiritual distress. Researchers should

  20. Alcoholics Anonymous and nursing. Lessons in holism and spiritual care.

    Science.gov (United States)

    McGee, E M

    2000-03-01

    Alcoholic Anonymous (AA) is a worldwide, million-member organization that has assisted countless alcoholics to achieve sobriety through a spiritual program of recovery from alcoholism. Based on spiritual principles known as the "Twelve Steps" and "Twelve Traditions," AA has provided a model for other recovery programs such as Narcotics Anonymous (NA), Gamblers Anonymous (GA), and Sex and Love Addicts Anonymous (SLAA). Recovery in AA appears to involve a process of self-transcendence. In recent years, nursing scholars have increasingly explored the concepts of self-transcendence and spirituality as they apply to nursing theory and practice. This article explores the roots and spiritual dimensions of 12-step recovery programs. It further explores the ways in which theoretical and clinical knowledge about the delivery of spiritual care interventions may be gained from an understanding of AA's spiritual approach to recovery.

  1. Spiritual care in the training of hospice volunteers in Germany.

    Science.gov (United States)

    Gratz, Margit; Paal, Piret; Emmelmann, Moritz; Roser, Traugott

    2016-10-01

    Hospice volunteers often encounter questions related to spirituality. It is unknown whether spiritual care receives a corresponding level of attention in their training. Our survey investigated the current practice of spiritual care training in Germany. An online survey sent to 1,332 hospice homecare services for adults in Germany was conducted during the summer of 2012. We employed the SPSS 21 software package for statistical evaluation. All training programs included self-reflection on personal spirituality as obligatory. The definitions of spirituality used in programs differ considerably. The task of defining training objectives is randomly delegated to a supervisor, a trainer, or to the governing organization. More than half the institutions work in conjunction with an external trainer. These external trainers frequently have professional backgrounds in pastoral care/theology and/or in hospice/palliative care. While spiritual care receives great attention, the specific tasks it entails are rarely discussed. The response rate for our study was 25.0% (n = 332). A need exists to develop training concepts that outline distinct contents, methods, and objectives. A prospective curriculum would have to provide assistance in the development of training programs. Moreover, it would need to be adaptable to the various concepts of spiritual care employed by the respective institutions and their hospice volunteers.

  2. Undergraduate nurse students' perspectives of spiritual care education in an Australian context.

    Science.gov (United States)

    Cooper, Katherine Louise; Chang, Esther

    2016-09-01

    The Australian Nursing and Midwifery Accreditation Council competency standards highlight the need to provide holistic care that is inclusive of spiritual care. Literature shows that internationally many nurses feel unsure of how to provide spiritual care which has been attributed to a lack of spiritual care education during undergraduate nursing programs. This study explores the impact of a spiritual care subject in an undergraduate nursing program in an Australian tertiary institution. Qualitative research design using in-depth semi-structured interviews. A tertiary institution with a Christian orientation in Sydney, Australia. Six undergraduate nursing students who had completed the spiritual care subject. Two themes emerged from the data: Seeing the person as a whole and Being with the person. The spiritual care subject had a positive impact on the perceptions of undergraduate nursing students. In particular students perceived themselves more prepared to provide holistic care that was inclusive of spiritual care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Holistic Nursing of Forensic Patients: A Focus on Spiritual Care

    Directory of Open Access Journals (Sweden)

    Annamaria Bagnasco

    2016-03-01

    Full Text Available Prisons are a unique context where nurses are required to have specific skills to ensure that prisoners receive the same type of holistic care as anyone else out of prison, including spiritual care. This discussion paper focuses on understanding how nurses deliver spiritual care in Italian prisons where there are often limited resources and where organizational priorities hinder the provision of holistic nursing. This paper draws from a previous qualitative research study that we had conducted. In this study, we observed that prison nurses reported that they experienced many difficulties related to the provision of holistic care to prisoners. This was particularly true for spiritual care in vulnerable forensic patients, such as older individuals, and physically and mentally frail prisoners. Prison officers did not allow nurses to just “listen and talk” to their patients in prison, because they considered it a waste of time. The conflict between prison organizational constraints and nursing goals, along with limited resources placed barriers to the development of therapeutic relationships between nurses and prisoners, whose holistic and spiritual care needs remained totally unattended. Therefore, prison organizational needs prevailed over prisoners’ needs for spiritual care, which, while fundamental, are nevertheless often underestimated and left unattended. Educational interventions are needed to reaffirm nurses’ role as providers of spiritual care.

  4. Utilization of Spirituality and Spiritual Care in Nursing Practice in Public Hospitals in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Sandhya Chandramohan

    2016-03-01

    Full Text Available This study explored the views of professional nurses in KwaZulu-Natal, South Africa regarding the role of spirituality and spiritual care in nursing practice and investigated whether professional nurses utilize spiritually based care in nursing practice. A cross-sectional descriptive design using multistage random sampling was utilized. Five hundred and fifty questionnaires were distributed to professional nurses between December 2012 and February 2013. A total of 385 participants completed the survey questionnaire, resulting in a 77% response rate. Data was analyzed using SSPS 0.20. The data revealed that nurses see spirituality and spiritual care as an important dimension of nursing practice but need greater preparedness. Nurses need to be effectively prepared to deal with the complexity of providing ethically based personalized spiritual care in an increasingly diverse society.

  5. [Development of Spiritual Care in Cancer Treatment in Japan].

    Science.gov (United States)

    Shimazono, Susumu

    2017-01-01

    Spiritual care started worldwide in the late 1960s with the development of the hospice movement and death studies. Why did spiritual care start duringthis time in history ? In some Christian societies, of that time,"pastoral care" evolved into an interfaith "spiritual care" where in the caretaker was the main agent instead of the caregiver. On the other hand, the importance of palliative care for cancer patients was gradually acknowledged. In addition, this progress was accompanied by the academic development of "death studies" which is called "death and life studies" in Japan. The Japanese hospice care and death studies movement started in the late 1970s. In the precedingperiod, the spiritual quest of cancer patients facingdeath was already gaining public attention. A scholar of religious studies, Hideo Kishimoto of the University of Tokyo, was diagnosed with cancer in 1954; he survived many operations until his death in 1964. Duringthose years, he wrote about his personal experience of acceptinghis approachingdeath. Although he did not believe in any specific faith, he had studied various religious teachings. It is important to understand his perception of his own death. His book, On Facing Death, was published immediately after his death. Therefore, it provided a prominent discourse on copingwith spiritual pain of approachingdeath even before the growth of spiritual care in Japan.

  6. Effects of a spiritual care training for nurses

    NARCIS (Netherlands)

    Vlasblom, J.P.; Steen, van der J.T.; Knol, D.L.; Jochemsen, H.

    2011-01-01

    Despite the fact that spiritual care is an essential part of nursing care according to many nursing definitions, it appears to be quite different in practice. A spirituality training for nurses may be necessary to give spiritual care the attention it deserves. In a trial a pre-tested “spirituality

  7. An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks.

    Science.gov (United States)

    Timmins, Fiona; Murphy, Maryanne; Neill, Freda; Begley, Thelma; Sheaf, Greg

    2015-01-01

    Holistic care that encompasses a spiritual dimension is an expectation in modern healthcare (Rothman, 2009). Increasing attention is being paid to the role of nurses in providing spiritual care to patients. However nurses lack specific skills and expertise in this area (Lundmark, 2006; Timmins, 2010; RCN, 2011), and the extent to which their undergraduate education prepares them for this role is unclear. There is often an absence of clear direction about what to teach undergraduate nursing students. The extent to which core textbooks direct student studies in this area is not known. There is some evidence that some of these fundamental core textbooks provide insufficient direction (Pesut, 2008), thus gaps in knowledge and care provision in this field could be exacerbated. The aim of this study is to examine the extent to which spiritual care concepts are addressed in core nursing textbooks. Five hundred and forty three books were sampled from the Nursing and Midwifery Core Collection list (UK) (Tomlinsons, 2010) representing 94% of the total (n=580). A survey, the Spirituality Textbook Analysis Tool (STAT), was developed and used to collect data. One hundred and thirty of the books included content related to spirituality and religion. However there was little consistency in the core nursing textbooks with regard to direction for providing spiritual care. Thirty eight percent of the books defined spiritual care and 36% provided an outline of the role of the nurse in providing this. While some books advocated the assessment of patients' spiritual needs (32%) few referred specifically to assessment tools. It is essential that nurses are adequately prepared to address the spiritual needs of patients. While there are numerous spiritual care texts that deal solely with this issue for nurses, there is an argument emerging that core nursing texts used by nursing students ought to encompass spiritual care elements. Lack of specific focus on this field, by these key

  8. ASSET: A Model for Actioning Spirituality and Spiritual Care Education and Training in Nursing.

    Science.gov (United States)

    Narayanasamy, Aru

    1999-01-01

    A model for improving nurses' preparation in spiritual care includes development of spiritual self-awareness, knowledge of varied traditions of spirituality, and ability to implement a spiritual dimension in nursing practice using the skills of communication, trust building, and giving hope. (SK)

  9. Why the cognitive science of religion cannot rescue 'spiritual care'.

    Science.gov (United States)

    Paley, John

    2015-10-01

    Peter Kevern believes that the cognitive science of religion (CSR) provides a justification for the idea of spiritual care in the health services. In this paper, I suggest that he is mistaken on two counts. First, CSR does not entail the conclusions Kevern wants to draw. His treatment of it consists largely of nonsequiturs. I show this by presenting an account of CSR, and then explaining why Kevern's reasons for thinking it rescues 'spirituality' discourse do not work. Second, the debate about spirituality-in-health is about classification: what shall count as a 'spiritual need' and what shall count as 'spiritual care'. It is about the politics of meaning, an exercise in persuasive definition. The function of 'spirituality' talk in health care is to change the denotation of 'spiritual', and attach its indelibly religious connotations to as many health-related concepts and practices as possible. CSR, however plausible it may be as a theory of the origins and pervasiveness of religious belief, is irrelevant to this debate. © 2015 John Wiley & Sons Ltd.

  10. Spiritual nursing care: A concept analysis.

    Science.gov (United States)

    Monareng, Lydia V

    2012-10-08

    Although the concept 'spiritual nursing care' has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech's eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result 'caring presence' was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

  11. Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia.

    Science.gov (United States)

    Ho, Rainbow T H; Wan, Adrian H Y; Chan, Caitlin K P

    2016-01-01

    Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

  12. Strategies to support spirituality in health care communication: a home hospice cancer caregiver case study.

    Science.gov (United States)

    Reblin, Maija; Otis-Green, Shirley; Ellington, Lee; Clayton, Margaret F

    2014-12-01

    Although there is growing recognition of the importance of integrating spirituality within health care, there is little evidence to guide clinicians in how to best communicate with patients and family about their spiritual or existential concerns. Using an audio-recorded home hospice nurse visit immediately following the death of a patient as a case-study, we identify spiritually-sensitive communication strategies. The nurse incorporates spirituality in her support of the family by 1) creating space to allow for the expression of emotions and spiritual beliefs and 2) encouraging meaning-based coping, including emphasizing the caregivers' strengths and reframing negative experiences. Hospice provides an excellent venue for modeling successful examples of spiritual communication. Health care professionals can learn these techniques to support patients and families in their own holistic practice. All health care professionals benefit from proficiency in spiritual communication skills. Attention to spiritual concerns ultimately improves care. © The Author(s) 2014.

  13. Spirituality and distress in palliative care consultation.

    Science.gov (United States)

    Hills, Judith; Paice, Judith A; Cameron, Jacqueline R; Shott, Susan

    2005-08-01

    One's spirituality or religious beliefs and practices may have a profound impact on how the individual copes with the suffering that so often accompanies advanced disease. Several previous studies suggest that negative religious coping can significantly affect health outcomes. The primary aim of this study was to explore the relationship between spirituality, religious coping, and symptoms of distress among a group of inpatients referred to the palliative care consult service. Pilot study. The study was conducted in a large academic medical center with a comprehensive Palliative Care and Home Hospice Program. (1) National Comprehensive Cancer Network Distress Management Assessment Tool; (2) Pargament Brief Religious Coping Scale (Brief RCOPE); (3) Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp); (4) Puchalski's FICA; and (5) Profile of Mood States-Short Form (POMS-SF). The 31 subjects surveyed experienced moderate distress (5.8 +/- 2.7), major physical and psychosocial symptom burden, along with reduced function and significant caregiving needs. The majority (87.2%) perceived themselves to be at least somewhat spiritual, with 77.4% admitting to being at least somewhat religious. Negative religious coping (i.e., statements regarding punishment or abandonment by God) was positively associated with distress, confusion, depression, and negatively associated with physical and emotional well-being, as well as quality of life. Palliative care clinicians should be alert to symptoms of spiritual distress and intervene accordingly. Future research is needed to identify optimal techniques to address negative religious coping.

  14. Spirituality, religion, and healing in palliative care.

    Science.gov (United States)

    Puchalski, Christina M; Dorff, Rabbi Elliot; Hendi, Imam Yahya

    2004-11-01

    In end-of-life care, attending to spiritual needs ensures that a dying patient has the opportunity to find meaning in the midst of suffering and to have the opportunity for love, compassion, and partnership in their final journey. This article summarizes some of the beliefs and traditions from Judaism, Islam, and Christianity that affect people as they face their own dying and mortality. People who do not participate in any formal religion also have a drive to find meaning in the midst of suffering and dying. They may find this in personal ways. This article presents some practical tools to help clinicians address and respect spiritual and religious issues of patients. It is crucial that our culture and our systems of care for the dying include a spiritual approach so that dying can be meaningful and even filled with hope.

  15. Spiritual nursing care: A concept analysis

    Directory of Open Access Journals (Sweden)

    Lydia V. Monareng

    2012-10-01

    Full Text Available Although the concept ‘spiritual nursing care’ has its roots in the history of the nursing profession, many nurses in practice have difficulty integrating the concept into practice. There is an ongoing debate in the empirical literature about its definition, clarity and application in nursing practice. The study aimed to develop an operational definition of the concept and its application in clinical practice. A qualitative study was conducted to explore and describe how professional nurses render spiritual nursing care. A purposive sampling method was used to recruit the sample. Individual and focus group interviews were audio-taped and transcribed verbatim. Trustworthiness was ensured through strategies of truth value, applicability, consistency and neutrality. Data were analysed using the NUD*IST power version 4 software, constant comparison, open, axial and selective coding. Tech’s eight steps of analysis were also used, which led to the emergence of themes, categories and sub-categories. Concept analysis was conducted through a comprehensive literature review and as a result ‘caring presence’ was identified as the core variable from which all the other characteristics of spiritual nursing care arise. An operational definition of spiritual nursing care based on the findings was that humane care is demonstrated by showing caring presence, respect and concern for meeting the needs not only of the body and mind of patients, but also their spiritual needs of hope and meaning in the midst of health crisis, which demand equal attention for optimal care from both religious and nonreligious nurses.

  16. Pengaruh Metode Drill dalam Supervisi Klinis terhadap Spiritual Care Perawat

    Directory of Open Access Journals (Sweden)

    Nunung Rachmawati

    2017-11-01

    Full Text Available The holistic nursing service is based on the concept that humans are sick not only physically that cured by drug delivery, but also pay attention to other aspects of mental where the patient needs motivation and spirit to cope with illness, social where the patient wants to meet and gather with family/friends and spiritual where the patient wants to pray and pray for healing. Spiritual care is an important part of the overall care provided to improve the quality of life of patients. The role of nurses is now more involved on treatment measures. Proper methods in clinical supervision are necessary for the implementation of spiritual care to be as important as physical care, one of them using drill method. This study aims to analyze the influence of drill methods in the team leader's clinical supervision on the implementation of nurses spiritual care. The research method used is quasy experiment with pretest-posttest research design with control group design. The population of nurse research in inpatient room of PKU Muhammadiyah Yogyakarta and PKU Muhammadiyah Gamping Hospital. A total of 32 nurses were taken as samples through consecutive sampling technique. To see the implementation of spiritual care used observation sheet refers to the label Nursing Interventions Classification, spiritual care is observed before and after the application of drill methods in clinical supervision. Data were analyzed by paired t-test. The results showed the average of nurses' spiritual care before the drill method applied to the intervention group was 6,56 and 6,13 in the control group, after drill method applied in the intervention group was 17,44 and 6,50 in the control group. The results of statistical tests showed that there was a significant difference in nurse's spiritual care before and after the application of drill methods in the intervention group. It is recommended for the hospital to improve the implementation of clinical supervision to the nurses

  17. Iranian nurses' perception of spirituality and spiritual care: a qualitative content analysis study.

    Science.gov (United States)

    Mahmoodishan, Gholamreza; Alhani, Fatemeh; Ahmadi, Fazlollah; Kazemnejad, Anoshirvan

    2010-01-01

    The purpose of the present study was to explore nurses' perception about spirituality and spiritual care. A qualitative content analysis approach was conducted on 20 registered nurses interviewed using unstructured strategy in 2009. Three themes emerged from the data analysis: 1) "meaning and purpose of work and life" including 'spiritualistic view to profession', 'commitment and professional responsibility', and 'positive attitude'; 2) "religious attitude" including 'God approval', 'spiritual reward', 'taking advice', 'inner belief in the Supreme Being', 'faith-based interactions and altruism'; 3) "transcendence-seeking" including 'need for respect' and 'personal-professional transcendence'. Therefore, the spirituality produces maintenance, harmony and balance in nurses in relation to God. Spiritual care focuses on respecting patients, friendly and sympathetic interactions, sharing in rituals and strengthening patients and nurses' inner energy. This type of spirituality gives a positive perspective to life and profession, peaceful interactions, a harmonious state of mind, and acts as a motivator among nurses to promote nursing care and spirituality.

  18. Competence and frequency of provision of spiritual care by nurses in the Netherlands.

    Science.gov (United States)

    Vogel, Annemieke; Schep-Akkerman, Annemiek E

    2018-04-25

    Spiritual care to patients is important for their well-being, and nurses do have a crucial role in it. Previous research focused on self-assessed competence in providing spiritual care, but little is known about the actual provision. The aims of this study were as follows: (i) to evaluate how often nurses provide spiritual care, (ii) if or which association there is between self-assessed competency and provision of spiritual care, and (iii) to study which factors do have influence on delivering spiritual care. A quantitative study was designed. Nurses were asked to complete a questionnaire. Self-assessment of spiritual care competence and actions was evaluated with the Spiritual Care Competence Scale New: a 27 items questionnaire on competence (SCCS-can) and frequency (SCCS-do) of providing spiritual care, measured with a five-point Likert scale. Mean competence score and frequency of provision were calculated, next to the correlation between those two. Several factors (mean SCCS-can, gender, age, education level, experience, life view, personal spirituality (measured on a 1-10 scale)) were included in regression analysis to study factors of influence on actual provision of spiritual care (measured with SCCS-do). A total of 104 completed questionnaires have been analysed. Mean score on the SCCS-can was 3.9, and on the SCCS-do 3.2. This means that nurses state they are highly competent in delivering spiritual care and provide this monthly. The Pearson correlation between SCCS-can and SCCS-do was 0.50, which means the higher the score on SCCS-can, the higher the score on SCCS-do. Regression analysis shows that the self-assessed competence of spiritual care (SCCS-can) and the personal spirituality are significant predictors of the outcome SCCS-do. The better the nurses think they can provide spiritual care, the more they say they practise it. Regression analysis supports this: the factors of influence on provision of spiritual care are self-assessed competence and

  19. [HIV Stigma and Spiritual Care in People Living With HIV].

    Science.gov (United States)

    Yu, Chia-Hui; Chiu, Yi-Chi; Cheng, Su-Fen; Ko, Nai-Ying

    2018-06-01

    HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

  20. Frequency of Faith and Spirituality Discussion in Health Care.

    Science.gov (United States)

    Bergamo, David; White, Dawn

    2016-04-01

    Faith and spirituality are important in the lives of many individuals, and therefore, many patients. This study was performed to determine whether faith and spirituality are active part of the healthcare field and patients' receipt of these sometimes delicate topics. The nuances of the concepts of faith, spirituality, and religion and their implications in the healthcare setting are discussed. Benefits and detriments of faith and spirituality are reviewed in terms of how they relate to the health of the patient and to the healthcare field. With the focus of healthcare shifting to holistic care, this conversation may be more necessary than ever in practice, yet it seems many providers are not discussing these matters with patients. The study analyzes whether healthcare providers are discussing these topics with patients and how the discussion is received or would be received by patients. Findings demonstrate the infrequency of the discussion regardless of the fact that the majority of patients consider themselves faithful or spiritual. This study was approved by the Clarkson University Institutional Review Board on June 18, 2104.

  1. Nurses' and midwives' acquisition of competency in spiritual care: a focus on education.

    Science.gov (United States)

    Attard, Josephine; Baldacchino, Donia R; Camilleri, Liberato

    2014-12-01

    The debate that spirituality is 'caught' in practice rather than 'taught' implies that spiritual awareness comes about through clinical experience and exposure, requiring no formal education and integration within the curricula. This is challenged as it seems that providing students with a 'taught' component equips students with tools to identify and strengthen resources in 'catching' the concept. This study forms part of a modified Delphi study, which aims to identify the predictive effect of pre- and post-registration 'taught' study units in spiritual care competency of qualified nurses/midwives. A purposive sample of 111 nurses and 101 midwives were eligible to participate in the study. Quantitative data were collected by the Spiritual Care Competency Scale (SCCS) (Van Leeuwen et al., 2008) [response rate: nurses (89%; n=99) and midwives (74%; n=75)]. Overall nurses/midwives who had undertaken the study units on spiritual care scored higher in the competency of spiritual care. Although insignificant, nurses scored higher in the overall competency in spiritual care than the midwives. 'Taught' study units on spiritual care at pre- or post-registration nursing/midwifery education may contribute towards the acquisition of competency in spiritual care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Spiritual beliefs and barriers among managed care practitioners.

    Science.gov (United States)

    McCauley, Jeanne; Jenckes, Mollie W; Tarpley, Margaret J; Koenig, Harold G; Yanek, Lisa R; Becker, Diane M

    2005-01-01

    Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'. Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

  3. Spiritual pain among patients with advanced cancer in palliative care.

    Science.gov (United States)

    Mako, Caterina; Galek, Kathleen; Poppito, Shannon R

    2006-10-01

    The large body of empirical research suggesting that patients' spiritual and existential experiences influence the disease process has raised the need for health care professionals to understand the complexity of patients' spiritual pain and distress. The current study explores the multidimensional nature of spiritual pain, in patients with end-stage cancer, in relation to physical pain, symptom severity, and emotional distress. The study combines a quantitative evaluation of participants' intensity of spiritual pain, physical pain, depression, and intensity of illness, with a qualitative focus on the nature of patients' spiritual pain and the kinds of interventions patients believed would ameliorate their spiritual pain. Fifty-seven patients with advanced stage cancer in a palliative care hospital were interviewed by chaplains. Overall, 96% of the patients reported experiencing spiritual pain, but they expressed it in different ways: (1) as an intrapsychic conflict, (2) as interpersonal loss or conflict, or (3) in relation to the divine. Intensity of spiritual pain was correlated with depression (r = 0.43, p spiritual pain did not vary by age, gender, disease course or religious affiliation. Given both the universality of spiritual pain and the multifaceted nature of pain, we propose that when patients report the experience of pain, more consideration be given to the complexity of the phenomena and that spiritual pain be considered a contributing factor. The authors maintain that spiritual pain left unaddressed both impedes recovery and contributes to the overall suffering of the patient.

  4. New Zealand Nurses’ Perceptions of Spirituality and Spiritual care: Qualitative Findings from a National Survey

    Directory of Open Access Journals (Sweden)

    Richard Egan

    2017-04-01

    Full Text Available This paper presents the qualitative findings from the first national survey of New Zealand nurses’ views on spirituality and spiritual care. The importance of spirituality as a core aspect of holistic nursing care is gaining momentum. Little is currently known about New Zealand nurses’ understandings, perceptions and experience of spirituality. Design: A descriptive online survey. Method: A random sample of 2000 individuals resident in New Zealand whose occupation on the New Zealand electoral roll suggested nursing was their current or past occupation were invited via postcard to participate in an online survey. This paper reports on the free response section of the survey. Findings: Overall, 472 invitees responded (24.1%. From the respondents, 63% completed at least one of the optional free response sections. Thematic analysis generated three metathemes: ‘The role of spirituality in nursing practice’, ‘Enabling best practice’, and ‘Creating a supportive culture’. Conclusions: Spirituality was predominantly valued as a core aspect of holistic nursing care. However, clarity is needed surrounding what constitutes spiritual care and how this intersects with professional responsibilities and boundaries. Participants’ insights suggest a focus on improving the consistency and quality of spiritual care by fostering inter-professional collaboration, and improved provision of resources and educational opportunities.

  5. Attitudes Toward Spirituality and Spiritual Care among Iranian Nurses and Nursing Students: A Cross-Sectional Study.

    Science.gov (United States)

    Babamohamadi, Hassan; Ahmadpanah, Mahsa-Sadat; Ghorbani, Raheb

    2017-08-22

    Addressing spiritual needs is taken into account as an integral part of holistic health care and also an important component of nursing practice. The aim of present study is to evaluate attitudes toward spirituality and spiritual care among nurses and nursing students at Semnan University of Medical Sciences in Iran. In this cross-sectional study, all nurses (n = 180) working in the teaching hospitals affiliated to Semnan University of Medical Sciences as well as senior nursing students (n = 50) selected by the census method. Finally, 168 individuals meeting the inclusion criteria were evaluated as the study sample. The data collection instrument was the Spirituality and Spiritual Care Rating Scale. The mean and standard deviation scores of attitudes toward spirituality and spiritual care among nurses and nursing students were 59 ± 10.9, and the scores obtained by the majority of study population (64.3%) ranged between 32 and 62 which were at a moderate and relatively desirable level. Nurses and nursing students working in aforementioned hospitals reported positive attitudes to spirituality and spiritual care. Given the importance of spiritual care and also the moderate level of spirituality and spiritual care among nurses and nursing students in this study, institutionalization of the concept of spirituality, provision of an appropriate context to deliver such care, and also implementation of interventions in order to improve spiritual care along with other nursing skills were assumed of utmost importance.

  6. Spirituality and caring in old age and the significance of religion - a hermeneutical study from Norway.

    Science.gov (United States)

    Rykkje, Linda L R; Eriksson, Katie; Raholm, Maj-Britt

    2013-06-01

    Spirituality is an important part of caring for the whole human being. However, there is lack of consensus about the concept parameter, and there is an ongoing discussion in nursing regarding the relation between religion and spirituality. Spirituality and religion is found to support health and well-being in old age, and this article portrays how older Norwegians understand religion and religious support as part of spirituality and caring. The theoretical framework in this study is Eriksson's caritative caring theory, and the research aim is to broaden the understanding of spirituality from a caring science perspective. The methodology is hermeneutical according to Gadamer. The study is based upon qualitative content analysis of 30 interviews with 17 participants above 74 years, six men and 11 women. The findings portray connectedness with a Higher power, including how Christianity has influenced upon the philosophy of life of the participants, wonders about the end of life/afterlife, and the meaning of religious symbols and rituals. The study also portrays how religious support may foster dignity, especially near the end of life, and experiences and opinions regarding support from nursing personnel. The study concludes that religiousness cannot be separated from spirituality, and that nurses should be able to provide spiritual care to a certain extent. Spiritual care including religious support according to patients' desires may foster health and preserve human dignity. © 2012 Nordic College of Caring Science.

  7. Learning effects of thematic peer-review : A qualitative analysis of reflective journals on spiritual care

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Jochemsen, Henk; Post, Doeke

    This study describes the learning effects of thematic peer-review discussion groups (Hendriksen, 2000. Begeleid intervisie model, Collegiate advisering en probleemoplossing, Nelissen, Baarn.) on developing nursing students' competence in providing spiritual care. It also discusses the factors that

  8. Learning effects of thematic peer-review: A qualitative analysis of reflective journals on spiritual care

    NARCIS (Netherlands)

    Leeuwen, van L.J.; Tiesinga, L.J.; Jochemsen, H.

    2009-01-01

    This study describes the learning effects of thematic peer-review discussion groups (Hendriksen, 2000. Begeleid intervisie model, Collegiale advisering en probleemoplossing, Nelissen, Baarn.) on developing nursing students’ competence in providing spiritual care. It also discusses the factors that

  9. An exploration of how spiritual nursing care is applied in clinical nursing practice

    Directory of Open Access Journals (Sweden)

    Lydia V. Monareng

    2013-05-01

    Full Text Available Spiritual nursing care is a significant concept for nurses as they are expected to provide holistic care to patients. Many nurses have difficulty to understand and integrate it into practice and consequently neglect this aspect of care. The study was conducted to explore and describe how professional nurses provide spiritual care to patients. A generic qualitative, explorative and descriptive study was conducted based on Symbolic Interactionism as the philosophical base. The population comprised professional nurses from a public hospital. Participants were recruited through purposive and snowball sampling methods. Data were collected through the use of individual, focus group interviews and observation. Data analysis methods utilised included the NUD*ISTcomputer program, coding, constant comparison method and Tesch’s guidelines on data analysis. Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer with or for patients and singing spiritual songs had the highest count of interventions perceived to be effective. Recommendations suggest that the scope of practice and curriculum of training of nurses be reviewed to consider how spiritual nursing care can be evidenced and realised both in the classroom and in the clinical setting. Spiritual nursing care is still a neglected and seemingly complex component of patient care. However, the scientific worldview practices, beliefs and insufficient statutory endorsement of such care hamper its realisation in practice.

  10. Patients’ and caregivers’ needs, experiences, preferences and research priorities in spiritual care: A focus group study across nine countries

    Science.gov (United States)

    Selman, Lucy Ellen; Brighton, Lisa Jane; Sinclair, Shane; Karvinen, Ikali; Egan, Richard; Speck, Peter; Powell, Richard A; Deskur-Smielecka, Ewa; Glajchen, Myra; Adler, Shelly; Puchalski, Christina; Hunter, Joy; Gikaara, Nancy; Hope, Jonathon

    2017-01-01

    Background: Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited. Aim: To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers. Design: Focus group study. Setting/participants: Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. Discussions were transcribed, translated into English and analysed thematically. Results: A total of 74 patients participated: median age 62 years; 53 had cancer; 48 were women. In total, 71 caregivers participated: median age 61 years; 56 were women. Two-thirds of participants were Christian. Five themes are described: patients’ and caregivers’ spiritual concerns, understanding of spirituality and its role in illness, views and experiences of spiritual care, preferences regarding spiritual care, and research priorities. Participants reported wide-ranging spiritual concerns spanning existential, psychological, religious and social domains. Spirituality supported coping, but could also result in framing illness as punishment. Participants emphasised the need for staff competence in spiritual care. Spiritual care was reportedly lacking, primarily due to staff members’ de-prioritisation and lack of time. Patients’ research priorities included understanding the qualities of human connectedness and fostering these skills in staff. Caregivers’ priorities included staff training, assessment, studying impact, and caregiver’s spiritual care needs. Conclusion: To meet patient and caregiver preferences, healthcare providers should be able to address their spiritual concerns. Findings should inform patient- and caregiver-centred spiritual care provision, education and

  11. [Spiritual care of a terminal liver cancer patient: a nursing experience].

    Science.gov (United States)

    Chien, Hui-Chi

    2010-04-01

    Death, an unavoidable event in the human experience, causes physical as well as mental and spiritual suffering. This paper reports on a nursing experience giving spiritual care to a terminal liver cancer patient between January 17 and February 9, 2009. Eleven nursing logs were used as the source of data for daily information. During the care period, patient religious needs featured prominently, including his desire to become a Christian and his eagerness to know about and help in the arrangement of his funeral. Taking the initiative, the nurse helped link him with religious resources, arranged a minister for his baptism ceremony, had the priest explain funeral proceedings, and assisted with the completion of his entrusted plans. The function of this nursing care intervention was to provide a personal touch to a patient who was in desperate need of warm spiritual care. It is hoped that this report can help caregivers increase their sensitivity toward patient spiritual needs and enhance routine nursing care quality.

  12. Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project.

    Science.gov (United States)

    Gomez-Castillo, Blanca J; Hirsch, Rosemarie; Groninger, Hunter; Baker, Karen; Cheng, M Jennifer; Phillips, Jayne; Pollack, John; Berger, Ann M

    2015-11-01

    Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement. Published by Elsevier Inc.

  13. Towards a fully-fledged integration of spiritual care and medical care

    NARCIS (Netherlands)

    Kruizinga, R.; Scherer-Rath, M.; Schilderman, J. B. A. M.; Puchalski, C. M.; van Laarhoven, H. W. M.

    2017-01-01

    In this article we aim to set out current problems that hinder a fully-fledged integration of spiritual and medical care that address these obstacles. We discuss the following five statements: 1. Spiritual care requires a clear and inclusive definition of spirituality; 2. Empirical evidence for

  14. Towards a fully-fledged integration of spiritual care and medical care

    NARCIS (Netherlands)

    Kruizinga, R.; Scherer-Rath, M.; Schilderman, J.B.A.M.; Puchalski, C.; Laarhoven, H.W.M. van

    2018-01-01

    In this article, we aimed to set out current problems that hinder a fully fledged integration of spiritual and medical care, which address these obstacles. We discuss the following five statements: 1) spiritual care requires a clear and inclusive definition of spirituality; 2) empirical evidence for

  15. What Impact Do Chaplains Have? A Pilot Study of Spiritual AIM for Advanced Cancer Patients in Outpatient Palliative Care.

    Science.gov (United States)

    Kestenbaum, Allison; Shields, Michele; James, Jennifer; Hocker, Will; Morgan, Stefana; Karve, Shweta; Rabow, Michael W; Dunn, Laura B

    2017-11-01

    Spiritual care is integral to quality palliative care. Although chaplains are uniquely trained to provide spiritual care, studies evaluating chaplains' work in palliative care are scarce. The goals of this pre-post study, conducted among patients with advanced cancer receiving outpatient palliative care, were to evaluate the feasibility and acceptability of chaplain-delivered spiritual care, utilizing the Spiritual Assessment and Intervention Model ("Spiritual AIM"), and to gather pilot data on Spiritual AIM's effects on spiritual well-being, religious and cancer-specific coping, and physical and psychological symptoms. Patients with advanced cancer (N = 31) who were receiving outpatient palliative care were assigned based on chaplains' and patients' outpatient schedules, to one of three professional chaplains for three individual Spiritual AIM sessions, conducted over the course of approximately six to eight weeks. Patients completed the following measures at baseline and post-intervention: Edmonton Symptom Assessment Scale, Steinhauser Spirituality, Brief RCOPE, Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12), Mini-Mental Adjustment to Cancer (Mini-MAC), Patient Dignity Inventory, Center for Epidemiological Studies-Depression (10 items), and Spielberger State Anxiety Inventory. From baseline to post-Spiritual AIM, significant increases were found on the FACIT-Sp-12 Faith subscale, the Mini-MAC Fighting Spirit subscale, and Mini-MAC Adaptive Coping factor. Two trends were observed, i.e., an increase in Positive religious coping on the Brief RCOPE and an increase in Fatalism (a subscale of the Mini-MAC). Spiritual AIM, a brief chaplain-led intervention, holds potential to address spiritual needs and religious and general coping in patients with serious illnesses. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  16. An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks.

    LENUS (Irish Health Repository)

    Timmins, Fiona

    2015-01-01

    Holistic care that encompasses a spiritual dimension is an expectation in modern healthcare (Rothman, 2009). Increasing attention is being paid to the role of nurses in providing spiritual care to patients. However nurses lack specific skills and expertise in this area (Lundmark, 2006; Timmins, 2010; RCN, 2011), and the extent to which their undergraduate education prepares them for this role is unclear. There is often an absence of clear direction about what to teach undergraduate nursing students. The extent to which core textbooks direct student studies in this area is not known. There is some evidence that some of these fundamental core textbooks provide insufficient direction (Pesut, 2008), thus gaps in knowledge and care provision in this field could be exacerbated.

  17. Bring about benefit, forestall harm: what communication studies say about spirituality and cancer care.

    Science.gov (United States)

    Tullis, Jillian A

    2010-01-01

    Technological advances in medicine allow health care providers to diagnose diseases earlier, diminish suffering, and prolong life. These advances, although widely revered for changing the face of cancer care, come at a cost for patients, families, and even health care providers. One widely cited consequence of better diagnostics and improved treatment regiments is the sense that there is always one more test or therapy available to extend life. Such an approach to cancer care can prove detrimental to patients? healing. In addition, these new tests and treatments further focus attention on the body as the site of healing and cure while downplaying other aspects of health. The absence of psychological, social, and spiritual care from a patient's cancer care plan compromises healing and makes palliative and end of life care more complicated. In this essay, I discuss the tensions that exist between contemporary cancer care and spirituality and use Communication Studies scholarship to navigate the challenges of integrating a patient's religious or spiritual beliefs into their cancer treatment and care. In addition to discussing the challenges of communicating about sensitive topics such as illness, spirituality, and dying, this article uses narrative examples from a comprehensive cancer center and a hospice (both in the United States) to understand how people with cancer and other terminal illnesses communicate their spirituality and how these conversations influence health care choices and provide comfort. By understanding how patients communicate about topics such as the meaning of life, quality of life, dying and death, providers are better equipped to offer care that is consistent with a patient's beliefs and life goals. This approach maintains that communication is more than a means of transferring information, but is constitutive. By understanding that communication creates our lives and shapes our worlds, lay and professional caregivers can meet patients where

  18. Spiritual Assessment within Clinical Interventions Focused on Quality of Life Assessment in Palliative Care: A Secondary Analysis of a Systematic Review

    Directory of Open Access Journals (Sweden)

    Gianluca Catania

    2016-03-01

    Full Text Available One of the most crucial palliative care challenges is in determining how patients’ needs are defined and assessed. Although physical and psychological needs are commonly documented in patient’s charts, spiritual needs are less frequently reported. The aim of this review was to determine which explicit, longitudinal documentation of spiritual concerns would sufficiently affect clinical care to alleviate spiritual distress or promote spiritual wellbeing. A secondary analysis of a systematic review originally aimed at appraising the effectiveness of complex interventions focused on quality of life in palliative care was conducted. Five databases were searched for articles reporting interventions focused on QoL including at least two or more QoL dimensions. A narrative synthesis was performed to synthesize findings. In total, 10 studies were included. Only three studies included spiritual wellbeing assessment. Spirituality tools used to assess spiritual wellbeing were different between studies: Hospital QoL Index 14; Spiritual Needs Inventory; Missoula-Vitas QoL Index; and the Needs Assessment Tool: Progressive Disease-Cancer. Only one study reported a healthcare professional’s session training in the use of the QoL tool. Two out of three studies showed in participants an improvement in spiritual wellbeing, but changes in spiritual wellbeing scores were not significant. Overall patients receiving interventions focused on QoL assessment experienced both improvements in their QoL and in their spiritual needs. Although spiritual changes were not significant, the results provide evidence that a spiritual need exists and that spiritual care should be appropriately planned and delivered. Spiritual needs assessment precedes spiritual caring. It is essential that interventions focused on QoL assessment in palliative care include training on how to conduct a spiritual assessment and appropriate interventions to be offered to patients to address their

  19. Spiritual well-being among outpatients with cancer receiving concurrent oncologic and palliative care.

    Science.gov (United States)

    Rabow, Michael W; Knish, Sarah J

    2015-04-01

    Spiritual well-being is threatened by cancer, but its correlation with other illness symptoms and the efficacy of palliative care (PC) to ameliorate spiritual suffering are not well understood. We conducted a retrospective study using a convenience sample of oncology patients at a comprehensive cancer center who received concurrent oncologic and palliative care between 2008 and 2011 and completed ESAS, QUAL-E, and Steinhauser Spiritual well-being survey questions was conducted. Descriptive, correlation, and t test statistics. Eight hundred eighty-three patients surveyed had an average age of 65.6 years, with 54.1 % female, 69.3 % white, and 49.3 % married. Half (452, 51.2 %) had metastatic disease. Religious affiliation was reported as Christian by 20.3 %, Catholic by 18.7 %, and "none" by 39.0 %. Baseline spiritual well-being was not significantly correlated with age, gender, race, cancer stage, marital status, insurance provider, or having a religious affiliation. Greater spiritual well-being was correlated with greater quality of life (well-being (spiritual well-being and anxiety, depression, fatigue, and quality of life (R (2) = 0.677). Spiritual well-being improved comparing mean scores immediately prior to initial PC consultation with those at first follow-up (2.89 vs. 3.23 on a 1-5 scale, p = 0.005). Among patients with cancer receiving concurrent oncologic and palliative care, spiritual well-being was not associated with patient age, gender, or race, or disease stage. It was correlated with physical and emotional symptoms. Spiritual well-being scores improved from just prior to the initial PC consultation to just prior to the first PC follow-up visit.

  20. Exploring Nurse Communication About Spirituality.

    Science.gov (United States)

    Wittenberg, Elaine; Ragan, Sandra L; Ferrell, Betty

    2017-07-01

    Although spiritual care is considered one of the pillars of palliative care, many health-care providers never receive formal training on how to communicate about spirituality with patients and families. The aim of this study was to explore the spiritual care experiences of oncology nurses in order to learn more about patient needs and nurse responses. A survey was circulated at a communication training course for oncology nurses in June 2015. Nurses recalled a care experience that included the initiation of a spiritual care topic and their response to the patient/family. Data were analyzed using thematic analysis. Nurses reported that communication about spirituality was primarily initiated by patients, rather than family members, and spiritual topics commonly emerged during the end of life or when patients experienced spiritual distress. Nurses' experiences highlighted the positive impact spiritual conversations had on the quality of patient care and its benefit to families. Spiritual communication was described as an important nursing role at the end of patients' lives, and nonverbal communication, listening, and discussing patients' emotions were emphasized as important and effective nurse communication skills during spiritual care conversations. Approximately one-third of nurses in the sample reported sharing their own personal spiritual or religious backgrounds with patients, and they reported that these sharing experiences strengthened their own faith. It is evident that patients want to discuss spiritual topics during care. Study findings illustrate the need to develop a spiritual communication curriculum and provide spiritual care communication training to clinicians.

  1. Spiritual and religious components of patient care in the neonatal intensive care unit: sacred themes in a secular setting.

    Science.gov (United States)

    Catlin, E A; Guillemin, J H; Thiel, M M; Hammond, S; Wang, M L; O'Donnell, J

    2001-01-01

    We hypothesized that spiritual distress was a common, unrecognized theme for neonatal intensive care unit (NICU) care providers. An anonymous questionnaire form assigned to a data table in a relational database was designed. Surveys were completed by 66% of NICU staff. All respondents viewed a family's spiritual and religious concerns as having a place in patient care. Eighty-three percent reported praying for babies privately. Asked what theological sense they made of suffering of NICU babies, 2% replied that children do not suffer in the NICU. Regarding psychological suffering of families, the majority felt God could prevent this, with parents differing (p = 0.039) from nonparents. There exists a strong undercurrent of spirituality and religiosity in the study NICU. These data document actual religious and spiritual attitudes and practices and support a need for pastoral resources for both families and care providers. NICU care providers approach difficulties of their work potentially within a religious and spiritual rather than a uniquely secular framework.

  2. How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies.

    Science.gov (United States)

    Keall, Robyn; Clayton, Josephine M; Butow, Phyllis

    2014-11-01

    To investigate the facilitators, barriers and strategies that Australian palliative care nurses identify in providing existential and spiritual care for patients with life-limiting illnesses. Palliative care aims to be holistic, incorporating all domains of personhood, but spiritual/existential domain issues are often undertreated. Lack of time and skills and concerns for what you may uncover hamper care provision. A qualitative study through semistructured interviews. We interviewed 20 palliative care nurses from a cross section of area of work, place of work, years of experience, spiritual beliefs and importance of those beliefs within their lives. Questions focused on their current practices of existential and spiritual care, identification of facilitators of, barriers to and strategies for provision of that care. Their responses were transcribed and subjected to thematic analysis. The nurses' interviews yielded several themes including development of the nurse-patient relationship (14/20 nurses), good communication skills and examples of questions they use to 'create openings' to facilitate care. Barriers were identified as follows: lack of time (11/20 nurses), skills, privacy and fear of what you may uncover, unresolved symptoms and differences in culture or belief. Novel to our study, the nurses offered strategies that included the following: undertaking further education in this area, being self-aware and ensuring the setting is conducive to in-depth conversations and interactions and documentation and/or interdisciplinary sharing for continuity of care. Palliative care nurses are well placed to provide existential and spiritual care to patients with the primary facilitator being the nurse-patient relationship, the primary barrier being lack of time and the primary strategy being undertaking further education in this area. These findings could be used for nurse-support programmes, undergraduate or graduate studies or communication workshop for nurses.

  3. Spiritual issues and quality of life assessment in cancer care.

    Science.gov (United States)

    Efficace, Fabio; Marrone, Robert

    2002-11-01

    Being diagnosed with cancer forces most human beings to face their own death. The comfortable sense of both invulnerability and immortality is shattered, making the patient thoroughly aware that life is finite and limited. Approaching death, cancer patients commonly embark on an inner journey involving a search for meaning as well as a reordering of priorities involving physical, psychological, social, and spiritual needs. Although interest in the role of spirituality, relating to both adjustment to cancer and the overall quality of life of cancer patients, has increased in recent years, most of the commonly used quality of life (QOL) instruments in oncology typically do not include spiritual issues. In this article, it is argued that assessing QOL effectively should involve all aspects of the personality, including mind, body, and spirit as well. This article also reviews recent studies, which have shown that spiritual well-being, although a many-sided and difficult construct to define, is closely related to the QOL of cancer patients. It is also suggested that further research is needed to understand how the new focus on spirituality can contribute to a more comprehensive assessment of patient's QOL in cancer care.

  4. Attachment Theory and Spirituality: Two Threads Converging in Palliative Care?

    Directory of Open Access Journals (Sweden)

    Cécile Loetz

    2013-01-01

    Full Text Available The aim of this paper is to discuss and explore the interrelation between two concepts, attachment theory and the concept of spirituality, which are important to palliative care and to founding a multivariate understanding of the patient’s needs and challenges. Both concepts have been treated by research in diverse and multiform ways, but little effort has yet been made to integrate them into one theoretical framework in reference to the palliative context. In this paper, we begin an attempt to close this scientific gap theoretically. Following the lines of thought in this paper, we assume that spirituality can be conceptualized as an adequate response of a person’s attachment pattern to the peculiarity of the palliative situation. Spirituality can be seen both as a recourse to securely based relationships and as an attempt to explore the ultimate unknown, the mystery of one’s own death. Thus, spirituality in the palliative context corresponds to the task of attachment behavior: to transcend symbiosis while continuing bonds and thus to explore the unknown environment independently and without fear. Spiritual activity is interpreted as a human attachment behavior option that receives special quality and importance in the terminal stage of life. Implications for clinical practice and research are discussed in the final section of the paper.

  5. Attachment theory and spirituality: two threads converging in palliative care?

    Science.gov (United States)

    Loetz, Cécile; Müller, Jakob; Frick, Eckhard; Petersen, Yvonne; Hvidt, Niels Christian; Mauer, Christine

    2013-01-01

    The aim of this paper is to discuss and explore the interrelation between two concepts, attachment theory and the concept of spirituality, which are important to palliative care and to founding a multivariate understanding of the patient's needs and challenges. Both concepts have been treated by research in diverse and multiform ways, but little effort has yet been made to integrate them into one theoretical framework in reference to the palliative context. In this paper, we begin an attempt to close this scientific gap theoretically. Following the lines of thought in this paper, we assume that spirituality can be conceptualized as an adequate response of a person's attachment pattern to the peculiarity of the palliative situation. Spirituality can be seen both as a recourse to securely based relationships and as an attempt to explore the ultimate unknown, the mystery of one's own death. Thus, spirituality in the palliative context corresponds to the task of attachment behavior: to transcend symbiosis while continuing bonds and thus to explore the unknown environment independently and without fear. Spiritual activity is interpreted as a human attachment behavior option that receives special quality and importance in the terminal stage of life. Implications for clinical practice and research are discussed in the final section of the paper.

  6. Development and Validation of the Spiritual Care Needs Inventory for Acute Care Hospital Patients in Taiwan.

    Science.gov (United States)

    Wu, Li-Fen; Koo, Malcolm; Liao, Yu-Chen; Chen, Yuh-Min; Yeh, Dah-Cherng

    2016-12-01

    Spiritual care is increasingly being recognized as an integral aspect of nursing practice. The aim of this study was to develop a new instrument, Spiritual Care Needs Inventory (SCNI), for measuring spiritual care needs in acute care hospital patients with different religious beliefs. The 21-item instrument was completed by 1,351 adult acute care patients recruited from a medical center in Taiwan. Principal components analysis of the SCNI revealed two components, (a) meaning and hope and (b) caring and respect, which together accounted for 66.2% of the total variance. The internal consistency measures for the two components were 0.96 and 0.91, respectively. Furthermore, younger age, female sex, Christian religion, and regularly attending religious activities had significantly higher mean total scores in both components. The SCNI was found to be a simple instrument with excellent internal consistency for measuring the spiritual care needs in acute care hospital patients. © The Author(s) 2015.

  7. Spirituality in end-of-life care: attending the person on their journey.

    LENUS (Irish Health Repository)

    Hayden, Deborah

    2011-11-01

    Spirituality is a fundamental element to the human experience of health and healing, illness and dying. Spiritual care is an essential component of palliative and end-of-life care provision and is the responsibility of all staff and carers involved in the care of patients and families. As end-of-life care is a significant element of community nursing, this article explores the relevancy of spirituality to end-of-life practice, the challenge of defining spirituality and the attributes and skills required for the practice of spiritual care. The aim of is to encourage self reflection and open dialogue about the subject, thus enhancing community nurses\\' understanding of spiritual care practice. By reflecting and generating talk about the practice of spiritual care, it may become more normalized, recognized, and practically meaningful, thereby retaining its significance in holistic nursing.

  8. What Is the Essence of Spiritual Care?

    DEFF Research Database (Denmark)

    Steenfeldt, Vibeke Østergaard

    2016-01-01

    This study explored patient, relatives, and healthcare professionals’ experience of life and caring practice in two Danish hospice settings. Using a phenomenological approach, four caring themes emerged from data analysis: Recognized as an individual human being; Caring as doing and being; Caring...

  9. Emotional intelligence and spiritual well-being: implications for spiritual care.

    Science.gov (United States)

    Beauvais, Audrey; Stewart, Julie G; DeNisco, Susan

    2014-01-01

    Understanding factors that influence spiritual well-being may improve nurses' spiritual caregiving. This study examined relationships between emotional intelligence (EI) and spiritual well-being (SWB) in undergraduate and graduate nursing students. Using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the spiritual well-being scale (SWBS) relationships were found between managing emotion and spiritual well-being, and managing emotion and existential well-being. Implications for education and practice are discussed.

  10. OA35 Shared humanity, shared mortality - spiritual care in care homes.

    Science.gov (United States)

    Thomas, Mark

    2015-04-01

    Currently a fifth of the population die in care homes and most residents are in the final year of life. Spiritual care is recognised as important (The National Institute for Health and Care Excellence [NICE] Quality Standards, Leadership Alliance) yet there is little teaching for care homes' staff in this vital area. Spiritual care is intrinsic in the Gold Standards Framework (GSF) programmes, it is one of the standards for GSF accreditation, yet often health and social care professionals are unaware or unconfident in this area, with a tendency to confuse spirituality with religion. To develop a Spiritual Care course to supplement the range of GSF programmes, especially for care homes, to increase confidence and ability of staff caring for people nearing the end of life. While we need to bring professional expertise to bear in our caring, we must also bring our humanity, our lack of answers and our ability to listen with mindfulness and compassion. Working in collaboration with Staffordshire University, blending academic and practical expertise, we developed a one day workshop and filmed a four-module distance-learning course. Evaluations have shown a broadening of awareness and perspective, increased confidence in assessing and meeting spiritual needs, greater self-care and resilience amongst staff and a more creative interpretation of spiritual care helping to meet the needs of care homes' residents. Early use of this spiritual care workshop and course for care homes' staff has been well received and encouraging. Sharing our common human experience of loss and mortality leads to greater resilience through inner transformation. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. The provision of spiritual and pastoral care following stillbirth in Ireland: a mixed methods study.

    Science.gov (United States)

    Nuzum, Daniel; Meaney, Sarah; O'Donoghue, Keelin

    2016-06-01

    The death of a baby is recognised as one of the most difficult bereavements with life-long impact for parents. How bereaved parents are cared for influences their grief journey. Optimal holistic care is provided when the physical, emotional, spiritual and social needs of parents are attended to. This study reviewed how spiritual care is provided to bereaved parents following stillbirth in maternity units in Ireland and the impact of stillbirth on healthcare chaplains. This was a mixed methods study using semistructured qualitative interviews with hospital chaplains in Irish maternity units. Quantitative data about the provision of services to bereaved parents were collated from the interviews. Qualitative data were analysed thematically to identify key themes. 20 chaplains from 17 units participated in the study (85% of Irish maternity units). 12 chaplains (60%) are formally accredited chaplains; only one has received specialist training in perinatal bereavement care. 11 chaplains (55%) provide follow-up bereavement care. Seven chaplains (35%) did not feel part of the multidisciplinary team. The main themes that emerged were the impact of stillbirth, suffering and the challenge to faith creating inner conflict and doubt. The provision of spiritual care following stillbirth in Ireland is diverse. Spiritual care in this specialised area by chaplains who are not professionally trained and accredited potentially impacts quality and depth of care. Chaplains experience considerable impact and challenge to personal faith and belief as they provide care. Recommendations are made for ongoing education and greater support for chaplains. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Attitudes of stakeholders and policymakers in the healthcare system towards the provision of spiritual care in Israel.

    Science.gov (United States)

    Bentur, Netta; Resnitzky, Shirli; Sterne, Abram

    2010-06-01

    Spiritual-care services and chaplaincy in the medical system are provided to people with serious illnesses, aiming to help them achieve moments of peace and acceptance while contending with illness or facing death. Chaplaincy has been available in Europe and in the U.S. for many decades, but such programs started to develop in Israel only few years ago. This paper examines the attitudes of stakeholders, directors and policymakers in the healthcare system towards the provision of spiritual care and the development of such programs. We conducted in-depth face-to-face interviews with 16 individuals in the healthcare system. All the interviews were transcribed in full and analyzed using qualitative study methods. Most of the interviewees had little knowledge of spiritual care and many mentioned barriers and challenges to its implementation in the healthcare system. These issues include: lack of knowledge and understanding about spiritual care precluding impeded their ability to evaluate its suitability for the healthcare services; confusion between spiritual care and religion; concerns about potential conflict with other professionals, especially social workers; barriers to funding of the new services; barriers to the successful integration of new ideas; and concerns about formal training and accreditation of the new profession. Spiritual care has begun to take root in Israel's health system, but it is still at an early stage of development. Implementation must continue apace and careful consideration must be given to optimizing its acceptance by the establishment. Copyright (c) 2010. Published by Elsevier Ireland Ltd.

  13. Culture and spirituality: essential components of palliative care.

    Science.gov (United States)

    Speck, Peter

    2016-06-01

    Palliative care advocates a holistic, multiprofessional approach to the care of people with life-threatening disease. In addition to the control of physical symptoms attention should also be paid to psychosocial, cultural and spiritual aspects of the patient's experience of illness. Guidance documents and research evidence reflect the complexity of the patient's journey and the need to regularly assess these areas of need over time. Cultural background can shape how patients respond to life-threatening illness, as can the beliefs held by the patients, whether religious or more broadly spiritual. Research evidence shows the importance of identifying and addressing cultural and spiritual aspects of care held by patients, families and staff. These are often neglected in clinical practice due to the focus on biomedical concerns and staff discomfort in engaging with beliefs and culture. Recent studies have highlighted gaps in the research, and some methodological difficulties and indicate many patients welcome healthcare staff enquiring about the importance of their beliefs and culture. Identifying research priorities is necessary to guide future research and strengthen the evidence base. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. The Role of Social Workers in Spiritual Care to Facilitate Coping With Chronic Illness and Self-Determination in Advance Care Planning.

    Science.gov (United States)

    Francoeur, Richard B; Burke, Nancy; Wilson, Alicia M

    2016-01-01

    Spiritual values and beliefs of patients and families influence resilience during chronic illness and shape patient choices during advance care planning. The spiritual needs of Baby Boomers will be more diverse than previous generations, in connection with the questioning, experimental mind-set of this group and the fact that it includes a higher proportion of immigrant populations outside the Judeo-Christian tradition. Social workers are trained explicitly to intervene with diverse populations and are well positioned to offer spiritual support in ways that do not necessarily conform to traditional religions. To the extent of their individual expertise and competence, social workers should assess and provide spiritual care to clients, including those who either are underserved or prefer not to seek assistance from clergy or chaplains because they feel alienated from religious institutions and representatives. They should also be aware of ethical dilemmas in consulting with spiritual care professionals in developing spiritual interventions. Social work education should address clients' humanistic and existential concerns, beliefs and behaviors of the major religions, and forms of nontraditional religious and spiritual experiences; it should also provide experiential opportunities for engaging with grief and earlier advance care planning. There should be attention to different theodical perspectives of the major religions regarding the problem of good and evil, which may preoccupy even clients who no longer participate in organized religion, because these unresolved existential issues may weaken client coping with chronic conditions and may diminish clarity and self-awareness for engaging authentically and effectively in advance care planning.

  15. The Context of Religious and Spiritual Care at the End of Life in Long-term Care Facilities.

    Science.gov (United States)

    Hamilton, V Lee; Daaleman, Timothy P; Williams, Christianna S; Zimmerman, Sheryl

    2009-01-01

    Despite the increasing numbers of Americans who die in nursing homes (NHs) and residential care/assisted living (RC/AL) facilities, and the importance of religious and spiritual needs as one approaches death, little is known about how these needs are met for dying individuals in long-term care (LTC) institutional settings. This study compared receipt of religious and spiritual help in four types of LTC settings: NHs, smaller (facilities, traditional RC/AL facilities, and new-model RC/AL facilities. Data were also available for religious affiliation of the facilities, size, and provision of religious and hospice services. Controlling for such factors, the importance of religion/spirituality to the decedent was the strongest predictor of the decedent's receipt of spiritual help. In addition, new-model RC/AL facilities were significantly more likely to provide help for religious and spiritual needs of decedent residents than other RC/AL types, but did not differ significantly from NHs.

  16. Learning effects of thematic peer-review: a qualitative analysis of reflective journals on spiritual care.

    Science.gov (United States)

    van Leeuwen, René; Tiesinga, Lucas J; Jochemsen, Henk; Post, Doeke

    2009-05-01

    This study describes the learning effects of thematic peer-review discussion groups (Hendriksen, 2000. Begeleid intervisie model, Collegiale advisering en probleemoplossing, Nelissen, Baarn.) on developing nursing students' competence in providing spiritual care. It also discusses the factors that might influence the learning process. The method of peer-review is a form of reflective learning based on the theory of experiential learning (Kolb, 1984. Experiential learning, Experience as the source of learning development. Englewoods Cliffs, New Jersey, Prentice Hill). It was part of an educational programme on spiritual care in nursing for third-year undergraduate nursing students from two nursing schools in the Netherlands. Reflective journals (n=203) kept by students throughout the peer-review process were analysed qualitatively The analysis shows that students reflect on spirituality in the context of personal experiences in nursing practice. In addition, they discuss the nursing process and organizational aspects of spiritual care. The results show that the first two phases in the experiential learning cycle appear prominently; these are 'inclusion of actual experience' and 'reflecting on this experience'. The phases of 'abstraction of experience' and 'experimenting with new behaviour' are less evident. We will discuss possible explanations for these findings according to factors related to education, the students and the tutors and make recommendations for follow-up research.

  17. Developing Agreed and Accepted Understandings of Spirituality and Spiritual Care Concepts among Members of an Innovative Spirituality Interest Group in the Republic of Ireland

    Directory of Open Access Journals (Sweden)

    Fiona Timmins

    2016-03-01

    Full Text Available A Spirituality Interest Group (SIG was set up in in the School of Nursing and Midwifery, Trinity College Dublin, Republic of Ireland (ROI, in March 2013. This paper reports on some of the journey and requirements involved in developing the group. It highlights the essential work of establishing agreed understandings in an objective way in order for the group to move forward with action. These agreed understandings have contributed to the group’s success. Outlining the group’s journey in arriving at agreements may be of use to others considering creating similar groups. One key action taken to determine the suitability of the group’s aims and terms of reference was the distribution of a Survey Monkey to group members (n = 28 in 2014. One early meeting of the group discussed future goals and direction using the responses of this anonymous survey. This paper reports on the results of the survey regarding the establishment of the SIG and the development of a shared understanding of spiritual care among the members. There is consensus in the group that the spiritual care required by clients receiving healthcare ought to be an integrated effort across the healthcare team. However, there is an acceptance that spirituality and spiritual care are not always clearly understood concepts in practice. By developing shared or at least accepted understandings of spirituality and spiritual care, SIG hopes to be able to underpin both research and practice with solid foundational conceptual understanding, and in the process also to meet essential prerequisites for achieving the group’s aims.

  18. Spirituality Self-Care Practices as a Mediator between Quality of Life and Depression

    Directory of Open Access Journals (Sweden)

    Mary L. White

    2016-05-01

    Full Text Available The purpose of this study was to develop a midrange theory, building on Orem’s self-care deficit nursing theory (SCDNT to include constructs of religion, spirituality, and spiritual self‑care practices. This mid-range theory, White’s theory of spirituality and spiritual self-care (WTSSSC, was developed and tested as part of a larger study of African American patients with heart failure (HF. The aim of the study was to determine if spiritual self-care practices were mediating the relationship between depression and quality of life for African Americans diagnosed with heart failure. Participants in this study included 142 African Americans diagnosed with HF who were recruited at the clinic where they were being treated. Four instruments were used to measure spiritual self-care practices (White’s Spiritual Self-Care Practice Scale (WSPSCPC, depression symptomology (Patient Health Questionnaire-9 (PHQ-9, quality of life (World Health Organization QOL (WHOQOL-Bref, and personal characteristics. Results of the analysis were statistically significant, indicating that spirituality self-care practices were mediating the relationship between depression and quality of life for African American individuals diagnosed with HF. As the population ages and chronic illness becomes more common, nurses need to promote the use of spirituality self-care practices to help patients maintain their well-being.

  19. Spirituality in adolescent patients.

    Science.gov (United States)

    Weaver, Meaghann S; Wratchford, Dale

    2017-07-01

    Adolescence, the transition between childhood and adulthood, represents a time of rapid biological, neurocognitive, and psychosocial changes. These changes have important implications for the development and evolution of adolescent spirituality, particularly for adolescents with chronic or life-limiting illnesses. To contribute positively to adolescent spiritual formation, palliative care teams benefit from understanding the normative changes expected to occur during adolescence. This paper provides a narrative review of adolescent spirituality while recognizing the role of religious, familial, and cultural influences on spiritual development during the teenage years. By giving explicit attention to the contextual norms surrounding adolescence and still recognizing each adolescent-aged patient as unique, palliative care teams can help adolescents transition toward meaningful and sustainable spiritual growth. This paper reviews the clinical and research implications relevant to integrating adolescent spiritual health as part of comprehensive palliative care.

  20. Quality of life and religious-spiritual coping in palliative cancer care patients

    Directory of Open Access Journals (Sweden)

    Ticiane Dionizio de Sousa Matos

    Full Text Available ABSTRACT Objectives: to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. Method: cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. Results: 192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (p<0.01 in both groups. Male sex, Catholic religion and the Brief Religious-Spiritual Coping score independently influenced the quality of life scores (p<0.01. Conclusion: both groups presented high quality of life and Religious-Spiritual Coping scores. Male participants who were active Catholics with higher Religious-Spiritual Coping scores presented a better perceived quality of life, suggesting that this coping strategy can be stimulated in palliative care patients.

  1. Integrating Spiritual Care into a Baccalaureate Nursing Program in Mainland China.

    Science.gov (United States)

    Yuan, Hua; Porr, Caroline

    2014-09-01

    Holistic nursing care takes into account individual, family, community and population well-being. At the level of individual well-being, the nurse considers biological, psychological, social, and spiritual factors. However, in Mainland China spiritual factors are not well understood by nursing students. And accordingly, nursing faculty and students are reluctant to broach the topic of spirituality because it is either unknown to students or students believe that the provision of spiritual care is beyond their capabilities. We wonder then, what can we do as nurse educators to integrate spiritual care into a baccalaureate nursing program in Mainland China? The purpose of this article is to propose the integration of Chinese sociocultural traditions (namely religious/spiritual practices) into undergraduate nursing curricula as a means to enter into dialogue about spiritual well-being, to promote spiritual care; and to fulfill the requirements of holistic nursing care. However, prior to discussing recommendations, an overview of the cultural context is in order. Thus, this article is constructed as follows: first, the complexity of Chinese society is briefly described; second, the historical evolution of nursing education in Mainland China is presented; and, third, strategies to integrate Chinese religious/spiritual practices into curricula are proposed. © The Author(s) 2014.

  2. Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers.

    Science.gov (United States)

    Borjalilu, Somaieh; Shahidi, Shahriar; Mazaheri, Mohammad Ali; Emami, Amir Hossein

    2016-01-01

    The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality and Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (Pspiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

  3. Learning Spiritual Dimensions of Care from a Historical Perspective.

    Science.gov (United States)

    Narayanasamy, Aru

    1999-01-01

    Looks at the spiritual dimensions of nursing at various historical periods: ancient civilizations, the Middle Ages, Renaissance, and the 18th and 19th centuries. Reviews contemporary perspectives on spirituality and nursing and suggests how nurses can be equipped to deal with patients' spiritual needs. (SK)

  4. Is failure to meet spiritual needs associated with cancer patients' perceptions of quality of care and their satisfaction with care?

    Science.gov (United States)

    Astrow, Alan B; Wexler, Ann; Texeira, Kenneth; He, M Kai; Sulmasy, Daniel P

    2007-12-20

    Few studies regarding patients' views about spirituality and health care have included patients with cancer who reside in the urban, northeastern United States. Even fewer have investigated the relationship between patients' spiritual needs and perceptions of quality and satisfaction with care. Outpatients (N = 369) completed a questionnaire at the Saint Vincent's Comprehensive Cancer Center in New York, NY. The instrument included the Quality of End-of-Life Care and Satisfaction with Treatment quality-of-care scale and questions about spiritual and religious beliefs and needs. The participants' mean age was 58 years; 65% were female; 67% were white; 65% were college educated; and 32% had breast cancer. Forty-seven percent were Catholic; 19% were Jewish; 16% were Protestant; and 6% were atheist or agnostic. Sixty-six percent reported that they were spiritual but not religious. Only 29% attended religious services at least once per week. Seventy-three percent reported at least one spiritual need; 58% thought it appropriate for physicians to inquire about their spiritual needs. Eighteen percent reported that their spiritual needs were not being met. Only 6% reported that any staff members had inquired about their spiritual needs (0.9% of inquiries by physicians). Patients who reported that their spiritual needs were not being met gave lower ratings of the quality of care (P = .009) and reported lower satisfaction with care (P = .006). Most patients had spiritual needs. A slight majority thought it appropriate to be asked about these needs, although fewer thought this compared with reports in other settings. Few had their spiritual needs addressed by the staff. Patients whose spiritual needs were not met reported lower ratings of quality and satisfaction with care.

  5. Nurses' perceptions of spiritual care and attitudes toward the principles of dying with dignity: A sample from Turkey.

    Science.gov (United States)

    Gurdogan, Eylem Pasli; Kurt, Duygu; Aksoy, Berna; Kınıcı, Ezgi; Şen, Ayla

    2017-03-01

    Spiritual care is vital for holistic care and dying with dignity. The aim of this study was to determine nurses' perceptions of spiritual care and their attitudes toward dying with dignity. This study was conducted with 289 nurses working at a public hospital. Results showed three things. First, spiritual care perceptions and attitudes toward dying with dignity were more positive in female participants than in male participants. Second, there was a correlation between participants' education levels and their perceptions of spiritual care. Third, there was also a correlation between participants' attitudes toward dying with dignity and their perceptions of spiritual care.

  6. 'Spiritual care is not the hospital's business': a qualitative study on the perspectives of patients about the integration of spirituality in healthcare settings.

    Science.gov (United States)

    Pujol, Nicolas; Jobin, Guy; Beloucif, Sadek

    2016-08-24

    Several studies have investigated the relationship between spirituality and health. They claim the need to develop spiritual care to answer patients' spiritual suffering and to promote spiritual well-being. However, the present study critically analyses the following idea: we ought to take care of the spiritual dimension of patients. Does this interest for spirituality not come from healthcare professionals' desire more than from the patients themselves? To answer this question, we explored the perspectives of individuals with cancer regarding the integration of spirituality in the healthcare setting. Qualitative design using semistructured interviews to focus on subjective experience. One of the major public hospitals of Paris, France. 20 participants (n=11 men and n=9 women) with advanced cancer (stage IV). Age ranges from 37 to 80 years with a mean age of 58.7 years. Findings demonstrated that participants do not expect help from the hospital to handle spiritual issues but they wish for their spiritual dimension to be simply recognised as a part of their identity and dignity. Findings invite us to view the question of spirituality not as a new dimension of care but as a new challenge for healthcare institutions to recognise that the persons they are working for are not just 'patients' but human beings with a precious interior life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Conflicts between religious or spiritual beliefs and pediatric care: informed refusal, exemptions, and public funding.

    Science.gov (United States)

    2013-11-01

    Although respect for parents' decision-making authority is an important principle, pediatricians should report suspected cases of medical neglect, and the state should, at times, intervene to require medical treatment of children. Some parents' reasons for refusing medical treatment are based on their religious or spiritual beliefs. In cases in which treatment is likely to prevent death or serious disability or relieve severe pain, children's health and future autonomy should be protected. Because religious exemptions to child abuse and neglect laws do not equally protect all children and may harm some children by causing confusion about the duty to provide medical treatment, these exemptions should be repealed. Furthermore, public health care funds should not cover alternative unproven religious or spiritual healing practices. Such payments may inappropriately legitimize these practices as appropriate medical treatment.

  8. Patient Storytelling in the Classroom: A Memorable Way to Teach Spiritual Care.

    Science.gov (United States)

    Garner, Shelby L

    2016-01-01

    Storytelling is an evidence-based teaching and learning strategy that engages students and promotes critical thinking. Although most nursing textbooks incorporate spiritual nursing care, the texts lack examples of how to tie evidence-based spiritual interventions to specific medical-suigical content. Stories told from the patient's perspective can communicate insights that nurses and students can use when planning spiritual carefor patients. Stories shared by patients with undergraduate nursing students were effective in promoting learning and offered concrete examples of supportive spiritual resources for patients.

  9. Spiritual needs in health care settings: a qualitative meta-synthesis of clients' perspectives.

    Science.gov (United States)

    Hodge, David R; Horvath, Violet E

    2011-10-01

    Spiritual needs often emerge in the context of receiving health or behavioral health services. Yet, despite the prevalence and salience of spiritual needs in service provision, clients often report their spiritual needs are inadequately addressed. In light of research suggesting that most social workers have received minimal training in identifying spiritual needs, this study uses a qualitative meta-synthesis (N=11 studies) to identify and describe clients'perceptions of their spiritual needs in health care settings. The results revealed six interrelated themes: (1) meaning, purpose, and hope; (2) relationship with God; (3) spiritual practices; (4) religious obligations; (5) interpersonal connection; and (6) professional staff interactions. The implications of the findings are discussed as they intersect social work practice and education.

  10. Music Therapy and Spiritual Care in End-of-Life: A Qualitative Inquiry into Ethics and Training Issues Identified by Chaplains and Music Therapists.

    Science.gov (United States)

    Masko, Meganne K

    2016-01-01

    Music therapists are increasingly employed by hospices. As such, they are often called upon to provide additional spiritual care to patients receiving end-of-life care. However, researchers have not yet examined the appropriateness of music therapists providing spiritual care as part of the hospice team, or ethics and training issues related to music therapist-led spiritual care. The purpose of this study was to explore the thoughts and attitudes of hospice chaplains and music therapists (MTs) about ethics and training issues related to music therapists providing spiritual care as part of the hospice interdisciplinary team. The study used semi-structured interviews with a purposive sample of music therapists and chaplains specializing in hospice care as part of a larger exploratory mixed methods study. Each interview was recorded, transcribed, and analyzed using a two-step process including both a modified phenomenological inductive approach and thematic analysis. Participants discussed ethics and training issues related to the provision of music therapist-led spiritual care as part of the hospice team. These issues included scope of practice, cultural competence and maintaining personal boundaries, and spiritual care training topics such as educational content and educational methods. While it was clear that both chaplains and music therapists felt it was appropriate for music therapists to provide spiritual care as part of the hospice team, there is a need for formal and informal spiritual care training for music therapists doing this type of work. Training should potentially include information about comparative religions, cultural competence, scope of practice, and maintaining personal boundaries. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Training hospital staff on spiritual care in palliative care influences patient-reported outcomes : Results of a quasi-experimental study

    NARCIS (Netherlands)

    van de Geer, Joep; Groot, Marieke; Andela, Richtsje; Leget, Carlo; Prins, Jelle; Vissers, Kris; Zock, Hetty

    Background: Spiritual care is reported to be important to palliative patients. There is an increasing need for education in spiritual care. Aim: To measure the effects of a specific spiritual care training on patients' reports of their perceived care and treatment. Design: A pragmatic controlled

  12. Embracing a broad spirituality in end of life discussions and advance care planning.

    Science.gov (United States)

    Churchill, Larry R

    2015-04-01

    Advance care planning for end of life typically focuses on the mechanics of completing living wills and durable power of attorney documents. Even when spiritual aspects of end of life care are discussed, the dominant assumptions are those of traditional religious systems. A broad view of spirituality is needed, one that may involve traditional religious beliefs but also includes personal understandings of what is holy or sacred. Embracing this broad practice of spirituality will help both familial and professional caregivers honor an essential aspect of end of life discussions and promote greater discernment of the deep meaning in advance care documents.

  13. Spiritual pain and suffering.

    Science.gov (United States)

    Brunjes, George B

    2010-01-01

    Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families. Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt, depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotional and spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for each patient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, in relationship to a deity or deities are important to understand. Cultural interpretations of pain and suffering may conflict with the goals of palliative care. Understanding the spiritual framework of the patient and family can help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peaceful death. Spiritual practices may help in the management of physical pain.

  14. Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study.

    Science.gov (United States)

    Nakau, Maiko; Imanishi, Jiro; Imanishi, Junichi; Watanabe, Satoko; Imanishi, Ayumi; Baba, Takeshi; Hirai, Kei; Ito, Toshinori; Chiba, Wataru; Morimoto, Yukihiro

    2013-01-01

    Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment. The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention. In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased. It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. An exploration of how spiritual nursing care is applied in clinical nursing practice

    Directory of Open Access Journals (Sweden)

    Lydia V. Monareng

    2013-05-01

    Full Text Available Spiritual nursing care is a significant concept for nurses as they are expected to provide holistic care to patients. Many nurses have difficulty to understand and integrate it into practice and consequently neglect this aspect of care. The study was conducted to explore and describe how professional nurses provide spiritual care to patients. A generic qualitative, explorative and descriptive study was conducted based on Symbolic Interactionism as the philosophical base. The population comprised professional nurses from a public hospital. Participants were recruited through purposive and snowball sampling methods. Data were collected through the use of individual, focus group interviews and observation. Data analysis methods utilised included the NUD*IST computer program, coding, constant comparison method and Tesch’s guidelines on data analysis. Findings revealed that nurses struggled to conceptualise spiritual nursing care and to differentiate it from emotional, social or psychological care. However, prayer with or for patients and singing spiritual songs had the highest count of interventions perceived to be effective. Recommendations suggest that the scope of practice and curriculum of training of nurses be reviewed to consider how spiritual nursing care can be evidenced and realised both in the classroom and in the clinical setting. Spiritual nursing care is still a neglected and seemingly complex component of patient care. However, the scientific worldview practices, beliefs and insufficient statutory endorsement of such care hamper its realisation in practice. Geestelike verpleegsorg is ’n belangrike konsep omdat van verpleegkundiges verwag word om pasiënte holisties te versorg. Baie verpleegkundiges vind dié begrip en die integrering daarvan problematies en verwaardeloos gevolglik hierdie aspek van sorg. Die studie ondersoek en beskryf die mate waartoe verpleegkundiges geestelike sorg aan pasiënte verleen. ’n Basiese

  16. Religion, spirituality, health and medicine: Why should Indian physicians care?

    NARCIS (Netherlands)

    Chattopadhyay, S.

    2007-01-01

    Religion, spirituality, health and medicine have common roots in the conceptual framework of relationship amongst human beings, nature and God. Of late, there has been a surge in interest in understanding the interplay of religion, spirituality, health and medicine, both in popular and scientific

  17. Workplace spirituality in health care: an integrated review of the literature.

    Science.gov (United States)

    Pirkola, Heidi; Rantakokko, Piia; Suhonen, Marjo

    2016-10-01

    The aim is to describe workplace spirituality as a concept and phenomenon in health care and to explore the points of view from which it has been studied in nursing. Personnel in nursing are ageing and recruitment is challenging; workplace spirituality might benefit both employees and organisations. Workplace spirituality has three levels - individual, group and organisational - and presents different components at each level. An integrated literature search identified 632 studies; after screening for relevance and quality, we identified eight peer-reviewed articles. The data were analysed with qualitative content analysis. Workplace spirituality in nursing is mostly defined and researched from the individual viewpoint. The definition includes dimensions of inner life, meaningful work, interconnectedness, transcendence and alignment between values. A sense of community and meaningful work are the most important dimensions of workplace spirituality in health care. Group and organisational levels of workplace spirituality are the most important and still the least studied. Research is concentrated in Canada and Asia; more research in Europe is needed. Nurse managers can enhance workplace spirituality by contributing to organisational culture and emphasising teamwork. This requires more education and training in workplace spirituality. © 2016 John Wiley & Sons Ltd.

  18. The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

    Science.gov (United States)

    Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

    2017-06-01

    Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

  19. Faith and Belief, Importance, Community, Address in Care spiritual history tool by C. M. Puchalski as an instrument for an interdisciplinary team in patient car

    Directory of Open Access Journals (Sweden)

    Krakowiak Piotr

    2015-12-01

    Full Text Available Being aware of the tradition of research on spirituality in theology and the existence of detailed publications and research concerning psychology of religion and religiosity in psychology as well as other sciences in Poland, the authors propose the recognition and adaptation of the FICA tool for spirituality research. The belief in the importance of deepening the knowledge and providing tools to research spirituality of human existence results from a long practice of the authors in palliative and hospital care. Understanding a difficulty in operationalizing the category of spirituality, they attempted at searching for a method that would be applicable to persons at the end of their lives as well as to all the suffering. Having analyzed the research tools built by Polish science as well as available ones on religiosity and spirituality the following paper aims at presenting the unknown FICA tool (F – Faith and Believe, I – Importance, C – Community, A – Address in Care in Poland by Prof. Dr. Christina M. Puchalski, USA, being adapted to Polish practice. The tool presented allows for the evaluation of spiritual experience of persons taken medical and social care of by every member of multidisciplinary team of professionals. Since the FICA tool is a qualitative scale it does not need a normalization and standardization methodology. However, a cultural adaptation is crucial in order to make the practical tool become help in answering spiritual and existential questions posed by patients to workers and voluntaries engaged in the process of Care.

  20. Art, Objects, and Beautiful Stories: A "New" Approach to Spiritual Care.

    Science.gov (United States)

    Smith, Aaron P B; Read, Julia E

    2017-06-01

    The use of story, and the use of art or various arts-based techniques have become popular in a number of helping professions, including spiritual care. There remains a gap in the literature, however, in which an approach comprised of both story and art or objects is explored. This paper addresses this gap by discussing the experience, theory, benefits, and technique of combining story and art or object-based techniques for the provision of spiritual care.

  1. The Affordable Care Act and hospital chaplaincy: re-visioning spiritual care, re-valuing institutional wholeness.

    Science.gov (United States)

    Frierdich, Matthew D

    2015-01-01

    This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.

  2. Psychiatric care in Asia: spirituality and religious connotations.

    Science.gov (United States)

    Chaudhry, Haroon Rashid

    2008-10-01

    Throughout the history of humanity it has been said that the individual ego, is a very limited form of identity. Spirituality is shaped by larger social circumstances and by the beliefs and values present in the wider culture. In Asia, as compared to other regions, people fall back on spiritualism. Mental health professionals, laymen and patients have great interest in spirituality and religious activities but still it is one of the most neglected fields of life. Spirituality and religion often are used interchangeably and it has also been described as an individual search for meaning. In psychiatry, religion and spirituality play a vital role in an individual's personal and social life. They are part of a very powerful medium to help in the healing process. Spiritual people know the meaning and goal of their life, have strong belief and firm faith in God or themselves, they can easily cope with stress and have the ability to adjust in every situation. They have satisfaction and contentment. They are less anxious and depressed and if they feel so, they try to overcome it through religious activities or rituals. Patients who depend heavily on their religious faith are significantly less depressed than those who don't. Spiritual practices foster an awareness that serves to identify and promote values such as creativity, patience, perseverance, honesty, kindness, compassion, wisdom, equanimity, hope and joy, all of which support good healthcare practice. Spirituality and religion form a bridge of contact between human, a composite of body and soul, and the Creator. Realizing this need, mental health professionals working in this field need to understand the spiritual values of patients and incorporate them in assessment and treatment.

  3. “HABITUS” IN SOUL CARE. TOWARDS “SPIRITUAL ...

    African Journals Online (AJOL)

    by ideas emanating from the fields of psychology and sources of secular therapeutic ... second assumption is that Christian spirituality, as a theological category, ..... in American psychology due to the impact of Anton Boisen's thesis of the.

  4. [Support to spiritual needs in hospital care. Integration perspective in modern hospitals].

    Science.gov (United States)

    Proserpio, Tullio; Piccinelli, Claudia; Arice, Carmine; Petrini, Massimo; Mozzanica, Mario; Veneroni, Laura; Clerici, Carlo Alfredo

    2014-01-01

    Within the course of medical care in the most advanced health care settings, an increasing attention is being paid to the so-called care humanization. According to this perspective, we try to integrate the usual care pathways with aspects related to the spiritual and religious dimension of all people and their families, as well as the employees themselves. It is clearly important to establish this kind of practices on the basis of scientific evidences. That is the reason why it's a necessity to improve the knowledge about the importance that spiritual assistance can offer within the current health service. The aim of this work is to show the relevance of the integration of spiritual perspectives in the hospital setting according to a multidisciplinary point of view. In this work many data that emerge from the international scientific literature, as well as the definition that is given to the concept of "spirituality" are analyzed; about this definition in fact there is not unanimous consent even today. It is also analyzed the legal situation in force within the European territory according to the different laws and social realities. Finally, the possible organizational practices related to spiritual support are described and the opportunity to specific accreditation pathways and careful training of chaplains able to integrate traditional religious practices with modern spiritual perspectives is discussed.

  5. Palliative Nursing and Sacred Medicine: A Holistic Stance on Entheogens, Healing, and Spiritual Care.

    Science.gov (United States)

    Rosa, William E; Hope, Stephanie; Matzo, Marianne

    2018-04-01

    The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided. Clinical trials show impressive preliminary findings regarding the healing potential of these medicinal agents. While other professions, such as psychology, pharmacy, and medicine, are disseminating data related to patient outcomes secondary to entheogen administration, the nursing literature has not been involved in raising awareness of such advancements. Research is illustrating their effectiveness in achieving integrative experiences for patients confronting advanced serious illness and their ability to promote presence, introspection, decreased fear, and increased joy and acceptance. Evidence-based knowledge surrounding this potentially sensitive topic is necessary to invite understanding, promote scientific knowledge development, and create healing environments for patients, nurses, and researchers alike.

  6. A critical analysis of scales to measure the attitude of nurses toward spiritual care and the frequency of spiritual nursing care activities

    NARCIS (Netherlands)

    Garssen, Bert; Ebenau, Anne Frederieke; Visser, Anja; Uwland, Nicoline; Groot, Marieke

    Quantitative studies have assessed nurses' attitudes toward and frequency of spiritual care [SC] and which factors are of influence on this attitude and frequency. However, we had doubts about the construct validity of the scales used in these studies. Our objective was to evaluate scales measuring

  7. Matters of spirituality at the end of life in the pediatric intensive care unit.

    Science.gov (United States)

    Robinson, Mary R; Thiel, Mary Martha; Backus, Meghan M; Meyer, Elaine C

    2006-09-01

    Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications. A qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires was conducted at 3 PICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after the withdrawal of life-sustaining therapies participated. Overall, spiritual/religious themes were included in the responses of 73% (41 of 56) of parents to questions about what had been most helpful to them and what advice they would offer to others at the end of life. Four explicitly spiritual/religious themes emerged: prayer, faith, access to and care from clergy, and belief in the transcendent quality of the parent-child relationship that endures beyond death. Parents also identified several implicitly spiritual/religious themes, including insight and wisdom; reliance on values; and virtues such as hope, trust, and love. Many parents drew on and relied on their spirituality to guide them in end-of-life decision-making, to make meaning of the loss, and to sustain them emotionally. Despite the dominance of technology and medical discourse in the ICU, many parents experienced their child's end of life as a spiritual journey. Staff members, hospital chaplains, and community clergy are encouraged to be explicit in their hospitality to parents' spirituality and religious faith, to foster a culture of acceptance and integration of spiritual perspectives, and to work collaboratively to deliver spiritual care.

  8. Integrating Religion and Spirituality into Mental Health Care, Psychiatry and Psychotherapy

    OpenAIRE

    René Hefti

    2011-01-01

    Integrating spirituality into mental health care, psychiatry and psychotherapy is still controversial, albeit a growing body of evidence is showing beneficial effects and a real need for such integration. In this review, past and recent research as well as evidence from the integrative concept of a Swiss clinic is summarized. Religious coping is highly prevalent among patients with psychiatric disorders. Surveys indicate that 70–80% use religious or spiritual beliefs and activities to cope wi...

  9. "To cherish each day as it comes": a qualitative study of spirituality among persons receiving palliative care.

    Science.gov (United States)

    Asgeirsdottir, Gudlaug Helga; Sigurbjörnsson, Einar; Traustadottir, Rannveig; Sigurdardottir, Valgerdur; Gunnarsdottir, Sigridur; Kelly, Ewan

    2013-05-01

    Spirituality is one of the main aspects of palliative care. The concept is multidimensional and encompasses the existential realm as well as value-based and religious considerations. The aim of this study was to explore spirituality from the perspective of persons receiving palliative care and examine their experience of spirituality and its influence on their lives and well-being. Qualitative interviews were conducted with ten persons receiving palliative care from Palliative Care Services in Iceland. The interviews were tape-recorded, transcribed and analysed. The study is in the field of practical theology and used the theoretical approach of hermeneutical phenomenology. Thematic analysis found that the spiritual dimension was of significance for the participants who understood it as a vital element connected to seeking meaning, purpose and transcendence in life. Religious and non-religious aspects of spirituality were expressed including strong spiritual components of family relationships, the meaning of God/a higher being and spiritual practices which served as a key factor in giving strength, activating inner resources and motivating hope. Nine of the participants expressed their spirituality as faith. Spirituality was experienced broadly as an important dimension of how participants lived with terminal illness. Religious and non-religious characteristics were recognised which reveals the complex nature of the phenomenon. Faith was a significant part of the participants' spirituality indicating the importance of attending to this aspect of palliative care. The study suggests the potential contributions of theological approaches which are relevant for palliative care research and practice.

  10. Nurses' Experiences of Spiritual Communication with Seriously III Children.

    Science.gov (United States)

    Ferrell, Betty; Wittenberg, Elaine; Battista, Vanessa; Walker, Gay

    2016-11-01

    The goal of this study was to explore nurse experiences in communication with children about spiritual topics in order to develop training in this area. Although spiritual care is essential in pediatric palliative care, few providers receive training about communication with ill children about spirituality. Researchers developed a brief survey to prompt nurses to reflect on pediatric palliative care experiences that included spiritual discussions. Nurses attending training courses voluntarily submitted stories. Qualitative data were thematically analyzed by members of the research team, consisting of two researchers with expertise in palliative care, spirituality, and communication and two expert pediatric palliative care clinicians. Nurses' spiritual conversations with children revealed that children question God and the reason for their illness, have a desire to talk about the afterlife as a way of understanding their limited lifespan, and to share descriptions of an afterlife, in these cases described as heaven. Nurses conveyed the importance of being present and engaging in spiritual communication with children. Communication training is needed and should prepare providers to respond to a child's spiritual questioning, assist parents when the child initiates discussion about the afterlife, and help parent and child understand the spiritual meaning of their illness. Chaplains serve as spiritual care experts and can help train nurses to screen for spiritual distress, have greater competence in spiritual communication, and to collaborate with chaplains in care. Quality palliative care is incomplete without attention to spiritual care.

  11. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  12. Existential and spiritual needs in mental health care: an ethical and holistic perspective.

    Science.gov (United States)

    Koslander, Tiburtius; da Silva, António Barbosa; Roxberg, Asa

    2009-03-01

    This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals' mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients' needs are holistically addressed in Western health care systems that neglect patients' existential and spiritual needs, because of their biomedical view of Man which recognizes only patients' physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients' improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.

  13. [Validity and Reliability of Korean Version of the Spiritual Care Competence Scale].

    Science.gov (United States)

    Chung, Mi Ja; Park, Youngrye; Eun, Young

    2016-12-01

    The aim of this study was to examine the validity and reliability of the Korean Version of the Spiritual Care Competence Scale (K-SCCS). A cross-sectional study design was used. The K-SCCS consisted of 26 questions to measure spiritual care competence of nurses. Participants, 228 nurses who had more than 3 years'experience as a nurse, completed the survey. Confirmatory factor analysis was used to examine the construct validity and correlations of K-SCCS and spiritual well-being (SWB) were used to examine the criterion validity of K-SCCS. Cronbach's alpha was used to test internal consistency. The construct and the criterion-related validity of K-SCCS were supported as measures of spiritual care competence. Cronbach's alpha was .95. Factor loadings of the 26 questions ranged from .60 to .96. Construct validity of K-SCCS was verified by confirmatory factor analysis (RMSEA=.08, CFI=.90, NFI=.85). Criterion validity compared to the SWB showed significant correlation (r=.44, pspiritual care competence with validity and reliability. However, further study is needed to retest the verification of the factor analysis related to factor 2 (professionalisation and improving the quality of spiritual care) and factor 3 (personal support and patient counseling). Therefore, we recommend using the total score without distinguishing subscales.

  14. Sacred spaces in public places: religious and spiritual plurality in health care.

    Science.gov (United States)

    Reimer-Kirkham, Sheryl; Sharma, Sonya; Pesut, Barb; Sawatzky, Richard; Meyerhoff, Heather; Cochrane, Marie

    2012-09-01

    Several intriguing developments mark the role and expression of religion and spirituality in society in recent years. In what were deemed secular societies, flows of increased sacralization (variously referred to as 'new', 'alternative', 'emergent' and 'progressive' spiritualities) and resurgent globalizing religions (sometimes with fundamentalist expressions) are resulting in unprecedented plurality. These shifts are occurring in conjunction with increasing ethnic diversity associated with global migration, as well as other axes of difference within contemporary society. Democratic secular nations such as Canada are challenged to achieve social cohesion in the face of growing religious, spiritual and ethnic diversity. These challenges are evident in the high-paced, demanding arena of Health care. Here, religious and spiritual plurality enter in, sometimes resulting in conflict between medical services and patients' beliefs, other times provoking uncertainties on the part of healthcare professionals about what to do with their own religiously or spiritually grounded values and beliefs. In this paper, we present selected findings from a 3-year study that examined the negotiation of religious and spiritual pluralism in Health care. Our focus is on the themes of 'sacred' and 'place', exploring how the sacred - that which is attributed as special and set apart as it pertains to the divine, transcendence, God or higher power - takes form in social and material spaces in hospitals. © 2011 Blackwell Publishing Ltd.

  15. Finding Paradise Within: How Spirituality Protects Palliative Care Clients and Caregivers From Depression.

    Science.gov (United States)

    Penman, Joy

    2017-06-01

    The aims of this article are to explore the experience of depression among palliative care clients and caregivers, describe the strategies they use in coping with depression, and clarify the role of spirituality in preventing and/or overcoming depression. This article discusses an aspect of the findings of a larger doctoral study that explored the nature of spirituality and spiritual engagement from the viewpoint of individuals with life-limiting conditions and their caregivers. van Manen's phenomenology was used in the study. The data generated from the doctoral study were subjected to secondary analysis to uncover the experience of depression. The methodology underpinning the secondary analysis was phenomenology also by van Manen. Fourteen clients and caregivers from across regional and rural South Australia informed the study. Data collection involved in-depth nonstructured home-based interviews that were audiotaped and transcribed verbatim. The findings highlighted relate to participants succumbing to depression, but having spiritual beliefs and practices helped them cope. One of the most insightful understanding was the role spirituality played in protecting individuals from depression, encapsulated in the theme "finding paradise within." Spirituality, understood from a religious or secular perspective, must be embedded in palliative care as it assisted in preventing and overcoming depression.

  16. The circle of the soul: the role of spirituality in health care.

    Science.gov (United States)

    Moss, Donald

    2002-12-01

    This paper examines the critical attitude of behavioral professionals toward spiritual phenomena, and the current growing openness toward a scientific study of spirituality and its effects on health. Health care professionals work amidst sickness and suffering, and become immersed in the struggles of suffering persons for meaning and spiritual direction. Biofeedback and neurofeedback training can facilitate relaxation, mental stillness, and the emergence of spiritual experiences. A growing body of empirical studies documents largely positive effects of religious involvement on health. The effects of religion and spirituality on health are diverse, ranging from such tangible and easily understood phenomena as a reduction of health-risk behaviors in church-goers, to more elusive phenomena such as the distant effects of prayer on health and physiology. Psychophysiological methods may prove useful in identifying specific physiological mechanisms mediating such effects. Spirituality is also a dimension in much of complementary and alternative medicine (CAM), and the CAM arena may offer a window of opportunity for biofeedback practice.

  17. There be dragons: effects of unexplored religion on nurses' competence in spiritual care.

    Science.gov (United States)

    Pesut, Barbara

    2016-09-01

    On ancient maps unexplored lands were simply labeled 'there be dragons' indicating the fear that attends the unknown. Despite three decades of theoretical and empirical work on spirituality in nursing, evidence still suggests that nurses do not feel competent to engage in spiritual care. In this paper I propose that one of the reasons for this is a theory-theory gap between religion and spirituality. Generalized anxiety about the role of religion in society has led to under-theorizing in nursing about religious care. As a result, when religion and spirituality overlap at the point of care, nurses are left without the substantive knowledge required for practice. Robust religious theorizing should include thick accounts of lived religion and integrative work that enables nurses to understand commonalities across religions that are relevant to practice. As a starting point to this integrative work, nurses can be introduced to the nature and lexicon of lived religion, religious perspectives on suffering, and religious reasoning that holds meaning and mystery in tension. Such an approach will better prepare them for the realities of practice where the complexities of spirituality and religion come to play. © 2016 John Wiley & Sons Ltd.

  18. Religion, Spirituality and Speech-Language Pathology: A Viewpoint for Ensuring Patient-Centred Holistic Care.

    Science.gov (United States)

    Mathisen, Bernice; Carey, Lindsay B; Carey-Sargeant, Christa L; Webb, Gwendalyn; Millar, CaraJane; Krikheli, Lilli

    2015-12-01

    This paper presents a viewpoint concerning the largely neglected clinical relevance of spirituality and religious belief in speech-language pathology (SLP) assessments, interventions and outcomes across the lifespan. An overview of the refereed SLP literature is presented with regard to religion and spirituality. It was found that while there is increasing research with regard to spirituality, health and well-being, there is very little specific to SLP. What is available and clinically relevant, generally relates to holistic care and/or cultural and linguistic diversity. Amidst the health care literature, however, there is a growing number of recommended instruments (for religious/spiritual screening) sensitive to intercultural and interfaith issues that are currently available to medical, nursing, allied health and chaplaincy practitioners. These instruments can also be of value to SLPs to ensure holistic assessments and interventions. It would seem timely for SLPs (and other allied health practitioners) to consider including spiritual screenings/assessments as part of their clinical practice so as to ensure appropriate holistic care. This would also mean undertaking research and including relevant education within tertiary institutions and professional development programs.

  19. Development and validation of a cross-cultural EORTC measure of spiritual wellbeing (swb) for palliative care patients with cancer

    NARCIS (Netherlands)

    Vivat, B.; Young, T.; Winstanley, J.; Arraras, J. I.; Bennett, M. I.; Brédart, A.; Costantini, A.; Fisher, S. E.; Greimel, E.; Guo, J.; Irarrazaval, M. E.; Kobayashi, K.; Kruizinga, R.; Navarro, M.; Omidvari, S.; Rohde, G. E.; Serpentini, S.; van Laarhoven, H. W. M.; Yang, G.

    2014-01-01

    Spiritual care and spiritual wellbeing (SWB) are central to palliative care, but no measures of SWB have yet been developed cross-culturally. In 2002 the EORTC Quality of Life (QL) Group began international development of an SWB measure for palliative patients. Three domains of SWB were initially

  20. Training hospital staff on spiritual care in palliative care influences patient-reported outcomes: Results of a quasi-experimental study.

    Science.gov (United States)

    van de Geer, Joep; Groot, Marieke; Andela, Richtsje; Leget, Carlo; Prins, Jelle; Vissers, Kris; Zock, Hetty

    2017-09-01

    Spiritual care is reported to be important to palliative patients. There is an increasing need for education in spiritual care. To measure the effects of a specific spiritual care training on patients' reports of their perceived care and treatment. A pragmatic controlled trial conducted between February 2014 and March 2015. The intervention was a specific spiritual care training implemented by healthcare chaplains to eight multidisciplinary teams in six hospitals on regular wards in which patients resided in both curative and palliative trajectories. In total, 85 patients were included based on the Dutch translation of the Supportive and Palliative Care Indicators Tool. Data were collected in the intervention and control wards pre- and post-training using questionnaires on physical symptoms, spiritual distress, involvement and attitudes (Spiritual Attitude and Involvement List) and on the perceived focus of healthcare professionals on patients' spiritual needs. All 85 patients had high scores on spiritual themes and involvement. Patients reported that attention to their spiritual needs was very important. We found a significant ( p = 0.008) effect on healthcare professionals' attention to patients' spiritual and existential needs and a significant ( p = 0.020) effect in favour of patients' sleep. No effect on the spiritual distress of patients or their proxies was found. The effects of spiritual care training can be measured using patient-reported outcomes and seemed to indicate a positive effect on the quality of care. Future research should focus on optimizing the spiritual care training to identify the most effective elements and developing strategies to ensure long-term positive effects. This study was registered at the Dutch Trial Register: NTR4559.

  1. Life perceptions of patients receiving palliative care and experiencing psycho-social-spiritual healing.

    Science.gov (United States)

    Li, Lingsheng; Sloan, Danetta H; Mehta, Ambereen K; Willis, Gordon; Weaver, Meaghann S; Berger, Ann C

    2017-07-01

    It is important to identify, from the patients' perspectives, the different factors that contribute toward psycho-social-spiritual healing. This was a qualitative study that took place at a large research center, an underserved clinic, and a community hospital. We used a needs assessment questionnaire and open-ended questions to assess the constituents of psycho-social-spiritual healing: (I) how previous life experiences affected patients' present situations in dealing with their illnesses; (II) barriers to palliative care, and (III) benefits of palliative care. Of a total of 30 participants from 3 different study sites, 24 (80%) were receiving inpatient or outpatient palliative care at a research center. Thirteen (43%) participants were female, 10 (33%) were Black/African American, and 16 (53%) reported being on disability. While the initial shock of the diagnosis made participants feel unprepared for their illnesses, many looked to role models, previous work experiences, and spiritual as well as religious support as sources of strength and coping mechanisms. Barriers to palliative care were identified as either external (lack of proper resources) or internal (symptom barriers and perceived self-limitations). The feeling of "being seen/being heard" was perceived by many participants as the most beneficial aspect of palliative care. The needs assessment questionnaire and open-ended questions presented in this study may be used in clinical settings to better help patients achieve psycho-social-spiritual healing through palliative care and to help clinicians learn about the person behind the patient.

  2. Practical approaches to spiritual pain.

    Science.gov (United States)

    Brunjes, George B

    2010-01-01

    Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families. Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt, depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotional and spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for each patient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, in relationship to a deity or deities are important to understand. Cultural interpretations of pain and suffering may conflict with the goals of palliative care. Understanding the spiritual framework of the patient and family can help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peaceful death. Spiritual practices may help in the management of physical pain.

  3. Quality of life and religious-spiritual coping in palliative cancer care patients.

    Science.gov (United States)

    Matos, Ticiane Dionizio de Sousa; Meneguin, Silmara; Ferreira, Maria de Lourdes da Silva; Miot, Helio Amante

    2017-07-10

    to compare the quality of life and religious-spiritual coping of palliative cancer care patients with a group of healthy participants; assess whether the perceived quality of life is associated with the religious-spiritual coping strategies; identify the clinical and sociodemographic variables related to quality of life and religious-spiritual coping. cross-sectional study involving 96 palliative outpatient care patient at a public hospital in the interior of the state of São Paulo and 96 healthy volunteers, using a sociodemographic questionnaire, the McGill Quality of Life Questionnaire and the Brief Religious-Spiritual Coping scale. 192 participants were interviewed who presented good quality of life and high use of Religious-Spiritual Coping. Greater use of negative Religious-Spiritual Coping was found in Group A, as well as lesser physical and psychological wellbeing and quality of life. An association was observed between quality of life scores and Religious-Spiritual Coping (pestrategias de coping religioso-espiritual; identificar las variables clínicas y sociodemográficas relacionadas a la calidad de vida y al coping religioso-espiritual. estudio transversal, desarrollado con 96 pacientes de ambulatorio de cuidados paliativos en un hospital público en el interior del Estado de São Paulo, Brasil, y 96 voluntarios sanos, mediante cuestionario utilizando datos sociodemográficos, el McGill Quality of Life Questionnaire y el Coping Religioso-Espiritual-Breve. fueron entrevistados 192 participantes que presentaron buena calidad de vida y alta utilización del Coping Religioso-Espiritual. Fue encontrado mayor uso de Coping Religioso-Espiritual negativo en el Grupo A, y también menor bienestar físico, psicológico y de calidad de vida. Fue observada asociación entre los scores de calidad de vida y Coping Religioso-Espiritual (pestrategia de enfrentamiento en pacientes bajo cuidados paliativos.

  4. Building bridges: an interpretive phenomenological analysis of nurse educators' clinical experience using the T.R.U.S.T. Model for inclusive spiritual care.

    Science.gov (United States)

    Scott Barss, Karen

    2012-04-30

    Educating nurses to provide evidence-based, non-intrusive spiritual care in today's pluralistic context is both daunting and essential. Qualitative research is needed to investigate what helps nurse educators feel more prepared to meet this challenge. This paper presents findings from an interpretive phenomenological analysis of the experience of nurse educators who used the T.R.U.S.T. Model for Inclusive Spiritual Care in their clinical teaching. The T.R.U.S.T. Model is an evidence-based, non-linear resource developed by the author and piloted in the undergraduate nursing program in which she teaches. Three themes are presented: "The T.R.U.S.T. Model as a bridge to spiritual exploration"; "blockades to the bridge"; and "unblocking the bridge". T.R.U.S.T. was found to have a positive influence on nurse educators' comfort and confidence in the teaching of spiritual care. Recommendations for maximizing the model's positive impact are provided, along with "embodied" resources to support holistic teaching and learning about spiritual care.

  5. EFFECT OF SPIRITUAL NURSING CARE ON THE LEVEL OF ANXIETY IN PATIENTS WITH STROKE

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    Bernadeta Trihandini

    2018-02-01

    Full Text Available Background: Anxiety in stroke patients occurs as a normal reaction to stress with life changes; however, when it becomes excessive, It becomes disabling. Effort to deal with anxiety is needed and spiritual approach nursing care is considered useful in caring patients with stroke. Objective: To examine the effect of spiritual nursing care on anxiety in stroke patients in the inpatient ward. Methods: This study used a quasy experimental design with pretest-postest control group. Thirty respondents were selected using consecutive sampling, which 15 respondents assigned in the experiment and control group. The Hamilton Anxiety Rating Scale was used to measure anxiety. Data were analyzed using paired t-test and independent t-test. Results: The results showed that the mean level of anxiety in the experiment group before intervention was 29.33 and decreased to 9 after intervention, while in the control group the mean level of anxiety before intervention was 29.47 and decreased to 17.73 after intervention. Paired t-test obtained p-value 0.000 (<0.05, which indicated that there was a significant effect of spiritual nursing care on anxiety levels in patients with stroke. Conclusion: Spiritual nursing care could reduce anxiety in patients with stroke.

  6. Training Spiritual Care in Palliative Care in Teaching Hospitals in the Netherlands (SPIRIT-NL) : A Multicentre Trial

    NARCIS (Netherlands)

    Geer, Joep van de; Zock, Tanja; Leget, Carlo; Veeger, Nic; Prins, Jelle; de Groot, Marieke; Vissers, Kris

    Background: In the Netherlands, the spiritual dimension in healthcare became marginal in the second part of the twentieth century. In the Dutch healthcare sys- tem, palliative care is not a medical specialization and teaching hospitals do not have specialist palliative care units with specialized

  7. Islamic Spiritual Care as a New Profession : Expectations and Professional Standards

    NARCIS (Netherlands)

    Ajouaou, M.; Ayten, Ali; Koç, Mustafa

    2016-01-01

    Spiritual care is a discipline that is practised on the interface of religion on the one hand and the public domain on the other, i.e., in penitentiary institutions, heath institutions, and the military, etc. Its legitimacy is found primarily in the sacred sources of a religion (Ajouaou, M., R.

  8. Sound Heart: Spiritual Nursing Care Model from Religious Viewpoint.

    Science.gov (United States)

    Asadzandi, Minoo

    2017-12-01

    Different methods of epistemology create different philosophical views. None of the nursing theories have employed the revelational epistemology and the philosophical views of Abrahamic religions. According to Abrahamic religions, the universe and human being have been created based on God's affection. Human being should deserve the position of God's representative on earth after achieving all ethical merits. Humans have willpower to shape their destiny by choosing manner of their relationship with God, people, themselves and the whole universe. They can adopt the right behavior by giving a divine color to their thoughts and intentions and thus attain peace and serenity in their heart. Health means having a sound heart (calm spirit with a sense of hope and love, security and happiness) that is achievable through faith and piety. Moral vices lead to diseases. Human beings are able to purge their inside (heart) through establishing a relationship with God and then take actions to reform the outside world. The worlds are run by God's will based on prudence and mercy. All events happen with God's authorization, and human beings have to respond to them. Nurses should try to recognize the patient's spiritual response to illness that can appear as symptoms of an unsound heart (fear, sadness, disappointment, anger, jealousy, cruelty, grudge, suspicion, etc.) due to the pains caused by illness and then alleviate the patient's suffering by appropriate approaches. Nurses help the patient to achieve the sound heart by hope in divine mercy and love, and they help the patient see good in any evil and relieve their fear and sadness by viewing their illness positively and then attain the status of calm, satisfaction, peace and serenity in their heart and being content with the divine fate. By invitation to religious morality, the model leads the patients to spiritual health.

  9. A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review.

    Science.gov (United States)

    Fang, Mei Lan; Sixsmith, Judith; Sinclair, Shane; Horst, Glen

    2016-05-18

    Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June-August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004-2014. The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making. This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.

  10. A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

    Directory of Open Access Journals (Sweden)

    Chiu-Hsien Yang

    2013-08-01

    Full Text Available While symptomatic differences exist between younger and older advanced cancer patients, few studies have examined the differences in their care with respect to age. Our goals were to examine the influences of age differences on physical, psychosocial and spiritual distress among advanced cancer patients. Advanced cancer patients who resided in Kaohsiung Medical University Hospital during 2007–2008 were recruited. Data were collected through professional consultants. The influences of age variations on physical, psychosocial and spiritual distress in nonelderly (<60 years old and elderly (≧60 years old patients were analyzed. A total of 1013 advanced cancer patients were included in the analyses with 467 nonelderly patients and 546 elderly patients. Nonelderly patients were identified to have a higher baseline pain level (4.0 vs. 2.8, p<0.001, breakthrough pain (19.3% vs. 9.9%, p<0.01, insomnia (6.4% vs. 2.7%, p=0.006, emotional distress (69.0% vs. 60.6%, p=0.013, and unwillingness to pass away because of concern for loved ones (18.8% vs. 11.9%, p=0.003 with significant difference. Elderly ones were concerned about unfulfilled wishes (29.7% vs. 18.4%, p<0.001 in spiritual concerns. After adjustments in regression models, nonelderly age (<60 years old still revealed significant positive or negative impact on all categories of distress. Patients aged under 60 years have more physical, psychosocial and spiritual suffering. This study suggested that professional practitioners should provide intensive care for vulnerable terminally ill cancer patients.

  11. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

    Science.gov (United States)

    Snowden, Austyn; Telfer, Iain

    2017-01-01

    Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

  12. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

    International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

  13. The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring.

    Science.gov (United States)

    Rassool, G H

    2000-12-01

    Caring from Islamic perspectives is not well versed in Eurocentric nursing literature. There is widespread misunderstanding of the concept and practice of Islam within the context of health care and nursing practice. The areas of contention, in the context of health care systems, are whether the western paradigm to nursing care and management are applicable to Muslims and non-Muslims in both Islamic and non-Islamic countries. What is lacking in some of the conceptual frameworks and models of care is not only the fundamental spiritual dimension of care, but also the significance of spiritual development of the individual towards healing. The focus of this paper is to provide an awareness of Islamic health practices, health behaviours, code of ethics and the framework of Islamic perspectives of caring and spirituality. A brief overview of the Muslim world, the historical development in caring and health and the pillars of the Islamic faith provide the context of the paper. The development of a model of care based on the Islamic perspective is suggested.

  14. Providing pediatric palliative care: PACT in action.

    Science.gov (United States)

    Duncan, Janet; Spengler, Emily; Wolfe, Joanne

    2007-01-01

    High-quality pediatric palliative care should be an expected standard in the United States, especially since the publication of the numerous position statements such as "Precepts of Palliative Care for Children and Adolescents and Their Families," a joint statement created by the Association of Pediatric Oncology Nurses, the National Association of Neonatal Nurses, and the Society of Pediatric Nurses. Although many barriers still exist, dedicated individuals and teams strive to promote models of excellence and improve care for children with life-threatening conditions and their families. The Pediatric Advanced Care Team, a joint project of Dana-Farber Cancer Institute and Children's Hospital, Boston, is one such interdisciplinary pediatric palliative care consultation service. Founded in 1997, we have grown and learned from formal study and our extensive clinical work with families, children, and our colleagues. This article describes our journey as an interdisciplinary team forging a new service within two renowned medical institutions in which historically the primary emphasis of care has been on cure and innovation. Although these values remain, our work has resulted in an increased acceptance of balancing treatment of the underlying disease or condition along with treatment of the physical, psychosocial, and spiritual needs of the child and family through life or death. One of our goals is to help promote a balance of hope for cure with hope for comfort, dignity, and integrity for every child and family.

  15. Developing and testing a spiritual care questionnaire in the Iranian context.

    Science.gov (United States)

    Iranmanesh, Sedigheh; Tirgari, Batool; Cheraghi, Mohammad Ali

    2012-12-01

    As most research exploring nurses' perceptions on the topic of spiritual care was conducted in Western countries, these findings may not be applicable in Iran because of cultural and health system differences. Therefore, a new survey instrument was developed for the Iranian context. The study was conducted in two steps: (1) development and validation of items for perception scale and (2) distribution of the questionnaire among nursing students to determine scale reliability and construct validity. The preliminary scale consisted of 50 items designed to measure the participants' perception of spiritual care. Construct validity of the scale was examined on the remaining 33 items. On interpretation of the items, the following four components were identified: (1) meeting patient as a being in meaning and hope, (2) meeting patient as a being in relationship, (3) meeting patient as a religious being, and (4) meeting patients as a being with autonomy. The results in this paper showed that preserving dignity in the nurses' practice meant getting involved in interpersonal caring relationships, with respect for the involved peoples' religious beliefs and their autonomy. Proper education and professionally led supervision with reflection on past and recent experiences may develop student nurses' and nurses' perceptions as well as their attitudes toward spiritual care and to achieve a realistic view of the profession.

  16. Spiritual care may impact mental health and medication adherence in HIV+ populations

    Directory of Open Access Journals (Sweden)

    Oji VU

    2017-04-01

    Full Text Available Valerie U Oji,1–3 Leslie C Hung,3 Reza Abbasgholizadeh,1,4 Flora Terrell Hamilton,5 E James Essien,6 Evaristus Nwulia7 1Lifefountain Center Ministries Inc, Houston, TX, USA; 2Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX, USA; 3University of Texas, College of Pharmacy, Austin, TX, USA; 4University of Houston, Houston, TX, USA; 5Administration, Family & Medical Counseling Service, Inc. (FMCS, Washington, DC, USA; 6University of Houston Institute for Community Health, Houston, TX, USA; 7Psychiatry, Howard University Translational Neuroscience Laboratory, Washington, DC, USA Objective: To explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations. Method: A systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS, major depressive disorder (MDD incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale. Results: The literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005 and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of

  17. Christian Spirituality in Eating Disorder Recovery

    Directory of Open Access Journals (Sweden)

    Cora Grant

    2018-02-01

    Full Text Available Eating disorders are some of the most severe and destructive of all psychological conditions. They are associated with restricted capacities in cognitive, emotional, physical, and spiritual development. This paper provides an examination of the practical application of Christian spirituality as a force for recovery from an eating disorder. Specifically, it expounds the transformative potential in the spiritual qualities of hope, trust, acceptance, surrender, and courage underpinning engagement with evidence-based therapeutic models of care in eating disorder recovery.

  18. The Evolution of Research Paradigms in Pastoral/Spiritual Care, Counseling, and Education.

    Science.gov (United States)

    Carr, John C

    2015-12-01

    This partially autobiographical article is presented as a chapter in the narrative of the evolution of research methodology in the social sciences and the impact that evolution has had on pastoral/spiritual care research as the author has experienced and observed it during the latter part of the 20th century and the early years of the 21st century. © The Author(s) 2015.

  19. Spiritual Needs of Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Harold G. Koenig

    2010-11-01

    Full Text Available For many patients confronted with chronic diseases, spirituality/religiosity is an important resource for coping. Patients often report unmet spiritual and existential needs, and spiritual support is also associated with better quality of life. Caring for spiritual, existential and psychosocial needs is not only relevant to patients at the end of their life but also to those suffering from long-term chronic illnesses. Spiritual needs may not always be associated with life satisfaction, but sometimes with anxiety, and can be interpreted as the patients’ longing for spiritual well-being. The needs for peace, health and social support are universal human needs and are of special importance to patients with long lasting courses of disease. The factor, Actively Giving, may be of particular importance because it can be interpreted as patients’ intention to leave the role of a `passive sufferer´ to become an active, self-actualizing, giving individual. One can identify four core dimensions of spiritual needs, i.e., Connection, Peace, Meaning/Purpose, and Transcendence, which can be attributed to underlying psychosocial, emotional, existential, and religious needs. The proposed model can provide a conceptual framework for further research and clinical practice. In fact, health care that addresses patients’ physical, emotional, social, existential and spiritual needs (referring to a bio-psychosocial-spiritual model of health care will contribute to patients’ improvement and recovery. Nevertheless, there are several barriers in the health care system that makes it difficult to adequately address these needs.

  20. 'Peace' and 'life worthwhile' as measures of spiritual well-being in African palliative care: a mixed-methods study.

    Science.gov (United States)

    Selman, Lucy; Speck, Peter; Gysels, Marjolein; Agupio, Godfrey; Dinat, Natalya; Downing, Julia; Gwyther, Liz; Mashao, Thandi; Mmoledi, Keletso; Moll, Tony; Sebuyira, Lydia Mpanga; Ikin, Barbara; Higginson, Irene J; Harding, Richard

    2013-06-10

    Patients with incurable, progressive disease receiving palliative care in sub-Saharan Africa experience high levels of spiritual distress with a detrimental impact on their quality of life. Locally validated measurement tools are needed to identify patients' spiritual needs and evaluate and improve spiritual care, but up to now such tools have been lacking in Africa. The African Palliative Care Association (APCA) African Palliative Outcome Scale (POS) contains two items relating to peace and life worthwhile. We aimed to determine the content and construct validity of these items as measures of spiritual wellbeing in African palliative care populations. The study was conducted at five palliative care services, four in South Africa and one in Uganda. The mixed-methods study design involved: (1) cognitive interviews with 72 patients, analysed thematically to explore the items' content validity, and (2) quantitative data collection (n = 285 patients) using the POS and the Spirit 8 to assess construct validity. (1) Peace was interpreted according to the themes 'perception of self and world', 'relationship to others', 'spiritual beliefs' and 'health and healthcare'. Life worthwhile was interpreted in relation to 'perception of self and world', 'relationship to others' and 'identity'. (2) Conceptual convergence and divergence were also evident in the quantitative data: there was moderate correlation between peace and Spirit 8 spiritual well-being (r = 0.46), but little correlation between life worthwhile and Spirit 8 spiritual well-being (r = 0.18) (both p spiritual well-being in African palliative care. Peace and life worthwhile are brief and simple enough to be integrated into routine practice and can be used to measure this important but neglected outcome in this population.

  1. The association between spiritual well-being and burnout in intensive care unit nurses: A descriptive study.

    Science.gov (United States)

    Kim, Hyun Sook; Yeom, Hye-Ah

    2018-06-01

    To describe the spiritual well-being and burnout of intensive care unit nurses and examine the relationship between these factors. This was a cross-sectional descriptive study. The participants were 318 intensive care unit recruited from three university hospitals in South Korea. The survey questionnaire included demographic information, work-related characteristics and end-of-life care experience, along with the Spiritual Well-Being Scale and Burnout Questionnaire. The data were analysed using descriptive statistics, t-tests, ANOVA with Scheffé test and a multiple regression analysis. The burnout level among intensive care unit nurses was 3.15 out of 5. A higher level of burnout was significantly associated with younger age, lower education level, single marital status, having no religion, less work experience and previous end-of-life care experience. Higher levels of spiritual well-being were associated with lower levels of burnout, even after controlling for the general characteristics in the regression model. Intensive care unit nurses experience a high level of burnout in general. Increased spiritual well-being might reduce burnout among intensive care unit nurses. Younger and less experienced nurses should receive more attention as a vulnerable group with lower spirituality and greater burnout in intensive care unit settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Integrating Religion and Spirituality into Mental Health Care, Psychiatry and Psychotherapy

    Directory of Open Access Journals (Sweden)

    René Hefti

    2011-11-01

    Full Text Available Integrating spirituality into mental health care, psychiatry and psychotherapy is still controversial, albeit a growing body of evidence is showing beneficial effects and a real need for such integration. In this review, past and recent research as well as evidence from the integrative concept of a Swiss clinic is summarized. Religious coping is highly prevalent among patients with psychiatric disorders. Surveys indicate that 70–80% use religious or spiritual beliefs and activities to cope with daily difficulties and frustrations. Religion may help patients to enhance emotional adjustment and to maintain hope, purpose and meaning. Patients emphasize that serving a purpose beyond one’s self can make it possible to live with what might otherwise be unbearable. Programs successfully incorporating spirituality into clinical practice are described and discussed. Studies indicate that the outcome of psychotherapy in religious patients can be enhanced by integrating religious elements into the therapy protocol and that this can be successfully done by religious and non-religious therapists alike.

  3. Longitudinal Pediatric Palliative Care: Quality of Life & Spiritual Struggle (FACE): design and methods.

    Science.gov (United States)

    Dallas, Ronald H; Wilkins, Megan L; Wang, Jichuan; Garcia, Ana; Lyon, Maureen E

    2012-09-01

    As life expectancy increases for adolescents ever diagnosed with AIDS due to treatment advances, the optimum timing of advance care planning is unclear. Left unprepared for end-of-life (EOL) decisions, families may encounter miscommunication and disagreements, resulting in families being charged with neglect, court battles and even legislative intervention. Advanced care planning (ACP) is a valuable tool rarely used with adolescents. The Longitudinal Pediatric Palliative Care: Quality of Life & Spiritual Struggle study is a two-arm, randomized controlled trial assessing the effectiveness of a disease specific FAmily CEntered (FACE) advanced care planning intervention model among adolescents diagnosed with AIDS, aimed at relieving psychological, spiritual, and physical suffering, while maximizing quality of life through facilitated conversations about ACP. Participants will include 130 eligible dyads (adolescent and family decision-maker) from four urban cities in the United States, randomized to either the FACE intervention or a Healthy Living Control. Three 60-minute sessions will be conducted at weekly intervals. The dyads will be assessed at baseline as well as 3-, 6-, 12-, and 18-month post-intervention. The primary outcome measures will be in congruence with EOL treatment preferences, decisional conflict, and quality of communication. The mediating and moderating effects of threat appraisal, HAART adherence, and spiritual struggle on the relationships among FACE and quality of life and hospitalization/dialysis use will also be assessed. This study will be the first longitudinal study of an AIDS-specific model of ACP with adolescents. If successful, this intervention could quickly translate into clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment.

    Science.gov (United States)

    Anandarajah, G; Hight, E

    2001-01-01

    The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patient's spirituality or religious commitment and health outcomes, and that patients would like physicians to consider these factors in their medical care. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process. The HOPE concepts for discussion are as follows: H--sources of hope, strength, comfort, meaning, peace, love and connection; O--the role of organized religion for the patient; P--personal spirituality and practices; E--effects on medical care and end-of-life decisions.

  5. Spiritual well-being of Italian advanced cancer patients in the home palliative care setting.

    Science.gov (United States)

    Martoni, A A; Varani, S; Peghetti, B; Roganti, D; Volpicella, E; Pannuti, R; Pannuti, F

    2017-07-01

    This study evaluates the spiritual well-being (SpWB) in very advanced cancer patients assisted by the home palliative care program of ANT Foundation, a no-profit Italian organisation. SpWB was assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12), including Meaning, Peace, and Faith subscales. The quality-of-life (QoL) was evaluated by using the Functional Assessment of Cancer Therapy-General scale. Questionnaires were distributed to 1,055 patients and 683 were compiled and evaluable for analysis. The mean scores of FACIT-Sp12 as well as of QoL were notably lower than reference values for cancer survivors. The FACIT-Sp12 score was higher in patients with less impaired Karnofsky Performance Status, fully participating in religious rituals and living in central Italy. A high Pearson's correlation was found between QoL and FACIT-Sp12 (r = .60), Peace (r = .71) and Meaning (r = .52), while it was marginal for Faith (r = .27). The hierarchical regression analysis showed that FACIT-Sp12 is a significant predictor of QoL. The study suggests that Italian patients with advanced cancer assisted by expert multi-professional teams in the home palliative care setting have a low level of SpWB thereby highlighting the need for the integration of spiritual support as part of comprehensive cancer care. © 2017 John Wiley & Sons Ltd.

  6. Insure Kids Now (IKN) (Dental Care Providers)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Insure Kids Now (IKN) Dental Care Providers in Your State locator provides profile information for oral health providers participating in Medicaid and Children's...

  7. Screening Patient Spirituality and Spiritual Needs in Oncology Nursing

    NARCIS (Netherlands)

    van Leeuwen, René; Schep-Akkerman, Annemiek; van Laarhoven, Hanneke W. M.

    2013-01-01

    Aim. To select 2 appropriate spiritual assessment tools and evaluate these by involving oncology nurses. Background. Spirituality is recognized as an important domain of cancer care. At admission, integration of spiritual assessment seems necessary. It is unclear what kind of spiritual assessment

  8. Screening patient spirituality and spiritual needs in oncology nursing

    NARCIS (Netherlands)

    Leeuwen, R. van; Schep-Akkerman, A.E.; Laarhoven, H.W.M. van

    2013-01-01

    AIM.: To select 2 appropriate spiritual assessment tools and evaluate these by involving oncology nurses. BACKGROUND.: Spirituality is recognized as an important domain of cancer care. At admission, integration of spiritual assessment seems necessary. It is unclear what kind of spiritual assessment

  9. Evaluation of the effect of Spiritual care on patients with generalized anxiety and depression: a randomized controlled study.

    Science.gov (United States)

    Sankhe, A; Dalal, K; Save, D; Sarve, P

    2017-12-01

    The present study was conducted to assess the effect of spiritual care in patients with depression, anxiety or both in a randomized controlled design. The participants were randomized either to receive spiritual care or not and Hamilton anxiety rating scale-A (HAM-A), Hamilton depression rating scale-D (HAM-D), WHO-quality of life-Brief (WHOQOL-BREF) and Functional assessment of chronic illness therapy - Spiritual well-being (FACIT-Sp) were assessed before therapy and two follow-ups at 3 and 6 week. However, with regard to the spiritual care therapy group, statistically significant differences were observed in both HAM-A and HAM-D scales between the baseline and visit 2 (p scales during the follow-up periods for the control group of participants. When the scores were compared between the study groups, HAM-A, HAM-D and FACIT-Sp 12 scores were significantly lower in the interventional group as compared to the control group at both third and sixth weeks. This suggests a significant improvement in symptoms of anxiety and depression in the spiritual care therapy group than the control group; however, large randomized controlled trials with robust design are needed to confirm the same.

  10. The Impact of Spiritual Care Education on the Self-Efficacy of the Family Caregivers of Elderly People with Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Azam Salamizadeh

    2017-07-01

    Full Text Available Background: Caring for people who suffer from Alzheimer’s disease is stressful. Family caregivers of these people usually experience physical and mental burnout and lose their efficacy in doing care-related activities. The present study aimed to examine the impacts of spiritual care education on self-efficacy of the family caregivers of people with Alzheimer’s disease. Methods: This study was conducted from October to December 2015 by using a two-group pretest-posttest quasi-experimental design. In total, 60 family caregivers of people with Alzheimer’s disease were recruited and randomly allocated to the intervention and control groups. A spiritual care educational intervention was implemented for the caregivers in the intervention group. The data were collected before and three weeks after the study intervention by using the ten-item General Self Efficacy scale. The study data were analyzed in SPSS using Chi-square and independent t-test. Results: Before the study intervention, the means of pretest self-efficacy scores in the intervention and control groups were 29.80±4.80 and 28.39±6.41, respectively. There was no significant difference between the groups regarding the mean score of self-efficacy (P=0.36. After the study, these two scores changed to 32.73±4.75 and 27.85±5.98, respectively. However, after the intervention, the mean score of self-efficacy in the intervention group was significantly higher than the control group (P=0.002. Conclusion: Spiritual care can enhance the self-efficacy of the family caregivers of people who suffer from Alzheimer’s disease. Therefore, care providers are recommended to use such spirituality-based interventions for empowering family caregivers.

  11. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Science.gov (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  12. Longitudinal spiritual coping with trauma in people with HIV: implications for health care.

    Science.gov (United States)

    Kremer, Heidemarie; Ironson, Gail

    2014-03-01

    This 10-year study (N=177) examines how people with HIV use spirituality to cope with life's trauma on top of HIV-related stress (e.g., facing death, stigma, poverty, limited healthcare) usual events. Spirituality, defined as a connection to a higher presence, is independent from religion (institutionalized spirituality). As a dynamic adaptive process, coping requires longitudinal studying. Qualitative content-analysis of interviews/essays yielded a coding of specific aspects and a longitudinal rating of overall spiritual coping. Most participants were rated as spiritual, using spiritual practices, about half experienced comfort, empowerment, growth/transformation, gratitude, less than one-third meaning, community, and positive reframing. Up to one-fifth perceived spiritual conflict, struggle, or anger, triggering post-traumatic stress, which sometimes converted into positive growth/transformation later. Over time, 65% used spiritual coping positively, 7% negatively, and 28% had no significant use. Spirituality was mainly beneficial for women, heterosexuals, and African Americans (pspirituality is a major source of positive and occasionally negative coping (e.g., viewing HIV as sin). We discuss how clinicians can recognize and prevent when spirituality is creating distress and barriers to HIV treatment, adding a literature review on ways of effective spiritual assessment. Spirituality may be a beneficial component of coping with trauma, considering socio-cultural contexts.

  13. Home care providers to the rescue

    DEFF Research Database (Denmark)

    Hansen, Steen Møller; Brøndum, Stig; Thomas, Grethe

    2015-01-01

    AIM: To describe the implementation of a novel first-responder programme in which home care providers equipped with automated external defibrillators (AEDs) were dispatched in parallel with existing emergency medical services in the event of a suspected out-of-hospital cardiac arrest (OHCA......). METHODS: We evaluated a one-year prospective study that trained home care providers in performing cardiopulmonary resuscitation (CPR) and using an AED in cases of suspected OHCA. Data were collected from cardiac arrest case files, case files from each provider dispatch and a survey among dispatched...... providers. The study was conducted in a rural district in Denmark. RESULTS: Home care providers were dispatched to 28 of the 60 OHCAs that occurred in the study period. In ten cases the providers arrived before the ambulance service and subsequently performed CPR. AED analysis was executed in three cases...

  14. Treading lightly: spirituality issues in mental health nursing.

    Science.gov (United States)

    Wilding, Clare; Muir-Cochrane, Eimear; May, Esther

    2006-06-01

    Spirituality has been recognized as an important part of nursing practice since its early beginnings. However, debate continues about whether and how nurses and other mental health professionals should include spirituality within their daily work. This paper aims to contribute to the discussion of spirituality within mental health nursing, through considering findings from a Heideggerian phenomenological study conducted with six people with mental illness living in regional Australia. This study aimed to provide a greater understanding of the phenomenon of spirituality by answering a primary research question, 'What does spirituality mean for people with a mental illness?' Participants were interviewed and data analysed using an iterative approach. Findings emerged through multiple readings and meanings were gradually constructed from the data into themes. The themes describe that spirituality is experienced uniquely for the participants, and that spirituality became vitally important to them when they became mentally unwell. In addition, issues of interest to mental health nurses were raised but not completely addressed by the study. The issues relate to potential interactions about spirituality between nurses and their patients. Although participants wanted to discuss their experiences of spirituality with others, they raised concerns about whether their mental health care providers would be accepting of their beliefs. Spirituality was deemed to be a highly individual phenomenon; it could be experienced as a journey and it was life-sustaining. For these reasons, it is proposed that mental health professionals must be prepared to discuss patients' spiritual needs in the context of their health concerns.

  15. A contemplative care approach to training and supporting hospice volunteers: a prospective study of spiritual practice, well-being, and fear of death.

    Science.gov (United States)

    Scherwitz, Larry; Pullman, Marcie; McHenry, Pamela; Gao, Billy; Ostaseski, Frank

    2006-01-01

    Inspired by a 2,500-year-old Buddhist tradition, the Zen Hospice Project (ZHP) provides residential hospice care, volunteer programs, and educational efforts that cultivate wisdom and compassion in service. The present study was designed to understand how being with dying hospice residents affects hospice volunteers well-being and the role of spiritual practice in ameliorating the fear of death. A one-year longitudinal study of two volunteer cohorts (N = 24 and N = 22) with repeated measures of spiritual practice, well-being, and hospice performance during one-year service as volunteers. The Zen Hospice Guest House and Laguna Honda Residential Hospital of San Francisco, CA. All 46 individuals who became ZHP volunteers during two years. A 40-hour training program for beginning hospice volunteers stressing compassion, equanimity, mindfulness, and practical bedside care; a one-year caregiver assignment five hours per week; and monthly group meeting. Self-report FACIT spiritual well-being, general well-being, self-transcendence scale, and a volunteer coordinator-rated ZHP performance scale. The volunteers had a high level of self-care and well-being at baseline and maintained both throughout the year; they increased compassion and decreased fear of death. Those (n = 20) practicing yoga were found to have consistently lower fear of death than the group average (P = .04, P = .008, respectively). All rated the training and program highly, and 63% continued to volunteer after the first year's commitment. The results suggest that this approach to training and supporting hospice volunteers fosters emotional well-being and spiritual growth.

  16. Multicultural Nursing: Providing Better Employee Care.

    Science.gov (United States)

    Rittle, Chad

    2015-12-01

    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided. © 2015 The Author(s).

  17. Effective communication with primary care providers.

    Science.gov (United States)

    Smith, Karen

    2014-08-01

    Effective communication requires direct interaction between the hospitalist and the primary care provider using a standardized method of information exchange with the opportunity to ask questions and assign accountability for follow-up roles. The discharge summary is part of the process but does not provide the important aspects of handoff, such as closed loop communication and role assignments. Hospital discharge is a significant safety risk for patients, with more than half of discharged patients experiencing at least one error. Hospitalist and primary care providers need to collaborate to develop a standardized system to communicate about shared patients that meets handoff requirements. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. ‘Peace’ and ‘life worthwhile’ as measures of spiritual well-being in African palliative care: a mixed-methods study

    NARCIS (Netherlands)

    Selman, L.; Speck, P.; Gysels, M.; Agupio, G.; Dinat, N.; Downing, J.; Gwyther, L.; Mashao, T.; Mmoledi, K.; Moll, T.; Mpanga Sebuyira, L.; Ikin, B.; Higginson, I.J.; Harding, R.

    2013-01-01

    Background Patients with incurable, progressive disease receiving palliative care in sub-Saharan Africa experience high levels of spiritual distress with a detrimental impact on their quality of life. Locally validated measurement tools are needed to identify patients’ spiritual needs and evaluate

  19. Enhancing psychosocial and spiritual palliative care: Four-year results of the program of comprehensive care for people with advanced illnesses and their families in Spain.

    Science.gov (United States)

    Gómez-Batiste, Xavier; Mateo-Ortega, Dolors; Lasmarías, Cristina; Novellas, Anna; Espinosa, Jose; Beas, Elba; Ela, Sara; Barbero, Javier

    2017-02-01

    We aimed to describe the overall quantitative and qualitative results of a "La Caixa" Foundation and World Health Organization Collaborating Center Program entitled "Comprehensive Care for Patients with Advanced Illnesses and their Families" after four years of experience. Qualitative and quantitative methods were employed to assess the program. Quasiexperimental, prospective, multicenter, single-group, and pretest/posttest methods were utilized to assess the quantitative data. The effectiveness of psychosocial interventions was assessed at baseline (visit 1) and after four follow-up visits. The following dimensions were assessed: mood state, discomfort, anxiety, degree of adjustment or adaptation to disease, and suffering. We also assessed the four dimensions of the spiritual pain scale: faith or spiritual beliefs, valuable faith or spiritual beliefs, meaning in life, and peace of mind/forgiveness. Qualitative analyses were performed via surveys to evaluate stakeholder satisfaction. We built 29 psychosocial support teams involving 133 professionals-mainly psychologists and social workers. During the study period, 8,964 patients and 11,810 family members attended. Significant improvements were observed in the psychosocial and spiritual dimensions assessed. Patients, family members, and stakeholders all showed high levels of satisfaction. This model of psychosocial care could serve as an example for other countries that wish to improve psychosocial and spiritual support. Our results confirm that specific psychosocial interventions delivered by well-trained experts can help to ease suffering and discomfort in end-of-life and palliative care patients, particularly those with high levels of pain or emotional distress.

  20. How parents of children receiving pediatric palliative care use religion, spirituality, or life philosophy in tough times.

    Science.gov (United States)

    Hexem, Kari R; Mollen, Cynthia J; Carroll, Karen; Lanctot, Dexter A; Feudtner, Chris

    2011-01-01

    How parents of children with life threatening conditions draw upon religion, spirituality, or life philosophy is not empirically well described. Participants were parents of children who had enrolled in a prospective cohort study on parental decision-making for children receiving pediatric palliative care. Sixty-four (88%) of the 73 parents interviewed were asked an open-ended question on how religion, spirituality, or life philosophy (RSLP) was helpful in difficult times. Responses were coded and thematically organized utilizing qualitative data analysis methods. Any discrepancies amongst coders regarding codes or themes were resolved through discussion that reached consensus. Most parents of children receiving palliative care felt that RSLP was important in helping them deal with tough times, and most parents reported either participation in formal religious communities, or a sense of personal spirituality. A minority of parents, however, did not wish to discuss the topic at all. For those who described their RSLP, their beliefs and practices were associated with qualities of their overall outlook on life, questions of goodness and human capacity, or that "everything happens for a reason." RSLP was also important in defining the child's value and beliefs about the child's afterlife. Prayer and reading the bible were important spiritual practices in this population, and parents felt that these practices influenced their perspectives on the medical circumstances and decision-making, and their locus of control. From religious participation and practices, parents felt they received support from both their spiritual communities and from God, peace and comfort, and moral guidance. Some parents, however, also reported questioning their faith, feelings of anger and blame towards God, and rejecting religious beliefs or communities. RSLP play a diverse and important role in the lives of most, but not all, parents whose children are receiving pediatric palliative care.

  1. Physician-Assisted Suicide and Other Forms of Euthanasia in Islamic Spiritual Care.

    Science.gov (United States)

    Isgandarova, Nazila

    2015-12-01

    The muteness in the Qur'an about suicide due to intolerable pain and a firm opposition to suicide in the hadith literature formed a strong opinion among Muslims that neither repentance nor the suffering of the person can remove the sin of suicide or mercy 'killing' (al-qatl al-rahim), even if these acts are committed with the purpose of relieving suffering and pain. Some interpretations of the Islamic sources even give advantage to murderers as opposed to people who commit suicide because the murderers, at least, may have opportunity to repent for their sin. However, people who commit suicide are 'labeled' for losing faith in the afterlife without a chance to repent for their act. This paper claims that Islamic spiritual care can help people make decisions that may impact patients, family members, health care givers and the whole community by responding to questions such as 'What is the Islamic view on death?', 'What is the Islamic response to physician-assisted suicide and other forms of euthanasia?', 'What are the religious and moral underpinnings of these responses in Islam?' © The Author(s) 2015.

  2. Music Therapy is Associated With Family Perception of More Spiritual Support and Decreased Breathing Problems in Cancer Patients Receiving Hospice Care.

    Science.gov (United States)

    Burns, Debra S; Perkins, Susan M; Tong, Yan; Hilliard, Russell E; Cripe, Larry D

    2015-08-01

    Music therapy is a common discretionary service offered within hospice; however, there are critical gaps in understanding the effects of music therapy on hospice quality indicators, such as family satisfaction with care. The purpose of this study was to examine whether music therapy affected family perception of patients' symptoms and family satisfaction with hospice care. This was a retrospective, cross-sectional analysis of electronic medical records from 10,534 cancer patients cared for between 2006 and 2010 by a large national hospice. Logistic regression was used to estimate the effect of music therapy using propensity scores to adjust for non-random assignment. Overall, those receiving music therapy had higher odds of being female, having longer lengths of stay, and receiving more services other than music therapy, and lower odds of being married/partnered or receiving home care. Family satisfaction data were available for 1495 (14%) and were more likely available if the patient received music therapy (16% vs. 12%, P music therapy vs. those not. Patients who received music therapy were more likely to report discussions about spirituality (odds ratio [OR] = 1.59, P = 0.01), had marginally less trouble breathing (OR = 0.77, P = 0.06), and were marginally more likely to receive the right amount of spiritual support (OR = 1.59, P = 0.06). Music therapy was associated with perceptions of meaningful spiritual support and less trouble breathing. The results provide preliminary data for a prospective trial to optimize music therapy interventions for integration into clinical practice. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Spiritual perspectives and practices at the end-of-life: A review of the major world religions and application to palliative care

    Directory of Open Access Journals (Sweden)

    Bauer-Wu S

    2007-01-01

    Full Text Available Palliative care professionals promote well-being and ease suffering at the end-of-life through holistic care that addresses physical, emotional, social and spiritual needs. The ways that individuals cope with serious illness and prepare for death are often done so within a religious context. Therefore, it is essential that palliative care practitioners are sensitive to and have an appreciation of different religious perspectives and rituals to meet the unique needs of their patients and families. This paper provides a brief overview of the five major world religions - Buddhism, Christianity, Hinduism, Islam and Judaism - with particular emphasis of the respective perspectives on suffering, death and afterlife. Despite wide variation in these traditions, an understanding of common rituals surrounding death, funerals and bereavement can improve care for patients, families and communities facing the end-of-life.

  4. Standardizing communication from acute care providers to primary care providers on critically ill adults.

    Science.gov (United States)

    Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

    2015-11-01

    To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

  5. PROMOTING PSYCHO-SOCIAL-SPIRITUAL RESPONSE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS THROUGH APLICATION ON SELF CARE MANAGEMENT MODUL

    Directory of Open Access Journals (Sweden)

    Kusnanto Kusnanto

    2017-04-01

    Full Text Available Introduction: Diabetes mellitus was a kind of incurable chronic disease that actually manageable. The global prevalence tends to increase due to less self management of the disease and the impact of it was severe health condition. There were so many interventions implemented but failed to give optimal improvement in patient’s condition and there are so many DM patients have insufficient ability to manage their own disease. Patients need to have knowledge, skills, and self confident to be able to manage their disease. Patient’s self-management depends on patient’s education, empowerment, and self monitoring in evaluating their self-care management. The purpose of this research was promoting patient’s psychological, social, and spiritual conditions through Self Care Management. Improvement in psychological, social, and spiritual conditions in patients with DM will lead to better level of blood glucose and HbA1C. Method: Patient newly diagnose with Type 2 DM at Puskesmas Kebonsari was selected with purposive sampling and divided into two groups. Each group contains 25 patients. Intervention group was given Self Diabetes Management Module. Before and after intervention patient was given Questionnaire. The data then analyzed using Student-T test, McNemar and Chi-Square. Result: The result of this research showed patient have constructive coping, increase interpersonal relation. Patients also have better acceptance about the disease and involve in its management. Discussion: Self Care Management Module promotes psychological, social, and spiritual conditions in patients with type 2 DM.

  6. Pilot-testing the French version of a provisional European organisation for research and treatment of cancer (EORTC) measure of spiritual well-being for people receiving palliative care for cancer.

    Science.gov (United States)

    Lucette, A; Brédart, A; Vivat, B; Young, T

    2014-03-01

    Spiritual well-being is increasingly recognised as an important aspect of patients' quality of life when living with a potentially life-limiting illness such as cancer. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group is developing a measure for assessing spiritual well-being cross-culturally for people receiving palliative care for cancer. The pilot-testing phase of the study explored potential problems related to the content and administration of a provisional version of this measure. The French version was pilot-tested with 12 patients in a palliative and supportive day care unit in Paris. Participants were asked to complete the measure and the EORTC QLQ-C15-PAL before being interviewed about their responses. The administration of the measure enabled participants to express the difficulties and existential concerns they experienced. The items were not considered intrusive, despite the sensitive topic of the measure. This article considers difficulties with items pertaining to 'religion' and 'spirituality' in the context of French culture. Overall, this measure appears to enhance holistic care, by providing caregivers with a means of broaching spirituality issues, a topic otherwise difficult to discuss in the context of palliative care. © 2013 John Wiley & Sons Ltd.

  7. Frequency, intensity, and correlates of spiritual pain in advanced cancer patients assessed in a supportive/palliative care clinic.

    Science.gov (United States)

    Delgado-Guay, Marvin Omar; Chisholm, Gary; Williams, Janet; Frisbee-Hume, Susan; Ferguson, Andrea O; Bruera, Eduardo

    2016-08-01

    Regular assessments of spiritual distress/spiritual pain among patients in a supportive/palliative care clinic (SCPC) are limited or unavailable. We modified the Edmonton Symptom Assessment Scale (ESAS) by adding spiritual pain (SP) to the scale (0 = best, 10 = worst) to determine the frequency, intensity, and correlates of self-reported SP (≥1/10) (pain deep in your soul/being that is not physical) among these advanced cancer patients. We reviewed 292 consecutive consults of advanced cancer patients (ACPs) who were evaluated at our SCPC between October of 2012 and January of 2013. Symptoms were assessed using the new instrument (termed the ESAS-FS). The median age of patients was 61 (range = 22-92). Some 53% were male; 189 (65%) were white, 45 (15%) African American, and 34 (12%) Hispanic. Some 123 of 282 (44%) of ACPs had SP (mean (95% CI) = 4(3.5-4.4). Advanced cancer patients with SP had worse pain [mean (95% CI) = 5.3(4.8, 5.8) vs. 4.5(4.0, 5.0)] (p = 0.02); depression [4.2(3.7, 4.7) vs. 2.1(1.7, 2.6), p well-being [5.4(4.9, 5.8) vs. 4.5(4.1, 4.9), p = 0.0136]; and financial distress (FD) [4.4(3.9, 5.0) vs. 2.2(1.8, 2.7), p Spiritual pain correlated (Spearman) with depression (r = 0.45, p well-being (r = 0.27, p = 0.0006), nausea (r = 0.29, p = 0.0002), and financial distress (r = 0.42, p Spiritual pain, which is correlated with physical and psychological distress, was reported in more than 40% of ACPs. Employment of the ESAS-FS allows ACPs with SP to be identified and evaluated in an SCPC. More research is needed.

  8. Spiritual Perspective and Needs: A Comparative Study of Nursing Faculty in a Christian University and a State University

    Science.gov (United States)

    Gray, Jennifer; Garner, Linda; Snow, Diane; Wright, Kathy

    2004-01-01

    To care for the whole person, nurses must provide spiritual care (Narayanasamy, 1995; Wright, 1998). The inability to consistently and effectively provide spiritual care has been linked to the lack of educational preparation in our basic nursing programs (Govier, 2000; Piles, 1990). This lack of preparation is unacceptable because patients…

  9. Self-Perceived End-of-Life Care Competencies of Health-Care Providers at a Large Academic Medical Center.

    Science.gov (United States)

    Montagnini, Marcos; Smith, Heather M; Price, Deborah M; Ghosh, Bidisha; Strodtman, Linda

    2018-01-01

    In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. To assess health-care professionals' self-perceived competencies regarding the provision of EOL care in hospitalized patients. Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.

  10. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    Science.gov (United States)

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  11. A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review

    OpenAIRE

    Fang, Mei Lan; Sixsmith, Judith; Sinclair, Shane; Horst, Glen

    2016-01-01

    Background Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. Methods To explore atti...

  12. Multidisciplinary Training on Spiritual Care for Patients in Palliative Care Trajectories Improves the Attitudes and Competencies of Hospital Medical Staff: Results of a Quasi-Experimental Study.

    Science.gov (United States)

    van de Geer, Joep; Veeger, Nic; Groot, Marieke; Zock, Hetty; Leget, Carlo; Prins, Jelle; Vissers, Kris

    2018-02-01

    Patients value health-care professionals' attention to their spiritual needs. However, this is undervalued in health-care professionals' education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. A pragmatic multicenter trial using a quasi-experimental pretest-posttest design as part of an action research study. Eight multidisciplinary teams in regular wards and 1 team of PC consultants, in 8 Dutch teaching hospitals, received questionnaires before training about perceived barriers for SC, spiritual attitudes and involvement, and SC competencies. The effect on the barriers on SC and SC competencies were measured both 1 and 6 months after the training. For nurses (n = 214), 7 of 8 barriers to SC were decreased after 1 month, but only 2 were still after 6 months. For physicians (n = 41), the training had no effect on the barriers to SC. Nurses improved in 4 of 6 competencies after both 1 and 6 months. Physicians improved in 3 of 6 competencies after 1 month but in only 1 competency after 6 months. Concise SC training programs for clinical teams can effect quality of care, by improving hospital staff competencies and decreasing the barriers they perceive. Differences in the effects of the SC training on nurses and physicians show the need for further research on physicians' educational needs on SC.

  13. The 3 H and BMSEST Models for Spirituality in Multicultural Whole-Person Medicine

    Science.gov (United States)

    Anandarajah, Gowri

    2008-01-01

    PURPOSE The explosion of evidence in the last decade supporting the role of spirituality in whole-person patient care has prompted proposals for a move to a biopsychosocial-spiritual model for health. Making this paradigm shift in today’s multicultural societies poses many challenges, however. This article presents 2 theoretical models that provide common ground for further exploration of the role of spirituality in medicine. METHODS The 3 H model (head, heart, hands) and the BMSEST models (body, mind, spirit, environment, social, transcendent) evolved from the author’s 12-year experience with curricula development regarding spirituality and medicine, 16-year experience as an attending family physician and educator, lived experience with both Hinduism and Christianity since childhood, and a lifetime study of the world’s great spiritual traditions. The models were developed, tested with learners, and refined. RESULTS The 3 H model offers a multidimensional definition of spirituality, applicable across cultures and belief systems, that provides opportunities for a common vocabulary for spirituality. Therapeutic options, from general spiritual care (compassion, presence, and the healing relationship), to specialized spiritual care (eg, by clinical chaplains), to spiritual self-care are discussed. The BMSEST model provides a conceptual framework for the role of spirituality in the larger health care context, useful for patient care, education, and research. Interactions among the 6 BMSEST components, with references to ongoing research, are proposed. CONCLUSIONS Including spirituality in whole-person care is a way of furthering our understanding of the complexities of human health and well-being. The 3 H and BMSEST models suggest a multidimensional and multidisciplinary approach based on universal concepts and a foundation in both the art and science of medicine. PMID:18779550

  14. Nursing students' spiritual talks with patients - evaluation of a partnership learning programme in clinical practice.

    Science.gov (United States)

    Strand, Kari; Carlsen, Liv B; Tveit, Bodil

    2017-07-01

    To evaluate the impact of a partnership learning programme designed to support undergraduate nursing students' competence in speaking with patients about spiritual issues. Spiritual care is an oft-neglected and underexposed area of nursing practice. Despite the increasing amount of research on spiritual care in educational programmes, little is known about nursing students' experiences with existential/spiritual talks and the process of learning about spiritual care in the clinical placement. The project used a qualitative evaluation design to evaluate the impact of a partnership-initiated intervention focusing on student learning of spiritual care in a hospital ward. Data were collected through three focus group interviews with bachelor of nursing students from one Norwegian university college and supplemented with notes. Data were analysed by means of qualitative interpretative content analysis. The intervention was found to enhance students' competence in spiritual talks. The students developed an extended understanding of spirituality, became more confident in speaking with patients about spiritual issues and more active in grasping opportunities to provide spiritual care. Participating nurses significantly contributed to the students' learning process by being role models, mentoring the students and challenging them to overcome barriers in speaking with patients about spiritual issues. The partnership learning programme proved to be a useful model in terms of enhancing students' confidence in speaking with patients about spiritual concerns. Collaboration between nursing university colleges and clinical placements could help nursing students and clinical nurses to develop competencies in spiritual care and bridge the gap between academic education and clinical education, to the benefit of both. © 2016 John Wiley & Sons Ltd.

  15. An investigation into the spiritual needs of neuro-oncology patients from a nurse perspective

    Directory of Open Access Journals (Sweden)

    Nixon Aline Victoria

    2013-02-01

    Full Text Available Abstract Background Spiritual needs of cancer patients should be assessed and discussed by healthcare professionals. Neurosurgical nurses need to be able to assess and support neuro-oncology patients with their spiritual needs from diagnosis and throughout their hospital stay. Methods Data were collected through questionnaires using a Critical Incident Technique (CIT from neurosurgical nurses, findings were analysed using thematic analysis. Results Nurses reported some awareness of their patients’ spiritual needs during their stay on neurosurgical units although some used expressions approximating what could be described as spiritual needs. Patients’ spiritual needs were identified as: need to talk about spiritual concerns, showing sensitivity to patients’ emotions, responding to religious needs; and relatives’ spiritual needs included: supporting them with end of life decisions, supporting them when feeling being lost and unbalanced, encouraging exploration of meaning of life, and providing space, time and privacy to talk. Participants appeared largely to be in tune with their patients’ spiritual needs and reported that they recognised effective strategies to meet their patients’ and relatives’ spiritual needs. However, the findings also suggest that they don’t always feel prepared to offer spiritual support for neuro-oncology patients. Conclusions There is a need for healthcare professionals to provide spiritual care for neuro-oncology patients and their relatives. Although strategies were identified that nurses can use to support patients with spiritual needs further research is required to explore how effective nurses are at delivering spiritual care and if nurses are the most appropriate professionals to support neuro-oncology patients with spiritual care.

  16. Self-rated health of primary care house officers and its relationship to psychological and spiritual well-being

    Directory of Open Access Journals (Sweden)

    Mueller Caroline V

    2007-05-01

    Full Text Available Background The stress associated with residency training may place house officers at risk for poorer health. We sought to determine the level of self-reported health among resident physicians and to ascertain factors that are associated with their reported health. Methods A questionnaire was administered to house officers in 4 residency programs at a large Midwestern medical center. Self-rated health was determined by using a health rating scale (ranging from 0 = death to 100 = perfect health and a Likert scale (ranging from "poor" health to "excellent" health. Independent variables included demographics, residency program type, post-graduate year level, current rotation, depressive symptoms, religious affiliation, religiosity, religious coping, and spirituality. Results We collected data from 227 subjects (92% response rate. The overall mean (SD health rating score was 87 (10; range, 40–100, with only 4 (2% subjects reporting a score of 100; on the Likert scale, only 88 (39% reported excellent health. Lower health rating scores were significantly associated (P Conclusion Residents' self-rated health was poorer than might be expected in a cohort of relatively young physicians and was related to program type, depressive symptoms, and spiritual well-being. Future studies should examine whether treating depressive symptoms and attending to spiritual needs can improve the overall health and well-being of primary care house officers.

  17. Spirituality and the physician executive.

    Science.gov (United States)

    Kaiser, L R

    2000-01-01

    The "s" word can now be spoken without flinching in health care organizations. Spirituality is becoming a common topic in management conferences around the world. Many U.S. corporations are recognizing the role of spirituality in creating a new humanistic capitalism that manages beyond the bottom line. Spirituality refers to a broad set of principles that transcend all religions. It is the relationship between yourself and something larger, such as the good of your patient or the welfare of the community. Spirituality means being in right relationship to all that is and understanding the mutual interdependence of all living beings. Physician executives should be primary proponents of spirituality in their organizations by: Modeling the power of spirituality in their own lives; integrating spiritual methodologies into clinical practice; fostering an integrative approach to patient care; encouraging the organization to tithe its profits for unmet community health needs; supporting collaborative efforts to improve the health of the community; and creating healing environments.

  18. Nursing and spirituality

    Directory of Open Access Journals (Sweden)

    Raphael de Brito Pedrão

    2010-03-01

    Full Text Available Objectives: To evaluate the spiritual well-being of nurses; to appraise their opinions as to the importance of offering patients spiritual assistance, and to verify whether nurses received any specific type of preparation during their professional training for giving spiritual assistance to patients. Methods: This is an exploratory and descriptive study, carried out with a sample of 30 nurses who worked at the Stepdown Unit and Oncology Unit of Hospital Israelita Albert Einstein, using the application of the Spiritual Well-Being Scale (SWS and a questionnaire prepared by the authors. Results: On the Spiritual Well-Being Scale, 76.6% of nurses produced positive scores. On the Existential Well-Being subscale, 80% had positive scores, and on the Religious Well-Being subscale, 76.6% had positive scores. On the SWBS, the general average score was 107.26, and for the Existential and Religious ones, the average scores were 54.4 and 53.2, respectively. Most nurses responded affirmatively as to the importance of offering patients spiritual assistance, and 40% of nurses offered as rationale “to provide well-being and comfort to the patient”. Most nurses reported not having received professional training for giving spiritual assistance to patients in any of the nursing courses they had done. Conclusions: The results indicate the need for professional training and/or continued education courses in nursing to extend the reflection and discussion on spirituality and spiritual assistance to patients.

  19. The supportive roles of religion and spirituality in end-of-life and palliative care of patients with cancer in a culturally diverse context: a literature review.

    Science.gov (United States)

    López-Sierra, Héctor E; Rodríguez-Sánchez, Jesús

    2015-03-01

    This is a literature review of the supportive roles of religion and spirituality (R/S) in end-of-life (EoL) and palliative care of patients with cancer in a culturally diverse context. This review examines 26 noteworthy articles published between August 2013 and August 2014 from five well supported databases. Current evidence shows that R/S evokes in patients the sources to find the necessary inner strengths, which includes perspective thinking, rituals for transcending immediate physical condition and modalities of coping with their oncological illnesses. R/S are not a monolithically experience for they always manifest themselves in diverse cultural settings. As such, R/S provide the individual and their families with a practical context and social memory, which includes traditions and social family practices for maintaining meaning and well-being. Nonetheless, although various dimensions of R/S show a link between cancer risk factors and well being in cancer patients, more specific dimensions of R/S need to be studied taking into account the individuals' particular religious and cultural contexts, so that R/S variables within that context can provide a greater integrative structure for understanding and to move the field forward. Behavioral, cognitive and psychosocial scientists have taken a more in-depth look at the claims made in the past, suggesting that a relationship between R/S, cultural diversity and health exists. Case in point are the studies on EoL care, which have progressively considered the role of cultural, religion and spiritual diversity in the care of patients with oncological terminal illnesses. Beyond these facts, this review also shows that EoL supportive and palliative care providers could further enhance their practical interventions by being sensitive and supportive of cultural diversity. http://links.lww.com/COSPC/A10

  20. Vulnerable populations: cultural and spiritual direction.

    Science.gov (United States)

    Quest, Tammie E; Franks, Nicole M

    2006-08-01

    Cultural, spiritual, and religious diversity of emergency department patients is increasing while that of emergency physicians in particular remains predominantly homogeneous. With a discordance of cultural, race, and ethnicity exist, in the case of ethical conflict -resolution becomes that much more difficult. Patients may feel vulnerable when their emergency care provider does not understand his or her cultural, spiritual, and religious uniqueness as it relates to the patient-doctor interaction and health care decision making. This review will examine (1) language differences; (2) cultural, religious, and spiritual differences between patient and provider; (3) differing explanatory models of disease between patient and provider; and (4) diverse bioethical models of decision making of differing cultures in an effort to reduce vulnerabilities.

  1. Revisiting Viktor Frankl: his contributions to the contemporary interest in spirituality and health care.

    Science.gov (United States)

    Gojmerac-Leiner, Georgia

    2005-01-01

    The case is made for location of spirituality to be in the body, and at the same time for the power of the spirit to transcend the body when it is afflicted. The author highlights Viktor Frankl's strongest convictions that one can survive through the shear power of one's spirit. Correspondingly, the promise of resurrection can help a Christian to maintain a vision of life, stay courageous though there may be no hope of tomorrow as we have known it. The author asserts the role of the hospital chaplain in helping the sick person to draw upon his or her spiritual strength to cope with their physical illness or affliction.

  2. Do you want some spiritual support? Different rates of positive response to chaplains' versus nurses' offer.

    Science.gov (United States)

    Martinuz, Marco; Dürst, Anne-Véronique; Faouzi, Mohamed; Pétremand, Daniel; Reichel, Virginie; Ortega, Barbara; Waeber, Gérard; Vollenweider, Peter

    2013-01-01

    Access to spiritual support appears to be important in the hospital setting. The offer of spiritual support can be done by different providers such as doctors, nurses or chaplains. Who should initiate or coordinate this spiritual care. This study addresses the following questions: 1) How many patients accept spiritual proposition? 2) What is the better mode of proposition? The study's objectives are the assessment and comparison of the rates of acceptance to an offer of spiritual support made by nurses and chaplains. Two hundred twenty-three consecutive hospitalized patients hospitalized received a proposal of spiritual support and were randomly assigned to one of two conditions. Results revealed that 85.8% of patients accepted the offer in the chaplains' group and 38.5% in the nurses' group. Acceptance of the offer of spiritual support was positively associated with the proposal being made by the chaplains by the frequency of meditation and age, and negatively related to physical well-being.

  3. Recovery Spirituality

    Directory of Open Access Journals (Sweden)

    Ernest Kurtz

    2015-01-01

    Full Text Available There is growing interest in Alcoholics Anonymous (A.A. and other secular, spiritual, and religious frameworks of long-term addiction recovery. The present paper explores the varieties of spiritual experience within A.A., with particular reference to the growth of a wing of recovery spirituality promoted within A.A. It is suggested that the essence of secular spirituality is reflected in the experience of beyond (horizontal and vertical transcendence and between (connection and mutuality and in six facets of spirituality (Release, Gratitude, Humility, Tolerance, Forgiveness, and a Sense of Being-at-home shared across religious, spiritual, and secular pathways of addiction recovery. The growing varieties of A.A. spirituality (spanning the “Christianizers” and “Seculizers” reflect A.A.’s adaptation to the larger diversification of religious experience and the growing secularization of spirituality across the cultural contexts within which A.A. is nested.

  4. The essence of spirituality of terminally ill patients.

    Science.gov (United States)

    Chao, Co-Shi Chantal; Chen, Ching-Huey; Yen, Miaofen

    2002-12-01

    The purpose of this hermeneutic study was to investigate the essence of spirituality of terminally ill patients. In-depth unstructured interviews were used as the method for data collection. In the six-month period of data collection, the researcher was in the role of a hospice palliative care consultant who directly took care of the subject patients in a hospice ward of a teaching hospital. The six subjects were selected purposively according to various demographic backgrounds. Interview transcripts provided the data for analysis. The results were composed of four constitutive patterns and ten themes. The first constitutive pattern was "Communion with Self" which included three themes: (1) Self-identity--spirituality is the discovery of the authentic self. (2) Wholeness--a human being is full of contradictions but still in wholeness. (3) Inner peace--spirituality is negotiating conflicts for self-reconciliation. The second constitutive pattern was "Communion with others" which included two themes: (1) Love--spirituality is a caring relationship but not an over-attachment to others. (2) Reconciliation--spirituality is to forgive and to be forgiven. The third constitutive pattern was "Communion with Nature" which included two themes: (1) Inspiration from the nature--spirituality is the resonance of the marvelous beauty of nature. (2) Creativity--spirituality is conceiving imaginatively. The fourth constitutive pattern was "Communion with Higher Being" which included three themes: (1) Faithfulness--spirituality is keeping the trust dependably. (2) Hope--spirituality is claiming possibilities. (3) Gratitude--spirituality is giving thanks and embracing grace. The scientific rigor of this qualitative research as well as the strength and limitations of the study are reported. Implications for hospice palliative care and future research are recommended.

  5. Spirituality in the Healthcare Workplace

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino

    2017-11-01

    Full Text Available Spirituality involves a sense of connectedness, meaning making and transcendence. There is abundant published research that focuses on the importance of spirituality to patients and their families during times of illness and distress. However over the last decade there has also been a growing awareness about the importance of considering the need to address peoples’ spiritual needs in the workplace. Engaging in ones own personal spirituality involves connecting with the inner self, becoming more self aware of ones humanity and limitations. Engaging with ones personal spirituality can also mean that people begin to greater find meaning and purpose in life and at work. This may be demonstrated in the workplace by collegial relationships and teamwork. Those who engage with their own spirituality also engage more easily with others through a connectedness with other staff and by aligning their values with the respective organization if they fit well with ones personal values. Workplace spirituality is oriented towards self-awareness of an inner life which gives meaning, purpose and nourishment to the employees’ dynamic relationships at the workplace and is eventually also nourished by meaningful work. Exercising ones personal spirituality contributes towards generating workplace spirituality. Essentially acting from ones own personal spirituality framework by being in doing can contribute towards a person becoming a healing and therapeutic presence for others, that is nourishing in many workplaces. Personal spirituality in healthcare can be enhanced by: reflection in and on action; role-modeling; taking initiative for active presence in care; committing oneself to the spiritual dimension of care; and, integrating spirituality in health caregivers’ education. As spirituality is recognized as becoming increasingly important for patients in healthcare, increasing educational opportunities are now becoming available for nurses internationally that

  6. “ Habitus ” in soul care. Towards “spiritual fortigenetics” (parrhesia ...

    African Journals Online (AJOL)

    It is argued that habitus plays a fundamental role in both a practical theological and pastoral-anthropological approach in order to focus on the “wholeness” of the human soul (soul as a qualitative and relational entity). It is hypothesized that a spiritual understanding of fortigenetics and the emphasis on a positive growth ...

  7. Providing Palliative Care to LGBTQ Patients.

    Science.gov (United States)

    Barrett, Nina; Wholihan, Dorothy

    2016-09-01

    Nurses should be familiar with and equipped to address the challenges that arise when caring for lesbian, gay, bisexual, transgender, or queer-identified (LGBTQ) patients. LGBTQ individuals have increased rates of certain physical diseases and are at greater risk of suffering from stress-sensitive mental health issues. Negative social attitudes, widespread discrimination and stigma, physical and psychological victimization, and less social support with aging contribute to the complexity of care for these individuals. Open communication, welcoming and accepting attitudes and environments, and sensitivity to unique multidimensional issues improve care to LGBTQ patients with serious advanced illness. Nursing can reach this vulnerable minority and positively impact the quality of care. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Occupational Health for Health Care Providers

    Science.gov (United States)

    Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

  9. Fibromyalgia: management strategies for primary care providers.

    Science.gov (United States)

    Arnold, L M; Gebke, K B; Choy, E H S

    2016-02-01

    Fibromyalgia (FM), a chronic disorder defined by widespread pain, often accompanied by fatigue and sleep disturbance, affects up to one in 20 patients in primary care. Although most patients with FM are managed in primary care, diagnosis and treatment continue to present a challenge, and patients are often referred to specialists. Furthermore, the lack of a clear patient pathway often results in patients being passed from specialist to specialist, exhaustive investigations, prescription of multiple drugs to treat different symptoms, delays in diagnosis, increased disability and increased healthcare resource utilisation. We will discuss the current and evolving understanding of FM, and recommend improvements in the management and treatment of FM, highlighting the role of the primary care physician, and the place of the medical home in FM management. We reviewed the epidemiology, pathophysiology and management of FM by searching PubMed and references from relevant articles, and selected articles on the basis of quality, relevance to the illness and importance in illustrating current management pathways and the potential for future improvements. The implementation of a framework for chronic pain management in primary care would limit unnecessary, time-consuming, and costly tests, reduce diagnostic delay and improve patient outcomes. The patient-centred medical home (PCMH), a management framework that has been successfully implemented in other chronic diseases, might improve the care of patients with FM in primary care, by bringing together a team of professionals with a range of skills and training. Although there remain several barriers to overcome, implementation of a PCMH would allow patients with FM, like those with other chronic conditions, to be successfully managed in the primary care setting. © 2016 John Wiley & Sons Ltd.

  10. "Oh, yeah, I'm getting closer to god": spirituality and religiousness of family caregivers of cancer patients undergoing palliative care.

    Science.gov (United States)

    Paiva, Bianca Sakamoto Ribeiro; Carvalho, André Lopes; Lucchetti, Giancarlo; Barroso, Eliane Marçon; Paiva, Carlos Eduardo

    2015-08-01

    Within the cancer palliative care setting, where both patients and family caregivers (FCs) undergo a transition from the end of curative treatment to palliative therapy, spirituality and religiousness (S/R) may be a strategy to help the patients and FCs better cope with the disease, in addition to exerting a positive impact on symptoms, particularly emotional symptoms. The present study aimed to understand how S/R influence FCs of cancer patients undergoing palliative care. This study was an exploratory and descriptive qualitative study. The qualitative approach to the data was based on Bardin's content analysis technique. The consolidated criteria for reporting qualitative research (COREQ-32) was used in the description of the results. Thirty FCs of individuals with advanced cancer undergoing palliative care were included. Analysis of the FCs' narratives indicated that the FCs considered that religiousness and faith in God or a Supreme Being provide them with the strength to cope with the suffering associated with the care of relatives with advanced cancer. Many FCs emphasized that talking about God was somehow comforting and made them feel at peace with themselves. Four categories were identified in the FCs' narratives: (1) increase in faith and closeness to God becomes stronger, (2) rethink life issues, (3) negative interference in the extrinsic religiosity, and (4) quest for religiousness to gain strength or support. A conceptual framework was developed. The results of the present study indicated that S/R are a coping strategy frequently used by FCs of individuals with advanced cancer. The perceptions of the FCs interviewed in the present study corresponded to the four distinct categories related to spirituality and religiousness.

  11. Religious and Spiritual Dimensions of the Vietnamese Dementia Caregiving Experience

    Science.gov (United States)

    Hinton, Ladson; Tran, Jane NhaUyen; Tran, Cindy; Hinton, Devon

    2010-01-01

    This paper focuses on the role of religion and spirituality in dementia caregiving among Vietnamese refugee families. In-depth qualitative interviews were conducted with nine Vietnamese caregivers of persons with dementia, then tape-recorded, transcribed, and analyzed for emergent themes. Caregivers related their spirituality/religion to three aspects of caregiving: (1) their own suffering, (2) their motivations for providing care, and (3) their understanding of the nature of the illness. Key terms or idioms were used to articulate spiritual/religious dimensions of the caregivers’ experience, which included sacrifice, compassion, karma, blessings, grace and peace of mind. In their narratives, the caregivers often combined multiple strands of different religions and/or spiritualities: Animism, Buddhism, Taoism, Confucianism and Catholicism. Case studies are presented to illustrate the relationship between religion/spirituality and the domains of caregiving. These findings have relevance for psychotherapeutic interventions with ethnically diverse populations. PMID:20930949

  12. Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families.

    Science.gov (United States)

    Longo, Lianne; Slater, Serena

    2014-01-01

    Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.

  13. Special Sitters: Youth as Respite Care Providers.

    Science.gov (United States)

    Edgar, Eugene B.; And Others

    1988-01-01

    A training program taught 120 teenage sitters child care skills identified as important by parents (N=250) of children with disabilities. Training included first aid and 15 hours of instruction emphasizing communication, responsive play, simple behavior management, handling of emergencies, and interviews with parents. The program also linked…

  14. Aligning Islamic Spirituality to Medical Imaging.

    Science.gov (United States)

    Zainuddin, Zainul Ibrahim

    2017-10-01

    This paper attempts to conceptualize Islamic spirituality in medical imaging that deals with the humanistic and technical dimensions. It begins with establishing an understanding concerning spirituality, an area that now accepted as part of patient-centred care. This is followed by discussions pertaining to Islamic spirituality, related to the practitioner, patient care and the practice. Possible avenues towards applying Islamic spirituality in medical imaging are proposed. It is hoped that the resultant harmonization between Islamic spirituality and the practice will trigger awareness and interests pertaining to the role of a Muslim practitioner in advocating and enhancing Islamic spirituality.

  15. Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

    Science.gov (United States)

    Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

    2017-08-01

    The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

  16. Meditational spiritual intercession and recovery from disease in palliative care: a literature review.

    Science.gov (United States)

    Agarwal, Siddharth; Kumar, Vijai; Agarwal, Sapna; Brugnoli, Maria Paola; Agarwal, Ansh

    2018-01-01

    Human body is a biological, open system and maintains itself in the changing environment. Disease state is cured by many medicinal systems for healing. Esoteric healing (through introspective hypnosis, meditation and spiritual intercession) is the system where its believers regard Supreme Being as Omnipotent, Omnipresent and Omniscient. Such persons take ill health as a boon and pray through meditation that He may by His Mercy grant health or if God wishes otherwise, they happily accept it so that they keep moving ahead on their spiritual path. This study is a review of literature, where results clearly point towards better psychological and spiritual healing in patients who believe in esoteric cures. Modern science in terms of cognitive psychology or neurophysiology has begun to emphasize the role of consciousness but, that is confined only to the physical world. It is only with the advent of Param Purush Puran Dhani Soami Ji Maharaj (200 years ago) that in the religion of Saints, the ultimate consciousness or the Super Consciousness of the highest order has been revealed.

  17. Creating conditions for good nursing by attending to the spiritual.

    Science.gov (United States)

    Biro, Anne L

    2012-12-01

    To note similarities, differences, and gaps in the literature on good nursing and spiritual care. Good nursing care is essential for meeting patient health needs. With growing recognition of the role of spirituality in health, understanding spiritual care as it relates to good nursing is important, especially as spiritual care has been recognized as the most neglected area of nursing care. Nursing research, reports and discussion articles from a variety of countries were reviewed on the topics of good nursing, spiritual care and spirituality. A nurse's spirituality and the nurse-patient relationship are integral to spiritual care and good nursing. There are many commonalities between good nursing and spiritual care. Personal attributes of the nurse are described in similar terms in research on spiritual care and good nursing. Professional attributes common to good nursing and spiritual care are the nurse-patient relationship, assessment skills and communication skills. Good nursing through spiritual care is facilitated by personal spirituality, training in spiritual care and a culture that implements changes supportive of spiritual care. Further research is needed to address limitations in the scope of literature. © 2012 Blackwell Publishing Ltd.

  18. Who Cares for Kids? A Report on Child Care Providers.

    Science.gov (United States)

    Benson, Carolyn

    This study offers a profile of child care workers in family day care homes and child care centers, reporting general statistics and examining their wages, benefits, training, working conditions, and turnover rates. In addition, it looks at government regulation and licensing, employer-sponsored programs, child abuse, insurance rates, and federal…

  19. The expectations of fathers concerning care provided by midwives to ...

    African Journals Online (AJOL)

    2012-04-06

    Apr 6, 2012 ... qualitative interviews were conducted with fathers about the care provided to their .... Caring, care: (Note: In this study the terms 'care' and 'caring' .... the coder to compare and discuss their analysis in order to ..... contact and by talking. ... couple; fathers focused on the baby's face, open eyes and facial.

  20. Health Care Providers' Spirit at Work Within a Restructured Workplace.

    Science.gov (United States)

    Wagner, Joan I J; Brooks, Denise; Urban, Ann-Marie

    2018-01-01

    Spirit at work (SAW) research emerged as a response to care provider determination to maintain a healthy and productive health care work environment, despite restructuring. The aim of this descriptive mixed-methods research is to present the care provider's perceptions of SAW. SAW is a holistic measure of care provider workplace outcomes, defined as the unique experience of individuals who are passionate about and energized by their work. A mixed group of licensed and unlicensed care providers in a continuing care workplace were surveyed. Eighteen Likert-type scale survey questions were further informed by two open-ended questions. Results indicated that unlicensed continuing care providers' perceptions of SAW are lower than licensed care providers. Responses suggest that open discussion between managers and team members, combined with structured workplace interventions, will lead to enhanced SAW and improved patient care. Further research on SAW within the continuing care workplace is required.

  1. Social media usage among health care providers.

    Science.gov (United States)

    Surani, Zoya; Hirani, Rahim; Elias, Anita; Quisenberry, Lauren; Varon, Joseph; Surani, Sara; Surani, Salim

    2017-11-29

    The objective of this study was to evaluate the use of social media among healthcare workers in an attempt to identify how it affects the quality of patient care. An anonymous survey of 35 questions was conducted in South Texas, on 366 healthcare workers. Of the 97% of people who reported owning electronic devices, 87.9% indicated that they used social media. These healthcare workers indicated that they spent approximately 1 h on social media every day. The healthcare workers below the age of 40 were more involved in social media compared to those above 40 (p social media among physicians and nurses was noted to be identical (88% for each group), and both groups encouraged their patients to research their clinical conditions on social media (p social media policy in their hospital compared to nurses (p < 0.05). However, a large proportion of healthcare workers (40%) were unaware of their workplace policy, which could potentially cause a privacy breach of confidential medical information. Further studies are required to evaluate specific effects of these findings on the quality of patient care.

  2. Assessment of the relationship between spiritual and social health and the self-care ability of elderly people referred to community health centers

    Directory of Open Access Journals (Sweden)

    Mahboobeh Mohammadi

    2017-01-01

    Full Text Available Background: Promotion of self-care ability among older people is an essential means to help maintain and improve their health. However, the role of spiritual and social health has not yet been considered in detail in the context of self-care ability among elderly. The aim of this study was to assess the relationship between spiritual and social health and self-care ability of older people referred to community health centers in Isfahan. Materials and Methods: In this cross-sectional correlation study, 200 people, aged 60 years and older, referred to healthcare centers in 2016 were recruited through convenience sampling method. Data were collected by four-part tool comprising of: (a demographics, (b Ellison and Palotzin's spiritual well-being scale, (c Kees's “social health” scale, and (d self-care ability scale for the elderly by Soderhamn's; data were analyzed by descriptive and inferential (independent t-test, analysis of variance – ANOVA, Pearson's coefficient tests, and multiple regression analysis statistics by SPSS16 software. Results: Findings showed that the entered predictor variables were accounted for 41% of total variance (R2 of the two self-care ability in the model (p < 0.001, F3, 199 = 46.02. Two out of the three predictor variables including religious well-being and social health, significantly predicted the self-care ability of older people. Conclusions: The results of this study emphasized on the relationship between spiritual and social health of the elderly people and their ability to self-care. Therefore, it would be recommended to keep the focus of the service resources towards improving social and spiritual health to improve self-care ability in elderly people.

  3. Assessment of the Relationship between Spiritual and Social Health and the Self-Care Ability of Elderly People Referred to Community Health Centers.

    Science.gov (United States)

    Mohammadi, Mahboobeh; Alavi, Mousa; Bahrami, Masoud; Zandieh, Zahra

    2017-01-01

    Promotion of self-care ability among older people is an essential means to help maintain and improve their health. However, the role of spiritual and social health has not yet been considered in detail in the context of self-care ability among elderly. The aim of this study was to assess the relationship between spiritual and social health and self-care ability of older people referred to community health centers in Isfahan. In this cross-sectional correlation study, 200 people, aged 60 years and older, referred to healthcare centers in 2016 were recruited through convenience sampling method. Data were collected by four-part tool comprising of: (a) demographics, (b) Ellison and Palotzin's spiritual well-being scale, (c) Kees's "social health" scale, and (d) self-care ability scale for the elderly by Soderhamn's; data were analyzed by descriptive and inferential (independent t -test, analysis of variance - ANOVA, Pearson's coefficient tests, and multiple regression analysis) statistics by SPSS16 software. Findings showed that the entered predictor variables were accounted for 41% of total variance ( R 2 ) of the two self-care ability in the model ( p well-being and social health, significantly predicted the self-care ability of older people. The results of this study emphasized on the relationship between spiritual and social health of the elderly people and their ability to self-care. Therefore, it would be recommended to keep the focus of the service resources towards improving social and spiritual health to improve self-care ability in elderly people.

  4. The Spirituality of Q

    African Journals Online (AJOL)

    2015-07-01

    Jul 1, 2015 ... deeper communication with the divine, or stem from contemplative reflection upon one's ... In the discourse surrounding the study of religion, 'spirituality' has ..... but as an early strand of Jesus tradition, the Q source provides.

  5. How Do Health Care Providers Diagnose Turner Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Turner syndrome? Health care providers use a combination of physical ... the X chromosomes is partially or completely missing. Turner syndrome also can be diagnosed during pregnancy by testing ...

  6. How Do Health Care Providers Diagnose Cushing's Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Cushing syndrome? Diagnosing Cushing syndrome can be complex and difficult. This syndrome is ... health care provider may try different tests. Diagnosing Cushing syndrome often requires several steps. If you are being ...

  7. Comprehensive Care For Joint Replacement Model - Provider Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...

  8. Use of spiritual coping strategies by gender, race/ethnicity, and religion at 1 and 3 months after infant's/child's intensive care unit death.

    Science.gov (United States)

    Hawthorne, Dawn M; Youngblut, JoAnne M; Brooten, Dorothy

    2017-10-01

    In the United States, 57,000 children (newborn to 18 years) die annually. Bereaved parents may rely on religious or spiritual beliefs in their grief. The study's purpose was to examine differences in parents' use of spiritual and religious coping practices by gender, race/ethnicity, and religion at 1 and 3 months after infant/ICU death. The sample consisted of 165 bereaved parents, 78% minority. The Spiritual Coping Strategies Scale was used to measure religious and spiritual coping practices, separately. One-way ANOVAs indicated that Black non-Hispanic mothers used significantly more religious coping practices at 3 months than White non-Hispanic mothers. Protestant and Catholic parents used more religious coping practices than the "no" and "other" religion groups at 1 and 3 months. Within the 30 mother-father dyads (paired t-tests), mothers reported significantly greater use of religious coping practices at 1 and 3 months and spiritual coping practices at 3 months than fathers. Religious coping practices were most commonly used by Black mothers and Protestant and Catholic parents. Within dyads, mothers used more spiritual and religious coping practices than fathers. These findings are beneficial for healthcare personnel in providing support to bereaved parents of diverse races/ethnicities and religions. ©2017 American Association of Nurse Practitioners.

  9. Death the great leveller? Towards a transcultural spirituality of dying and bereavement.

    Science.gov (United States)

    Holloway, Margaret

    2006-07-01

    This paper aims to provide a critical engagement with the subject of transcultural spirituality and nursing practice in the context of dying and bereavement. There has been considerable interest in the subject of spirituality over the past decade, and a particular association between the study of death and the study of spirituality. The nursing literature has been at the forefront of these developments amongst health and social care professionals. Some of this literature has begun to address the issues raised for culturally competent practice and the significance of patients' belief systems in the diverse cultural contexts with which nurses must engage in contemporary health care. However, the author argues that understanding of the range of contemporary spiritualities and transcultural practice is at an early stage. Transcultural spirituality is explored through a critical review of the literature, including the author's own published research on spiritual and philosophical issues in death, dying and bereavement. The conclusion is drawn that some common themes and approaches can be found which offer a framework to guide nursing practice with the individual patient and family. In the absence of guidance, nurses struggle with implementing spiritual care in the fluid and complex context of contemporary spiritualities and frequently resort to broad categorizations. This paper opens up a way of connecting with the unique spiritual position of each patient.

  10. Spiritual distress of military veterans at the end of life.

    Science.gov (United States)

    Chang, Bei-Hung; Stein, Nathan R; Skarf, Lara M

    2015-06-01

    Although combat experiences can have a profound impact on individuals' spirituality, there is a dearth of research in this area. Our recent study indicates that one unique spiritual need of veterans who are at the end of life is to resolve distress caused by combat-related events that conflict with their personal beliefs. This study sought to gain an understanding of chaplains' perspectives on this type of spiritual need, as well as the spiritual care that chaplains provide to help veterans ease this distress. We individually interviewed five chaplains who have provided spiritual care to veterans at the end of life in a Veterans Administration hospital. The interviews were recorded, transcribed, and analyzed based on "grounded theory." Chaplains reported that they frequently encounter veterans at the end of life who are still suffering from thoughts or images of events that occurred during their military career. Although some veterans are hesitant to discuss their experiences, chaplains reported that they have had some success with helping the veterans to open up. Additionally, chaplains reported using both religious (e.g., confessing sins) and nonreligious approaches (e.g., recording military experience) to help veterans to heal. Our pilot study provides some insight into the spiritual distress that many military veterans may be experiencing, as well as methods that a chaplain can employ to help these veterans. Further studies are needed to confirm our findings and to examine the value of integrating the chaplain service into mental health care for veterans.

  11. Data governance for health care providers.

    Science.gov (United States)

    Andronis, Katerina; Moysey, Kevin

    2013-01-01

    Data governance is characterised from broader definitions of governance. These characteristics are then mapped to a framework that provides a practical representation of the concepts. This representation is further developed with operating models and roles. Several information related scenarios covering both clinical and non-clinical domains are considered in information terms and then related back to the data governance framework. This assists the reader in understanding how data governance would help address the issues or achieve a better outcome. These elements together enable the reader to gain an understanding of the data governance framework and how it applies in practice. Finally, some practical advice is offered for establishing and operating data governance as well as approaches for justifying the investment.

  12. Health is a spiritual thing: perspectives of health care professionals and female Somali and Bangladeshi women on the health impacts of fasting during Ramadan.

    Science.gov (United States)

    Pathy, Rubini; Mills, Kelsey E; Gazeley, Sharon; Ridgley, Andrea; Kiran, Tara

    2011-02-01

    To explore perspectives of health care professionals and female Somali and Bangladeshi Muslim women on practices related to fasting during Ramadan, the impact of fasting on health and the role of health professionals during Ramadan. A cross-sectional qualitative study was conducted. Two culturally specific focus groups were conducted with six Somali and seven Bangladeshi Muslim women who observed Ramadan and lived in an inner-city neighbourhood of Toronto, Canada. Individual semi-structured interviews were conducted with 22 health care professionals practicing in this inner-city area (three of whom were Muslim). Data were analysed using thematic qualitative analysis. Both Muslim women and health care professionals recognised the spiritual significance of the Ramadan fast. Muslim participants considered the fast to be beneficial to health overall, whereas health care professionals tended to reflect on health concerns from fasting. Many health care professionals were not fully aware of fasting practices during Ramadan and some found it challenging to counsel patients about the health effects of fasting. Muslim women expressed disagreement regarding which medical interventions were permitted during fasting. They generally agreed that health care professionals should not specifically advise against fasting, but instead provide guidance on health maintenance while fasting. Both groups agreed that guidelines developed by the health care and faith communities together would be useful. There are a variety of health beliefs and observances among female Muslim Somali and Bangladeshi women and a range of knowledge, experience and opinions among health care professionals related to fasting during Ramadan and health. Overall, there is a need for improved communication between members of the Muslim community and health professionals in Canada about health issues related to fasting during Ramadan. Strategies could include published practice guidelines endorsed by the Muslim

  13. Influence of intestinal stoma on spiritual quality of life of U.S. veterans.

    Science.gov (United States)

    Baldwin, Carol M; Grant, Marcia; Wendel, Christopher; Rawl, Susan; Schmidt, C Max; Ko, Clifford; Krouse, Robert S

    2008-09-01

    To examine spiritual quality of life (QOL) of veterans with intestinal ostomies. Mixed-method cross-sectional. Male veterans with total scores in the upper (n = 59) and lower (n = 61) quartiles of the City of Hope Quality-of-Life-Ostomy survey provided spiritual QOL data. Analyses included chi-square and analysis of variance with significance set at p < .05. Content analysis was used to explicate narratives and focus groups. The high spiritual QOL group was more likely to be married, older, and report more years since surgery (each p < .0001). Upper quartile participants had more favorable scores for several spiritual QOL domains (all p < .0001). Qualitative comments reflected high or low total QOL scores. Spiritual QOL is influenced by an intestinal stoma. Qualitative comments lend insight into the meaning of spirituality items. Findings can assist in the provision of holistic care in this population.

  14. Spiritual meaning culturocentric education

    Directory of Open Access Journals (Sweden)

    O. H. Rohova

    2014-06-01

    The spiritually­values educational sense of culture consists in changes that take place in personality during the process of culture­centering education that offers «modernisation» of civilizations component of its maintenance due to the opening of its spiritually­values essence where the symphony of secular and religious cultures acquires a value that assists providing of firmness of personality in conditions of Postmodern.

  15. Find Ryan White HIV/AIDS Medical Care Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Find Ryan White HIV/AIDS Medical Care Providers tool is a locator that helps people living with HIV/AIDS access medical care and related services. Users can...

  16. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

    Science.gov (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

    2014-04-01

    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  17. Spiritual intelligence of nurses in two Chinese social systems: a cross-sectional comparison study.

    Science.gov (United States)

    Yang, Ke-Ping; Wu, Xin-Juan

    2009-09-01

    The spirituality of healthcare providers and their clients is becoming a crucial issue in a world increasingly preoccupied with material issues. In light of such, how do nurses enhance their spiritual intelligence against such materialist pressures? After a 60-year separation of Chinese on both sides of the Taiwan Strait and the rancor between their two governments, what are the similarities and the differences in nurse spirituality profiles between these two different societies? With increasing contact between the two, this issue should be examined and explored, as it has the potential to become an essential unspoken element underpinning holistic care quality. The purpose of this study was to compare spiritual intelligence between nurses in two different Chinese societies. A cross-sectional descriptive and inferential study was conducted at five medical centers in China and Taiwan. A total of 524 registered hospital nurses were recruited as participants. We used R. N. Wolman's (2001) self-reported PsychoMatrix Spirituality Inventory to measure participant levels of spiritual intelligence. The PsychoMatrix Spirituality Inventory incorporated seven factors, including divinity, mindfulness, extrasensory perception, community, intellectuality, trauma, and childhood spirituality. Results showed that social systems did have an impact on nurses' spiritual intelligence. Childhood spirituality and religious beliefs and activities greatly affected and effectively predicted nurses' spiritual intelligence. Nurses on either side of the Taiwan Strait all reported a need to deal with their daily lives pragmatically, objectively, and rationally and relied on empirical evidence in work settings. As social and economic contacts increase across the Taiwan Strait, it is imperative that nurses adopt cultural awareness and sensitivity as they provide holistic care to clients. This study opens doors to dialogue about and a better understanding of nurses' spiritual intelligence in Taiwan

  18. Effective factors in providing holistic care: a qualitative study.

    Science.gov (United States)

    Zamanzadeh, Vahid; Jasemi, Madineh; Valizadeh, Leila; Keogh, Brian; Taleghani, Fariba

    2015-01-01

    Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses' provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  19. Providing care for critically ill surgical patients: challenges and recommendations.

    Science.gov (United States)

    Tisherman, Samuel A; Kaplan, Lewis; Gracias, Vicente H; Beilman, Gregory J; Toevs, Christine; Byrnes, Matthew C; Coopersmith, Craig M

    2013-07-01

    Providing optimal care for critically ill and injured surgical patients will become more challenging with staff shortages for surgeons and intensivists. This white paper addresses the historical issues behind the present situation, the need for all intensivists to engage in dedicated critical care per the intensivist model, and the recognition that intensivists from all specialties can provide optimal care for the critically ill surgical patient, particularly with continuing involvement by the surgeon of record. The new acute care surgery training paradigm (including trauma, surgical critical care, and emergency general surgery) has been developed to increase interest in trauma and surgical critical care, but the number of interested trainees remains too few. Recommendations are made for broadening the multidisciplinary training and practice opportunities in surgical critical care for intensivists from all base specialties and for maintaining the intensivist model within acute care surgery practice. Support from academic and administrative leadership, as well as national organizations, will be needed.

  20. Electronic consultation system demonstrates educational benefit for primary care providers.

    Science.gov (United States)

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

    2017-01-01

    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  1. Modeling Market Shares of Competing (e)Care Providers

    Science.gov (United States)

    van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

    In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

  2. Neuropsychologists as primary care providers of cognitive health: A novel comprehensive cognitive wellness service delivery model.

    Science.gov (United States)

    Pimental, Patricia A; O'Hara, John B; Jandak, Jessica L

    2018-01-01

    By virtue of their extensive knowledge base and specialized training in brain-behavior relationships, neuropsychologists are especially poised to execute a unique broad-based approach to overall cognitive wellness and should be viewed as primary care providers of cognitive health. This article will describe a novel comprehensive cognitive wellness service delivery model including cognitive health, anti-aging, lifelong wellness, and longevity-oriented practices. These practice areas include brain-based cognitive wellness, emotional and spiritually centric exploration, and related multimodality health interventions. As experts in mind-body connections, neuropsychologists can provide a variety of evidence-based treatment options, empowering patients with a sense of value and purpose. Multiple areas of clinical therapy skill-based learning, tailor-made to fit individual needs, will be discussed including: brain stimulating activities, restorative techniques, automatic negative thoughts and maladaptive thinking reduction, inflammation and pain management techniques, nutrition and culinary focused cognitive wellness, spirituality based practices and mindfulness, movement and exercise, alternative/complimentary therapies, relationship restoration/social engagement, and trauma healing/meaning. Cognitive health rests upon the foundation of counteracting mind-body connection disruptions from multiple etiologies including inflammation, chronic stress, metabolic issues, cardiac conditions, autoimmune disease, neurological disorders, infectious diseases, and allergy spectrum disorders. Superimposed on these issues are lifestyle patterns and negative health behaviors that develop as ill-fated compensatory mechanisms used to cope with life stressors and aging. The brain and body are electrical systems that can "short circuit." The therapy practices inherent in the proposed cognitive wellness service delivery model can provide preventative insulation and circuit breaking against

  3. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    Science.gov (United States)

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

  4. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    OpenAIRE

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is l...

  5. Physical Profiling Performance of Air Force Primary Care Providers

    Science.gov (United States)

    2017-08-09

    AFRL-SA-WP-TR-2017-0014 Physical Profiling Performance of Air Force Primary Care Providers Anthony P. Tvaryanas1; William P...COVERED (From – To) September 2016 – January 2017 4. TITLE AND SUBTITLE Physical Profiling Performance of Air Force Primary Care Providers...encounter with their primary care team. An independent medical standards subject matter expert (SME) reviewed encounters in the electronic health record

  6. Prayer or spiritual healing as adjuncts to conventional care: a cross sectional analysis of prevalence and characteristics of use among women.

    Science.gov (United States)

    Rao, Angela; Sibbritt, David; Phillips, Jane L; Hickman, Louise D

    2015-06-25

    To determine the prevalence and characteristics of users of prayer or spiritual healing among women. This cross sectional study was conducted as a part of the Australian Longitudinal Study on Women's Health (ALSWH), a 20-year study that examines various factors affecting women's health and well-being. The sample used in the current study were women from the 1946-1951 cohort (n=9965) (59-64 years) who were surveyed in 2010. Use of prayer or spiritual healing; demographic factors and measures of health status. χ(2) Tests, analyses of variance (to determine associations) and a stepwise backward logistic regression model (for the most significant predictors) using a likelihood ratio test were used to determine the outcome measures. It is estimated that 26% of Australian women from the 1946-1951 cohort (aged 59-64 years) use prayer or spiritual healing on a regular basis. Women were significantly more likely to use prayer or spiritual healing if they were non-smokers, non-drinkers or low-risk drinkers, had symptoms of severe tiredness (OR 1.25; 95% CI 1.12 to 1.40), depression, (OR 1.30; 95% CI 1.11 to 1.53), anxiety (OR 1.33; 95% CI 1.15 to 1.53), diagnosed cancer (OR 1.84; 95% CI 1.28 to 2.65) or other major illnesses (OR 1.43; 95% CI 1.18 to 1.75) and used other complementary therapies. A significant proportion of adult women are using prayer or spiritual healing. Given that prayer or spiritual healing was significantly associated with health symptoms, chronic illnesses and positive health seeking behaviours, respect for prayer or spiritual healing practices is required within health care settings. Future research is recommended around specific populations using prayer or spiritual healing, reasons for their use and potential benefits on health related outcomes and general well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. A "good death": perspectives of Muslim patients and health care providers.

    Science.gov (United States)

    Tayeb, Mohamad A; Al-Zamel, Ersan; Fareed, Muhammed M; Abouellail, Hesham A

    2010-01-01

    Twelve "good death" principles have been identified that apply to Westerners. This study aimed to review the TFHCOP good death perception to determine its validity for Muslim patients and health care providers, and to identify and describe other components of the Muslim good death perspective. Participants included 284 Muslims of both genders with different nationalities and careers. We used a 12-question questionnaire based on the 12 principles of the TFHCOP good death definition, followed by face-to-face interviews. We used descriptive statistics to analyze questionnaire responses. However, for new themes, we used a grounded theory approach with a "constant comparisons" method. On average, each participant agreed on eight principles of the questionnaire. Dignity, privacy, spiritual and emotional support, access to hospice care, ability to issue advance directives, and to have time to say goodbye were the top priorities. Participants identified three main domains. The first domain was related to faith and belief. The second domain included some principles related to self-esteem and person's image to friends and family. The third domain was related to satisfaction about family security after the death of the patient. Professional role distinctions were more pronounced than were gender or nationality differences. Several aspects of "good death," as perceived by Western communities, are not recognized as being important by many Muslim patients and health care providers. Furthermore, our study introduced three novel components of good death in Muslim society.

  8. Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

    Science.gov (United States)

    Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

    2013-07-23

    Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

  9. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  10. THE IMPROVEMENT OF FAMILY COPING IN TAKING CARE OF PATIENT MENTAL DISORDER WITH SPIRITUAL THERAPY; DIRECTION, OBEDIENCE AND ACCEPTANCE (DOA

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-04-01

    Full Text Available Introduction: Mental disorder remains a stigma in society, even until now. A family who have a member with mental disorder, will experience continues objective and subjective burden, experience serious stress for a lifetime, which may cause ineffective coping. Method: Design used in this study was experimental (pre post test control group design. The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, has been taking care there twice, in minimum, lived in Surabaya. The samples were chosen by allocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Result: Results in this study showed that there was significant change in total of family coping (p = 0.040, maintaining family integration, cooperation and an optimistic definition of the stuation (p = 0.009, maintaining social support, self esteem, and psychological stability (p = 0.230, understanding the medical situations through communication with other parents and concultation with medical staff (p = 0.025. Discussion: The provision of family therapy with spiritual approach (DOA can increase family coping in taking care of patient with mental disorder.

  11. Focus on Dementia Care: Continuing Education Preferences, Challenges, and Catalysts among Rural Home Care Providers

    Science.gov (United States)

    Kosteniuk, Julie G.; Morgan, Debra G.; O'Connell, Megan E.; Dal Bello-Haas, Vanina; Stewart, Norma J.

    2016-01-01

    Home care staff who provide housekeeping and personal care to individuals with dementia generally have lower levels of dementia care training compared with other health care providers. The study's purposes were to determine whether the professional role of home care staff in a predominantly rural region was associated with preferences for delivery…

  12. Spirituality in the natural sciences and nursing: an interdisciplinary perspective.

    Science.gov (United States)

    Tyler, Indira D; Raynor, James E

    2006-01-01

    The Big Bang theory, a widely accepted theory of the origin of the universe, states that the universe was created between ten to twenty billion years ago from a cosmic explosion. Charles Darwin, a 19th century English naturalist, convinced the scientific community through his work that life evolved by natural selection over three and a half million years ago rather than through the influence of a Supreme Being or creator. Although there has been scientific data to support the claims of natural selection, there still remain many unanswered questions suggesting that other mechanisms contributed to the evolution of life. These unresolved findings greatly influenced mysticism and the development of the theological argument, which suggest the existence of a supreme being (God), who is believe to be an omnipotent healer, comforter, provider of salvation, and the center of mysticism spirituality. There has been consistent use of spiritual practices to address health concerns by individuals for thousands of years. There is increasing data that supports the implementation of spirituality in nursing for client care to enhance health outcome and patient wellbeing. Incorporating spiritual care into practice is an integral dimension of holistic care that is the crux of nursing practice in the 21st century. Holistic care of clients requires that nurses use the nursing process to implement spiritual care in practice.

  13. Cancer as part of the journey: the role of spirituality in the decision to decline conventional prostate cancer treatment and to use complementary and alternative medicine.

    Science.gov (United States)

    White, Margaret; Verhoef, Marja

    2006-06-01

    The role of spirituality in patients' use of complementary and alternative medicine (CAM) approaches to cancer management has hardly been explored. To explore the role of spirituality in cancer management by men with prostate cancer who have declined conventional treatment and are using CAM. This qualitative analysis is part of a longitudinal study to assess decision making by men with prostate cancer who decline conventional treatment and use CAM. In-depth interviews were conducted at study entry (n = 29). Themes were presented to participants in focus groups to further explore and validate the interview results. For a subset of participants (n = 10), spirituality emerged as an important theme; therefore, we conducted a secondary analysis of the interview data of these men to explore the role of spirituality in cancer management and decision making. Spirituality appeared to influence all aspects of the cancer experience. Most participants intensified their use of spiritual practice after a diagnosis of prostate cancer. These practices included spiritual ceremonies, indigenous healing, prayer, meditation, and use of spiritual imagery. Themes related to the role of spirituality in cancer management include beliefs about Western medicine, the role of spiritual beliefs in treatment decision making, the use of spiritual imager y and metaphor in healing, and the impact of cancer on spirituality. The discussion of these themes draws on quotes and case examples, illustrating how spirituality influenced study participants' response to diagnosis, treatment decision making, and cancer care. Two case examples provide a more in-depth understanding of how some participants incorporated spiritual imagery and metaphor into treatment decision making and cancer care. Ways in which cancer influenced spirituality are also discussed. Having prostate cancer appeared to influence their spirituality by strengthening their links with a spiritual community, increasing feelings of gratitude

  14. Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review.

    Science.gov (United States)

    Luu, Ngoc-Phuong; Pitts, Samantha; Petty, Brent; Sawyer, Melinda D; Dennison-Himmelfarb, Cheryl; Boonyasai, Romsai Tony; Maruthur, Nisa M

    2016-04-01

    Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communication and its impact on quality of care. We searched the MEDLINE, CINAHL, Scopus, EMBASE, and Cochrane databases for English-language articles describing direct communication between outpatient providers and acute care providers around patients presenting to the emergency department or admitted to the hospital. We conducted double, independent review of titles, abstracts, and full text articles. Conflicts were resolved by consensus. Included articles were abstracted using standardized forms. We maintained search results via Refworks (ProQuest, Bethesda, MD). Risk of bias was assessed using a modified version of the Downs' and Black's tool. Of 4009 citations, twenty articles evaluated direct provider-to-provider communication around the outpatient to acute care transition. Most studies were cross-sectional (65%), conducted in the US (55%), and studied communication between primary care and inpatient providers (62%). Of three studies reporting on the association between communication and 30-day readmissions, none found a significant association; of these studies, only one reported a measure of association (adjusted OR for communication vs. no communication, 1.08; 95% CI 0.92-1.26). The literature on provider-to-provider communication at the transition from outpatient to acute care is sparse and heterogeneous. Given the known importance of communication for other transitions of care, future studies are needed on provider-to-provider communication during this transition. Studies evaluating ideal methods for communication to reduce medical errors, utilization, and optimize patient satisfaction at this transition are especially needed.

  15. The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

    Directory of Open Access Journals (Sweden)

    Martin Estelle

    2010-12-01

    Full Text Available Abstract Background Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. Methods A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT: 1 Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2 Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT investigating needs related to each of the defined dimensions; 3 Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. Results Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. Conclusions The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

  16. Psychometric testing of the properties of the spiritual health scale short form.

    Science.gov (United States)

    Hsiao, Ya-Chu; Chiang, Yi-Chien; Lee, Hsiang-Chun; Han, Chin-Yen

    2013-11-01

    To further examine the psychometric properties of the spiritual health scale short form, including its reliability and validity. Spirituality is one of the main factors associated with good health outcomes. A reliable and valid instrument to measure spirituality is essential to identify the spiritual needs of an individual and to evaluate the effect of spiritual care. A cross-sectional study design was used. The study was conducted in six nursing schools in northern, central and southern Taiwan. The inclusion criterion for participants was nursing students with clinical practice experience. Initially, 1141 participants were recruited for the study, but 67 were absent and 48 did not complete the questionnaires. A total of 1026 participants were finally recruited, indicating a response rate of 89·9%. The psychometric testing of the spiritual health scale short form included construct validity with confirmatory factor analysis, known-group validity and internal consistency reliability. The results of the confirmatory factor analysis supported the five-factor model as an acceptable model fit. In the known-group validity, the results indicated that people who are in the category of primary religious affiliation have better spiritual health than people in the category of secondary religious affiliation and atheism. The result also indicated that the 24-item spiritual health scale short form achieved an acceptable internal consistency coefficient. The findings suggest that the spiritual health scale short form is a valid and reliable instrument for the appraisal of individual spiritual health. The spiritual health scale short form could provide useful information to guide clinical practice in assessing and managing people's spiritual health in Taiwan. © 2013 John Wiley & Sons Ltd.

  17. Do spiritual patients want spiritual interventions?: A qualitative exploration of underserved cancer patients' perspectives on religion and spirituality.

    Science.gov (United States)

    Stein, Emma M; Kolidas, Evelyn; Moadel, Alyson

    2015-02-01

    This study examines religion and spirituality among advanced cancer patients from an underserved, ethnically-diverse population by exploring patient conceptualizations of religion and spirituality, the role of religion and spirituality in coping with cancer, and patient interest in spiritual support. Qualitative semi-structured interviews were conducted with patients who had participated in a study of a "mind-body" support group for patients with all cancer types. Analysis based on grounded theory was utilized to identify themes and theoretical constructs. With regard to patient conceptualizations of religion and spirituality, three categories emerged: (1) Spirituality is intertwined with organized religion; (2) Religion is one manifestation of the broader construct of spirituality; (3) Religion and spirituality are completely independent, with spirituality being desirable and religion not. Religion and spirituality played a central role in patients' coping with cancer, providing comfort, hope, and meaning. Patients diverged when it came to spiritual support, with some enthusiastic about interventions incorporating their spiritual values and others stating that they already get this support through religious communities. Spirituality plays a central role in the cancer experience of this underserved ethnically-diverse population. While spirituality seems to be a universal concern in advanced cancer patients, the meaning of spirituality differs across individuals, with some equating it with organized religion and others taking a more individualized approach. It is important that psychosocial interventions are developed to address this concern. Future research is needed to further explore the different ways that patients conceptualize spirituality and to develop spiritually-based treatments that are not "one size fits all."

  18. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    Science.gov (United States)

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  19. Attitude and practice of health care providers towards autopsies in ...

    African Journals Online (AJOL)

    Background: Attitude and practice of health care professionals toward autopsy are important as they will give information regarding factors that contribute to the low rate of autopsies in children under five years. Objective: To evaluate the attitude and practice of health care providers towards autopsies in children under five ...

  20. The care provided by general practitioners for persistent depression

    NARCIS (Netherlands)

    Van Os, TWDP; Van den Brink, RHS; Van der Meer, K; Ormel, J

    Purpose. - To examine the care provided by general practitioners (GPs) for persistent depressive illness and its relationship to patient, illness and consultation characteristics. Subjects and method. - Using the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) a

  1. Parents\\' lived experience of providing kangaroo care to their ...

    African Journals Online (AJOL)

    Premature and low birthweight infants pose particular challenges to health services in South Africa. While there is good evidence to demonstrate the benefits of kangaroo care in low birthweight infants, limited research has been conducted locally on the experiences of parents who provide kangaroo care to their preterm ...

  2. How effective are spiritual care and body manipulation therapies in pediatric oncology? A systematic review of the literature.

    Science.gov (United States)

    Poder, Thomas G; Lemieux, Renald

    2013-12-10

    The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals. The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer. This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed. Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy.

  3. Using Spiritual Intelligence to Transform Organisational Cultures

    OpenAIRE

    McGhee, Peter; Grant, Patricia

    2017-01-01

    Recently spirituality has become a viable topic of discussion for management scholars seeking a means to enhance work cultures and improve organisational effectiveness. However, the path from spirituality to transforming organisational culture is not immediately obvious. Fortunately,several authors have developed frameworks that provide connections. In particular, the notion of spiritual intelligence (SIhereafter) is helpful. This paper begins by describing spirituality and SI in the conte...

  4. What is spirituality? | Waaijman | Acta Theologica

    African Journals Online (AJOL)

    This essay provides, first of all, a historical perspective on the nature of spirituality by investigating its early forms, followed by a discussion of two approaches in the last century. It then investigates three basic forms of spirituality, concluding with an overview of elements of spirituality.

  5. Integrating advanced practice providers into medical critical care teams.

    Science.gov (United States)

    McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

    2013-03-01

    Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

  6. An exploration of how spiritual nursing care is applied in clinical ...

    African Journals Online (AJOL)

    2013-05-28

    May 28, 2013 ... nursing care is still not well understood, nor applied meaningfully in practice. ... This study used a qualitative research design to explore and describe professional ... Context, population and sample. The research setting was ...

  7. Diarrhea - what to ask your health care provider - adult

    Science.gov (United States)

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health ... medicines, vitamins, herbs, or supplements I take cause diarrhea? Should I stop taking any of them? What ...

  8. Skin Diseases: Questions for Your Health Care Provider

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Questions for Your Health Care Provider Past ... dermatitis worse? What are the most common irritants? Skin cancer What type of skin cancer do I ...

  9. How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?

    Science.gov (United States)

    ... www.nbstrn.org/ or the Centers for Disease Control and Prevention webpage at http://www.cdc.gov/ncbddd/birthdefects/diagnosis.html . Prenatal Screening Health care providers recommend that certain pregnant ...

  10. Choosing the right health care provider for pregnancy and childbirth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000596.htm Choosing the right health care provider for pregnancy and childbirth To use the sharing features on this page, please enable JavaScript. ...

  11. How Do Health Care Providers Diagnose Klinefelter Syndrome?

    Science.gov (United States)

    ... Email Print How do health care providers diagnose Klinefelter syndrome (KS)? The only way to confirm the presence ... in 166 boys, adolescents and adults with nonmosaic Klinefelter syndrome: A Copenhagen experience. Acta Paediatrica , Jun;100(6), ...

  12. Using the National Provider Identifier for Health Care...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The establishment in recent years of a National Provider Identifier (NPI) offers a new method for counting and categorizing physicians and other health care...

  13. A qualitative study of barriers to enrollment into free HIV care: perspectives of never-in-care HIV-positive patients and providers in Rakai, Uganda.

    Science.gov (United States)

    Nakigozi, Gertrude; Atuyambe, Lynn; Kamya, Moses; Makumbi, Fredrick E; Chang, Larry W; Nakyanjo, Neema; Kigozi, Godfrey; Nalugoda, Fred; Kiggundu, Valerian; Serwadda, David; Wawer, Maria; Gray, Ronald

    2013-01-01

    Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5%) of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. We conducted 48 in-depth interviews among HIV-infected individuals aged 15-49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Barriers to using HIV care included fear of stigma and HIV disclosure, women's lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.

  14. Competence of health care providers on care of newborns at birth in ...

    African Journals Online (AJOL)

    Introduction: This is an observational study which was carried out at a level one health facility in Yaoundé from June to July 2009. The aim was to evaluate the competence of health care providers towards newborns' care at birth. Methods: Ten health care providers took care of three hundred and thirty-five pregnant women ...

  15. Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

    Science.gov (United States)

    Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

    2017-07-01

    To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

  16. Mysticism and spirituality

    Directory of Open Access Journals (Sweden)

    Nils G. Holm

    2009-01-01

    Full Text Available How does the popular correspond to the grand terms of the title? Are not mysticism and spirituality something very exclusive, reserved for a few individuals? No they are not, as this presentation of both the author's own studies and the research of others will provide a different picture of these two concepts. Mysticism and spirituality are notions that are very difficult to define. Traditionally mysticism has been regarded as a way to reach the inner dimensions of human life, dimensions where man even achieves unity with the Divine Being. Such traditions have been found in all the major religions, and since the times of William James a hundred years ago, the features of mysticism in various religions have been analysed. Spirituality is a concept that can hold various meanings. It has often been associated with religious traditions where inner life and its growth are emphasized. These include, in particular, various schools, orders and movements that aim at cultivating a deeper spiritual life. In its more recent use, the term spirituality has, to a fairly large extent, been dissociated from religion and has become a notion that seeks to grasp the searching of modern man for ethics and norms in a globalised world, where pollution is accelerating and where stress and entertainment disrupt the inner harmony of people. Keywords

  17. ROLE OF SPIRITUALITY AS A WAY OF COPING FROM BURNOUT IN MEDICAL STUDENTS OF A TERTIARY CARE INSTITUTE IN INDIA

    Directory of Open Access Journals (Sweden)

    Sagar Shrikant

    2016-03-01

    Full Text Available BACKGROUND Medical students are exposed to various stressful conditions in their journey towards becoming a successful doctor leading to burnout. Adoption of faulty coping mechanisms increases the risk further. Spirituality as a way of coping can help to reduce burnout in these students. MATERIALS & METHODS We decided to conduct a study with aims to assess the prevalence of burnout in medical students, to study their socio-demographic profile and to understand the role of spirituality as a way of coping from burnout. Ethics Committee approval was obtained. It was a cross-sectional study wherein random 100 medical students studying in MBBS were selected. A semi-structured questionnaire to obtain details about socio- demographic profile, Burnout Measure-Short Version Scale and Spiritual attitude inventory were administered. RESULTS The present study shows prevalence of burnout as 64%. According to socio-demographic profile, there was no association of burnout with age. Burnout was significantly more in females (n=48; 75%, hostellers (n=51; 79.69% and students studying in final year (n=22; 34.37% or in internship (n=28; 43.75%. There was no significant difference in burnout and non-burnout Group with respect to rural or urban background and socioeconomic class. On comparing spirituality, it was found that students without burnout were more spiritual when compared to students with burnout, also severity of burnout was negatively correlated with spirituality in all four domains i.e religious spiritual practice, negative religious coping, sense of purpose/connection and sense of hope/control. Thus spirituality as a way of coping acts as a buffer and prevents from burnout.

  18. Duty to provide care to Ebola patients: the perspectives of Guinean lay people and healthcare providers.

    Science.gov (United States)

    Kpanake, Lonzozou; Tonguino, Tamba Kallas; Sorum, Paul Clay; Mullet, Etienne

    2018-05-21

    To examine the views of Guinean lay people and healthcare providers (HCPs) regarding the acceptability of HCPs' refusal to provide care to Ebola patients. From October to December 2015, lay people (n=252) and HCPs (n=220) in Conakry, Guinea, were presented with 54 sample case scenarios depicting a HCP who refuses to provide care to Ebola patients and were instructed to rate the extent to which this HCP's decision is morally acceptable. The scenarios were composed by systematically varying the levels of four factors: (1) the risk of getting infected, (2) the HCP's working conditions, (3) the HCP's family responsibilities and (4) the HCP's professional status. Five clusters were identified: (1) 18% of the participants expressed the view that HCPs have an unlimited obligation to provide care to Ebola patients; (2) 38% held that HCPs' duty to care is a function of HCPs' working conditions; (3) 9% based their judgments on a combination of risk level, family responsibilities and working conditions; (4) 23% considered that HCPs do not have an obligation to provide care and (5) 12% did not take a position. Only a small minority of Guinean lay people and HCPs consider that HCPs' refusal to provide care to Ebola patients is always unacceptable. The most commonly endorsed position is that HCPs' duty to provide care to Ebola patients is linked to society's reciprocal duty to provide them with the working conditions needed to fulfil their professional duty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Religious and/or spiritual practices: extending spiritual freedom to people with schizophrenia.

    Science.gov (United States)

    Smith, Sharon; Suto, Melinda J

    2012-04-01

    It continues to be a challenge to define and utilize spirituality in client-centred occupational therapy practice. Dialogue about spirituality is especially problematic for occupational therapists working with people with schizophrenia. To explore the meaning of religion and/or spirituality for people living with a diagnosis of schizophrenia. Nine community-based individuals with schizophrenia engaged in interviews about the meaning of religion and/or spirituality and demonstrated self-defined spiritual practices. Phenomenology, hermeneutic theory, and a symbolic interactionism framework provided methodological and analytic guidance. Participants employed religious and/or spiritual practices to cope with schizophrenia symptoms and make meaning of their lives. Individuals used multiple systems of meaning to explain their experiences. Religious and/or spiritual agency, an individual's sense of freedom to choose among the spiritual options, renewed their sense of empowerment. Therapists can engage in spiritual negotiation with clients by using well-worded empowering questions toward a common goal of life enhancement.

  20. Spirituality, religiousness and coping in patients with schizophrenia: A cross sectional study in a tertiary care hospital.

    Science.gov (United States)

    Das, Soumitra; Punnoose, Varghese Panickasseril; Doval, Nimisha; Nair, Vijayakrishnan Yathindran

    2018-04-24

    Religion is a form of coping that helps individuals to deal with a wide variety of difficult life situations. But most of the research in this field has been in acute patients of schizophrenia. Also, most of the research on religion and schizophrenia has focused on religion and spirituality as coping mechanisms, and research evaluating the relationship between spirituality/religiousness and repertoire of other coping skills is sparse. Our objective was to evaluate the association between spirituality, religiousness and coping skills in patients with schizophrenia in remission. Hence, a total of 48 consecutive patients with schizophrenia were assessed on Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance Scale (PSP), WHO Quality of Life-Spirituality, Religiousness and Personal Belief scale (WHOQOL-SRPB) and Ways of Coping Checklist - Revised (WCC). Findings were described as patients who used more religiosity and spirituality as measured with WHO-SRPB domain score were better in their managing their stress as they used all the adaptive strategies like planful problem solving, positive reappraisal, distancing, self-controlling, seeking social support rather than maladaptive skills like confrontive coping and escape avoidance. A sound spiritual, religious, or personal belief system positively affects active and adaptive coping skills in patients with schizophrenia during remission, thus helping the individual to cope with illness related stressors. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Surrogate pregnancy: a guide for Canadian prenatal health care providers

    Science.gov (United States)

    Reilly, Dan R.

    2007-01-01

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks ofsurrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support. PMID:17296962

  2. Surrogate pregnancy: a guide for Canadian prenatal health care providers.

    Science.gov (United States)

    Reilly, Dan R

    2007-02-13

    Providing health care for a woman with a surrogate pregnancy involves unique challenges. Although the ethical debate surrounding surrogacy continues, Canada has banned commercial, but not altruistic, surrogacy. In the event of a custody dispute between a surrogate mother and the individual(s) intending to parent the child, it is unclear how Canadian courts would rule. The prenatal health care provider must take extra care to protect the autonomy and privacy rights of the surrogate. There is limited evidence about the medical and psychological risks of surrogacy. Whether theoretical concerns about these risks are clinically relevant remains unknown. In the face of these uncertainties, the prenatal health care provider should have a low threshold for seeking obstetrical, social work, ethical and legal support.

  3. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    Science.gov (United States)

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

    Directory of Open Access Journals (Sweden)

    Jalana N. Lazar

    2013-01-01

    Full Text Available Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC. Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement.

  5. Effective factors in providing holistic care: A qualitative study

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2015-01-01

    Full Text Available Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses′ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  6. Otolaryngology Needs in a Free Clinic Providing Indigent Care.

    Science.gov (United States)

    Hu, Amanda; Sibert, Thomas; Zhao, Wei; Zarro, Vincent

    2016-06-01

    To determine the otolaryngology needs in a free clinic providing care to medically indigent patients, as perceived by the patients and health care providers. Cross-sectional survey. A survey was administered to patients and health care providers of a free clinic from September 2014 through January 2015 in an urban, inner-city location. One hundred and thirty-seven patients (35.8% male, age 50.8 ± 13.0 years) completed the survey. Mean household income was $29,838 ± $10,425; 32.1% spoke English; 54.7% were employed; 10.2% had health insurance; and 37.2% had seen a primary care provider outside of the free clinic. The top three otolaryngology symptoms among patients were sleep apnea/snoring (39.4%), heartburn/reflux (30.7%), and dizziness (29.9%). Eleven health care providers (45% male, age 50.5 ± 15.3 years, 63.6% physician, 36% nurse) completed the survey. Providers perceived the following otolaryngology complaints as the most prevalent, in descending order: cough, nasal congestion, reflux/heartburn, sore throat, and ear infection/otalgia. Providers felt that sleep apnea and hearing loss were the less common otolaryngology complaints, whereas surveyed patients indicated these symptoms with high frequency. The most requested diagnostic tool among patients and providers was chest X-rays. There are unmet otolaryngology needs in a free clinic. Medically indigent patients have significant barriers to accessing health care. Patient and provider perceptions of top otolaryngology complaints differed, but both identified access to chest X-rays as a major unmet need. Knowledge of patient perceptions may help providers elicit the breadth of otolaryngology complaints. 4. Laryngoscope, 126:1321-1326, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Spirituality in diaconia

    DEFF Research Database (Denmark)

    Zeitler, Ullrich Martin Rudenko

    2014-01-01

    The subject of this article is the role of spirituality in diaconal work. This raises two questions: first, what do we mean by spirituality, and second, what characterises the field of diaconia and diaconal practice?. To begin with, a few conceptual clarifications are necessary. C. Otto Scharmer......’s Theory U (TU) provides the conceptual and methodological framework for operationalising spirituality in diaconal work. It is argued that the concept of “presencing” is an adequate way to express “spirituality”, and that, overall TU is an appropriate model to describe and develop the essential features...... of diaconal social work and diaconal leadership. I shall use the Danish Blue Cross as an example of an organisation that can be interpreted as working on the basis of TU....

  8. Spiritual Meaning in Life and Values in Patients With Severe Mental Disorders.

    Science.gov (United States)

    Huguelet, Philippe; Mohr, Sylvia Madeleine; Olié, Emilie; Vidal, Sonia; Hasler, Roland; Prada, Paco; Bancila, Mircea; Courtet, Philippe; Guillaume, Sébastien; Perroud, Nader

    2016-06-01

    Spirituality and meaning in life are key dimensions of recovery in psychiatric disorders. The aim of this study was to explore spiritual meaning in life in relation to values and mental health among 175 patients with schizophrenia, borderline personality disorder, bipolar disorder, and anorexia nervosa. For 26% of the patients, spirituality was essential in providing meaning in life. Depending on the diagnosis, considering spirituality as essential in life was associated with better social functioning; self-esteem; psychological and social quality of life; fewer negative symptoms; higher endorsement of values such as universalism, tradition (humility, devoutness), and benevolence (helpfulness); and a more meaningful perspective in life. These results highlight the importance of spirituality for recovery-oriented care.

  9. Spirituality is associated with better prostate cancer treatment decision making experiences.

    Science.gov (United States)

    Mollica, Michelle A; Underwood, Willie; Homish, Gregory G; Homish, D Lynn; Orom, Heather

    2016-02-01

    This study examined whether spiritual beliefs are associated with greater decision-making satisfaction, lower decisional conflict and decision-making difficulty with the decision-making process in newly diagnosed men with prostate cancer. Participants were 1114 men diagnosed with localized prostate cancer who had recently made their treatment decision, but had not yet been treated. We used multivariable linear regression to analyze relationships between spirituality and decision-making satisfaction, decisional conflict, and decision-making difficulty, controlling for optimism and resilience, and clinical and sociodemographic factors. Results indicated that greater spirituality was associated with greater decision-making satisfaction (B = 0.02; p conflict (B = -0.42; p spiritual beliefs may be a coping resource during the treatment decision-making process. Providing opportunities for patients to integrate their spiritual beliefs and their perceptions of their cancer diagnosis and trajectory could help reduce patient uncertainty and stress during this important phase of cancer care continuum.

  10. Embodied Spirituality

    Science.gov (United States)

    Trousdale, Ann

    2013-01-01

    This article explores the concept of embodied spirituality from early Celtic traditions through the British medieval mystic Julian of Norwich to the present day. A "high theology" of the body in early Christianity and early Christian understandings of the relation among body, soul and spirit gave way to the influences of Greek thought with its…

  11. Nursing textbooks need to inform about spirituality.

    Science.gov (United States)

    2016-09-21

    Considering the spiritual needs of patients is an important aspect of holistic patient care. However, many nurses lack knowledge and awareness of the subject, and spirituality is not strongly featured as a key part of holistic care in core nursing textbooks. The author argues that guidance given by nursing textbooks needs to be more applicable to practice.

  12. Health Care Provider Accommodations for Patients with Communication Disorders

    Science.gov (United States)

    Burns, Michael I.; Baylor, Carolyn; Dudgeon, Brian J.; Starks, Helene; Yorkston, Kathryn

    2017-01-01

    Health care providers can experience increased diffculty communicating with adult patients during medical interactions when the patients have communication disorders. Meeting the communication needs of these patients can also create unique challenges for providers. The authors explore Communication Accommodation Theory (H. Giles, 1979) as a guide…

  13. Impact of Health Care Provider's Training on Patients ...

    African Journals Online (AJOL)

    Material and Methods: A situation analysis was done before training to assess existing practice of providers' communication skills and patient's satisfaction. All care providers in labour ward were trained and their practice was assessed before and after training. A ten percent sample of patients delivered in hospital before ...

  14. Providing Medical Care in Yekaterynoslav during World War I

    Directory of Open Access Journals (Sweden)

    V.V. Haponov

    2015-04-01

    Full Text Available Providing medical care to the ill and wounded persons during World War I in Yekaterynoslav is described. The history of the creation of field hospitals, military hospitals, Red Cross hospitals and church-monument to the fallen heroes is presented. The selfless work of military medical personnel is shown. Biographical information about a doctor, public figure Yefim Pavlovskyi is provided.

  15. Evaluation of patients ' satisfaction with quality of care provided at ...

    African Journals Online (AJOL)

    Background: The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery. Objective: This study was aimed at evaluating patientsf satisfaction with quality of care provided ...

  16. Provider and systems factors in diabetes quality of care.

    Science.gov (United States)

    Ghaznavi, Kimia; Malik, Shaista

    2012-02-01

    A gap exists in knowledge and the observed frequency with which patients with diabetes actually receive treatment for optimal cardiovascular risk reduction. Many interventions to improve quality of care have been targeted at the health systems level and provider organizations. Changes in several domains of care and investment in quality by organizational leaders are needed to make long-lasting improvements. In the studies reviewed, the most effective strategies often have multiple components, whereas the use of one single strategy, such as reminders only or an educational intervention, is less effective. More studies are needed to examine the effect of several care management strategies simultaneously, such as use of clinical information systems, provider financial incentives, and organizational model on processes of care and outcomes.

  17. Cultural competency: providing quality care to diverse populations.

    Science.gov (United States)

    Betancourt, Joseph R

    2006-12-01

    The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence

  18. Hiring appropriate providers for different populations: acute care nurse practitioners.

    Science.gov (United States)

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

  19. Achieving health care cost containment through provider payment reform that engages patients and providers.

    Science.gov (United States)

    Ginsburg, Paul B

    2013-05-01

    The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers.

  20. Male nurses' experiences of providing intimate care for women clients.

    Science.gov (United States)

    Inoue, Madoka; Chapman, Rose; Wynaden, Dianne

    2006-09-01

    This paper reports a study of male nurses' experiences of providing intimate care for women clients. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

  1. Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses.

    Science.gov (United States)

    Stumbo, Scott P; Yarborough, Bobbi Jo H; Yarborough, Micah T; Green, Carla A

    2018-01-01

    Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Cross-sectional; mixed methods. An integrated health system and a network of federally qualified health centers and safety net clinics. Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Semi-structured interviews and surveys. Thematic analysis for qualitative data; frequencies for quantitative data. More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients' chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician-patient collaboration on

  2. Investigation Clinical Competence and Its Relationship with Professional Ethics and Spiritual Health in Nurses

    Directory of Open Access Journals (Sweden)

    Elahe Ramezanzade Tabriz

    2017-03-01

    Full Text Available Abstract Background and Objectives: Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses. Methods: In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21. Results: The total scores for self-assessment scale of nurses' clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence. Conclusion: Managers' and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.

  3. The cultural expression of spiritual distress in Israel.

    Science.gov (United States)

    Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil

    2018-03-30

    Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

  4. Requests from professional care providers for consultation with palliative care consultation teams.

    NARCIS (Netherlands)

    Groot, M.F. de; Vernooy-Dassen, M.J.F.J.; Courtens, A.M.; Kuin, A.; Linden, B.A. van der; Zuylen, L. van; Crul, B.J.P.; Grol, R.P.T.M.

    2005-01-01

    GOALS OF WORK: Professional care providers need a substantial basis of competence and expertise to provide appropriate palliative care. Little is known about the problems professionals experience in their palliative care provision in daily practice or about the nature of the advice and support they

  5. Exploring the role of farm animals in providing care at care farms

    NARCIS (Netherlands)

    Hassink, Jan; Bruin, de Simone R.; Berget, Bente; Elings, Marjolein

    2017-01-01

    We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with

  6. Exploring the Role of Farm Animals in Providing Care at Care Farms.

    NARCIS (Netherlands)

    Hassink, Jan; De Bruin, Simone R; Berget, Bente; Elings, Marjolein

    2017-01-01

    We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with

  7. Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study.

    Science.gov (United States)

    Gheibizadeh, Mahin; Abedi, Heidar Ali; Mohammadi, Easa; Abedi, Parvin

    2016-06-01

    Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women. © The Author(s) 2015.

  8. Spirituality in Contemporary Paradigms: An Integrative Review

    Directory of Open Access Journals (Sweden)

    Monir Ramezani

    2016-07-01

    Full Text Available Background: As two of the most prominent cultural components, spirituality and religion give sense to our human values, conducts, and experiences. The spiritual dimension is one of the four significant aspects of holistic care. However, the diversity of views has resulted in different interpretations of the reality of spirituality and its origins and consequences. Aim: This study aimed to examine the available approaches and paradigms in the realm of spirituality. Method: In the present integrative review, the initial search was performed in national and international databases, including Science Direct, PubMed, Google Scholar, Scopus, Sage, Medline, Wiley, SID, MagIran, IranMedex, and IranDoc, using the keyword, "spirituality", without considering any time limits. Articles relevant to the objectives of the study were then fully reviewed. Results: Since ancient times, spirituality has been sporadically discussed in human intellectual and artistic artifacts. This concept was expanded as an independent, systematic, and conscious movement since the second half of the 19th century in Europe, USA, and Canada. The three prominent approaches to spirituality include religious, secular, and holistic health perspectives. Implications for Practice: Despite the growing interest in research on spirituality, it is difficult to reach a unanimous decision about this concept. However, it should be noted that spiritual concerns cannot be disregarded, considering the holistic perspective to humanity as the building block of holistic nursing care. Overall, every patient is a unique human being whose spiritual needs are affected by his/her cultural beliefs and values.

  9. When does spiritual intelligence particularly predict job engagement? The mediating role of psychological empowerment.

    Science.gov (United States)

    Torabi, Mohsen; Nadali, Iman Zohoorian

    2016-01-01

    Regarding the importance of health care providers such as nurses who are always in stressful environments, it is imperative to better understand how they become more engaged in their work. The purpose of this paper is to focus on health care providers (nurses), and examine how the interaction between spiritual intelligence and psychological empowerment affect job engagement. This descriptive and quantitative study was conducted among nurses at the Faghihi Hospital in Shiraz, Iran in 2010. A sample of nurses ( n = 179) completed standard survey questionnaire including spiritual intelligence, psychological empowerment, and job engagement which included 5 questions for each dimensions. For testing the hypotheses of the study, results were analyzed through structural equation modeling (SEM) using LISREL 8.8. SEM revealed that psychological empowerment could fully mediate the relationship between spiritual intelligence and job engagement. However, the correlation between spiritual intelligence and job engagement was significant but weak using Pearson coefficient method. This can imply that psychological empowerment plays a crucial role in the relationship between spiritual intelligence and job engagement. This paper indicates that spiritual intelligence might affect different organizational parameters, directly or indirectly. Therefore, it is recommended that the researchers evaluate probable relationships between spiritual intelligence and other variables.

  10. The Effect of Care Plan Application Based on Roy’s Adaptation Model on The Spiritual Well-Being of Elderly People in Urmia Nursing Homes

    Directory of Open Access Journals (Sweden)

    Esmaiel Maghsoodi

    2016-11-01

    Full Text Available Wth the growing elderly population and the incidence of complications and problems associated with this period, the need to make a positive adaptation during this important period of life, is considerable. In this regard, this is possible to use the nursing theory and particular, Roy's adaptation model to creation work positive with make the incompatible and unhealthy behaviors to compatible and healthy behaviors and also improve their SWB as one if the overall health. The present study was determine the effects of the health careplan based on Roy's adaptation model on the Spiritual Well-Being of elderly people In Urmia nursing homes, have been done. In this study, 60persons of elderly, which had conditions related to this study, had been selected and randomly divided into control group (30 persons and intervention group (30 persons, were selected. Tools for Collecting data was SWB questionnaire, which was completed in post and pre – test. The care plan was designed according to conclusions from investigation and knowing Roy's adaptation model and applicated in intervention group, in 2 sessions teaching for elderly and 4 individual sessions , in order to manipulate focal stimulants in during 1.5 month and a month later was followed. The analysis of data were done by SPSS software and by using the descriptive and inferential statistics. The results indicate that overall mean scores below the scale dual SWB and average of SWB, after a study of 2 groups is statistically significant (P< 0.001.Also the average of scores in elderly SWB in the intervention group after care plan, was increased which, according to T-test, this increase is significant(P< 0.001. Caring plan which based on self concept mode of Roy's adaptation model,have positive influence in promoting the SWB of the elderly. Therefor, it's suggested, health caring providers and nurses by strengthen the adaptation in the elderly based on the theories of nursing and caring plan, increase

  11. Concrete spirituality

    OpenAIRE

    Kritzinger, Johannes N.J.

    2014-01-01

    This article reflects on a number of liturgical innovations in the worship of Melodi ya Tshwane, an inner-city congregation of the Uniting Reformed Church in Southern Africa (URCSA). The focus of the innovations was to implement the understanding of justice in Article 4 of the Confession of Belhar, a confessional standard of the URCSA. The basic contention of the article is that well designed liturgies that facilitate experiences of beauty can nurture a concrete spirituality to mobilise urba...

  12. Primary Health Care Providers' Knowledge Gaps on Parkinson's Disease

    Science.gov (United States)

    Thompson, Megan R.; Stone, Ramona F.; Ochs, V. Dan; Litvan, Irene

    2013-01-01

    In order to determine primary health care providers' (PCPs) knowledge gaps on Parkinson's disease, data were collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson's disease recognition and treatment from a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the…

  13. Can health care providers recognize a fibromyalgia personality?

    NARCIS (Netherlands)

    Da Silva, J.A.P.; Jacobs, J.W.G.; Branco, J.; Canaipa, R.; Gaspar, M.F.; Griep, E.N.; van Helmond, T.; Oliveira, P.J.; Zijlstra, T.R.; Geenen, R.

    2017-01-01

    OBJECTIVES: To determine if experienced health care providers (HCPs) can recognise patients with fibromyalgia (FM) based on a limited set of personality items, exploring the existence of a FM personality. METHODS: From the 240-item NEO-PI-R personality questionnaire, 8 HCPs from two different

  14. Knowledge, attitudes and opinions of health care providers in Minna ...

    African Journals Online (AJOL)

    Conclusion: The study revealed grossly inadequate knowledge on the operational principles of the scheme, but a positive attitudinal predisposition among health care providers studied. This calls for a conscious publicity drive and intensive educational campaigns. Keywords: knowledge, attitudes, opinions, healthcare ...

  15. Growing Healthy Bodies: Nutrition Education for Day Care Providers.

    Science.gov (United States)

    Viebrock, Margaret A.; Berry, Holly

    This booklet discusses the important role that day care providers can play in ensuring that children eat healthy snacks and meals and learn good eating habits. Section one of the booklet examines snack foods, discusses the difference between nutritious and less-nutritious snacks, and recommends snack foods appropriate for different age groups.…

  16. Theory in Practice: Helping Providers Address Depression in Diabetes Care

    Science.gov (United States)

    Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie

    2010-01-01

    Introduction: A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods: Participants completed assessments of attitudes, confidence,…

  17. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

    Science.gov (United States)

    Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

    2014-01-01

    Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve

  18. Selecting the Best Version of SHALOM to Assess Spiritual Well-Being

    Directory of Open Access Journals (Sweden)

    John Fisher

    2016-04-01

    Full Text Available This paper extends the reporting of contemporary use of the Spiritual Health and Life-Orientation Measure (SHALOM, which provides flexibility to researchers, enabling them to choose the version of the instrument that best suits the cohort under investigation. SHALOM was built on a solid theoretical foundation, provided by the Four Domains Model of Spiritual Health/Well-Being. It comprises 20 items that assess spiritual well-being, as reflected in the quality of relationships that each person has with themselves, others, the environment, and/or with God. Summary results are reported from 30 recent studies. SHALOM provides a unique form of assessment that is statistically stronger than just assessing lived experiences, in that spiritual harmony/dissonance is studied by comparing each person’s “lived experiences” with her/his “ideals” for spiritual well-being. SHALOM has been sought for use with hundreds of studies in 29 languages, in education, healthcare and wider community. A generic form of SHALOM was developed to expand the Transcendental domain to include more than God. However, recent studies have shown that relating with God is most important for spiritual well-being. The best version of SHALOM to assess spiritual well-being depends on the needs of the clients/participants and the project goals of the researcher. This will involve a selection between the original form of Spiritual Well-Being Questionnaire-SHALOM for comparison with other measures and investigation of characteristics influencing spiritual well-being; or the dissonance method for spiritual care; and either the original or the generic version of SHALOM for use with non-religious/secular participants.

  19. Agents for change: nonphysician medical providers and health care quality.

    Science.gov (United States)

    Boucher, Nathan A; Mcmillen, Marvin A; Gould, James S

    2015-01-01

    Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization's quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.

  20. Perception of health care providers about sexually transmitted infections

    International Nuclear Information System (INIS)

    Khan, A.; Izhar, V.

    2015-01-01

    Sexually transmitted infections represent a global health problem leading to social stigma and early morbidity and mortality. Prior to this study, different health care providers were dealing with sexually transmitted infections with various parameters and were not following the standard regime given by the WHO. The aim of this study was to investigate the perception of health care providers about sexually transmitted infections and its treatment guidelines. Methods: Cross sectional questionnaire based study was conducted from health care providers(specialists, family physicians, homeopaths and others )of Lahore from Jan 2014 to December 2014. Data was collected with consent through convenience purposive sampling of randomly selected 100 specialists, 200 family physicians, 100 homeopaths and 100 others. Trained investigators pre-tested the validity and reliability of the questionnaire before use. Data of response was coded, entered and analyzed using SPSS. Results: Out of 500 practitioners 475 (95%) completed the questionnaire. Those excluded were due to insufficient data in questionnaire. Almost all respondents were aware of STIs and the guidelines and claimed to have decent knowledge. Apart from some disagreement on the user- friendliness and communication facilitating properties, the health care provider's attitude were positive. Conclusion: Overall, all the health care providers knew about sexually transmitted infections. It was the treatment according to the guidelines, in which they differed. Specialists and Family physician in Lahore, Pakistan knew and followed the STIs guidelines while managing the patients. Homeopaths and others were receiving patients and treating most of these infections but were not aware of the standard guidelines yet somehow their patients were treated and satisfied. Enhancing the familiarity of the guidelines among users can result in a positive outcome on the treatment of STIs. (author)

  1. Primary care providers' lived experiences of genetics in practice.

    Science.gov (United States)

    Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

    2018-04-26

    To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

  2. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  3. The financial impact of deployments on reserve health care providers.

    Science.gov (United States)

    Petinaux, Bruno

    2008-08-01

    This study retrospectively surveyed the financial impact of deployments on 17 U.S. Army Reserve health care providers. Due to multiple mobilizations, 29 separate deployments were reported. The deployments, mostly between 2001 and 2005, typically lasted 3 months during which 86% reported no civilian income and 76% reported no civilian benefits. Solo practice providers reported the greatest financial losses due to continuing financial responsibility related to their civilian practice despite being deployed. Overall, 2 deployments did not change, 9 increased, and 16 decreased the medical officer's income. Two were not reported. In this small retrospective convenience sample study, solo practice U.S. Army Reserve health care providers were found to be at highest risk of financial losses during military deployments. This being said, no price can be put on the privilege of serving our men and women in uniform.

  4. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Science.gov (United States)

    2012-01-01

    Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and

  5. The effect of narrow provider networks on health care use.

    Science.gov (United States)

    Atwood, Alicia; Lo Sasso, Anthony T

    2016-12-01

    Network design is an often overlooked aspect of health insurance contracts. Recent policy factors have resulted in narrower provider networks. We provide plausibly causal evidence on the effect of narrow network plans offered by a large national health insurance carrier in a major metropolitan market. Our econometric design exploits the fact that some firms offer a narrow network plan to their employees and some do not. Our results show that narrow network health plans lead to reductions in health care utilization and spending. We find evidence that narrow networks save money by selecting lower cost providers into the network. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Primary Care Providers' Perspectives on Errors of Omission.

    Science.gov (United States)

    Poghosyan, Lusine; Norful, Allison A; Fleck, Elaine; Bruzzese, Jean-Marie; Talsma, AkkeNeel; Nannini, Angela

    2017-01-01

    Despite recent focus on patient safety in primary care, little attention has been paid to errors of omission, which represent significant gaps in care and threaten patient safety in primary care but are not well studied or categorized. The purpose of this study was to develop a typology of errors of omission from the perspectives of primary care providers (PCPs) and understand what factors within practices lead to or prevent these omissions. A qualitative descriptive design was used to collect data from 26 PCPs, both physicians and nurse practitioners, from the New York State through individual interviews. One researcher conducted all interviews, which were audiotaped, transcribed verbatim, and analyzed in ATLAS.ti, Berlin by 3 researchers using content analysis. They immersed themselves into data, read transcripts independently, and conducted inductive coding. The final codes were linked to each other to develop the typology of errors of omission and the themes. Data saturation was reached at the 26th interview. PCPs reported that omitting patient teaching, patient followup, emotional support, and addressing mental health needs were the main categories of errors of omission. PCPs perceived that time constraints, unplanned patient visits and emergencies, and administrative burden led to these gaps in care. They emphasized that organizational support and infrastructure, effective teamwork and communication, and preparation for the patient encounter were important safeguards to prevent errors of omission within their practices. Errors of omission are common in primary care and could threaten patient safety. Efforts to eliminate them should focus on strengthening organizational attributes of practices, improving teamwork and communication, and assigning manageable workload to PCPs. Practice and policy change is necessary to address gaps in care and prevent them before they result in patient harm. © Copyright 2017 by the American Board of Family Medicine.

  7. Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

    2017-03-01

    International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

  8. Providing primary health care with non-physicians.

    Science.gov (United States)

    Chen, P C

    1984-04-01

    The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

  9. [A Clinical Case of Grief Hallucination through the Mourning Work Normal Grief and Spiritual Care].

    Science.gov (United States)

    Kurotori, Isaku; Kato, Satoshi

    2015-01-01

    Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context.

  10. Experiences of spirituality and spiritual values in the context of nursing - an integrative review.

    Science.gov (United States)

    Rudolfsson, Gudrun; Berggren, Ingela; da Silva, António Barbosa

    2014-01-01

    Spirituality is often mistakenly equated with religion but is in fact a far broader concept. The aim of this integrative review was to describe experiences of the positive impact of spirituality and spiritual values in the context of nursing. The analysis was guided by Whittemore and Knafl's integrative review method. The findings revealed seven themes: 'Being part of a greater wholeness', 'Togetherness - value based relationships', 'Developing inner strength', 'Ministering to patients', 'Maintaining one's sense of humanity', 'Viewing life as a gift evokes a desire to 'give back'' and 'Achieving closure - life goes on'. It is difficult to draw definite conclusions, as spirituality involves many perspectives on various levels of awareness. However, spirituality was considered more inclusive, fluid and personal. Furthermore, it emerged that spirituality and spiritual values in the context of nursing are closely intertwined with the concept of caring.

  11. Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

    Science.gov (United States)

    Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

    2017-11-01

    In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

  12. Provider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review.

    Science.gov (United States)

    Myers, Jeff; Cosby, Roxanne; Gzik, Danusia; Harle, Ingrid; Harrold, Deb; Incardona, Nadia; Walton, Tara

    2018-01-01

    Advance care planning and goals of care discussions involve the exploration of what is most important to a person, including their values and beliefs in preparation for health-care decision-making. Advance care planning conversations focus on planning for future health care, ensuring that an incapable person's wishes are known and can guide the person's substitute decision maker for future decision-making. Goals of care discussions focus on preparing for current decision-making by ensuring the person's goals guide this process. To provide evidence regarding tools and/or practices available for use by health-care providers to effectively facilitate advance care planning conversations and/or goals of care discussions. A systematic review was conducted focusing on guidelines, randomized trials, comparative studies, and noncomparative studies. Databases searched included MEDLINE, EMBASE, and the proceedings of the International Advance Care Planning Conference and the American Society of Clinical Oncology Palliative Care Symposium. Although several studies report positive findings, there is a lack of consistent patient outcome evidence to support any one clinical tool for use in advance care planning or goals of care discussions. Effective advance care planning conversations at both the population and the individual level require provider education and communication skill development, standardized and accessible documentation, quality improvement initiatives, and system-wide coordination to impact the population level. There is a need for research focused on goals of care discussions, to clarify the purpose and expected outcomes of these discussions, and to clearly differentiate goals of care from advance care planning.

  13. Family Spirituality and Family Health Among Korean-American Elderly Couples.

    Science.gov (United States)

    Kim, Suk-Sun; Kim-Godwin, Yeoun Soo; Koenig, Harold G

    2016-04-01

    Spirituality has been regarded as an individual and private matter; consequently, research on spirituality as a family phenomenon has been largely neglected. In addition, most published research has been focused on Western cultures. The purpose of this study was to explore the experience of family spirituality and how it influences health among Korean-American elderly couples who are the first generation to reside in the Southeastern USA. A thematic and interpretive data analysis method was used. Thirteen elderly couples (N = 26) participated in in-depth individual interviews in Korean with the primary author. Interviews were audio-taped, transcribed, and then translated by two bilingual researchers with a background in Korean and American culture. Three main themes of family spirituality were identified: (1) family togetherness, (2) family interdependence, and (3) family coping. Also, participants reported that family spirituality strengthened family health by fostering family commitment, improving emotional well-being, developing new healthy behaviors, and providing healing experiences. This finding implies that healthcare providers need to assess family spiritual issues of elderly couples to maximize their strengths for coping with health problems. As our society becomes more culturally diverse, healthcare providers should seek to understand family spirituality from different cultural perspectives to develop a more holistic approach to care.

  14. Barriers to providing maternity care to women with physical disabilities: Perspectives from health care practitioners.

    Science.gov (United States)

    Mitra, Monika; Smith, Lauren D; Smeltzer, Suzanne C; Long-Bellil, Linda M; Sammet Moring, Nechama; Iezzoni, Lisa I

    2017-07-01

    Women with physical disabilities are known to experience disparities in maternity care access and quality, and communication gaps with maternity care providers, however there is little research exploring the maternity care experiences of women with physical disabilities from the perspective of their health care practitioners. This study explored health care practitioners' experiences and needs around providing perinatal care to women with physical disabilities in order to identify potential drivers of these disparities. We conducted semi-structured telephone interviews with 14 health care practitioners in the United States who provide maternity care to women with physical disabilities, as identified by affiliation with disability-related organizations, publications and snowball sampling. Descriptive coding and content analysis techniques were used to develop an iterative code book related to barriers to caring for this population. Public health theory regarding levels of barriers was applied to generate broad barrier categories, which were then analyzed using content analysis. Participant-reported barriers to providing optimal maternity care to women with physical disabilities were grouped into four levels: practitioner level (e.g., unwillingness to provide care), clinical practice level (e.g., accessible office equipment like adjustable exam tables), system level (e.g., time limits, reimbursement policies), and barriers relating to lack of scientific evidence (e.g., lack of disability-specific clinical data). Participants endorsed barriers to providing optimal maternity care to women with physical disabilities. Our findings highlight the needs for maternity care practice guidelines for women with physical disabilities, and for training and education regarding the maternity care needs of this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Impact of emotional intelligence and spiritual intelligence on the caring behavior of nurses: a dimension-level exploratory study among public hospitals in Malaysia.

    Science.gov (United States)

    Kaur, Devinder; Sambasivan, Murali; Kumar, Naresh

    2015-11-01

    The purpose of this research is to study the impact of individual factors such as emotional intelligence (EI) and spiritual intelligence (SI) on the caring behavior of nurses. A cross-sectional survey using questionnaire was conducted by sampling 550 nurses working in seven major public hospitals in Malaysia. Data were analyzed using structural equation modeling (SEM). The main findings are: (1) critical existential thinking and transcendental awareness dimensions of SI have significant impacts on assurance of human presence dimension of caring behavior; (2) personal meaning production and conscious state expansion dimensions of SI have significant impacts on perception of emotion and managing own emotions dimensions of EI; and (3) managing own emotions dimension of EI has significant impacts on respectful deference to other and assurance of human presence dimensions of caring behavior of nurses. The results can be used to recruit and educate nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Why do health and social care providers co-operate?

    Science.gov (United States)

    van Raak, Arno; Paulus, Aggie; Mur-Veeman, Ingrid

    2005-09-28

    Within Europe, although there are numerous examples of poor co-ordination in the delivery of integrated care, many providers do co-operate. We wanted to know why providers are moved to co-operate. In terms of systematic research, this is a new field; researchers have only begun to theorise about the rationales for co-operation. Practically, the issue of achieving co-operation attracts much attention from policymakers. Understanding the reasons for co-operation is a prerequisite for developing effective policy in support of integrated care. Our aim is to explore the comparative validity of different theoretical perspectives on the reasons for co-operation, to indicate directions for further study and for policy making. We used data from three successive studies to perform pattern matching with six established theoretical perspectives: transaction costs economics, strategic choice theory, resource dependence theory, learning theory, stakeholder theory and institutional theory. Insights from the studies were compared for validating purposes (triangulation). The first study concerned the evaluation of the Dutch 'National Home Health Care Programme' according to the case study methodology. The second and third studies were surveys among project directors: questionnaires were based on the concepts derived from the first study. Researchers should combine normative institutional theory, resource dependence theory and stakeholder theory into one perspective, in order to study relationship formation in health and social care. The concept of institutions (rules) is the linchpin between the theories. Policy makers must map the institutions of stakeholders and enable integrated care policy to correspond with these institutions as much as possible.

  17. Transcultural spirituality: the spiritual journey of hospitalized patients with schizophrenia in Taiwan.

    Science.gov (United States)

    Yang, Chun-Tien; Narayanasamy, Aru; Chang, Sung-Ling

    2012-02-01

    The aim of this study was to explore how hospitalization and the diagnosis of schizophrenia have an impact on Taiwanese patients' spiritual life. Psychiatric nurses tend to construe patients' spiritual issues as pathological problems and consequently are reluctant to address patient's spirituality, which results in spirituality being overlooked in mental illness. An individual's spiritual journey is dependent upon their cultural background and beliefs; however, the professional's preconceived ideas suppress the voice of patients with schizophrenia to share their experiences of their spiritual journey. The lack of research exploring spirituality in mental illness in Taiwan means that spiritual care is overlooked in practice. This study sets out to explore spirituality from the perspectives of patients in two mental hospitals in Taiwan. Using a qualitative approach, 22 long-term hospitalized patients diagnosed with schizophrenia were interviewed. Several themes from the data were identified using Ritchie and Spencer's (1994) five stages analytical framework. The study was carried out from 2006 to 2008. Patients revealed spiritual distress as a consequence of prolonged hospitalization. They used referents consistent with traditional Chinese philosophical perspectives derived from Taoism and Confucianism to describe various features of their spiritual distress and their longing for spiritual revival, transcendence and to be accepted as normal persons. In this age of globalization, nurses need to be fully cognisant of the cultural aspects of patients to respond to a mental health patient's spirituality. Clinical and educational guidelines and policies could be developed for spiritual care in Taiwan. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  18. Exploring Health Care Providers' Views About Initiating End-of-Life Care Communication.

    Science.gov (United States)

    Nedjat-Haiem, Frances R; Carrion, Iraida V; Gonzalez, Krystana; Ell, Kathleen; Thompson, Beti; Mishra, Shiraz I

    2017-05-01

    Numerous factors impede effective and timely end-of-life (EOL) care communication. These factors include delays in communication until patients are seriously ill and/or close to death. Gaps in patient-provider communication negatively affect advance care planning and limit referrals to palliative and hospice care. Confusion about the roles of various health care providers also limits communication, especially when providers do not coordinate care with other health care providers in various disciplines. Although providers receive education regarding EOL communication and care coordination, little is known about the roles of all health care providers, including nonphysician support staff working with physicians to discuss the possibility of dying and help patients prepare for death. This study explores the perspectives of physicians, nurses, social workers, and chaplains on engaging seriously ill patients and families in EOL care communication. Qualitative data were from 79 (medical and nonmedical) providers practicing at 2 medical centers in Central Los Angeles. Three themes that describe providers' perceptions of their roles and responsibility in talking with seriously ill patients emerged: (1) providers' roles for engaging in EOL discussions, (2) responsibility of physicians for initiating and leading discussions, and (3) need for team co-management patient care. Providers highlighted the importance of beginning discussions early by having physicians lead them, specifically due to their medical training and need to clarify medical information regarding patients' prognosis. Although physicians are a vital part of leading EOL communication, and are at the center of communication of medical information, an interdisciplinary approach that involves nurses, social workers, and chaplains could significantly improve patient care.

  19. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

    Science.gov (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

    2017-07-14

    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  20. Spiritual well-being and quality of life among Icelanders receiving palliative care: data from Icelandic pilot-testing of a provisional measure of spiritual well-being from the European Organisation for Research and Treatment of Cancer.

    Science.gov (United States)

    Asgeirsdottir, G H; Sigurdardottir, V; Gunnarsdottir, S; Sigurbjörnsson, E; Traustadottir, R; Kelly, E; Young, T; Vivat, B

    2017-03-01

    Palliative care focuses on improving quality of life (QoL). This study examined the feasibility of the Icelandic version of a provisional European Organisation for Research and Treatment of Cancer (EORTC) measure of spiritual well-being (SWB), and explored the relationship between SWB and QoL for palliative care patients in Iceland. Instruments from the EORTC were used: the provisional measure of SWB, which was undergoing pilot-testing in Iceland, and the EORTC QLQ C15-PAL. The correlation between scores was examined and descriptive statistics were used. Structured interviews explored feasibility. Thirty persons participated with average age 72 years. Belief in God or a higher power had the mean 3.33 on a 1-4 scale and the mean for overall SWB was 5.73 on a 1-7 scale. The mean score for global health/QoL was 59.4, physical functioning 48.5 and emotional functioning 78.9 on a 0-100 scale. Overall QoL was positively correlated with SWB showing r(30) = 0.386, P = 0.035. The participants found that answering the provisional EORTC QLQ-SWB prompted an emotional response and took the opportunity to discuss the subject. The provisional SWB measure was found relevant for the Icelandic context, and the study indicates that SWB and QoL are closely connected. © 2015 John Wiley & Sons Ltd.

  1. Interactions between patients and dental care providers: does gender matter?

    Science.gov (United States)

    Inglehart, Marita R

    2013-04-01

    Research findings concerning the role of gender in patient-physician interactions can inform considerations about the role of gender in patient-dental care provider interactions. Medical research showed that gender differences in verbal and nonverbal communication in medical settings exist and that they affect the outcomes of these interactions. The process of communication is shaped by gender identities, gender stereotypes, and attitudes. Future research needs to consider the cultural complexity and diversity in which gender issues are embedded and the degree to which ongoing value change will shape gender roles and in turn interactions between dental patients and their providers. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Collaboration of midwives in primary care midwifery practices with other maternity care providers.

    Science.gov (United States)

    Warmelink, J Catja; Wiegers, Therese A; de Cock, T Paul; Klomp, Trudy; Hutton, Eileen K

    2017-12-01

    Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians. More insight is needed into the professional working relations of primary care midwives in the Netherlands before major changes are made OBJECTIVE: To assess how satisfied primary care midwives are with collaboration with other maternity care providers and to assess the relationship between their 'satisfaction with collaboration' and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics (accessibility). The aim of this study was to provide insight into the professional working relations of primary care midwives in the Netherlands. Our descriptive cross-sectional study is part of the DELIVER study. Ninety nine midwives completed a written questionnaire in May 2010. A Friedman ANOVA test assessed differences in satisfaction with collaboration with six groups of maternity care providers. Bivariate analyses were carried out to assess the relationship between satisfaction with collaboration and personal and work-related characteristics of the midwives, their attitudes towards their work and collaboration characteristics. Satisfaction experienced by primary care midwives when collaborating with the different maternity care providers varies within and between primary and secondary/tertiary care. Interactions with non-physicians (clinical midwives and MCA(O)) are ranked consistently higher on satisfaction compared with

  3. Time providing care outside visits in a home-based primary care program.

    Science.gov (United States)

    Pedowitz, Elizabeth J; Ornstein, Katherine A; Farber, Jeffrey; DeCherrie, Linda V

    2014-06-01

    To assess how much time physicians in a large home-based primary care (HBPC) program spend providing care outside of home visits. Unreimbursed time and patient and provider-related factors that may contribute to that time were considered. Mount Sinai Visiting Doctors (MSVD) providers filled out research forms for every interaction involving care provision outside of home visits. Data collected included length of interaction, mode, nature, and with whom the interaction was for 3 weeks. MSVD, an academic home-visit program in Manhattan, New York. All primary care physicians (PCPs) in MSVD (n = 14) agreed to participate. Time data were analyzed using a comprehensive estimate and conservative estimates to quantify unbillable time. Data on 1,151 interactions for 537 patients were collected. An average 8.2 h/wk was spent providing nonhome visit care for a full-time provider. Using the most conservative estimates, 3.6 h/wk was estimated to be unreimbursed per full-time provider. No significant differences in interaction times were found between patients with and without dementia, new and established patients, and primary-panel and covered patients. Home-based primary care providers spend substantial time providing care outside home visits, much of which goes unrecognized in the current reimbursement system. These findings may help guide practice development and creation of new payment systems for HBPC and similar models of care. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  4. Customer assessment of long-term care pharmacy provider services.

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

  5. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer.

    Science.gov (United States)

    Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M

    2015-01-09

    Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears.

  6. The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden.

    Science.gov (United States)

    Torabi Chafjiri, Razieh; Navabi, Nasrin; Shamsalinia, Abbas; Ghaffari, Fatemeh

    2017-01-01

    Stroke is a chronic condition that necessitates multidimensional and overwhelming care. The caregivers of stroke patients are faced with various stressors that can threaten different aspects of their health, especially their mental health. Spiritual attitude and being spiritually oriented contribute significantly to mental health and can be used as a strategy for adapting to the stressful events that are part of the role of caregiving. This study was therefore conducted to investigate the relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden. This descriptive cross-sectional study was conducted in 2016. The study population consisted of all the family caregivers of older patients with stroke presenting to health care centers and nursing service companies of Gilan Province in Iran. The participants were selected through convenience sampling and consisted of 407 participants. Data were collected using the Spiritual Attitude Scale and the Caregiver Burden Inventory and were then analyzed in SPSS-18 using Pearson's correlation coefficient at a significance level of 0.05. The results showed that 88.9% of the caregivers were females. The mean age of the participants was 38.3±8.8 years. The duration of caregiving was relationship was observed in this study between the mean score of spiritual attitude and the total score of burden in all its dimensions, namely, time dependence, as well as the developmental, physical, social and emotional dimensions. Providing strategies for improving spirituality, such as teaching spiritual self-care, can improve their burden. Given that such strategies are psychologically approved and pose no side effects, they can be used as an effective, low-cost and risk-free approach for all caregivers, so that they can acquire the necessary spiritual support for overcoming the stress caused by caring for family members through the reinforcement of their spiritual beliefs in the ultimate

  7. Hospital Social Work and Spirituality: Views of Medical Social Workers.

    Science.gov (United States)

    Pandya, Samta P

    2016-01-01

    This article is based on a study of 1,389 medical social workers in 108 hospitals across 12 countries, on their views on spirituality and spiritually sensitive interventions in hospital settings. Results of the logistic regression analyses and structural equation models showed that medical social workers from European countries, United States of America, Canada, and Australia, those had undergone spiritual training, and those who had higher self-reported spiritual experiences scale scores were more likely to have the view that spirituality in hospital settings is for facilitating integral healing and wellness of patients and were more likely to prefer spiritual packages of New Age movements as the form of spiritual program, understand spiritual assessment as assessing the patients' spiritual starting point, to then build on further interventions and were likely to attest the understanding of spiritual techniques as mindfulness techniques. Finally they were also likely to understand the spiritual goals of intervention in a holistic way, that is, as that of integral healing, growth of consciousness and promoting overall well-being of patients vis-à-vis only coping and coming to terms with health adversities. Results of the structural equation models also showed covariances between religion, spirituality training, and scores on the self-reported spiritual experiences scale, having thus a set of compounding effects on social workers' views on spiritual interventions in hospitals. The implications of the results for health care social work practice and curriculum are discussed.

  8. Kabuki syndrome: a challenge for the primary care provider.

    Science.gov (United States)

    Crane, Bonnie; Alpert, Patricia T; Cyrkiel, Dianne; Jauregui, Alan

    2013-10-01

    Using a case format, the pathogenesis, clinical manifestations, diagnosis, and management of Kabuki syndrome, a rare genetic condition, is presented. Nurse practitioners (NPs) may encounter patients presenting to the primary care setting with this rare syndrome; understanding this condition may help them to better care for these patients. A case presentation of a pediatric patient supported by the currently available literature from multiple health and medial databases. Kabuki syndrome is a rare phenomenon that occurs in 1 in every 32,000 births. A diagnosis of this syndrome may take several months to years because there are no specific tests, and the physical features may be subtle at birth, becoming more pronounced over a period of time during childhood. The degree of disease severity varies widely. Understanding this syndrome increases the NP's ability to provide primary care to affected patients and their families. Management of this condition requires the NP take on the role of gatekeeper, so timely coordination of specialty or subspecialty services is provided. Special consideration should be given to monitoring caregiver fatigue and impact on siblings so family members can be directed to the appropriate support services. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  9. Predictors of stethoscope disinfection among pediatric health care providers.

    Science.gov (United States)

    Muniz, Jeanette; Sethi, Rosh K V; Zaghi, Justin; Ziniel, Sonja I; Sandora, Thomas J

    2012-12-01

    Stethoscopes are contaminated with bacteria, but predictors of stethoscope disinfection frequency are unknown. We sought to describe health care provider stethoscope disinfection attitudes and practices and determine predictors of frequent disinfection. We used an anonymous online survey of nurses, nurse practitioners, and physicians at a pediatric hospital. We assessed frequency and methods of disinfection, perceptions of contamination, and barriers to disinfection. Multivariate logistic regression models were used to identify independent predictors of disinfecting after every use. One thousand four hundred one respondents completed the survey: 76% believed that infection transmission occurs via stethoscopes, but only 24% reported disinfecting after every use. In multivariate analyses, belief that infection transmission occurs via stethoscopes significantly increased the odds of disinfection after every use (odds ratio [OR], 2.06 [95% confidence interval (CI): 1.38-3.06]). The odds of disinfection after every use were significantly decreased in those who perceived the following barriers: lack of time (OR, 0.31 [95% CI: 0.18-0.54]), lack of access to disinfection material (OR, 0.41 [95% CI: 0.29-0.57]), or lack of visual reminders to disinfect (OR, 0.22 [95% CI: 0.14-0.34]). Only a minority of pediatric health care providers reported disinfecting their stethoscopes after every use. Increasing access to disinfection materials and visual reminders in health care facilities may improve stethoscope disinfection practices. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Spiritual Politics

    Directory of Open Access Journals (Sweden)

    Frédéric Rambeau

    2015-01-01

    Full Text Available According to Foucault, the uprising of the Iranian people in the seventies reveals how much the political force of Islam is due precisely to the fact that it is not principally located in the field of politics, but in that of ethics. Religion (Shiite Islam appears as the guarantee of real change in the very mode of existence. This spiritual politics is marginalized by Marxism, where it is understood as a discontinuity in relation to proper politics, given that the latter is necessarily linked to a strategic rationalization. By indicating, at this juncture of what is intolerable, the living source and the critical impulse of the Foucauldian ethics, this spiritual politics also leads to recognize in the concept of “subjectivation” a dimension that might escape the circle of freedom as determined by a total immanence to power. This conceptual possibility is highly present in the aporias of the Foucauldian concept of the “relation to oneself”, both as a first condition of governmentality and the ultimate point of resistance against any governmentality. It thus reveals the difficulties in relating political to ethical subjectivation.

  11. Health Care Resource Utilization for Outpatient Cardiovascular Disease and Diabetes Care Delivery Among Advanced Practice Providers and Physician Providers in Primary Care.

    Science.gov (United States)

    Virani, Salim S; Akeroyd, Julia M; Ramsey, David J; Deswal, Anita; Nasir, Khurram; Rajan, Suja S; Ballantyne, Christie M; Petersen, Laura A

    2017-10-10

    Although effectiveness of diabetes or cardiovascular disease (CVD) care delivery between physicians and advanced practice providers (APPs) has been shown to be comparable, health care resource utilization between these 2 provider types in primary care is unknown. This study compared health care resource utilization between patients with diabetes or CVD receiving care from APPs or physicians. Diabetes (n = 1,022,588) or CVD (n = 1,187,035) patients with a primary care visit between October 2013 and September 2014 in 130 Veterans Affairs facilities were identified. Using hierarchical regression adjusting for covariates including patient illness burden, the authors compared number of primary or specialty care visits and number of lipid panels and hemoglobinA1c (HbA1c) tests among diabetes patients, and number of primary or specialty care visits and number of lipid panels and cardiac stress tests among CVD patients receiving care from physicians and APPs. Physicians had significantly larger patient panels compared with APPs. In adjusted analyses, diabetes patients receiving care from APPs received fewer primary and specialty care visits and a greater number of lipid panels and HbA1c tests compared with patients receiving care from physicians. CVD patients receiving care from APPs received more frequent lipid testing and fewer primary and specialty care visits compared with those receiving care from physicians, with no differences in the number of stress tests. Most of these differences, although statistically significant, were numerically small. Health care resource utilization among diabetes or CVD patients receiving care from APPs or physicians appears comparable, although physicians work with larger patient panels.

  12. Role of nursing leadership in providing compassionate care.

    Science.gov (United States)

    Quinn, Barry

    2017-12-13

    This article encourages nurses to explore the concept of leadership in the constantly changing field of health and social care. All nurses have an important role in leadership, and they should consider what type of leader they want to be and what leadership skills they might wish to develop. This article examines what leadership might involve, exploring various leadership styles and characteristics and how these could be applied in nurses' practice. A core component of nursing and nursing leadership is the ability to provide compassionate care. This could correspond with the idea of servant leadership, an approach that moves the leader from a position of power to serving the team and supporting individuals to develop their potential. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  13. Geriatric care: ways and means of providing comfort.

    Science.gov (United States)

    Ribeiro, Patricia Cruz Pontifice Sousa Valente; Marques, Rita Margarida Dourado; Ribeiro, Marta Pontifice

    2017-01-01

    To know the ways and means of comfort perceived by the older adults hospitalized in a medical service. Ethnographic study with a qualitative approach. We conducted semi-structured interviews with 22 older adults and participant observation of care situations. The ways and means of providing comfort are centered on strategies for promoting care mobilized by nurses and recognized by patients(clarifying/informing, positive interaction/communication, music therapy, touch, smile, unconditional presence, empathy/proximity relationship, integrating the older adult or the family as partner in the care, relief of discomfort through massage/mobilization/therapy) and on particular moments of comfort (the first contact, the moment of personal hygiene, and the visit of the family), which constitute the foundation of care/comfort. Geriatric care is built on the relationship that is established and complete with meaning, and is based on the meeting/interaction between the actors under the influence of the context in which they are inserted. The different ways and means of providing comfort aim to facilitate/increase care, relieve discomfort and/or invest in potential comfort. Conhecer os modos e formas de confortar percecionadas pelos idosos hospitalizados num serviço de medicina. Estudo etnográfico com abordagem qualitativa. Realizamos entrevistas semiestruturadas com 22 doentes idosos e observação participante nas situações de cuidados. Os modos e formas de confortar centram-se em estratégias promotoras de conforto mobilizadas pelo enfermeiro e reconhecidas pelos doentes (informação/esclarecimento, interação/comunicação positiva, toque, sorriso, presença incondicional, integração do idoso/família nos cuidados e o alívio de desconfortos através da massagem/mobilização/terapêutica) e em momentos particulares de conforto (contato inaugural, visita da família., cuidados de higiene e arranjo pessoal), que se constituem como alicerces do cuidar

  14. A need for otolaryngology education among primary care providers

    Science.gov (United States)

    Hu, Amanda; Sardesai, Maya G.; Meyer, Tanya K.

    2012-01-01

    Objective Otolaryngic disorders are very common in primary care, comprising 20–50% of presenting complaints to a primary care provider. There is limited otolaryngology training in undergraduate and postgraduate medical education for primary care. Continuing medical education may be the next opportunity to train our primary care providers (PCPs). The objective of this study was to assess the otolaryngology knowledge of a group of PCPs attending an otolaryngology update course. Methods PCPs enrolled in an otolaryngology update course completed a web-based anonymous survey on demographics and a pre-course knowledge test. This test was composed of 12 multiple choice questions with five options each. At the end of the course, they were asked to evaluate the usefulness of the course for their clinical practice. Results Thirty seven (74%) PCPs completed the survey. Mean knowledge test score out of a maximum score of 12 was 4.0±1.7 (33.3±14.0%). Sorted by area of specialty, the mean scores out of a maximum score of 12 were: family medicine 4.6±2.1 (38.3±17.3%), pediatric medicine 4.2±0.8 (35.0±7.0%), other (e.g., dentistry, emergency medicine) 4.2±2.0 (34.6±17.0%), and adult medicine 3.9±2.1 (32.3±17.5%). Ninety one percent of respondents would attend the course again. Conclusion There is a low level of otolaryngology knowledge among PCPs attending an otolaryngology update course. There is a need for otolaryngology education among PCPs. PMID:22754276

  15. Job Satisfaction and Affecting Factors in Primary Health Care Providers

    Directory of Open Access Journals (Sweden)

    Ferit Kaya

    2016-06-01

    Full Text Available Objective: The aim of this study is to assess the job sat­isfaction of the primary health care providers and the fac­tors affecting it. Methods: This cross-sectional and descriptive study was carried out among the staff in The Public Health Care Centers (PHCC by performing a questionnaire under di­rect observation. Results: Out of 310 people consisting of the study uni­verse, 282 participants (94% were reached. The par­ticipants were 104 doctors, 132 assistant health care providers and 46 others (janitors, drivers The mean age of the participants was 37.21±7.70; 60.6% of them were women, 80.1% married, 96.5% graduated from at least High school. The mean of the general job satisfac­tion point of the participants in the study is 63.24±13.63. While the mean of the general job satisfaction point of the physicians and the nurses is found higher, the mean of the general job satisfaction point of janitors and other staff was found lower. The mean of the general job sat­isfaction point was found higher among the permanent and contract employee, women, health care staff, those whose wife/husband works, who chose his job willingly, more educated; who has longer working hours, high in­come, has 3 or less children and finds his job suitable for his skills; however the marital status, having children and age do not affect the mean job satisfaction point. Conclusion: Subjects having high income, found his job suitable for his skills, chose his job willingly had higher job satisfaction scores. This implies that there should be a wage balance among the staff with the same status. The lower job satisfaction score in PHCC indicates the neces­sity of improving the conditions of these centers.

  16. Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers

    Directory of Open Access Journals (Sweden)

    Seeleman Conny

    2012-07-01

    Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.

  17. Health care providers' comfort with and barriers to care of transgender youth.

    Science.gov (United States)

    Vance, Stanley R; Halpern-Felsher, Bonnie L; Rosenthal, Stephen M

    2015-02-01

    To explore providers' clinical experiences, comfort, and confidence with and barriers to providing care to transgender youth. An online survey was administered to members of the Society for Adolescent Health and Medicine and the Pediatric Endocrine Society with items querying about clinical exposure to transgender youth, familiarity with and adherence to existing clinical practice guidelines, perceived barriers to providing transgender-related care, and comfort and confidence with providing transgender-related care. The response rate was 21.9% (n = 475). Of the respondents, 66.5% had provided care to transgender youth, 62.4% felt comfortable with providing transgender medical therapy, and 47.1% felt confident in doing so. Principal barriers to provision of transgender-related care were lack of the following: training, exposure to transgender patients, available qualified mental health providers, and insurance reimbursement. This study suggests that more training in transgender-related care, available qualified mental health providers, and insurance reimbursement for transgender-related care are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. ROLE OF SPIRITUALITY AS A WAY OF COPING FROM BURNOUT IN MEDICAL STUDENTS OF A TERTIARY CARE INSTITUTE IN INDIA

    OpenAIRE

    Sagar Shrikant; Deepika Abhainath

    2016-01-01

    BACKGROUND Medical students are exposed to various stressful conditions in their journey towards becoming a successful doctor leading to burnout. Adoption of faulty coping mechanisms increases the risk further. Spirituality as a way of coping can help to reduce burnout in these students. MATERIALS & METHODS We decided to conduct a study with aims to assess the prevalence of burnout in medical students, to study their socio-demographic profile and to understand the role of spiritualit...

  19. Spiritual Dryness as a Measure of a Specific Spiritual Crisis in Catholic Priests: Associations with Symptoms of Burnout and Distress

    Directory of Open Access Journals (Sweden)

    Arndt Büssing

    2013-01-01

    Full Text Available Spirituality/religiosity is recognized as a resource to cope with burdening life events and chronic illness. However, less is known about the consequences of the lack of positive spiritual feelings. Spiritual dryness in clergy has been described as spiritual lethargy, a lack of vibrant spiritual encounter with God, and an absence of spiritual resources, such as spiritual renewal practices. To operationalize experiences of “spiritual dryness” in terms of a specific spiritual crisis, we have developed the “spiritual dryness scale” (SDS. Here, we describe the validation of the instrument which was applied among other standardized questionnaires in a sample of 425 Catholic priests who professionally care for the spiritual sake of others. Feelings of “spiritual dryness” were experienced occasionally by up to 40%, often or even regularly by up to 13%. These experiences can explain 44% of variance in daily spiritual experiences, 30% in depressive symptoms, 22% in perceived stress, 20% in emotional exhaustion, 19% in work engagement, and 21% of variance of ascribed importance of religious activity. The SDS-5 can be used as a specific measure of spiritual crisis with good reliability and validity in further studies.

  20. Providing surgical care in Somalia: A model of task shifting.

    Science.gov (United States)

    Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel

    2011-07-15

    Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves

  1. Evaluating a nurse-led model for providing neonatal care.

    Science.gov (United States)

    2004-07-01

    The paper presents an overview of a multi-dimensional, prospective, comparative 5-year audit of the quality of the neonatal care provided by a maternity unit in the UK delivering 2000 babies a year, where all neonatal care after 1995 was provided by advanced neonatal nurse practitioners, in relation to that provided by a range of other medically staffed comparator units. The audit includes 11 separate comparative studies supervised by a panel of independent external advisors. Data on intrapartum and neonatal mortality is reported. A review of resuscitation at birth, and a two-tier confidential inquiry into sentinel events in six units were carried out. The reliability of the routine predischarge neonatal examination was studied and, in particular, the recognition of congenital heart disease. A review of the quality of postdischarge letters was undertaken alongside an interview survey to elicit parental views on care provision. An audit of all hospital readmissions within 28 days of birth is reported. Other areas of study include management of staff stress, perceived adequacy of the training of nurse practitioners coming into post, and an assessment of unit costs. Intrapartum and neonatal death among women with a singleton pregnancy originally booked for delivery in Ashington fell 39% between 1991-1995 and 1996-2000 (5.12 vs. 3.11 deaths per 1000 births); the decline for the whole region was 27% (4.10 vs. 2.99). By all other indicators the quality of care in the nurse-managed unit was as good as, or better than, that in the medically staffed comparator units. An appropriately trained, stable team with a store of experience can deliver cot-side care of a higher quality than staff rostered to this task for a few months to gain experience, and this is probably more important than their medical or nursing background. Factors limiting the on-site availability of medical staff with paediatric expertise do not need to dictate the future disposition of maternity services.

  2. Factors associated with job satisfaction by Chinese primary care providers.

    Science.gov (United States)

    Shi, Leiyu; Song, Kuimeng; Rane, Sarika; Sun, Xiaojie; Li, Hui; Meng, Qingyue

    2014-01-01

    This study provides a snapshot of the current state of primary care workforce (PCW) serving China's grassroots communities and examines the factors associated with their job satisfaction. Data for the study were from the 2011 China Primary Care Workforce Survey, a nationally representative survey that provides the most current assessment of community-based PCW. Outcome measures included 12 items on job satisfaction. Covariates included intrinsic and extrinsic factors associated with job satisfaction. In addition, PCW type (i.e., physicians, nurses, public health, and village doctors) and practice setting (i.e., rural versus urban) were included to identify potential differences due to the type of PCW and practice settings. The overall satisfaction level is rather low with only 47.6% of the Chinese PCW reporting either satisfied or very satisfied with their job. PCW are least satisfied with their income level (only 8.6% are either satisfied or very satisfied), benefits (12.8%), and professional development (19.5%). They (particularly village doctors) are also dissatisfied with their workload (37.2%). Lower income and higher workload are the two major contributing factors toward job dissatisfaction. To improve the general satisfaction level, policymakers must provide better pay and benefits and more opportunities for career development, particularly for village doctors.

  3. Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

    Science.gov (United States)

    Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

    2017-07-14

    Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

  4. The role of religion and spirituality in coping with kidney disease and haemodialysis in Thailand.

    Science.gov (United States)

    Yodchai, Kantaporn; Dunning, Trisha; Savage, Sally; Hutchinson, Alison M

    2017-06-01

    People with chronic kidney disease (CKD) face various problems including psychological, socioeconomic and physical effects associated with CKD and its treatment. They need to develop strategies to help them cope with CKD and life challenges. Religion and spirituality are important coping strategies, but their role in helping people cope with CKD and haemodialysis (HD) in Thailand is relatively unknown. To investigate the role of religion and spirituality in coping with CKD and its treatment in Thailand. An exploratory, qualitative approach was undertaken using semistructured individual interviews. Purposive sampling was used to recruit participants. Face-to-face, in-depth individual interviews using open questions were conducted during January and February 2012. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the framework method of qualitative data analysis. Twenty people receiving HD participated: age range 23-77 years, mean 53.7 (±16.38 SD). Ten were women. Participants reported use of religious and spiritual practices to cope with CKD and its treatment, including religious and spiritual explanations for developing CKD, karmic disease, making merit, reading Dharma books, praying and chanting to save life and making a vow to Pran-Boon. Religion and spirituality provide powerful coping strategies that can help Thai people with CKD overcome the associated distress and difficulties. Religion and spirituality cannot be separated in Thai culture because Thai people are both religious and spiritual. © 2016 Nordic College of Caring Science.

  5. Primordial Spirituality

    Directory of Open Access Journals (Sweden)

    Kees Waaijman

    2010-11-01

    Full Text Available This article explores the primordial spirituality of the Bible, as expressed in names, narratives and prayers. It looks at the nomadic families of Abraham and Sarah, Isaac and Rebecca, Jacob, Lea and Rachel, moving around from Mesopotamia via Canaan into Egypt and vice versa (see Gn 11:31–32; 12:4–5; 27:43; 28:10; 29:4; Gn 24 and 29–31. It analyses their experiences, covering the span between birth and death and listens to their parental concerns about education as survival. It also follows their journeys along the margins of the deserts. It shares their community life as it takes shape in mutual solidarity, mercy and compassion.

  6. Generic substitution of antiretrovirals: patients' and health care providers' opinions.

    Science.gov (United States)

    Kieran, Jennifer A; O'Reilly, Eimear; O'Dea, Siobhan; Bergin, Colm; O'Leary, Aisling

    2017-10-01

    There is interest in introducing generic antiretroviral drugs (ARVs) into high-income countries in order to maximise efficiency in health care budgets. Studies examining patients' and providers' knowledge and attitudes to generic substitution in HIV are few. This was a cross-sectional, observational study with a convenience sample of adult HIV-infected patients and health care providers (HCPs). Data on demographics, knowledge of generic medicine and facilitators of generic substitution were collected. Descriptive and univariate analysis was performed using SPSS V.23™. Questionnaires were completed by 66 patients. Seventy-one per cent would have no concerns with the introduction of generic ARVs. An increase in frequency of administration (61%) or pill burden (53%) would make patients less likely to accept generic ARVs. There were 30 respondents to the HCP survey. Concerns included the supply chain of generics, loss of fixed dose combinations, adherence and use of older medications. An increase in dosing frequency (76%) or an increase in pill burden (50%) would make HCPs less likely to prescribe a generic ARV. The main perceived advantage was financial. Generic substitution of ARVs would be acceptable to the majority of patients and HCPs. Reinvesting savings back into HIV services would facilitate the success of such a programme.

  7. To provide care and be cared for in a multiple-bed hospital room.

    Science.gov (United States)

    Persson, Eva; Määttä, Sylvia

    2012-12-01

    To illuminate patients' experiences of being cared for and nurses' experiences of caring for patients in a multiple-bed hospital room. Many patients and healthcare personnel seem to prefer single-bed hospital rooms. However, certain advantages of multiple-bed hospital rooms (MBRs) have also been described. Eight men and eight women being cared for in a multiple-bedroom were interviewed, and two focus-group interviews (FGI) with 12 nurses were performed. A qualitative content analysis was used. One theme--Creating a sphere of privacy--and three categories were identified based on the patient interviews. The categories were: Being considerate, Having company and The patients' area. In the FGI, one theme--Integrating individual care with care for all--and two categories emerged: Experiencing a friendly atmosphere and Providing exigent care. Both patients and nurses described the advantages and disadvantages of multiple-bed rooms. The patient culture of taking care of one another and enjoying the company of room-mates were considered positive and gave a sense of security of both patients and nurses. The advantages were slight and could easily become disadvantages if, for example, room-mates were very ill or confused. The patients tried to maintain their privacy and dignity and claimed that there were small problems with room-mates listening to conversations. In contrast, the nurses stressed patient integrity as a main disadvantage and worked to protect the integrity of individual patients. Providing care for all patients simultaneously had the advantage of saving time. The insights gained in the present study could assist nurses in reducing the disadvantages and taking advantage of the positive elements of providing care in MBRs. Health professionals need to be aware of how attitudes towards male and female patients, respectively, could affect care provision. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  8. Spirituality in self-care for intensive care nursing professionals La espiritualidad en el cuidado de si para profesionales de enfermería en terapia intensiva A espiritualidade no cuidado de si para profissionais de enfermagem em terapia intensiva

    Directory of Open Access Journals (Sweden)

    Luciana Winterkorn Dezorzi

    2008-04-01

    Full Text Available This study aimed to understand how spirituality permeates the process of caring for oneself and for others in the intensive care scenario from nursing professionals' point of view. This study used the qualitative approach of Cabral's Creative-Sensitive Method to guide information production and analysis in nine art and experience workshops. Nine nursing caregivers from the Intensive Care Unit (ICU of a university hospital participated in the study. This article presents one of the topics that emerged during this process: spirituality in self-care, which is evidenced in the daily practices that take place through prayers, close contact with nature, as well as in the sense of connection with a Higher Power that provides peace, welfare, and greater strength to ICU caregivers' life and work. Self-knowledge emerged as an essential practice in caring for oneself, in order to deliver better care to others.Este estudio tuvo por objetivo comprender como la espiritualidad envuelve al proceso de cuidar de sí mismo y de otros, en el mundo de la terapia intensiva, bajo la perspectiva de los profesionales de enfermería. La investigación se caracterizó por un abordaje cualitativo del método creativo sensible de Cabral, que guió la producción y el análisis de las informaciones en nueve talleres de arte y experiencias. Participaron del estudio nueve cuidadoras de enfermería del Centro de Tratamiento Intensivo (CTI de un hospital universitario. Este artículo presenta uno de los temas que surgieron en la investigación: la espiritualidad en el cuidado de sí mismo, la que fue evidenciada en las prácticas cotidianas que acontecían por medio de la oración, del contacto íntimo con la naturaleza, así como en el sentimiento de conexión con una Fuerza Superior que propiciaba tranquilidad, bienestar y fortalecía la vida y el trabajo de las cuidadoras en el CTI. El auto conocimiento se reveló como una práctica esencial en el cuidado de sí mismo que

  9. Moral distress experienced by health care professionals who provide home-based palliative care.

    Science.gov (United States)

    Brazil, Kevin; Kassalainen, Sharon; Ploeg, Jenny; Marshall, Denise

    2010-11-01

    Health care providers regularly encounter situations of moral conflict and distress in their practice. Moral distress may result in unfavorable outcomes for both health care providers and those in their care. The purpose of this study was to examine the experience of moral distress from a broad range of health care occupations that provide home-based palliative care as the initial step of addressing the issue. A critical incident approach was used in qualitative interviews to elicit the experiences on moral distress from 18 health care providers drawn from five home visiting organizations in south central Ontario, Canada. Most participants described at least two critical incidents in their interview generating a total of 47 critical incidents. Analyses of the critical incidents revealed 11 issues that triggered moral distress which clustered into three themes, (a) the role of informal caregivers, b) challenging clinical situations and (c) service delivery issues. The findings suggest that the training and practice environments for health care providers need to be designed to recognize the moral challenges related to day-to-day practice. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. A pastoral evaluation and responses to the challenge of spiritual insecurity in African pastoral ministry and Christianity

    Directory of Open Access Journals (Sweden)

    Vhumani Magezi

    2017-01-01

    Full Text Available This article argues that there is a form of Christian syncretism operating in African Christians� use of traditional African powers to address their spiritual insecurity challenges that arises from their former traditional African worldview of spiritual powers. It provides an overview description of the nature of the spiritual insecurity which still grips African Christians by delving into the traditional African worldview of spiritual powers (such as the notions of a Supreme Being, lesser divinities, spirits and ancestors and the centrality of traditional powers such as diviners in addressing this insecurity. After underscoring the aforementioned, this article proceeds to demonstrate three predominant views proposed by theological scholars as a response to the spiritual insecurity of African Christians. The first stance calls African Christians to discontinue with anything that is linked to traditional African spiritual worldview because Christianity entails a complete new ontological being. The second stance disapproves African Christians� reliance on traditional African powers and then proceeds to argue that Christian ministry should identify positives within the African spiritual world system and worldview that is useful and can be imported for use in contextualising the gospel. The third position advocates for Christians� continual reliance on traditional African spiritual powers in addressing their African contextual needs. In doing this, the weaknesses and strengths of these approaches are established with the view to outline an alternative biblical theological basis to ensure biblical Christianity in the challenging African contexts of spiritual insecurity. This article concludes by drawing from various theological responses to the spiritual insecurity of African Christians to ensure Christian ministry that is thoroughly biblical and contextual in African Christianity.Intradisciplinary and/or interdisciplinary implications: This

  11. Modelling catchment areas for secondary care providers: a case study.

    Science.gov (United States)

    Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

    2011-09-01

    Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating

  12. Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units.

    Science.gov (United States)

    Abuatiq, Alham

    2015-01-01

    The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care

  13. Time to standardise levels of care amongst Out-of-Hospital Emergency Care providers in Africa

    OpenAIRE

    Mould-Millman, N.K.; Stein, C.; Wallis, L.A.

    2016-01-01

    The African Federation for Emergency Medicine’s Out-of-Hospital Emergency Care (OHEC) Committee convened 15 experts from various OHEC systems in Africa to participate in a consensus process to define levels of care within which providers in African OHEC systems should safely and effectively function. The expert panel concluded that four provider levels were relevant for African OHEC systems: (i) first aid, (ii) basic life support, (iii) intermediate life support, and (iv) advanced life suppor...

  14. Clearing the airway by an emergency care provider in the prehospital emergency care

    OpenAIRE

    NOVOTNÁ, Magdalena

    2008-01-01

    Clearing an obstructed airway to facilitate breathing is a critical element of airway management. It is the emergency care provider who administers first aid and he/she has to master the technique of opening the airway as well as the aspiration prevention. The right airway management may avert the life-threatening condition of an injured person. The thesis is focused on the possibilities of clearing the airway by the emergency care provider in the Central Bohemian region. Techniques of openin...

  15. Exploring the Role of Farm Animals in Providing Care at Care Farms

    Science.gov (United States)

    Hassink, Jan; De Bruin, Simone R.; Berget, Bente; Elings, Marjolein

    2017-01-01

    Simple Summary This paper provides insight into the role of farm animals in farm-based programs and their importance to different types of participants. Farm animals provide real work, close relationships, challenging tasks and opportunities for reflection. They also contribute to a welcoming atmosphere for various types of participants. Abstract We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with animals compared to a therapeutic healthcare setting. We performed a literature review, conducted focus group meetings and carried out secondary data-analysis of qualitative studies involving care farmers and different types of participants. We found that farm animals are important to many participants and have a large number of potential benefits. They can (i) provide meaningful day occupation; (ii) generate valued relationships; (iii) help people master tasks; (iv) provide opportunities for reciprocity; (v) can distract people from them problems; (vi) provide relaxation; (vii) facilitate customized care; (viii) facilitate relationships with other people; (ix) stimulate healthy behavior; (x) contribute to a welcoming environment; (xi) make it possible to experience basic elements of life; and (xii) provide opportunities for reflection and feedback. This shows the multi-facetted importance of interacting with animals on care farms. In this study the types of activities with animals and their value to different types of participants varied. Farm animals are an important element of the care farm environment that can address the care needs of different types of participants. PMID:28574435

  16. Youth Mentoring and Spiritual Development

    Science.gov (United States)

    Rhodes, Jean E.; Chan, Christian S.

    2008-01-01

    Religious organizations offer a potentially rich pool of caring adults who are driven by their own spiritual commitments and a strong ethic to serve others. Indeed, more Americans volunteer through religious organizations than through any other venue. Religious organizations account for half of all volunteering, with an estimated 60 percent of the…

  17. Drug Resistance versus Spiritual Resistance: A Comparative Analysis from the Perspective of Spiritual Health

    Directory of Open Access Journals (Sweden)

    Mohammad Baqer Mohammadi Laini

    2014-12-01

    Full Text Available Background and Objectives: Taking into account a few principles concerning human being, it becomes plausible that the human spirit would also have a similar reaction to spiritual “medicine” provided to it. In order to better understand how this is possible, we must consider the means by which the human spirit becomes resistant to spiritual remedies and compare them with the resistance developed by the body against physical drugs. As such, this research aimed at creating a comparative analysis between the elements that cause the human spirit to become resistant against spiritual remedies in comparison to the body’s resistance against physical treatments (e.g. drugs and other physical treatment. Methods: The research at hand highlights the conclusions of an overall study of the Holy Quran, books of Islamic narration, and extensive Internet research concerning this subject. With these resources, the various aspects of the spirit’s resistance against spiritual remedies were discussed in detail. Results: According to Holy Quran and Islamic narrations: Based on the expectations which God has of man, his heart (i.e. spirit has the potential to fall under one of two categories – positive or negative. An afflicted heart may at times, like an afflicted body, become resistant against a remedy designed to cure it. In both cases of physical or metaphysical resistance, the underlying element that causes this resistance as well as the symptoms which accompany it are similar to one another. Having considered the teachings found in religious texts, this research discovered the underlying causes of spiritual resistance, and outlined some solutions which can prevent this issue from arising in the first place. Conclusion: Based on the standards of health and spiritual wellbeing as outlined in Holy Quran, it is said that some hearts are unhealthy and require treatment and healing. In Holy Quran, there is also no doubt in it, guidance to the God wary

  18. Spiritual leadership: a new model.

    Science.gov (United States)

    Wolf, Emily J

    2004-01-01

    Recent unethical business practices of some corporations and the overall loss of confidence by the public in corporate leadership have given rise to a unique leadership model--one that focuses on spirituality. "Ninety percent of our diverse American population and health-care workforce have spiritual and religious beliefs. While these beliefs may be mystical, religious, or secular, there are many common patterns that influence change and leadership within our organizations." So says Gary Strack, CHE, president and chief executive officer of Boca Raton (FL) Community Hospital. Strack presented a seminar on the topic at ACHE's 2003 Congress on Healthcare Management.

  19. Care of the spirit that transcends religious, ideological and philosophical boundaries

    Directory of Open Access Journals (Sweden)

    Hegarty Meg

    2007-01-01

    Full Text Available Spirit and spirituality are human universals, which are understood, expressed and lived out in different ways. Care of the spirit is an integral component of holistic palliative care, respecting the individual spirituality and experience of the person for whom we care. Whatever be the religious, ideological or philosophical background of the patient and the clinician/carer, certain skills, knowledge and attitudes are essential in providing effective care of the spirit. Rather than using a single perspective, such as either a secular or a religious approach, to meet the needs of all in a pluralistic setting, effective, patient-centered spiritual care draws on the (often shared wisdoms of the great spiritual and philosophical traditions and of the evolving understandings of these, science and art. Carers need both an awareness of their own spirituality and spiritual practice and an ability to ′bracket′ this in focusing on the needs and care of the patient′s spirit.

  20. THE EFFECT OF FAMILY THERAPY WITH SPIRITUAL APPROACH TOWARD FAMILY’S HEALTH BELIEF MODEL IN TAKING CARE OF PATIENT WITH SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Ah. Yusuf

    2017-04-01

    Full Text Available Introduction: Schizophrenia is the problem with kognitive, mal-adaptive thought and behavior. Family who have a member with mental disorder can experience serious conflict, become an objective and subjective burden, blame each other, get involved in hostility among family members. Various negative effect faced by family can caused by wrong family’s health belief model about Schizophrenia, hence the failure on choosing the treatment and taking care of patient at home. Someone with severe stress will seek comfort and strength from God. But so far, the most effective spiritual models to improve the health belief model of the family in caring for patients with schizophrenia has not been found. Method: Design used in this study was experimental (pre post test control group design. The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, chosen by alocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Results: There were significant changes in total of family’s health belief model (p=0,004, there was significantly change in aspects of (1 perceptions about bene fi ts (p=0,009, (2 perception about barriers (p=0,035 and perception about self efficacy (p=0,002. There were no significant changing in perception about susceptibility and severity (p=0,052. Discussion: Family believes that all events experienced by the patient and the family is God's will, hoping the patient can be more independent, and believe mental disorders can be changed for the better. The conclusion of this study is that family therapy with a spiritual approach can improve the health belief model of the family in caring for patients with mental disorders.

  1. Prescribing Outdoor Physical Activity to Children: Health Care Providers' Perspectives.

    Science.gov (United States)

    Christiana, Richard W; James, J Joy; Battista, Rebecca A

    2017-01-01

    Little evidence exists on health care provider (HCP) prescriptions for children's outdoor physical activity (PA). Semistructured interviews were conducted with 15 children's HCPs to explore perspectives on outdoor PA prescription programs for children and barriers to implementation. Thematic analytic techniques were used to analyze the data. Most participants reported an awareness of health benefits to children being in the outdoors. Ten themes emerged from the data related to 3 thematic categories: (1) current strategies that HCPs are using to promote PA among children, (2) barriers that HCPs see to prescribing outdoor PA, and (3) potential strategies for promoting outdoor PA among children. Assessment of the local outdoor PA environment and resource development must be done prior to a prescription program. HCPs should be skilled in conducting conversations and setting goals related to outdoor PA tailored to the patient. Developing a system for follow-up with patients on established goals should also be included.

  2. Family caregivers' health in connection with providing care.

    Science.gov (United States)

    Erlingsson, Christen L; Magnusson, Lennart; Hanson, Elizabeth

    2012-05-01

    Our aim was to investigate connections between Swedish family caregivers' health and providing care for an ill relative by conducting a systematic search and synthesis of previous research. We analyzed 31 articles using first qualitative content analysis then hermeneutic analysis. Analysis resulted in three derived themes-sliding sideways into caregiving, caregiving in reciprocity, and caregiving in disintegration-and a main interpretation and conceptual model of Swedish family caregivers' health-caregiving in a sphere of beliefs. Results indicated that Swedish family caregivers' beliefs, experiences of reciprocity, or nonsupport, together with quality of interpersonal relationships and feelings of responsibility and guilt, have a profound impact on their health. These results point to the value and importance of nurses gaining an understanding of family caregivers' beliefs and experiences of reciprocity or nonsupport to effectively promote family caregivers' health.

  3. Providing patient care in community pharmacies in Australia.

    Science.gov (United States)

    Benrimoj, Shalom I; Roberts, Alison S

    2005-11-01

    To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.

  4. Spiritual therapy to improve the spiritual well-being of Iranian women with breast cancer: a randomized controlled trial.

    Science.gov (United States)

    Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir; Jafari, Nooshin

    2013-01-01

    Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL) of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT) recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n = 34) or control group (n = 31). Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL) were assessed using Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12) and cancer quality-of-life questionnaire (QLQ-C30), respectively. t-test, Paired t-test, pearson's correlation, and hierarchical regression analyses were used for analysis using Predictive Analytic software (PASW, version 18) for Windows. Results. After six spiritual therapy sessions, the mean spiritual well-being score from 29.76 (SD = 6.63) to 37.24 (SD = 3.52) in the intervention group (P spiritual well-being and overall QOL. Social functioning was another significant predictor of spiritual well-being. Conclusion. The results of this randomized controlled trial study suggest that participation in spiritual therapy program is associated with improvements in spiritual well-being and QOL. Targeted interventions to acknowledge and incorporate spiritual needs into conventional treatment should be considered in caring of Iranian patients with breast cancer.

  5. Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

    Science.gov (United States)

    Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

    2016-10-01

    To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and

  6. Nurses Exploring the Spirituality of Their Patients With Cancer: Participant Observation on a Medical Oncology Ward.

    Science.gov (United States)

    van Meurs, Jacqueline; Smeets, Wim; Vissers, Kris C P; Groot, Marieke; Engels, Yvonne

    2017-07-19

    Attention for spirituality should be an integral part of professionals' caregiving. Particularly, nurses caring for patients with cancer might have opportunities to give attention to this dimension. The aim of this study was to gain insight in the way and extent to which nurses during daily caregiving observe and explore spiritual issues of hospitalized patients with cancer. We performed an ethnographic study with participant observation. Data were collected in 2015 during 4 shifts at the medical oncology department of a university hospital. The researcher, a spiritual care provider (chaplain) wearing the same kind of uniform as the nurses, observed the nurses, participated in their actions, and interviewed them after the shift. Although the patients did send many implicit and explicit messages concerning spiritual issues, the nurses did not explore them. If noticed, 3 barriers for exploring spiritual issues were mentioned by the nurses: lack of time, conflict with their mindset, and being reserved to talk about such issues. During their daily caregiving to patients with a life-threatening illness, nurses have many opportunities to explore spiritual issues, but they do not often recognize them. If they do, they tend not to explore the spiritual issues. Communication training for nurses is necessary to develop skills for exploring the spiritual dimension in patients with cancer. In such training, attention to the misconception that such a conversation requires a lot of time and for recognizing signals from patients inviting an exploration of their concerns is necessary.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  7. Health care providers' knowledge and practice of focused antenatal ...

    African Journals Online (AJOL)

    ... observational checklist were the instruments for data collection. Findings revealed poor knowledge of concept, components, timing of visits on focused antenatal care and non compliance with the guidelines for the practice of focused antenatal care, because of health workers lack of knowledge on focused antenatal care.

  8. End-of-life decisions in perinatal care. A view from health-care providers

    Directory of Open Access Journals (Sweden)

    Patricia Grether

    2015-11-01

    Full Text Available Objective. To examine the opinions of a perinatal health team regarding decisions related to late termination of pregnancy and severely ill newborns. Materials and Methods. An anonymous questionnaire was administered to physicians, social workers, and nurses in perinatal care. Differences were evaluated using the chi square and Student’s t tests. Results. When considering severely ill fetuses and newborns, 82% and 93% of participants, respectively, opted for providing palliative care, whereas 18% considered feticide as an alter- native. Those who opted for palliative care aimed to diminish suffering and those who opted for intensive care intended to protect life or sanctity of life. There was poor knowledge about the laws that regulate these decisions. Conclusions. Although there is no consensus on what decisions should be taken with severely ill fetuses or neonates, most participants considered palliative care as the first option, but feticide or induced neonatal death was not ruled out.

  9. Spirituality in pre-registration nurse education and practice: A review of the literature.

    Science.gov (United States)

    Lewinson, Lesline P; McSherry, Wilfred; Kevern, Peter

    2015-06-01

    Spirituality is known to be an integral part of holistic care, yet research shows that it is not well valued or represented in nurse education and practice. However, the nursing profession continues to make efforts to redress the balance by issuing statements and guidance for the inclusion of spirituality by nurses in their practice. A systematic literature review was undertaken and confirms that nurses are aware of their lack of knowledge, understanding and skills in the area of spirituality and spiritual care, and desire to be better informed and skilled in this area. Consequently, in order for nurses to support the spiritual dimension of their role, nurse education has a vital part to play in raising spiritual awareness and facilitating competence and confidence in this domain. The literature review also reveals that studies involving pre-registration are few, but those available do provide examples of innovation and various teaching methods to deliver this topic in nursing curricular. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Pregnant at work: time for prenatal care providers to act.

    Science.gov (United States)

    Karkowsky, Chavi Eve; Morris, Liz

    2016-09-01

    Fifty years ago, when a woman became pregnant, she was expected to stop working. Today, however, most women who work are the primary, sole, or co-breadwinner for their families, and their earnings during pregnancy are often essential to their families' economic well-being. Medical data about working during pregnancy are sparse but generally show that both low-risk and high-risk women can tolerate work-related duties well, although some work accommodations (eg, providing a chair for sitting, allowing snacks, or modifying the work schedule) may be necessary. However, some employers refuse to accommodate pregnant women who need adjustments. This can result in a woman being forced to make the choice between working without accommodations and losing her income and health insurance or even her job. Prenatal care providers can play an important role by implementing changes in their own practice, shaping public policy, and conducting research to increase protections for pregnant women and to ensure that they receive medically recommended accommodations while continuing to earn income for their growing families. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. [Experience of Spiritual Conflict in Hospice Nurses: A Phenomenological Study].

    Science.gov (United States)

    Lee, Byoung Sook; Kwak, Su Young

    2017-02-01

    This aim of this phenomenological study was to describe and understand the experience of spiritual conflict in hospice nurses by identifying the meanings and structures of the experience. Participants were 12 nurses working for one year or more at hospice units of general hospitals in a metropolitan city and experiencing of spiritual conflict as hospice nurses. Over six months data were collected using individual in-depth interviews and analyzed with the method suggested by Colaizzi. The experience of spiritual conflict in participants was organized into three categories, six theme-clusters, and 13 themes. The participants felt existential anxiety on death and a fear of death which is out of human control and skepticism for real facts of human beings facing death. They also experienced agitation of fundamental beliefs about life with agitation of the philosophy of life guiding themselves and mental distress due to fundamental questions that are difficult to answer. Also they had distress about poor spiritual care with guilty feelings from neglecting patients' spiritual needs and difficulties in spiritual care due to lack of practical competencies. Findings indicate the experience of spiritual conflict in hospice nurses is mainly associated with frequent experience of death in hospice patients. The experience of spiritual conflict consisted of existential anxiety, agitation of fundamental beliefs and distress over poor spiritual care. So, programs to help relieve anxiety, agitation and distress are necessary to prevent spiritual conflict and then spiritual burnout in hospice nurses. © 2017 Korean Society of Nursing Science

  12. [Providing regular relief; considerations for palliative care in the Netherlands].

    Science.gov (United States)

    Crul, B J; van Weel, C

    2001-10-20

    Over the last few decades the attention devoted to the palliative aspects of medicine, particularly those in hospital care, has declined due to the emphasis on medical technology. In Anglo-Saxon countries a review of this development resulted in structured palliative care that benefited terminally ill patients with a progressive fatal disease, especially cancer patients. Due to increasing national and international criticism of both the practice of euthanasia (assumed to be too liberal) and the lack of attention devoted to structured palliative care in the Netherlands, the Dutch government decided to improve the structure of palliative care. The government's viewpoint is based on the assumption that good palliative care that includes adequate pain control benefits patient care and might eventually lead to fewer requests for euthanasia. The improvements to palliative care should be realised by means of improvements in the structure, training and knowledge. Six academic medical clusters have been designated as Centres for the Development of Palliative Care (Dutch acronym: COPZ) for a 5-year period. Each COPZ must develop the various aspects needed to improve palliative care within the region it serves and ensure that its activities are carefully coordinated with those in the other centres. Research will focus on measuring the efficacy of palliative care as well as ethical and epidemiological aspects. A government committee will assess the appropriateness of the activities undertaken by each of the centres.

  13. Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics.

    Science.gov (United States)

    Gruca, Thomas S; Pyo, Tae-Hyung; Nelson, Gregory C

    2016-06-30

    Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access. Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty-five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office-based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year. Cardiologists in Iowa and adjoining states have expanded access to office-based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full-time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients' home county. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. Out-of-hospital emergency care providers' work and challenges in a changing care environment.

    Science.gov (United States)

    Mikkola, Riitta; Paavilainen, Eija; Salminen-Tuomaala, Mari; Leikkola, Päivi

    2018-03-01

    Acutely ill patients are often treated on site instead of being transported to hospital, so wide-ranging professional competence is required from staff. The aim of this study was to describe and produce new information about out-of-hospital emergency care providers' competence, skills and willingness to engage in self-development activities, and to uncover challenges experienced by care providers in the midst of changing work practices. A quantitative questionnaire was sent to out-of-hospital emergency care providers (N = 142, response rate 53%) of one Finnish hospital district. Data were analysed using spss for Windows 22 software. Almost all respondents found their work interesting and their ability to work independently sufficient. The majority found the work meaningful. Almost 20% felt that work was dominated by constant rush, and 40%, more than half of 25-year-olds but <10% of over 45-years-olds, found the work physically straining. The majority indicated that they had a sufficient theoretical-practical basis to perform their regular duties, and more than one-third felt that they had sufficient skills to deal with multiple patient or disaster situations. Over 20% stated that they were unsure about performing new or infrequent procedures. A number of factors experienced as challenging were revealed. The results provide a basis for improving care providers' initial and further training. © 2017 Nordic College of Caring Science.

  15. Nurses caring for the spirit: patients with cancer and family caregiver expectations.

    Science.gov (United States)

    Taylor, Elizabeth Johnston

    2003-01-01

    To determine what patients with cancer and primary family caregivers expect from nurses with regard to having their spiritual needs addressed. Descriptive, cross-sectional, qualitative study using Miles and Huberman s approach to data reduction. Outpatient and inpatient settings in a county hospital and a comprehensive cancer center, both located in a large, southwestern, metropolitan area. 28 African American and Euro-American adult patients with cancer and primary family caregivers were purposively selected to provide variation of experiences (e.g., religious backgrounds). In-depth, semistructured, tape-recorded interviews conducted by the investigator. Analysis of transcribed interviews concurrently with data collection followed a process of data concentration, data display, and conclusion drawing. Spiritual needs, spiritual care. Informants identified nursing approaches for spiritual needs, including kindness and respect; talking and listening; prayer; connecting with symmetry, authenticity, and physical presence; quality temporal nursing care; and mobilizing religious or spiritual resources. To provide spiritual care, nurses must possess requisites of a personal, relational, or professional nature. Although some patients or caregivers do not want overt forms of spiritual care, others are eager for them. Many recognize nonreligious actions or attitudes that nurses can practice to care for spiritual needs. Nurses must consider how they can address patient preconceptions and requisites for spiritual caregiving. Nurses may need to educate the public regarding their role as holistic and spiritual healthcare providers.

  16. Spirituality: An Affective Facet for Curriculum Consideration.

    Science.gov (United States)

    Dickmann, Leonore W.

    1980-01-01

    The current age has been characterized as an Age of Materialism in which personal goals are material aims and pleasures. The need for getting back to a spiritual culture is considered foundational. It is the duty of educators to provide for the spiritual or affective domain of a learner's development. To neglect this aspect of a person's being is…

  17. [Intercultural health care policy from the perspective of health care providers and Mapuche clients].

    Science.gov (United States)

    Alarcón, Ana María; Astudillo, Paula; Barrios, Sara; Rivas, Edith

    2004-09-01

    Intercultural health is becoming an emergent topic in the design of health care programs for Mapuche people of Chile. This process faces important challenges such as the scarce theoretical support about the meaning of intercultural health and their practical consequences for providers and clients. To explore the perception in providers and Mapuche clients about intercultural health. A survey performed in 11 counties with the highest concentration of Mapuche people, of the IX region of Chile. The perception about the development of a new health policy specially designed for Mapuche patients was surveyed in 399 Mapuche patients and 64 providers of primary health care centers. Mapuche clients considered, as the main regional challenges, the indifference and discrimination of health care teams towards Mapuche patients, aggravated by the indifference of authorities. Providers considered that the main problem was a lack of knowledge about Mapuche culture and skills to deal with this ethnic group. Patients and providers agreed on the need to use Mapuche dialect in health care attentions, to coordinate actions with traditional healers and to accept ethnical therapeutic practices. There is scarce agreement between providers and Mapuche clients about the need for an special intercultural health policy, its contents, and the regional conditions for its implementation and development.

  18. Moral Injury, Spiritual Care and the Role of Chaplains: An Exploratory Scoping Review of Literature and Resources.

    Science.gov (United States)

    Carey, Lindsay B; Hodgson, Timothy J; Krikheli, Lillian; Soh, Rachel Y; Armour, Annie-Rose; Singh, Taranjeet K; Impiombato, Cassandra G

    2016-08-01

    This scoping review considered the role of chaplains with regard to 'moral injury'. Moral injury is gaining increasing notoriety. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions and afflictions than just physiological or psychological harm, for there may also be wounds affecting the 'soul' that are far more difficult to heal-if at all. As part of a larger research program exploring moral injury, a scoping review of literature and other resources was implemented utilising Arksey and O'Malley's scoping method (Int J Soc Res Methodol 8(1):19-32, 2005) to focus upon moral injury, spirituality (including religion) and chaplaincy. Of the total number of articles and/or resources noting the term 'moral injury' in relation to spiritual/religious issues (n = 482), the results revealed 60 resources that specifically noted moral injury and chaplains (or other similar bestowed title). The majority of these resources were clearly positive about the role (or the potential role) of chaplains with regard to mental health issues and/or moral injury. The World Health Organization International Classification of Diseases: Australian Modification of Health Interventions to the International Statistical Classification of Diseases and related Health problems (10th revision, vol 3-WHO ICD-10-AM, Geneva, 2002), was utilised as a coding framework to classify and identify distinct chaplaincy roles and interventions with regard to assisting people with moral injury. Several recommendations are made concerning moral injury and chaplaincy, most particularly the need for greater research to be conducted.

  19. [Providing regular relief; considerations for palliative care in the Netherlands

    NARCIS (Netherlands)

    Crul, B.J.P.; Weel, C. van

    2001-01-01

    Over the last few decades the attention devoted to the palliative aspects of medicine, particularly those in hospital care, has declined due to the emphasis on medical technology. In Anglo-Saxon countries a review of this development resulted in structured palliative care that benefited terminally

  20. Paediatric palliative care providers' experiences in rural KwaZulu ...

    African Journals Online (AJOL)

    based palliative care (including paediatric palliative care) is available to patients in rural ... reported that one of the most distressing tasks a nurse has to carry out is telling any .... die, as a miracle (such as a cure) is presented as a possibility.

  1. Racial disparities in reported prenatal care advice from health care providers.

    Science.gov (United States)

    Kogan, M D; Kotelchuck, M; Alexander, G R; Johnson, W E

    1994-01-01

    OBJECTIVES. The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS. Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS. After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS. These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome. PMID:8279618

  2. Derivative financial instruments and nonprofit health care providers.

    Science.gov (United States)

    Stewart, Louis J; Owhoso, Vincent

    2004-01-01

    This article examines the extent of derivative financial instrument use among US nonprofit health systems and the impact of these financial instruments on their cash flows, reported operating results, and financial risks. Our examination is conducted through a case study of New Jersey hospitals and health systems. We review the existing literature on interest rate derivative instruments and US hospitals and health systems. This literature describes the design of these derivative financial instruments and the theoretical benefits of their use by large health care provider organizations. Our contribution to the literature is to provide an empirical evaluation of derivative financial instruments usage among a geographically limited sample of US nonprofit health systems. We reviewed the audited financial statements of the 49 community hospitals and multi-hospital health systems operating in the state of New Jersey. We found that 8 percent of New Jersey's nonprofit health providers utilized interest rate derivatives with an aggregate principle value of $229 million. These derivative users combine interest rate swaps and caps to lower the effective interest costs of their long-term debt while limiting their exposure to future interest rate increases. In addition, while derivative assets and liabilities have an immaterial balance sheet impact, derivative related gains and losses are a material component of their reported operating results. We also found that derivative usage among these four health systems was responsible for generating positive cash flows in the range of 1 percent to 2 percent of their total 2001 cash flows from operations. As a result of our admittedly limited samples we conclude that interest rate swaps and caps are effective risk management tools. However, we also found that while these derivative financial instruments are useful hedges against the risks of issuing long-term financing instruments, they also expose derivative users to credit, contract

  3. Providing high-quality care in primary care settings: how to make trade-offs.

    Science.gov (United States)

    Beaulieu, Marie-Dominique; Geneau, Robert; Del Grande, Claudio; Denis, Jean-Louis; Hudon, Eveline; Haggerty, Jeannie L; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William

    2014-05-01

    To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Three regions of Quebec. Health care professionals and staff of 5 PC practices. Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Irrespective of their models, PC practices' pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. Copyright© the College of Family Physicians of Canada.

  4. Spiritual well-being and quality of life in Iranian women with breast cancer undergoing radiation therapy.

    Science.gov (United States)

    Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir

    2013-05-01

    Psychological distress and morbidity are common consequences of diagnosis and treatment of breast cancer and associated with poor quality of life (QOL). Spiritual well-being is an important aspect of QOL, but little is known about the spiritual well-being and its relationship with QOL in patients of different cultures such as Iranian Muslim patients. The aim of this study was to investigate the association of QOL and spirituality among patients with breast cancer undergoing radiation therapy. This was a cross-sectional study which was conducted in the Breast Cancer Research Center of St. S. Al-Shohada Hospital, Isfahan, Iran. Spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp12). The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and its supplementary breast cancer questionnaire (QLQ-BR23) were used to assess the quality of life of patients. Descriptive analysis, Pearson's correlation, and multiple regression analysis were performed for statistical assessment. In all, 68 patients fulfilled the study's inclusion criteria and were interviewed. The mean global QOL was 41.42 (SD = 18.02), and the mean spiritual well-being was 28.41 (SD = 6.95). There was a significant positive correlation between general QOL and total spiritual well-being scores. Also, spiritual well-being, social functioning, pain, and arm symptoms were significant predictors of global QOL. The results of this study provide evidence that breast cancer survivors in Iran experience a poor quality of life across a broad spectrum of health domains, particularly social, emotional, and spiritual, indicating that psychosocial-spiritual support should be considered in caring for patients with breast cancer.

  5. Nurses' comfort level with spiritual assessment: a study among nurses working in diverse healthcare settings.

    Science.gov (United States)

    Cone, Pamela H; Giske, Tove

    2017-10-01

    To gain knowledge about nurses' comfort level in assessing spiritual matters and to learn what questions nurses use in practice related to spiritual assessment. Spirituality is important in holistic nursing care; however, nurses report feeling uncomfortable and ill-prepared to address this domain with patients. Education is reported to impact nurses' ability to engage in spiritual care. This cross-sectional exploratory survey reports on a mixed-method study examining how comfortable nurses are with spiritual assessment. In 2014, a 21-item survey with 10 demographic variables and three open-ended questions were distributed to Norwegian nurses working in diverse care settings with 172 nurse responses (72 % response rate). SPSS was used to analyse quantitative data; thematic analysis examined the open-ended questions. Norwegian nurses reported a high level of comfort with most questions even though spirituality is seen as private. Nurses with some preparation or experience in spiritual care were most comfortable assessing spirituality. Statistically significant correlations were found between the nurses' comfort level with spiritual assessment and their preparedness and sense of the importance of spiritual assessment. How well-prepared nurses felt was related to years of experience, degree of spirituality and religiosity, and importance of spiritual assessment. Many nurses are poorly prepared for spiritual assessment and care among patients in diverse care settings; educational preparation increases their comfort level with facilitating such care. Nurses who feel well prepared with spirituality feel more comfortable with the spiritual domain. By fostering a culture where patients' spirituality is discussed and reflected upon in everyday practice and in continued education, nurses' sense of preparedness, and thus their level of comfort, can increase. Clinical supervision and interprofessional collaboration with hospital chaplains and/or other spiritual leaders can

  6. Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review.

    Science.gov (United States)

    Schmid, W; Rosland, J H; von Hofacker, S; Hunskår, I; Bruvik, F

    2018-02-20

    The use of music as therapy in multidisciplinary end-of-life care dates back to the 1970s and nowadays music therapy (MT) is one of the most frequently used complementary therapy in in-patient palliative care in the US. However existing research investigated music therapy's potential impact mainly from one perspective, referring to either a quantitative or qualitative paradigm. The aim of this review is to provide an overview of the users' and providers' perspectives on music therapy in palliative care within one research article. A systematic literature search was conducted using several databases supplemented with a hand-search of journals between November 1978 and December 2016. Inclusion criteria were: Music therapy with adults in palliative care conducted by a certified music therapist. Both quantitative and qualitative studies in English, German or a Scandinavian language published in peer reviewed journals were included. We aimed to identify and discuss the perspectives of both patients and health care providers on music therapy's impact in palliative care to forward a comprehensive understanding of it's effectiveness, benefits and limitations. We investigated themes mentioned by patients within qualitative studies, as well as commonly chosen outcome measures in quantitative research. A qualitative approach utilizing inductive content analysis was carried out to analyze and categorize the data. Twelve articles, reporting on nine quantitative and three qualitative research studies were included. Seven out of the nine quantitative studies investigated pain as an outcome. All of the included quantitative studies reported positive effects of the music therapy. Patients themselves associated MT with the expression of positive as well as challenging emotions and increased well-being. An overarching theme in both types of research is a psycho-physiological change through music therapy. Both quantitative as well as qualitative research showed positive changes in

  7. Creating a safer workplace to provide quality care.

    Science.gov (United States)

    Simmons, J C

    2001-04-01

    In recent years, increasing interest has been placed on how health care workers can be trained and equipped to better protect them from possible workplace accidents and injuries while improving the care they deliver. Better workplace safety also means better customer and employee satisfaction, improved workforce retention and recruitment, and cost savings. Workplace safety is constantly evolving and addresses a whole host of issues ranging from needles and sharps injuries to moving patients to human factor analyses. This issue takes a cross-sectional look at how hospitals and health systems are addressing problem areas--and sharing information and best practices--to strengthen their quality of care at the workplace level.

  8. The use of life review to enhance spiritual well-being in patients with terminal illnesses: An integrative review.

    Science.gov (United States)

    Kwan, Cecilia W M; Ng, Marques S N; Chan, Carmen W H

    2017-12-01

    To conduct an integrative review of the current literature on using life review as an intervention to address the spiritual need of patients with terminal illnesses. Palliative care highlights the holistic approach of care including the spiritual aspect. Life review has been used in palliative nursing intending to enhance patients' emotional and spiritual well-being, and quality of life. However, there is a lack of publications that provide a structured overview on life review programmes and their effectiveness. Integrative review. The Whittemore and Knafl integrative review method was used. Five major online databases were included in our literature search. The keywords used were "life review" and "palliative care, terminal care, terminally ill, death & dying, hospice, spiritual wellbeing, spirituality". Seven primary papers were identified, critically appraised and synthesised in the final review. There are limited clinical studies on life review programmes for patients with terminal illness. The research design of these studies is too widely varied for meta-analysis. Here, we identified two major programmes of life review as an intervention to address the spiritual well-being of patients with terminal illness. However, repeated studies on the effectiveness of these two programmes are lacking. The shorter programme of life review is more likely to be applicable and effective for terminal patients. Further research in this area is required to provide strong evidence on the effectiveness and applicability of life review in patients receiving palliative care. This review adds weight to the need of a better understanding on the use of life review in addressing the spiritual needs of patients with terminal illness. Such understanding would provide evidence for the use of life review as an alternative approach in palliative care delivery. © 2017 John Wiley & Sons Ltd.

  9. Reframing Conscientious Care: Providing Abortion Care When Law and Conscience Collide.

    Science.gov (United States)

    Buchbinder, Mara; Lassiter, Dragana; Mercier, Rebecca; Bryant, Amy; Lyerly, Anne Drapkin

    2016-01-01

    Much of the debate on conscience has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decision about offering care.

  10. Community Health Centers: Providers, Patients, and Content of Care

    Science.gov (United States)

    ... can be more easily delivered than specialty and inpatient care, and if properly distributed could be effective ... services : Include education about asthma, diet and nutrition, exercise, growth and development, injury prevention, stress management, tobacco ...

  11. The Quality of Care Provided to Patients with Chronic Non ...

    African Journals Online (AJOL)

    Communicable Diseases is very low in both settings though it is relatively better in Jimma University Specialized Hospital. Therefore, a continuous process of quality improvement is recommended in both settings. KEYWORDS: Health care, Health ...

  12. Improving Health Care Provider Availability through Information Technology

    National Research Council Canada - National Science Library

    Lasell, Jon R

    2005-01-01

    .... This study identifies the need for change in collecting data on patient care time, reviews different methods/systems for gathering data, documents the implementation of the selected system (eUCAPERS...

  13. Not Babysitting: Work Stress and Well-Being for Family Child Care Providers

    Science.gov (United States)

    Gerstenblatt, Paula; Faulkner, Monica; Lee, Ahyoung; Doan, Linh Thy; Travis, Dnika

    2014-01-01

    Family child care providers contend with a number of work stressors related to the dual roles of operating a small business and providing child care in their home. Research has documented many sources of work related stress for family child care providers; however, research examining family child care providers' experiences outside of the…

  14. Native American Death Taboo: Implications for Health Care Providers.

    Science.gov (United States)

    Colclough, Yoshiko Yamashita

    2017-07-01

    This study was conducted to highlight Native American (NA) perspectives on death taboo in order to examine the cultural appropriateness of hospice services for NA patients, if any. Searching literature that addressed taboo and death from historical, psychological, sociological, and anthropological aspects, a comparison of death perspectives was made between NAs and European Americans. A culturally sensitive transition from palliative care to hospice care was suggested for NA patients and their family.

  15. Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease.

    Science.gov (United States)

    Yaghoobzadeh, Ameneh; Soleimani, Mohammad Ali; Allen, Kelly A; Chan, Yiong Huak; Herth, Kaye A

    2018-06-01

    Spirituality and hope have been identified as important constructs in health research, since both are thought to enhance a person's ability to cope with the consequences of serious illness. The aim of this study was to examine the relationship between spiritual well-being and hope in patients with cardiovascular disease. Using descriptive, correlational methodology, the investigator gathered data on a convenience sample of 500 patients with cardiovascular disease who were hospitalized in a medical institution in Iran. The study was conducted over a four-month period. Participants completed a demographic questionnaire, the Spiritual Well-Being Scale (SWBS) and the Herth Hope Index (HHI). The mean score on the SWBS and HHI was 86.21 (SD 12.46) and 34.80 (SD 5.05), respectively. Multivariate predictors for spiritual well-being were female gender (p = 0.047), religiosity (p = 0.018), and hope (p spiritual well-being (p spiritual well-being and hope. Therefore, this study has implications for those providing care to patients with cardiovascular disease.

  16. Physician assistant program education on spirituality and religion in patient encounters.

    Science.gov (United States)

    Berg, Gina M; Whitney, Melissa P; Wentling, Callie J; Hervey, Ashley M; Nyberg, Sue

    2013-01-01

    To describe educational practices of physician assistant (PA) programs regarding spirituality and religion discussions during patient encounters. Patients want their health care provider to be aware of their spiritual and religious beliefs. This topic is addressed in physician and nursing education but may not be included in PA programs. Data regarding curriculum were collected via electronic survey emailed to 143 PA programs across the United States. Thirty-eight programs responded for a response rate of 27%. Most (68.4%) program respondents reported students' desire to be trained to discuss spirituality and religion, yet 36.8% do not offer this training. Just over half (69.2%) would consider adding curriculum to teach students to discuss spirituality, but the majority (92.3%) would not add curriculum to discuss religion during patient encounters. PA programs offer training to discuss spirituality in patient encounters but not to discuss religiosity. Programs may want to consider adding some curriculum to increase PAs awareness of spirituality and religion needs of patients.

  17. Spirituality, illness and personal responsibility: the experience of Jordanian Muslim men with coronary artery disease.

    Science.gov (United States)

    Nabolsi, Manar M; Carson, Alexander M

    2011-12-01

    Spiritual care is an aspect of nursing in many parts of the world; however, there is very little evidence of this in an Arab Muslim country. This qualitative study explores the meaning of spirituality as experienced by Jordanian Muslim men living with coronary artery disease. A hermeneutical phenomenological orientation was used to explore the experience of spirituality as lived by Arab Muslim men with coronary artery disease. A purposive sample of 19 men was selected from the Coronary care Unit (CCU) in a teaching hospital in Jordan. Data were collected using semi-structured interviews. Data were analyzed using Colaizzi's steps of phenomenological analysis. Four themes emerged from the data. The participants explained that faith facilitated their acceptance of illness and enhanced their coping strategies, that seeking medical treatment did not conflict with their belief in fate, that spirituality enhanced their inner strength, hope and acceptance of self-responsibility and it helped to them to find meaning and purpose in their life. In this study, Parse's theory of human becoming served as the foundation for understanding the paradoxical rhythmical pattern of the human experience of spirituality in illness. The findings suggest that patients' faith plays a central role in the choices they make either healthy or unhealthy, or accepting or rejecting their personal responsibility in promoting their future health and well-being. In addition, it provide nurses with the basis for providing spiritual care and developing a culturally sensitive healthcare plans in this population. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  18. Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Jamnik Veronica

    2011-09-01

    Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

  19. Challenges faced by hospitals in providing surgical care and ...

    African Journals Online (AJOL)

    Esem

    essential surgical staff, inadequate funding, poor state of ... individuals interested in surgical care in the developing world has been ... 5.69 per 100,000 in the United States . ... categorical variables e.g gender, the percentage of the ... lack of materials and supplies to be used, inability to pay ... Confirming a big gap in.

  20. Balance of power shifts when providing care in patients' homes.

    Science.gov (United States)

    Sander, Ruth

    2011-06-01

    Nursing practice at home involves entering a place where the patient's and family's values and habits predominate. In hospital, nurses work in safe territory with the aid of conferred authority but this manner might not be suitable in a patient's own home. When people need nursing care, the meaning of home is at risk of changing.

  1. Providing antiretroviral therapy in rural areas: acute or chronic care?

    African Journals Online (AJOL)

    basis we see patients with stab wounds, children with life-threatening dehydration, adults with severe disseminated ... care; maternal and child health; and TB. She is the Eastern Cape .... cause headaches in migraine sufferers, this allowed them to study an alcohol-induced headache without the complication of intoxication.

  2. Problems experienced by professional nurses providing care for HIV ...

    African Journals Online (AJOL)

    The nurses reported feelings of frustrations, treatment delay, lack of knowledge on HIV and AIDS, lack of support systems and work overload as challenges faced in caring for HIV/AIDS patients. The need for in-service education for professional nurses on treatment of HIV positive patients was discussed and recommended.

  3. Experiences of health care providers managing sexual assault ...

    African Journals Online (AJOL)

    ... participate in matters pertaining to sexual assault. Government should develop clear guidelines that are applicable to rural and urban South Africa. Health care sciences should aim to train more forensic nurses. All relevant departments should work together to alleviate the complications caused by sexual assault incidents ...

  4. Spiritually Competent Practice with Individuals and Families Dealing with Medical Conditions

    Science.gov (United States)

    Sperry, Len

    2011-01-01

    Counselors and psychotherapists are increasingly expected to provide services that are spiritually competent. Those counseling individuals and families where medical concerns are a focus would do well to consider the implications of spiritual competence in their work. The article defines spiritual competence, describes spiritual competencies, and…

  5. Defining Spirituality: Critical Implications for the Practice and Research of Educational Leadership

    Science.gov (United States)

    Hafner, Madeline M.; Capper, Colleen A.

    2005-01-01

    This essay problematizes the current discourses on spirituality and leadership, particularly in terms of how spirituality is defined. To this end, the authors provide a brief overview of the different definitions of spirituality as explicated in the literature on spirituality and leadership, identify the underlying epistemologies of these…

  6. Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

    Science.gov (United States)

    Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander; Ben-David, Boaz M.; Saragosa, Marianne; Boscart, Veronique M.; Wilson, Rozanne; Galimidi-Epstein, Karmit K.

    2016-01-01

    Background: Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care. Purpose: To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden. Method: The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study. Results: The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden. Conclusion: The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden. PMID:27899433

  7. Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?

    Science.gov (United States)

    Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

    2014-01-01

    We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community.…

  8. Kesejahteraan Spiritual Keluarga Pasien Stroke dan Kaitannya dengan Depresi

    OpenAIRE

    Muhamad Zulfatul A’la; Komarudin Komarudin; Defi Efendi

    2015-01-01

    Stroke is a one of major problem in palliative care. Spiritual and depression assessment of the family is an important element in the process of palliative care for stroke survivors. The purpose of this study was to know the description of the spiritual well-being among stroke family caregiver family and its relationship with depression. This study used cross-sectional design. Spiritual well-being scale (SWBS) was used to see the spiritual well-being of the family and the Center for Epidemiol...

  9. Managed care and clinical decision-making in child and adolescent behavioral health: provider perceptions.

    Science.gov (United States)

    Yanos, Philip T; Garcia, Christine I; Hansell, Stephen; Rosato, Mark G; Minsky, Shula

    2003-03-01

    This study investigated how managed care affects clinical decision-making in a behavioral health care system. Providers serving children and adolescents under both managed and unmanaged care (n = 28) were interviewed about their awareness of differences between the benefit arrangements, how benefits affect clinical decision-making, outcomes and quality of care; and satisfaction with care. Quantitative and qualitative findings indicated that providers saw both advantages and disadvantages to managed care. Although most providers recognized the advantages of managed care in increasing efficiency, many were concerned that administrative pressures associated with managed care compromise service quality.

  10. Spiritual AIM and the work of the chaplain: a model for assessing spiritual needs and outcomes in relationship.

    Science.gov (United States)

    Shields, Michele; Kestenbaum, Allison; Dunn, Laura B

    2015-02-01

    Distinguishing the unique contributions and roles of chaplains as members of healthcare teams requires the fundamental step of articulating and critically evaluating conceptual models that guide practice. However, there is a paucity of well-described spiritual assessment models. Even fewer of the extant models prescribe interventions and describe desired outcomes corresponding to spiritual assessments. This article describes the development, theoretical underpinnings, and key components of one model, called the Spiritual Assessment and Intervention Model (Spiritual AIM). Three cases are presented that illustrate Spiritual AIM in practice. Spiritual AIM was developed over the past 20 years to address the limitations of existing models. The model evolved based in part on observing how different people respond to a health crisis and what kinds of spiritual needs appear to emerge most prominently during a health crisis. Spiritual AIM provides a conceptual framework for the chaplain to diagnose an individual's primary unmet spiritual need, devise and implement a plan for addressing this need through embodiment/relationship, and articulate and evaluate the desired and actual outcome of the intervention. Spiritual AIM's multidisciplinary theory is consistent with the goals of professional chaplaincy training and practice, which emphasize the integration of theology, recognition of interpersonal dynamics, cultural humility and competence, ethics, and theories of human development. Further conceptual and empirical work is needed to systematically refine, evaluate, and disseminate well-articulated spiritual assessment models such as Spiritual AIM. This foundational work is vital to advancing chaplaincy as a theoretically grounded and empirically rigorous healthcare profession.

  11. Hope for the future: intensifying spirituality in the workplace.

    Science.gov (United States)

    Batcheller, Joyce; Davis, James; Yoder-Wise, Patricia S

    2013-01-01

    Healthy workplaces address various issues. Work focused on ergonomics addresses physical issues, satisfaction surveys reveal psychosocial issues; and other approaches address spirituality issues. Spirituality in the workplace contributes to holistic care and to the worth of the individual. Incorporating the concept of spirituality, in its broad sense, into the workplace enriches leadership practice and contributes to a holistic work environment. Spirituality is core to the servant leader approach to leadership and beneficial to other approaches. Followers benefit from a holistic approach to leadership; and some specific practices can exhibit the belief an organization holds related to the worth of the individual. Incorporating spirituality into an organization reflects the same values nursing holds for person-centered care, a view of integration of physical, psychological, and spiritual needs.

  12. Enhancing Spiritualism in Virtual World

    Science.gov (United States)

    Dangwal, Kiran Lata; Singh, Shireesh Pal

    2012-01-01

    Spiritualism is one word which puts man on the highest plinth of life. Spirituality is the way we find meaning, hope, comfort and inner peace in life. Spirituality in the virtual World is generally known as Virtual Spirituality. A goldmine of wisdom from all kinds of religious and spiritual philosophies, traditions and practices can be found in…

  13. Why Conduct a Spiritual Assessment? A Theoretical Foundation for Assessment

    Directory of Open Access Journals (Sweden)

    David R. Hodge

    2004-12-01

    Full Text Available In spite of increased interest in spirituality, the concept of a spiritual assessment remains a questionable practice in the eyes of many social workers. This paper develops five rationales to underscore the importance of including spirituality in assessment. These reasons can be summarized as follows: spiritual assessment provides insight into clients’ world views, serves as a vehicle to identify strengths, and demonstrates respect for client autonomy. In addition, the profession’s ethics implicitly recommend the administration of a spiritual assessment and, for a growing number of accrediting organizations and agencies, it is explicitly recommended.This paper concludes by discussing the implications for practitioners and educators.

  14. 25 CFR 20.507 - What requirements must foster care providers meet?

    Science.gov (United States)

    2010-04-01

    ... ASSISTANCE AND SOCIAL SERVICES PROGRAMS Child Assistance Foster Care § 20.507 What requirements must foster care providers meet? If a child needs foster care, the social services worker must select care that... contain an approved current home study. (c) An off-reservation foster home, or residential care facility...

  15. 口服化疗乳腺癌患者灵性需求和照护的真实体验%Real Experiences of Nursing Practice and Demand of Spiritual Care in Breast Cancer Patients Receiving Oral Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    魏春岚; 方琼; 袁长蓉

    2015-01-01

    目的:深入了解与探讨口服化疗乳腺癌患者对于灵性需求和照护的真实体验。方法2014年1-7月,采用目的抽样法选取在上海市某三级甲等医院住院的9名乳腺癌患者为研究对象,采用现象学研究方法,对其进行半结构式访谈,现场录音,借助 NVivo 8.0软件,根据 Colaizzi 的7步分析法对资料进行分析,提炼主题。结果口服化疗乳腺癌患者的灵性需求可归纳为4个主题:精神寄托的需求,提升希望的需求,面对死亡的需求和自我实现的需求;灵性照护可归纳为3个主题:尊重宗教信仰,提升希望及死亡教育。结论口服化疗乳腺癌患者的居家支持性护理应该满足患者的灵性需求,给予灵性照护。%Objective To deeply explore the real experiences of spiritual care of breast cancer patients re-ceiving oral chemotherapy.Methods Phenomenological method of semi-structured interview and onsite re-cord was adopted to understand and integrate spiritual care needs among 9 breast cancer patients receiving oral chemotherapy.Data were analyzed by Colaizzi’s analysis procedure and using NVivo 8.0.Results The themes of spiritual needs emerged as needs of spiritual sustenance,hope promotion,death confrontation and self-actualization.The themes of spiritual needs emerged as respecting the religious beliefs,promoting hope and death education.Conclusion Spiritual care needs should be satisfied while giving a holistic home-based care to breast cancer patients receiving oral chemotherapy.

  16. Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

    Science.gov (United States)

    Rahmani, Zuhal; Brekke, Mette

    2013-05-06

    Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

  17. Providing support to doctors working in intensive care

    LENUS (Irish Health Repository)

    Murphy, JFA

    2012-05-01

    ‘Jading’ is a process of exhaustion in which apathy and cynicism replace the drive to be responsive and caring. ‘Burnout’ a term first coined in the psychology literature in 1974 was based on Graham Greene’s novel ‘A Burnt-Out Case1. It is the umbrella description for disengagement in the workplace setting characterised by withdrawal, denial and inefficiency. There is an alienation from the pressures of work. Marshall and Kasman2 defined it as ‘the loss of motivation for creative thought’. It is the opposite of engagement which is associated with energy and optimism. People who experience all 3 symptoms- emotional exhaustion, negative attitude towards patients, reduced sense of personal accomplishment- have the greatest degree of burnout. It doesn’t get better by being ignored. These processes have serious consequences for the individual involved and the hospital that they work in. The doctor underperforms and the Unit becomes dysfunctional There is decreased quality of care, increased absenteeism, and high staff turnover. There is an inability to make decisions and a failure to set priorities.

  18. When does spiritual intelligence particularly predict job engagement? The mediating role of psychological empowerment

    OpenAIRE

    Mohsen Torabi; Iman Zohoorian Nadali

    2016-01-01

    Background: Regarding the importance of health care providers such as nurses who are always in stressful environments, it is imperative to better understand how they become more engaged in their work. The purpose of this paper is to focus on health care providers (nurses), and examine how the interaction between spiritual intelligence and psychological empowerment affect job engagement. Materials and Methods: This descriptive and quantitative study was conducted among nurses at the Faghihi Ho...

  19. Spirituality and job satisfaction among hospice interdisciplinary team members.

    Science.gov (United States)

    Clark, Leah; Leedy, Stephen; McDonald, Laurie; Muller, Barbara; Lamb, Cheryl; Mendez, Tracy; Kim, Sehwan; Schonwetter, Ronald

    2007-12-01

    As a continuing effort to enhance the quality of palliative care for the dying, this study examined (1) the prevalence of spirituality among hospice interdisciplinary team (IDT) members; (2) whether spirituality is related to job satisfaction; and (3) the structural path relationships among four variables: spiritual belief, integration of spirituality at work, self actualization and job satisfaction. The study surveyed 215 hospice IDT members who completed the Jarel Spiritual Well-Being Scale, the Chamiec-Case Spirituality Integration and Job Satisfaction Scales. Multiple regression and structural path modeling methods were applied to explain the path relationships involving all four variables. The IDT members surveyed were: nurses, 46.4%; home health aids, 24.9%; social workers, 17.4%; chaplains, 4.2%; physicians, 2.3%; and other, 4.8%. Ninety-eight percent of the respondents viewed themselves as having spiritual well-being. On a 0-100 scale, IDT staff reported high spiritual belief (mean = 89.4) and they were self-actualizing (mean = 82.6). Most reported high job satisfaction (mean = 79.3) and spiritual integration (mean = 67.9). In multiple regression, spirituality, integration and self-actualization explained 22% of the variation in job satisfaction (R = 0.48; adjusted R(2) = 0.218; df = 3,175; F = 17.2; p = 0.001). Structural path models revealed that job satisfaction is more likely to be realized by a model that transforms one's spirituality into processes of integrating spirituality at work and self actualization (chi(2) = 0.614; df = 1; p = 0.433) than a model that establishes a direct path from spirituality to job satisfaction (chi(2) = 1.65; df = 1; p = 0.199). Hospice IDT member's integration of their spirituality at work and greater self actualization significantly improve job satisfaction.

  20. Social representations about religion and spirituality.

    Science.gov (United States)

    Borges, Moema da Silva; Santos, Marília Borges Couto; Pinheiro, Tiago Gomes

    2015-01-01

    to identify the social representations about the concepts of spirituality and religion of of health teachers. exploratory and descriptive study, based on a qualitative approach. 25 subjects participated in it. The following instruments were used to collect data: questionnaire to identify the profile; questionnaire of free association, whose inducing words were religion and spirituality, and an interview based on the scale FICA (Puchalski, 2006). the representations about religion and spirituality, for professors, are forged around the faith in God and it gives them meaning and purpose to deal with the challenges of personal and professional living. there are still barriers that need to be overcome with a view to a comprehensive care. For this, it is essential to incorporate spirituality in the process in the curricula of health courses.

  1. Effects of Participation in Support Groups on Alzheimer’s Family Caregivers’ Strain and Spiritual Wellbeing

    Directory of Open Access Journals (Sweden)

    Farahnaz Mohammadi

    2011-04-01

    Full Text Available Objectives: Since support for family caregivers is crucial in providing care for elderly, this study was conducted to examine the effects of participation in support groups on Alzheimer’s family caregivers’ strain and spiritual wellbeing. Materials and Methods & Materials: In this semi-experimental study, 32 accessible family caregivers of elderly patients with Alzheimer who had at least one year of experience participated. The intervention consisted of a 4-month active participation in educational and emotional supportive sessions related to patient and caregivers care management. At the end of the intervention, the leadership of the groups was transferred to members of the groups. These sessions were conducted in 3 public centers in the community. Caregivers were assessed by caregiving strain and spiritual wellbeing questionnaires at the beginning, at the end of the intervention and 2 months later. Data was analyzed by ANOVA with repeated measurement. P<0.05 was considered statistically significant. Results: In general, 32 accessible family caregivers of elderly Alzheimer patients with at least one year of experience participated in this study. The mean of spiritual wellbeing through three mentioned measurements showed an improvement (26.029, 34.029, 34.471, whereas the care giving strain showed a decreasing trend (40.118, 32.706, 31.265. Findings based on ANOVA-repeated measurement revealed a significantly decrease in care giving strain (P=0.001 and an improvement in spiritual wellbeing (P=0.005. Conclusion: Participation in the support groups as a manifest of empowering helps family caregivers to deal effectively with care giving difficulties. Psychoeducational programs lead to a decreased care giving strain and improve the spiritual wellbeing of the caregivers. Hence, supportive interventions should be considered by policy makers and professional health care providers for elderly people.

  2. factors influencing the choice of health care providing facility among

    African Journals Online (AJOL)

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  3. Using Spiritual Genograms in Family Therapies

    Directory of Open Access Journals (Sweden)

    Yahya Şahin

    2018-02-01

    Full Text Available The genogram was developed by Bowen, a pioneer of the psychodynamic family theory, and has been used in therapies in different ways. Genogram types are named according to the area in which they are used, and spiritual genograms are one of these. Due to the increase in studies focusing on spirituality in family therapies, this research is conducted over the use of spiritual genograms as a therapeutic tool. Although Turkey has great potential for religiousness and spirituality, no study has yet been observed there on the use of spiritual genograms in the therapeutic process. This deficiency has led us to introduce spiritual genograms and provide a place for their use in therapy. This study also aims to provide information on the stages of spiritual genograms and how they should be used as a tool in therapy. Furthermore, results have been shared regarding the effect of using genograms in the therapeutic process based on sample cases employed by various researchers in therapy.

  4. Pharmacists in primary care. Determinants of the care-providing function of Dutch community pharmacists in primary care.

    NARCIS (Netherlands)

    Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To identify determinants of the care-providing function of the community pharmacists (CPs) to explain variations in professional practice. SETTING: The Netherlands 2001. PARTICIPANTS: 328 CPs. METHOD: A cross-sectional questionnaire survey was performed. Questionnaires were used to

  5. The effect of financial incentives on the quality of health care provided by primary care physicians.

    Science.gov (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris

    2011-09-07

    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  6. Spirituality in education

    Directory of Open Access Journals (Sweden)

    Kirsi Tirri

    2009-01-01

    Full Text Available In this article the concept of spirituality in the educational framework is discussed. The concepts of religion and spirituality are compared. The psychological view of spirituality is presented with a new suggested intelligence type: spiritual intelligence. The educational view emphasizes spiritual sensitivity as a universal human ability that needs to be developed through education. The sociological view of spirituality explores it as an expression of postsecular religiosity. Empirical studies indicate that an increasing number of people­ now prefer to call themselves ‘spiritual’ rather than ‘religious’. This trend seems to be more present in some European countries, for example, in the Netherlands, the United Kingdom and Finland. Empirical studies on spirituality are reviewed and discussed. A special emphasis is given to the Finnish research findings related to the spirituality of a new generation or young adults. It is argued that understanding spirituality as an expression of postsecular religiosity gives more room for young adults to participate in communicative action concerning religion. This would promote a discursive religiousness in the spirit of Jürgen Habermas, in which a plurality of religious beliefs and practices are acknowledged and a dialogical and inter-religious approach is advocated.

  7. Hope, self-efficacy, spiritual well-being and job satisfaction.

    Science.gov (United States)

    Duggleby, Wendy; Cooper, Dan; Penz, Kelly

    2009-11-01

    Hope, self-efficacy, spiritual well-being and job satisfaction. This paper is a report of a study of the relations of spiritual well-being, global job satisfaction, and general self-efficacy to hope in Continuing Care Assistants. Healthcare providers have described their hope as an important part of their work and a form of work motivation. Hope may be an important factor in preventing burnout and improving job satisfaction. A concurrent triangulation mixed method design was used. Sixty-four Continuing Care Assistants (personal care aides) who registered for a 'Living with Hope' Conference completed a demographic form, Herth Hope Index, Global Job Satisfaction Questionnaire, Spiritual Well-Being Scale, General Self-Efficacy Scale, and a hope questionnaire. Data were collected in 2007. The response rate was 58%. Using linear regression, 29.9% of the variance in Herth Hope Index score was accounted for by scores from the General Self-Efficacy Scale and Spiritual Well-Being Scale. General Self-efficacy scores (positive relationship) and Spiritual Well-Being scores (negative relationship) accounted for a significant part of the variance. Qualitative data supported all findings, with the exception of the negative relationship between hope and spiritual well-being; participants wrote that faith, relationships, helping others and positive thinking helped them to have hope. They also wrote that hope had a positive influence on their job satisfaction and performance. Hope is an important concept in the work life of Continuing Care Assistants. Supportive relationships, adequate resources, encouragement by others, and improving perceptions of self-efficacy (ability to achieve goals in their workplace) may foster their hope.

  8. Benchmarking facilities providing care: An international overview of initiatives

    Science.gov (United States)

    Thonon, Frédérique; Watson, Jonathan; Saghatchian, Mahasti

    2015-01-01

    We performed a literature review of existing benchmarking projects of health facilities to explore (1) the rationales for those projects, (2) the motivation for health facilities to participate, (3) the indicators used and (4) the success and threat factors linked to those projects. We studied both peer-reviewed and grey literature. We examined 23 benchmarking projects of different medical specialities. The majority of projects used a mix of structure, process and outcome indicators. For some projects, participants had a direct or indirect financial incentive to participate (such as reimbursement by Medicaid/Medicare or litigation costs related to quality of care). A positive impact was reported for most projects, mainly in terms of improvement of practice and adoption of guidelines and, to a lesser extent, improvement in communication. Only 1 project reported positive impact in terms of clinical outcomes. Success factors and threats are linked to both the benchmarking process (such as organisation of meetings, link with existing projects) and indicators used (such as adjustment for diagnostic-related groups). The results of this review will help coordinators of a benchmarking project to set it up successfully. PMID:26770800

  9. Brand name changes help health care providers win market recognition.

    Science.gov (United States)

    Keesling, G

    1993-01-01

    As the healthcare industry continues to recognize the strategic implications of branding, more providers will undertake an identity change to better position themselves in competitive markets. The paper examines specific healthcare branding decisions, the reasons prompting brand name decisions and the marketing implications for a change in brand name.

  10. Integrating alternative providers into managed care: a case study.

    Science.gov (United States)

    Broida, M

    1997-09-01

    Alternative medical techniques have become extremely popular, particularly in the western United States. Washington State recently enacted a law requiring certain health plans to include alternative providers on their physician panels. The author describes the efforts of one MCO to comply.

  11. Pathways of Adult Children Providing Care to Older Parents

    Science.gov (United States)

    Barnett, Amanda E.

    2013-01-01

    Guided by life course and stress process theory, this study investigated pathways of adult child caregivers' family (caregiving, marital, parenting) and nonfamily (employment) roles. Eight waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers. Latent class analysis provided strong evidence for a 4-class…

  12. Determinants of the Level of Care Provided for Various Types and Sizes of Dogs in New Providence, The Bahamas

    Directory of Open Access Journals (Sweden)

    Fielding, William J.

    2010-01-01

    Full Text Available This paper reports the level of care offered 424 dogs, classified as small dogs, large dogs, pit bulls and potcakes (the colloquial name for the local mongrel in New Providence, The Bahamas. Levels of care that meet the legal minimum –food water and shelter– as well as care considered essential and enriched in The Bahamas were less common for large dogs than small dogs. Small dogs tended to get more care than other dogs and so were at lowest risk of being neglected.It is suggested that the size of the dog is an important factor which determines the level of care provided. Pit bulls generally received similar care to potcakes which are often considered neglected. Large dogs were more likely to be kept outside and less likely to be allowed inside the home than small dogs. It is conjectured that in many instances the level of care offered constitutes partial abandonment due to a lack of interaction between caregivers and their dogs.

  13. Cooperation between In-Hospital Psychological Support and Pastoral Care Providers: Obstacles and Opportunities for a Modern Approach.

    Science.gov (United States)

    Proserpio, Tullio; Ferrari, Andrea; Veneroni, Laura; Arice, Carmine; Massimino, Maura; Clerici, Carlo Alfredo

    2017-09-01

    The meaning that patients with cancer attribute to life influences their expectations and their attitudes to the disease and its treatment. Over the centuries, religion has commonly been the answer encoded by the social setting when it came to matters of life and death. The present article analyzes the historical grounds for forms of cooperation between the scientific disciplines that focus on mental health and the approach of religion, centered on the Italian situation. Such cooperation was hard to imagine in the past, but the situation has changed considerably and cooperation is not only possible but extremely desirable. Acknowledgment of their spiritual needs helps patients to battle with their disease. The care of patients should include catering for their spiritual needs by ensuring the constant presence of a chaplain on hospital wards.

  14. Better Together: Co-Location of Dental and Primary Care Provides Opportunities to Improve Oral Health.

    Science.gov (United States)

    Pourat, Nadereh; Martinez, Ana E; Crall, James J

    2015-09-01

    Community Health Centers (CHCs) are one of the principal safety-net providers of health care for low-income and uninsured populations. Co-locating dental services in primary care settings provides an opportunity to improve access to dental care. Yet this study of California CHCs that provide primary care services shows that only about one-third of them co-located primary and dental care services on-site. An additional one-third were members of multisite organizations in which at least one other site provided dental care. The remaining one-third of CHC sites had no dental care capacity. Policy options to promote co-location include requiring on-site availability of dental services, providing infrastructure funding to build and equip dental facilities, and offering financial incentives to provide dental care and recruit dental providers.

  15. Equipping Social Workers to Address Spirituality in Practice Settings: AModel Curriculum

    Directory of Open Access Journals (Sweden)

    David R. Hodge

    2002-12-01

    Full Text Available While there is growing interest in incorporating clients’ spiritual beliefs and values into social work practice, several studies have shown that social workers lack the necessary training to address spiritual issues in a culturally competent manner. This paper addresses this need by providing an annotated spirituality training course for use in various settings. Topics or domains covered in the curriculum include ethics and values, research and theory on spirituality, the nation’s spiritual demographics, the cultures of major spiritual traditions, value conflicts, spiritual interventions, assessment approaches, and the rights of spiritual believers. A number of potential assignments are offered,which are designed to promote practitioner self-awareness, respect for spiritual diversity, and an enhanced ability to assess and operationalize spiritual strengths to ameliorate problems in practice settings.

  16. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    2012-01-01

    Full Text Available This study explored primary care providers' (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 "MTM is just part of our team approach to the practice of medicine": MTM as an integral part of PCPs' practices; (2 "Frankly it's education for the patient but it's also education for me": MTM services as a source of education; (3 "It's not exactly just the pharmacist that passes out the medicines at the pharmacy": The MTM practitioner is different from the dispensing pharmacist; (4 "So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved": MTM services as preventative health care efforts; (5"I think that time is the big thing": MTM pharmacists spend more time with patients; (6 "There's an access piece, there's an availability piece, there's a finance piece": MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  17. Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

    Science.gov (United States)

    Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

    2012-02-01

    This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

  18. Does Risk-Adjusted Payment Influence Primary Care Providers' Decision on Where to Set Up Practices?

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Anell, Anders; Dackehag, Margareta

    Providing equal access to health care is an important objective in most health care systems. It is especially pertinent in systems like the Swedish primary care market, where providers are free to establish themselves in any part of the country. To improve equity in access to care, 15 out 21 county...... of private primary care centers in areas with unfavorable socioeconomic and demographic characteristics. More generally, this result indicates that risk-adjusted capitation can significantly affect private providers’ establishment decisions....

  19. Transforming Health Care Service Delivery and Provider Selection

    OpenAIRE

    Reiner, Bruce I.

    2011-01-01

    Commoditization pressures in medicine have risked transforming service provider selection from “survival of the fittest” to “survival of the cheapest.” Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented per...

  20. Cost analysis of consolidated federally provided health care

    Science.gov (United States)

    2017-06-01

    Government Accountability Office JIT just-in time KPO Kaizen promotion offices LT lead time MHS Military Health System MRI magnetic resonance...a hospital that is only large enough for one MRI unit may need to hold it idle much of the time to permit emergency testing; whereas, a hospital...Center San Diego and San Diego VA hospital both provide outpatient pharmaceutical services. Duplication and redundancy of operating two separate

  1. The meaning of providing caring to obese patients to a group of nurses

    Directory of Open Access Journals (Sweden)

    Emilly Souza Marques

    2014-03-01

    Full Text Available This qualitative study was performed with six nurses of a public hospital, with the objective to describe their view of the meaning of providing care to obese patients. Interviews were conducted using a semi-structured script. The data were organized under themes extracted from the subjects’ statements, after being thoroughly read. Symbolic Interactionism was adopted to interpret the findings. The results from the analysis were organized under the following themes: Being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. The grasped meanings can interfere in the care provided. The nurses, however, recognize the need to work as a team to deliver comprehensive care. Making positive changes to the meanings found in this study is possible, thus, contributing to providing prejudice-free nursing care to obese patients. Descriptors: Obesity; Nursing Care; Hospital Care.

  2. Critical care providers refer to information tools less during communication tasks after a critical care clinical information system introduction.

    Science.gov (United States)

    Ballermann, Mark; Shaw, Nicola T; Mayes, Damon C; Gibney, R T Noel

    2011-01-01

    Electronic documentation methods may assist critical care providers with information management tasks in Intensive Care Units (ICUs). We conducted a quasi-experimental observational study to investigate patterns of information tool use by ICU physicians, nurses, and respiratory therapists during verbal communication tasks. Critical care providers used tools less at 3 months after the CCIS introduction. At 12 months, care providers referred to paper and permanent records, especially during shift changes. The results suggest potential areas of improvement for clinical information systems in assisting critical care providers in ensuring informational continuity around their patients.

  3. Developmental patterns of adolescent spiritual health in six countries

    Directory of Open Access Journals (Sweden)

    Valerie Michaelson

    2016-12-01

    Full Text Available The spiritual health of adolescents is a topic of emerging contemporary importance. Limited numbers of international studies provide evidence about developmental patterns of this aspect of health during the adolescent years. Using multidimensional indicators of spiritual health that have been adapted for use within younger adolescent populations, we therefore: (1 describe aspects of the perceptions of the importance of spiritual health of adolescents by developmental stage and within genders; (2 conduct similar analyses across measures related to specific domains of adolescent spiritual health; (3 relate perceptions of spiritual health to self-perceived personal health status. Cross-sectional surveys were administered to adolescent populations in school settings during 2013–2014. Participants (n=45,967 included eligible and consenting students aged 11–15 years in sampled schools from six European and North American countries. Our primary measures of spiritual health consisted of eight questions in four domains (perceived importance of connections to: self, others, nature, and the transcendent. Socio-demographic factors included age, gender, and country of origin. Self-perceived personal health status was assessed using a simple composite measure. Self-rated importance of spiritual health, both overall and within most questions and domains, declined as young people aged. This declining pattern persisted for both genders and in all countries, and was most notable for the domains of “connections with nature” and “connections with the transcendent”. Girls consistently rated their perceptions of the importance of spiritual health higher than boys. Spiritual health and its domains related strongly and consistently with self-perceived personal health status. While limited by the 8-item measure of perceived spiritual health employed, study findings confirm developmental theories proposed from qualitative observation, provide foundational

  4. Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi

    Science.gov (United States)

    Mazenga, Alick C.; Simon, Katie; Yu, Xiaoying; Ahmed, Saeed; Nyasulu, Phoebe; Kazembe, Peter N.; Ngoma, Stanley; Abrams, Elaine J.

    2018-01-01

    Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; pBurnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the

  5. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

    Science.gov (United States)

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

    2017-06-01

    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Primary care providers and medical homes for individuals with spina bifida.

    Science.gov (United States)

    Walker, William O

    2008-01-01

    The contributions of primary care providers to the successful care of children with spina bifida cannot be underestimated. Overcoming systemic barriers to their integration into a comprehensive care system is essential. By providing routine and disability specific care through the structure of a Medical Home, they are often the first line resource and support for individuals and their families. The Medical Home model encourages primary care providers to facilitate discussions on topics as varied as education and employment. Knowledge of specific medical issues unique to this population allows the primary care provider to complement the efforts of other specialty clinics and providers in often neglected areas such as sexual health, obesity and latex sensitization. As individuals with spina bifida live into adulthood, and access to traditional multidisciplinary care models evolves, these skills will take on increasing importance within the scope of providing comprehensive and coordinated care.

  7. Comparison of Goals of Care Between Hemodialysis Patients and Their Health Care Providers

    Directory of Open Access Journals (Sweden)

    Ariel Lefkowitz

    2016-11-01

    Full Text Available Background: Patient-centered care requires knowledge of patients’ goals of care (GoC on the part of health care providers (HCPs. Whether HCPs caring for in-center hemodialysis patients meet this criterion is uncertain. Objective: We designed and conducted a GoC survey among patients and HCPs within a single in-center hemodialysis (ICHD program to determine whether HCPs have an understanding of their patients’ GoC. Design: This was a prospective comparative quantitative survey study. Setting: The study included a single Canadian maintenance ICHD center. Participants: These included hemodialysis patients and their primary nephrologists, nurses, social workers, pharmacists, and dietitians. Methods and Measurements: Two surveys, one for patients and another for primary HCPs, were designed, piloted, and administered. For each participating patient, HCPs consisted of the primary nephrologist, nurse, social worker, pharmacist, and dietitian. Surveys included questions pertaining to 7 GoC themes. Patient-HCP agreement on the importance of each domain individually and the most important domain overall was assessed with kappa statistics. Factors influencing agreement were assessed with logistic regression in a secondary analysis. Results: A total of 173 patients were invited to participate, of whom 137 (79% completed surveys. Fifty HCPs completed 623 corresponding surveys: 132 by physicians, 112 by nurses, 126 by pharmacists, 127 by social workers, and 126 by dietitians. A total of 70.1% and 78.8% of patients agreed with the importance of and would feel comfortable having GoC discussions, respectively, with their HCPs; 42.7% of physicians reported not having provided prognostic information to the corresponding patient. Patient-HCP agreement regarding GoC was poor (all κ .05. In adjusted analyses, only patients choosing “Be Cured” as the most important GoC was significantly associated with poorer HCP-patient agreement than expected (odds ratio, 0

  8. Realist Review of Programs, Policies, and Interventions to Enhance the Social, Emotional, and Spiritual Well-Being of Aboriginal and Torres Strait Islander Young People Living in Out-of-Home Care

    Directory of Open Access Journals (Sweden)

    Sophie Lindstedt

    2017-07-01

    Full Text Available The child protection system in Australia includes out-of-home care (OoHC for children and young people at risk of harm and neglect. In Australia, Aboriginal and Torres Strait Islander children and young people are 9 times more likely to be placed in care than non-Aboriginal young people (Australian Institute of Health and Welfare, 2015. Australia’s history of colonization and subsequent policies have caused trauma to individuals, families, and communities and resulted in poor physical and mental health and mistrust of services. This review was undertaken to identify programs and policies currently in place that aim to improve the mental health and well-being of this vulnerable population. It provides an analysis of both the strengths of the current system as well as what has been inadequately addressed based on literature in the area.By incorporating an Aboriginal perspective, this review focuses on social, emotional, and spiritual well-being (SESWB and the aspects of a child’s life and community that promote this. A realist review of the academic and grey literature was conducted in 2014. It included an extensive search of government and non-government (NGO publications. The review identified nine programs or policies that are designed to improve the SESWB of Aboriginal young people in OoHC in local and international settings. These are the Aboriginal and Torres Strait Islander Child Placement Principle, cultural support plans, Aboriginal Community Controlled Organisations (ACCOs, family group decision-making, therapeutic care, and Panyappi Mentoring Program. Given that culturally competent service provision is important to SESWB, the review concludes that an increase in monitoring and evaluation is necessary to determine the effectiveness of programs and ensure their implementation and sustainability when warranted. Policy and research work is needed to adapt and devise programs promoting the SESWB of Aboriginal young people (at both the

  9. Patients' perceptions of patient care providers with tattoos and/or body piercings.

    Science.gov (United States)

    Westerfield, Heather V; Stafford, Amy B; Speroni, Karen Gabel; Daniel, Marlon G

    2012-03-01

    This study evaluated patients' perceptions of patient care providers with visible tattoos and/or body piercings. As tattooing and body piercing are increasingly popular, research that informs nursing administrators regarding policies on patient care providers having visible tattoos and body piercings is warranted. A total of 150 hospitalized adult patients compared pictures of male and female patient care providers in uniform with and without tattoos and/or nonearlobe body piercings. Patient care providers with visible tattoos and/or body piercings were not perceived by patients in this study as more caring, confident, reliable, attentive, cooperative, professional, efficient, or approachable than nontattooed or nonpierced providers. Tattooed female providers were perceived as less professional than male providers with similar tattoos. Female providers with piercings were perceived as less confident, professional, efficient, and approachable than nonpierced female providers. Nursing administrators should develop and/or evaluate policies regarding patient care providers with visible tattoos and/or body piercings.

  10. Substitute Care Providers: Helping Abused and Neglected Children. The User Manual Series.

    Science.gov (United States)

    Watson, Kenneth

    This manual for child welfare staff and foster/adoptive parents is intended to provide guidelines for serving abused and neglected children who are in family foster care and adoption. The first section is on substitute care and permanency planning and offers an historical perspective on substitute care and definitions of family foster care and…

  11. The Role of Doctors and Other Health Personnel in Promotion of the Community\\'s Islamic Spiritual Health

    OpenAIRE

    Freidoun Azizi; Akram Heidari

    2017-01-01

    Human health includes physical, social, mental and spiritual dimensions and medicine is perfect when all aspects of health are considered. There are several reasons for the need for health personnel familiarity with issues related to spiritual health that some of them are: Finding best responds to the spiritual needs of patients, the use of spiritual care to improve health in four levels of prevention, the correct decision when creating a conflict between the spiritual beliefs of the patient ...

  12. Parental spirituality in life-threatening pediatric cancer.

    Science.gov (United States)

    Nicholas, David B; Barrera, Maru; Granek, Leeat; D'Agostino, Norma Mammone; Shaheed, Jenny; Beaune, Laura; Bouffet, Eric; Antle, Beverley

    2017-01-01

    This study addressed parental spirituality in the context of pediatric cancer with a poor prognosis. Drawing upon previous research implementing a longitudinal grounded theory design examining parental hope, 35 parents were interviewed regarding their experiences with an emergent description of the role of spirituality in parents' daily lives. Spirituality included religious beliefs and practices, notions of a higher force or cosmos, relationship with a divine being, as well as elements emerging from meaning-making and relationships. Parental expectations of spirituality remained relatively constant across data collection time points (3-9 months postdiagnosis), although limited variation occurred relative to shifting circumstance (e.g., deterioration of the child's condition). Spirituality appeared to offer: greater acceptance of parents' inability to protect their child from harm related to her/his life-threatening illness, guidance and emotion decompression, and support from one's faith community. Recommendations for integrating spiritual assessment in clinical care practice are offered.

  13. Electronic cigarettes and thirdhand tobacco smoke: two emerging health care challenges for the primary care provider.

    Science.gov (United States)

    Kuschner, Ware G; Reddy, Sunayana; Mehrotra, Nidhi; Paintal, Harman S

    2011-02-01

    PRIMARY CARE PROVIDERS SHOULD BE AWARE OF TWO NEW DEVELOPMENTS IN NICOTINE ADDICTION AND SMOKING CESSATION: 1) the emergence of a novel nicotine delivery system known as the electronic (e-) cigarette; and 2) new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as "thirdhand smoke". The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS). The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room. Counseling patients about the hazards of thirdhand smoke may provide additional motivation to quit smoking.

  14. Transcultural nursing: providing culturally congruent care to the Hausa of Northwest Africa.

    Science.gov (United States)

    Chmielarczyk, V

    1991-01-01

    Research around the world is now beginning to validate the theory of Cultural Care as an important means to provide culturally congruent care to clients, families, and groups of diverse cultures. Knowledge of Leininger's Theory of Cultural Care Diversity and Universality can provide meaningful care to clients who have different traditional and current beliefs and values. The Leininger Sunrise Model can serve as a valuable guide to discover care meanings and practices related to the theory, and to provide practical and meaningful culture specific care decisions and actions by nurses. The three major modes of action, namely, cultural care maintenance or preservation, accommodation or negotiation, and repatterning or restructuring, are important differential means to provide culturally congruent care to clients within their own cultural setting. This article considers the application of such care for the Hausa of Northwest Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Electronic cigarettes and thirdhand tobacco smoke: two emerging health care challenges for the primary care provider

    Directory of Open Access Journals (Sweden)

    Nidhi Mehrotra

    2011-02-01

    Full Text Available Ware G Kuschner, Sunayana Reddy, Nidhi Mehrotra, Harman S PaintalDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA, USAAbstract: Primary care providers should be aware of two new developments in nicotine addiction and smoking cessation: 1 the emergence of a novel nicotine delivery system known as the electronic (e- cigarette; and 2 new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as “thirdhand smoke”. The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS. The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room

  16. Exploring prayer as a spiritual modality.

    Science.gov (United States)

    Farah, Jennifer; McColl, Mary Ann

    2008-02-01

    What does it mean to focus on the spiritual in occupational therapy? What interventions would qualify as spiritual modalities? This paper attempts to define the boundaries of what may be considered legitimate uses of spirituality in occupational therapy by using the example of prayer. The purpose of this paper was to provide an in-depth analysis of the use of prayer in practice. Medical and allied health journals were searched using the terms spirituality, spirit, religion, and prayer. Identified articles were synthesized to identify potential advantages and disadvantages of using prayer in therapy. Prayer can be considered an appropriate occupational therapy intervention so long as four questions can be answered positively. To answer these questions, guidelines are provided that will lead the therapist through a decision making process to determine the appropriateness of incorporating prayer into any clinical situation.

  17. Freedom and Spirituality

    NARCIS (Netherlands)

    Vintges, K.; Taylor, D.

    2011-01-01

    Spirituality is an idiosyncratic concept in the work of Foucault, which might best be characterized as an "intensity without a ‘spirit