ArticlePDF Available

Spiritual Care Education of Health Care Professionals



Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE); work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.
Religions 2015, 6, 594–613; doi:10.3390/rel6020594
ISSN 2077-1444
Conference Report
Spiritual Care Education of Health Care Professionals
Donia Baldacchino 1,2,3
1 Faculty of Health Sciences, University of Malta, Msida MSD 2090, Malta;
E-Mail:; Tel: +356-2340-1847
2 Department of Nursing, University of South Wales, Pontypridd Rhondda Cynon Taff CF37 4BE,
Wales, UK
3 Department of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA
Academic Editors: Arndt Büssing and Hefti René
Received: 2 February 2015 / Accepted: 16 April 2015 / Published: 8 May 2015
Abstract: Nurses and health care professionals should have an active role in meeting the
spiritual needs of patients in collaboration with the family and the chaplain. Literature
criticizes the impaired holistic care because the spiritual dimension is often overlooked by
health care professionals. This could be due to feelings of incompetence due to lack of
education on spiritual care; lack of inter-professional education (IPE); work overload; lack
of time; different cultures; lack of attention to personal spirituality; ethical issues and
unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing,
respecting, and meeting patients’ spiritual needs; facilitating participation in religious
rituals; communicating through listening and talking with clients; being with the patient by
caring, supporting, and showing empathy; promoting a sense of well-being by helping
them to find meaning and purpose in their illness and overall life; and referring them to
other professionals, including the chaplain/pastor. This paper outlines the systematic mode
of intra-professional theoretical education on spiritual care and its integration into their
clinical practice; supported by role modeling. Examples will be given from the author’s
creative and innovative ways of teaching spiritual care to undergraduate and post-graduate
students. The essence of spiritual care is being in doing whereby personal spirituality and
therapeutic use of self contribute towards effective holistic care. While taking into
consideration the factors that may inhibit and enhance the delivery of spiritual care,
recommendations are proposed to the education, clinical, and management sectors for
further research and personal spirituality to ameliorate patient holistic care.
Religions 2015, 6 595
Keywords: spiritual care; holistic care; education; Benner’s Theory; Kolb’s Theory; ASSET
model; role modeling; students; health care professionals; intra/inter-professional education
1. Introduction
The International Council of Nurses (ICN) Code of Ethics ([1], p. 5) specifies the nurse’s role of
promoting “an environment in which the human rights, values, customs and spiritual beliefs of the
individual, family and community are respected”. The Malta Code of Ethics supports this for nurses
and midwives [2], stating that the nurse is to “recognize and respect the uniqueness of every
patient/client’s biological, psychological, social and spiritual status and needs”. Since patients are
attended by different members of the multi-disciplinary team, these codes of ethics also address the
holistic care of health care professionals that contribute towards patients’ safety. Examples of some
heroes in nursing are given, whereby, their being in care generated signs of spirituality in their
attempts to address patients’ needs, while their caring attitude instilled hope and healing.
Nightingale [3] proposed that the environment should do no harm to patients. In this paper, the
environment is provided by the presence of nurses and health care professionals, including the ward
management personnel who attempt to deliver care holistically. Patients’ safety may be achieved by
individualized spiritual care, whereby care is given according to the patients’ biological, psychological,
social, cultural, and spiritual needs [4]. Mary Seacole (1805–1881) nursed sick soldiers in the Crimean
War so kindly that she was known as “Mother Seacole”. Mary was exposed to prejudice and racism, as
her mother was from the Caribbean island of Jamaica and her father was Scottish. However,
courageously, Mary made her own way in the world, as a single woman and as a person of mixed race.
Mary mixed medicine with kindness and thus she is an admired role model to nurses and health
caregivers [5]. Elisabeth Cadwa-ladyr from Wales volunteered to nurse sick soldiers in the Crimean
War with Florence Nightingale in 1854. Betsy was devoutly religious and the small Welsh Bible, given
to her when she was young, remained her “constant companion” and appeared to help her overcome
the disappointments of her distorted plans in life and accept her situation in life [6].
During the last twenty-five years, care of patients has been criticized for neglecting the spiritual
dimension in patient care [7]. This may be due to various reasons such as, secularization of
contemporary society, unwillingness to deliver spiritual care, lack of time, work overload, feelings of
incompetence to deliver spiritual care, lack of education in undergraduate and post-graduate curricula,
and lack of inter-professional education, which generate omission of spiritual care [8–10].
Additionally, the medical model addresses primarily the illness of the patient and its progress to cure,
while overlooking the religious and spiritual needs, and, consequently, threatens holistic care.
2. Definition of Spirituality in Illness
Spirituality is derived from the Latin word spiritus; spirit is the important part of the person that
controls the mind, and the mind controls the body [11]. Religion may shed light on the interpretation of
this spirit. For example, as a Roman Catholic person, I relate this spirit to the spirit of God within me,
which gives me life day by day. Spirituality is also the power within a person that motivates that
Religions 2015, 6 596
person to find meaning, purpose, and fulfillment in life; suffering and death; and fosters hope for one’s
will to live [12]. It infers that spirituality is the vital life force that unifies all aspects of the human
being, including the religious component [13].
However, spirituality goes beyond religious affiliation, as it strives for inspirations, meaning and
purpose in life, even in those who do not believe in any god/higher power [14,15]. Consequently,
spirituality applies to both believers and non-believers, including the presence of different cultural and
religious beliefs. Thus, when a person is more in tune with the vital, unifying, life force of the spiritual
dimension, a will gain a more balanced state of physical, mental and social well-being, as a result [16].
3. Definition of Spiritual Care
Spiritual care is part of the art of nursing and professional care [17]. Spiritual care is defined by the
literature as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in
religious rituals; communicating through listening and talking with clients; being with the patient by
caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find
meaning and purpose in their illness and overall life; and referring them to other professionals,
including chaplains/pastors [18]. The outcome of spiritual care was found to enable patients to count
their blessings in life, achieve inner peace and explore coping strategies to overcome obstacles during
illness and crisis situations [19–21]. Spiritual care may also help patients to find a new equilibrium in
faith by re-conceptualizing the self as one who is known and loved by God in the context of their
specific illness [22,23].
The essence of spiritual care is being rather than simply doing [24]. Thus, therapeutic use of self is
of utmost importance [25]. The role of the multidisciplinary team is to help patients find meaning in
illness and purpose in life with a positive outlook to life and/or afterlife. Thus, in spiritual care it is not
merely the delivery of care that matters, but it also includes the heart and the spirit by which holistic
care is given [26].
In order to address spiritual needs both in health and in illness, competences are needed to guide the
education of the health care professionals.
4. Aim
The aim of this paper is to present the theories and methods of clinical education on spiritual care of
health care professionals and students, and outline the dimensions of spiritual leadership to sustain the
learning process.
5. Competences in Spiritual Care
The Nursing and Midwifery Council (NMC) in the UK [27] in line with the European Qualifications
Framework (EQF) [28] defines competence as “the proven ability to use knowledge, skills and
personal, social and/or methodological abilities in the work or study situations and in professional and
personal development” ([28], p. 11) referred to as “responsibility and autonomy” ([28], p. 11).
Benner’s Theory “From Novice to Expert” [29] defined nursing competency as the ability to
perform a task with desirable outcomes under the varied circumstances of the real world. Benner
Religions 2015, 6 597
placed competence in the middle of the continuum ranging from: novice to advanced beginner, to
competent, to proficient, to expert. Competent practitioners are consciously able to plan their actions,
but lack flexibility and speed [30]. The practitioner is described as “tolerably good but less than
expert” because when practitioners are considered competent, they would still have something more to
achieve for them to reach the level of proficiency and expertise [31]. This is highly applicable to the
education of health care professionals. While considering the characteristics of the students who are
undertaking the nursing, medical and paramedical education programs, who are young, with a lack of
personal life experiences and with minimum attention to spiritual issues in life, it is very important not
only to equip students with loads of information, but also attention needs to be given to their personal
formation as spiritual individuals, who find meaning and purpose in their profession, and to help them
develop the necessary skills and attitudes across their education programs in class and in the clinical
practice. This process will contribute towards transformation into a professional health care being who
becomes responsible and accountable for holistic patient care including the spiritual dimension of care.
Students and health care professionals need to achieve competence, i.e., acquiring knowledge, skills
and attitudes. Spiritual care competence is defined as an active ongoing process characterized by three
interrelated elements which involve a growing awareness of one’s value, developing an empathic
understanding of the client’s world view and the ability to implement individualized interventions
appropriate to each client [32].
Research on competences in spiritual care is growing. An exploratory study in Malta that collected
qualitative data from nurses, hospital and community chaplains as well as patients with heart attack
revealed the following seven generic competences: integrating the individual person within the role of
the nurse as a professional; assisting the search for meaning of illness and acceptance of illness;
maintaining trustful relationship with patients and family; communicating with patients, inter-disciplinary
team and clinical/educational Organizations; delivering spiritual care by the four stages of the nursing
process that is, assessment, planning, implementation and evaluation; controlling ethical issues in care
such as, confidentiality, data protection issues; and delivering holistic care [33].
These findings supported the three core themes derived from an extensive literature review which
revealed three core domains of competences for spiritual care namely, awareness and use of self;
spiritual dimensions of the nursing process (assessment, planning, implementation and evaluation of
care); and assurance and quality expertise [34].
Research has shown that the strongest predictor for effective spiritual care is personal spirituality.
No one can give from what he/she does not possess. This indicates the importance of maintaining the
integrity between the individual person and the role of health care professionals to address and meet
patients’ needs holistically [35]. Therefore, health care professionals can both provide spiritual care
and can also provide care spiritually [36]. Since, competence in professional practice incorporates
knowledge, skills and attitudes with achievable outcomes [37], additional to knowledge, the active
presence of the health care professional, that is being in doing, not simply doing, is needed to meet
patients’ spiritual needs and to generate the holistic doing of spiritual care. Therefore, the therapeutic
use of self could be very helpful as it may enhance a trustful helping relationship.
Research recommends that health care professionals should take an active role in meeting patients’
spiritual needs and not simply refer them to a chaplain [38]. However, it is argued that when patients
need help in their theological beliefs and conflicts, then the chaplain, an expert with Clinical Pastoral
Religions 2015, 6 598
Education should deliver this kind of specialized spiritual care [39]. Hence, the importance of considering
the hospital chaplain/pastor as an important collaborator in the inter-disciplinary team [40], especially
when prepared educationally for a chaplain’s role [41].
While considering the importance of the responsibility of the health care professionals, research
shows the concern of the nurses and health care professionals who consider themselves as incompetent
to deliver spiritual care [42].
6. Education on Spiritual Care/Modes of Clinical Education on Spiritual Care
An overview of the theoretical and practical education on spiritual care is included based on a
literature review following a literature search using the keywords: “spiritual care”, “holistic care”,
“education”, “Benner’s Theory”, “Kolb’s Theory”, “ASSET model”, “role modelling”, “students”,
“nurses”, “health care professionals”, and “intra/inter-professional education”. Additionally, the author’s
teaching experience in Malta and in various foreign universities presented some examples of innovative
teaching methods adopted to teach spirituality and spiritual care to undergraduate and post-graduate
students. Spiritual care contributes towards holistic care, which demands a multi-disciplinary team
approach to care, including the chaplain. This may be enhanced by intra- and inter-professional
education on spiritual care as it may foster teamwork and team learning.
6.1. Intra-Professional and/or Inter-Professional Education on Spiritual Care
Intra-professional education is when students from different levels of education in the same
profession are taught together. For example, currently, at the Faculty of Health Sciences in Malta, final
year nursing students work in their clinical placements with first year students under the same mentor
in preparation for the formative and summative clinical assessment. Feedback from both the first and
final year students is generally very satisfactory and the intra-professional clinical experience is
considered a rich learning opportunity. This experience supports project results in clinical simulation,
which support intra-professional nursing student education [43].
Inter-professional education (IPE) is also known as multi-professional education, common learning,
shared learning, and interdisciplinary learning [44]. Therefore, inter-professional education refers to
students from different professions learning from each other, with each other, and about each other. The
WHO-Study Group, consisting of 30 education, practice and policy experts, issued the WHO Framework
for Action on Inter-professional Education and collaborative Practice [45]. The framework highlights:
The current status of inter-professional collaboration around the world; identifies the mechanisms
that shape successful collaborative teamwork; outlines a series of action items that policy
makers can apply within their local health system; and
Provides strategies and ideas that can help health policymakers implement the elements of
inter-professional education and collaborative practice that will be most beneficial in their
own jurisdiction.
The effectiveness of inter-professional education in enabling collaborative practice is still debatable.
Some evidence was found by research studies on, for example ‘death and dying learning’ [46], and
systematic reviews [47], and on the effectiveness in changing attitudes [48]. However, more
Religions 2015, 6 599
longitudinal research is needed to identify the possible effects on service quality and patients’ and
service users’ experiences.
Inter-professional education (IPE) was also implemented to teach different professions, such as
social workers and chaplains; also IPE was adopted on students from different professions such as
medicine, nursing, chaplaincy and social work [49]. Online learning and interactive simulation modes
of teaching were adopted. Educational programs on spiritual and cultural aspects of palliative care and
spiritual assessment demonstrated that concepts of spirituality and basics of spiritual assessment may
be taught and learned while students were found to develop an understanding and respect for the role
of chaplains, social workers and physicians. Evaluation of these programs suggests that this
innovative, inter-professional educational course may be transferable for use in other educational
settings [50]. In addition to the physical presence of students together in class, online forums enable
learners to discuss and outline the contribution of each discipline to spiritual care and holistic care of a
patient case study. Thus, online forums may enhance understanding and appreciation of the precious
contribution of each member of the interdisciplinary team to holistic care.
6.2. Areas Essential for Learning Spiritual Care
A literature review identified four main areas as essential for learning spiritual care:
a. importance of learning in real-life situations with repeated exposure to patients in the clinical
placements supported by role modeling and mentorship;
b. use of pedagogical methods that assist students to understand, work with and reflect on
patient’s spirituality such as, reflective journals, written reflective accounts; writing care plans,
which include spiritual interventions; role plays to practice spiritual assessment, including
values, beliefs, and spiritual needs; group discussions on the relationship between religion,
spirituality and health; analysis of case studies; reading literature and analyzing research on
spirituality in illness and care;
c. awareness of and overcoming conditions inhibiting spiritual care learning, such as, lack of
knowledge about spirituality; uncertainty about the health care professional’s role in spiritual
care; unawareness about one’s own spirituality; having a different faith from that of the patient;
incompetence in addressing spiritual needs; lack of role models; lack of time; and work
overload; and
d. evaluation of students’ spiritual care learning related to how students are prepared and how
they are followed up after clinical studies by, for example, post clinical-reflection sessions;
sharing of stories with fellow students, teachers and chaplains; supporting their learning by
literature and research on spiritual care; reflective exercises and debriefing sessions to enhance
safety of students and safe patient care’ [51].
These are reflected in the ASSET Model for (Actioning Spirituality and Spiritual Care Education
and Training) for teaching spiritual care [52].
The ASSET model incorporates a tripod of structure content, process of learning and outcome of
education. First, the structure content encompasses self-awareness, spirituality and spiritual dimensions
of care. Second, the process of teaching and learning incorporates experiential learning related to value
Religions 2015, 6 600
clarification, holism, a broad perspective of spirituality, the four stages of the nursing process, and
evaluation of teaching and learning. Third, the outcome of education, which is measured by value
clarification, knowledge and competence in the delivery of spiritual care.
The foundation of this model lies on the importance of nurses’ self-awareness about their personal
spiritual beliefs, communication skills, and assessment procedures. Spirituality in this model has a
Judeo-Christian perspective. However, it is argued that the present era of displaced individuals and
refugees with different religions demands inclusion of other religions. Culture and interdisciplinary
teamwork including the chaplain play an important role in this model.
Culture may challenge both the students and the educator. In summer 2013 and 2014, I was invited
to teach various groups of students undertaking undergraduate courses such as nursing, psychology
and tourism; and post-graduate students undertaking counseling, pastoral care, theology, and
psychology programs at two Pontifical Catholic Universities in Parana` Brazil. Following analysis of
the definition of the concept of spirituality to a group of forty five students undertaking BA
Psychology, a student asked me, What has motivated you to tackle spirituality and spiritual care?
Having a class of young students in a quite secularized class environment, I explained my personal
spirituality regarding what gives me meaning and purpose in my life. This was oriented towards my
Catholic religious background, my affiliation with the Society of Christian Education, and my clinical
experience in Intensive Care Unit (ITU), and also my clinical care of an Arabic patient in a British
hospital whose prayers calmed him down post-operatively [53]. At the end of the session, several
young students shared with me privately their religious and/or their spiritual experiences in life. These
sessions appeared to stimulate ten students, (six were aged 19–22 years; four were mature, over 23
years), to attend also the research group session because they wished to investigate spirituality in their
research project.
Culture was again prominent in my teaching visit at the University of Pardubice, Czech Republic in
2014. It was interesting to note that a paramedic male student, aged 20 years asked me the same
question! “What motivated you to tackle spirituality and spiritual care? Having referred to my
research findings on Maltese patients’ spiritual coping strategies, of which some were religious coping,
students with an atheistic background asked me “Who is God? What is the relationship between God’s
plans in life and ‘destiny’ and ‘coincidence’ in life?” These profound questions generated discussions
across the whole week of my stay at the university.
Therefore, education of health care professionals should prepare students to recognize and act on
spiritual cues; and build a trusting relationship and communicate respectfully and sensitively to
patients to discover what is important to patients. Education should focus on holistic patient care with
attention to spiritual and existential themes throughout the nursing program to help students integrate
learning into the clinical practice [54].
Research could also be a medium of learning to explore the real experiences of patients and a
resource of learning on spirituality in illness and care. Thus, the author tried to give the opportunity to
patients with acute and chronic illness and healthcare professionals, consisting of hospital/community
chaplains and qualified nurses working in medical and surgical wards, to participate in various
research studies. While giving voice to patients and health care professionals, they contributed
additional knowledge on the importance of spirituality and culture in care [55,56].
Religions 2015, 6 601
6.3. Integrating Theoretical Learning on Spiritual Care into the Clinical Practice
Literature review on how to develop a clinical learning culture emphasizes the importance of role
model attitudes and behaviors of the health care professionals [57]. Role modeling in spiritual care is a
concept that is still theoretical in nature because of various reasons, such as feelings of incompetence
to deliver spiritual care and secularization of the contemporary society. It is argued that spiritual care
may be “caught rather than taught” [58]. However, research shows that both theoretical teaching and
clinical practice are needed in the education on spiritual care [59,60]. The clinical environment fosters
integration of knowledge, clinical reasoning and formation of students [61]. Practice facilitates
students’ discovery of professional beliefs, values and attitudes and it assists them in integrating
relevant knowledge and theories [62].
Experiential learning and voluntary work could also be a resource of learning for health care
professionals [63]. As presented earlier on the inter-professional educational programs, core study
units and organization of short- or long-term voluntary activities facilitate students from various
disciplines to learn together and share their learning experiences. Optional study units at the University
of Malta are open to all university students. However, timetables may clash with other study units
rendering a limited mix of students.
Voluntary work may play an important role in students’ learning in the form of community
outreach. Voluntary work is acknowledged by the University of Malta DegreePlus. Thus, a study unit
of 2 European Credits Transfer System (ECTS) on Spiritual Care for Health Caregivers (NUR3903)
offers the students to do a minimum of five hours voluntary care in the community or accompany
patients on a pilgrimage, such as to Lourdes in France. The experience of a group of seven students
consisting of four nursing and three midwifery students was impressive! It was a means of
self-reflection with enhancement of altruism. They confirmed the principle of giving and receiving as
they were impressed by the patients’ religious faith to travel so far to a sacred place, with an outcome
of empowerment to cope with their illness [64].
Voluntary work also took the format of a health promotion activity to groups of adults, mostly older
persons in the community by a small group of three to five undergraduate nursing students. The
program consisted of students’ delivery of a 20-minute Power Point presentation on preventive
measures and care of diabetes or hypertension; and they answered the queries of the audience under
the author’s supervision or a parish nurse. The audience themselves were then asked to teach the group
of students, by stating and interpreting proverbs or life principles of which spirituality was prominent.
Finally, the blood pressure was measured by students on voluntary basis. Following the community
outreach session, all students (average of 20 students) sit around and share their experiences using
Gibb’s Theory of Reflection [65]. Finally, a written reflective account formed part of the study unit
assessment strategy where students reflected on such an inter-generational teaching and learning
experience, which was usually a very positive experience.
This learning experience may take the format of a small group of three to four nursing students
paying a visit to a family taking care of a person with terminal illness at home; or visiting an older
person living alone at home while being supported by a relative/neighbor as an informal caregiver
and/or community service. Such a learning experience on how the patient and family coped in their
Religions 2015, 6 602
past and current life by the use of various religious and/or spiritual coping methods was usually
interpreted by students as “an experience which I will treasure for life”.
These health promotion activities in the community were further extended to students’ participation
on a one-hour weekly radio program: Il-Kuragg nofs il-Fejqan (Courage doubles the healing process)
on Radio Maria in Malta. A small group of three to four nursing students delivered a teaching session
on health promotion in my presence and the author responded live to the public queries on telephone
and text messages. This experience helped them to confirm the nurse’s educational role in the community.
6.4. The Use of Arts in Identifying the Spiritual Dimension of the Role of the Nurse in Holistic Care
Towards the end of the introductory study units (NUR0118/NUR1116) for first year nursing
students on foundations in nursing, they were invited to identify the spiritual dimension of the role of
the nurse in providing holistic care by drawing their thoughts on a piece of white paper. A brief
explanation was written by students on the back of the picture. This arts exercise helped them to
explain and analyze the complexity of the spiritual dimension in holistic care. After three years that is,
at the end of their nursing course program, a focus group of 12 nursing students discussed the
differences they noticed between the perceived version and the observed real-life holistic care. This
exercise enabled students to identify the preciousness and inaccuracies in the observed delivery of
holistic care and the importance of addressing patients’ spiritual needs to facilitate holistic care.
An experiential learning was conducted on first year students in their clinical placement with
institutionalized older persons. Only few clients from each ward attend the activity center, leaving the
majority of older persons passive, sitting all day, waiting for their meals to be served and perhaps
waiting for someone to visit and communicate with them. On paying a visit to these students under the
author’s link-mentorship, students were found at the nurses’ station discussing together the patients’
documented care, which was also a learning resource for them. However, students could not
understand the possible feelings of boredom and isolation experienced by older persons every day, day
in day out, until they could pass through this experience.
Permission was granted by the respective hospital and ward administration and following
individual’s written consent, a group of fifteen first year nursing students were invited to experience an
hour of aloneness, segregated in a room alone for an hour on the same day without having the wall
clock. Using Kolb’s Theory of experiential learning [66], each student stayed alone in a deserted room
on their respective ward, coordinated by their respective mentor and the author. Each student was
asked to enter the room without the uniform clock and without her/his mobile phone. During that hour,
students were asked to reflect on their experience and write notes on a piece of paper. The majority of
students experienced boredom due to lack of time orientation and communication system. They
became frustrated as that hour was eternity for them. The common exclamation of students on coming
out of that room was:how boring! Poor them! During the follow-up focus group discussion, this
experience was applied to the older persons’ aloneness on the ward and confirmed the importance of
communication and activity exercises to help them live with dignity. Thus, transfer of knowledge
appeared to be facilitated by this experiential learning session. A written reflective account of their
critical experience was submitted as part of their clinical portfolio and followed up by counseling as
deemed necessary.
Religions 2015, 6 603
The ability to be present is crucial in spiritual care. Availability, concentration at work and
reflection allow students to bear witness to patients’ suffering and do something meaningfully about it
without getting immune to patient’s suffering. Ability to listen to unspoken words accompanied by
compassion and sensitivity is part of professional presence and spiritual care. Thus, the nurses’ and
health care professionals’ connection and rapport with patients are fundamental for spiritual care [67].
Assignment of a mentor in the clinical environment fosters individual follow up system on a one-to-one
basis to help students to identify spirituality as part of the fabric of everyday patient care. This also
demands good collaboration between students, lecturers, health care professionals, and clinical mentors
for optimal learning outcomes. Furthermore, leadership in the clinical environment plays a key role in
maintaining holistic and creating a good learning environment [68].
6.5. Creating a Clinical Environment Conducive to Learning Spiritual Care
The Personal spirituality of the caregiver was found by research as the strongest predictor for
perceiving ability to provide spiritual care as no one can give from what he/she does not possess [69,70].
Personal spirituality enables caregivers to be sensitive to patients’ cultural and spiritual needs in their
holistic care [71–73]. Hence, the importance for students to be helped to reflect and explore their own
spirituality as it allows students to be more sensitive to the spirituality of others [74–76]. Research
shows that students reported discomfort with self-reflection, but it provided them with access to their
own growth [77].
Since health care professionals form the major part of the clinical environment of patients, attention
needs to be given to the spiritual dimension and the holistic perspective of the health care professionals
at the workplace [78,79]. Personal spirituality refers to an attitude and/or a lifestyle of an individual,
which recognizes his/her own spiritual dimension of one’s life. When personal spirituality is
acknowledged, teamwork will generate a peaceful environment with enhanced patient care, incorporating
also the individual patients’ spirituality in their care. Implementation of spirituality in the clinical and
the academic environments may motivate health care professionals to search meaning and purpose in
their work, understand the value of work and become aware of their personal belief system [80]. The
education system both in the clinical and the faculty sectors need highly motivated educators who
radiate happiness and peacefulness to others, including students, colleagues and patients [81]. To
sustain such an environment conducive to learning and self-development, the managers need to link
their personal life values and educators’ values to the respective university values, which may eventually
pass on these values to students resulting in spiritual growth of both students and educators [82,83].
Literature suggests that a successful learning environment is created through inspirational
leadership, reflective management and creation of a positive partnership between the clinical setting
and the educational organization [84–87].
The spiritual leadership theory was adopted as a guide for such an inspirational leadership in the
education of spiritual care. This is based on an intrinsic motivation model and on characteristics such
as, faith, hope and altruism, which may generate homogeneous vision and values at the individual,
team, and organizational levels [88]. These values may eventually generate higher levels of commitment
to holistic care supported by spiritual leadership [89].
Religions 2015, 6 604
Fry identifies seven dimensions of spiritual leadership that may be applied to an environment
conducive to learning, which are vision, altruistic love, hope/faith, membership, meaning/calling,
organizational commitment and productivity.
Vision: As a result of the advancement of technology, patient care may be enhanced but at the same
time health care professionals may be distracted from the actual holistic care of the person under their
care [90]. The vision looks to the future goal to be reached, which gives meaning to the organization’s
aspirations, and fosters hope and faith [91]. Ideally, undergraduates and post-graduate learners need to
be grouped together and learn together in classrooms and clinical seminar rooms about holistic care of
specific patients. Methods of education are consistently changing such as, the introduction of online
course programs that may facilitate interdisciplinary education.
Altruism: is a set of values, of going beyond one’s needs to deliver care to others, and ways of
thinking that are morally right, and are shared by group members and taught to new members. These
values may be taught theoretically, but also by role models, during patient care and communication
with colleagues.
Hope/Faith: During this pathway of looking to the future, hope and faith in the ability of the
educators and the students themselves may help actualization of the set vision and goals to be achieved
successfully in the proposed mission. The individuals’ spiritual belief system may generate empowerment
along this pathway.
Membership: The diversity of religious affiliations, spiritual beliefs, culture and social structures,
demands efforts to try to understand each other and appreciate each other’s strengths and tolerate each
other’s limitations with the intention to generate self-development and team work. This collegial
process stems from the interactions and communication between the members of the multidisciplinary
team and also the development of therapeutic relationship with the patient [92,93].
Meaning/Calling: Educators in the faculty and clinical placements identify the “calling”/vocational
aspect as the sacred part of the profession, which may yield a transcendent experience, while becoming
aware of the related empowerment to dedicate oneself to the care of others professionally. Eventually,
educators may realize the worth of serving others, the wealth of making a difference in students’ and
patients’ lives. Hopefully, through reflection, educators may realize that while they are giving to
others, they are also receiving. Consequently, meaning and purpose in life is created along the
pathway of learning from each other. Thus, the actual work environment is transformed into a
workplace with a social meaning and value and not simply a job of people, or just seeking competence
and knowledge [94].
Organizational Commitment: The practice of altruism, safe belongingness, and a sense of meaning
at work will contribute towards a healthy environment, enhanced collegiality and collaboration, with
less stress-induced sick leave, higher motivation and faithfulness to their individual “calling”/vocation
in their respective profession. Thus an environment with a culture based on values and altruism may
generate role-models to teach spiritual care and feelings of peace and security at work [95].
Productivity: Productivity is interpreted as an intelligent process of implementing interventions
based on research evidence, creativity and innovations to achieve the set goals. Consistent reflection in
and on action may lessen mistakes in care, one of which is the neglect of the spiritual dimension in
care [96].
Religions 2015, 6 605
These characteristics may foster learning by role models generated from an environment of
cooperation, trust, commitment and effectiveness of collegial work [97]. This environment may be
inhibited by various factors, such as work overload, lack of time, incomplete staff complement, lack of
job security [98], impaired personal spirituality, and career motivation system [99]. Motivation supported
by personal spirituality was found positively related with better performance due to achievement of
goals at work and collegial relationship in the education and delivery of holistic care [100].
7. Conclusions
Research identifies the active role of the nurses and health care professionals in meeting the
spiritual needs of patients in collaboration with the family and the chaplain. However, it is well
documented that nurses and health care professionals have overlooked the spiritual dimension in care
with the consequence of threatening holistic care. While considering the complexity of spirituality and
spiritual care, and the barriers to the delivery of spiritual care documented in the literature, the author
presented various innovative teaching methods, which were introduced in various undergraduate and
post-graduate course programs of nurses and health care professionals in Malta and foreign universities.
The teaching methods integrated within the theoretical and clinical dimensions were guided by
conceptual models to enhance learning such as, Benner’s theory: From Novice to Expert: Excellence and
Power in Clinical Nursing Practice; Kolb’s experiential learning theory; Gibbs theory of reflective
learning; and the ASSET model for Actioning Spirituality and Spiritual care Education and Training in
nursing. Experiential learning, visits in the community, reflective exercises and reflective written
accounts, use of arts for expression of the complex concepts of spiritual care, discussions on observed
delivery of holistic care, participation in research, tutorials, and role modeling were identified as
beneficial resources of learning. Various factors were identified which may influence students’
education on spiritual care, such as characteristics of students, the extent to which the academic and
clinical environments in hospital and in community are conducive to learning, and culture. This paper
identifies the essence of spiritual care, which is being in doing, whereby personal spirituality
and therapeutic use of self may contribute towards the education and delivery of spiritual care and
holistic care.
8. Recommendations
The following recommendations are set for the education, clinical, and management sectors;
personal spirituality; and further research to enhance education on spiritual care.
8.1. Education
Students tend to be examination-oriented so they tend to prefer to study for their examinations.
Thus, examining clinical skills in spiritual care would identify the degree of acquisition of competence
in spiritual care. Therefore, a framework on competences in spiritual care needs to be developed as a
guide for the education and clinical sectors.
Literature confirmed that theoretical study units on spiritual care may be effective to the nurses’ and
midwives’ perceived competence in spiritual care. Continuous professional development (CPD) is
Religions 2015, 6 606
mandatory by reading literature and research, attending seminars, conferences, CPD courses on
spiritual care in order to achieve competence and maintain high quality holistic care [101–103].
8.2. Clinical Practice
Literature discusses spiritual care learning as part of a total curriculum program emphasizing the
clinical studies and ways of facilitating reflection in practice together with clinical tutorials as
important in the students’ learning process. Thus, students need to be provided with “teachable
moments” by reflecting with students on patient care so that they can learn and approach new
encounters with greater awareness and appropriate action [104].
Clinical practice presents students with diverse and rich opportunities to learn about the reality and
nature of patients’ spiritual needs and spiritual well-being in real-life situations. Students need to
practice before they can fully understand the theoretical component. Thus role-modeling by health care
professionals and mentors in the clinical placements is of utmost importance to help students to
understand and to implement spiritual care. Furthermore, an effective dialogue between the clinical
settings and the educational organizations is needed to maximize learning opportunities for students.
Spirituality and spiritual care are complex concepts, especially when faced with the diverse
religions held by patients in hospital and the community. Learning about the relationship between
religion and health care is of utmost importance especially in this era of immigrants with different
religious affiliations who are admitted to hospital. Additionally, addressing spiritual distress and
spiritual needs may involve various ethical issues, such as confidentiality in documenting certain
aspects of spiritual assessment. Thus, support groups are needed for debriefing sessions to express
feelings, biases and address ethical issues involved in spiritual care.
8.3. Management
Spiritual leadership is needed to develop a clinical environment conducive to learning spiritual care
by facilitating holistic care and teamwork, which foster spirituality at the workplace.
Awareness of the sacredness of the caring profession and clinical environment is essential.
“When comparing the hospital to a sanctuary, the patient is the tabernacle”, whereby the patient is
the center of holistic care [105].
8.4. Further Research
Further transcultural longitudinal research is needed to identify the most appropriate and effective
pedagogical approaches to teach spiritual care to students [106], such as by online and interactive
simulation by intra-professional and inter-professional educational programs.
8.5. Personal Spirituality
The frequency of attending religious services and spiritual experiences were found to contribute
towards the students’ positive attitude towards spiritual care [107]. Thus, further research is suggested
to identify the possible impact of personal characteristics, such as age, gender, personality traits,
religious practices and life experiences on holistic care.
Religions 2015, 6 607
Personal religiosity and spirituality of students, their mentors and health care professionals may
foster a healthy spiritual clinical environment. Thus, organization of spiritual retreats, prayer meetings
for students and health care professionals may be beneficial to both the caregiver and the recipient of
their care. Finally, the richness of both the theoretical presentations and socio-religious events during
the European Conference on Religion Spirituality and Health in Malta in 2014, may enhance
motivation to become change agents with the possible ultimate ripple beneficial effects of spiritual care:
If you reform your spiritual-self, you will reform your professional care;
If you reform your professional care, you will reform your holistic care;
If you reform your holistic care, you will reform the care spiritually.
The author appreciates the cooperation of Roberta Sammut, Head of the Nursing Department,
Faculty of Health Sciences; the hospitals’/residences’ managers; the Catholic church authorities of the
day centers in the community; the Caritas and related Agencies; the Scientific Committee of the
ECRSH 2014 Conference; the nursing students who undertook the study units related to spiritual care;
Lilian Bonello for proof reading; Family Attard for providing a quiet reflective seaside environment to
write this manuscript; and the three anonymous reviewers.
Conflicts of Interest
The author declares no conflict of interest.
1. International Council for Nurses (ICN). Code of Ethics for Nurses. Geneva: ICN, 2000.
2. Nursing and Midwifery Board. Maltese Code of Ethics for Nurses and Midwives. Valletta:
Nursing and Midwifery Board, 2001.
3. Florence Nightingale. Notes on Nursing: What Is Nursing and What Is Not. New York: Dover
Publications Inc., 1860.
4. Donia Baldacchino. Spirituality in Illness and Care. Blata l-Bajda: Preca Library, 2003.
5. BBC. “Why Is Mary Seacole Famous? The History of Mary Seacole.” 2015. Available online: (accessed on 30
March 2014).
6. Jane Williams. Betsy Cadwaladyr: A Balaclave Nurse. An Autobiography of Elisabeth Davis.
Dinas Powys: Dinefwr Press, 2007.
7. Wilfred McSherry, and Linda Ross. Spiritual Assessment in Healthcare Practice. Cumbria:
M & K Update Ltd., 2010.
8. Wendy Cadge, Elaine Howard Ecklund, and Nicholas Short. “Religion and Spirituality: A barrier
and a bridge in everyday professional work of Paediatric Physicians.” Journal of Social Problems
56 (2009): 702–21.
Religions 2015, 6 608
9. Susan Ronaldson, Lilian Hayes, Christina Aggar, Jennifer Green, and Michele Carey.
“Spirituality and Spiritual Caring: Nurses’ Perspectives and Practice in Palliative and Acute Care
Environments.” Journal of Clinical Nursing 21 (2012): 2126–35.
10. Michael J. Balboni, Adam Sullivan, Andrea C. Enzinger, Zachary D. Epstein-Peterson, Yolanda
D. Tseng, Christine Mitchell, Joshua Niska, Angelika Zollfrank, Tyler J. Vanderweele, and Tracy
A. Balboni. “Nurse and physician barriers to spiritual care provision at end of life.” Journal of
Pain Symptom Management 48 (2014): 400–10.
11. Betty Neuman. The Neuman Systems Model. Norwalk: Appleton and Lange, 2010.
12. Larry F. Renetzky. “The fourth dimension: Applications to the social services.” In Spiritual
Well-Being. Sociological Perspectives. Edited by David O. Moberg. New York: University Press
of America, 1979.
13. Donia Baldacchino, and Peter Draper. “Spiritual coping strategies: A review of the nursing
research literature.” Journal of Advanced Nursing 34 (2001): 833–41.
14. Ruth Murray, and Judith Proctor Zentner. Nursing Concepts for Health Promotion. London:
Prentice Hall, 1989.
15. Kristina Torskenes, Donia Baldacchino, Tracey Baldacchino, Josette Borg, Marica Falzon, and
Mary Kalfoss. “Nurses’ and informal caregivers’ definition of spirituality from the Christian
perspective: A comparative study between Malta and Norway.” Journal of Nursing Management
23 (2013): 39–53.
16. Carolyn Young, and Cyndie Koopsen. Spirituality, Health, and Healing: An Integrative
Approach, 2nd ed. Sudbury: Jones & Bartlett Learning, 2011.
17. Donia Baldacchino. “Spiritual Care: Is it the nurse’s role?” Spirituality & Health International 9
(2009): 270–84.
18. Linda Ross. Nurses’ Perceptions of Spiritual Care. Avebury: Aldershot, 1997.
19. Mohsen Saffari, Harold Koenig, Ghader Ghanizadeh, Amir H. Pakpour, and Donia R.
Baldacchino. “Psychometric Properties of the Persian Spiritual Coping Strategies Scale in
Haemodialysis Patients.” Journal of Religion & Health 53 (2013): 1025–35.
20. Mohsen Saffari, Amir H. Pakpour, Maryam K. Naderi, Harold Koenig, Donia R. Baldacchino,
and Chrystal N. Piper. “Spiritual coping, religiosity and quality of life: A study on Muslim clients
on haemodialyis.” Nephrology 18 (2013): 269–75.
21. Cynthia Kociszewski. “A Phenomenological pilot study of the nurses’ experience providing
spiritual care.” Journal of Holistic Nursing 21 (2003): 131–48.
22. Leslie van Dover, and Jane Pfeiffe. “Patients of parish nurses experience renewed spiritual
identity: A grounded theory study.” Journal of Advanced Nursing 68 (2011): 1824–33.
23. Terry L. Koenig. “Caregivers use of spirituality in ethical decision-making.” Journal of
Gerentological Social Work 45 (2014): 155–72.
24. Tracy A. Balboni, Mary E. Paulk, Michael J. Balboni, Andrea C. Phelps, Elisabeth T. Loggers,
Alexi A. Wright, Susan D. Block, Eldrin F. Lewis, John R. Peteet, and Holly G. Prigerson.
“Provision of spiritual care to patients with advanced cancer: Associations with medical care and
quality of life near death.” Journal of Clinical Oncology 28 (2010): 445–52.
25. Dawn Freshwater. “The Therapeutic Use of Self in Nursing.” 2002. Available online: (accessed on 5 April 2015).
Religions 2015, 6 609
26. Ann Bradshaw. Lighting the Lamp. The Spiritual Dimension of Nursing Care. Middlesex: Scutari
Press, 1994.
27. The Nursing and Midwifery Council. The Nursing and Midwifery Council (NMC) in the UK
Requirements for Pre-Registration Nursing Programme. London: NMC, 2002.
28. The European Qualifications Framework for Lifelong Learning. The European Qualifications
Framework for Lifelong Learning. Belgium: European Commission Press, 2008.
29. Patricia Benner. “Issues in competency-based training.” Nursing Outlook 30 (1982): 303–09.
30. Patricia Benner. From Novice to Expert: Excellence and Power in Clinical Nursing Practice.
Menlo Park: Addison-Wesley, 1984.
31. Michael Eraut. Developing Professional Knowledge and Competence. London: Falmer Press,
32. David R. Hodge. “Developing cultural competence with Evangelical Christians.” Families in
Societies 85 (2004): 251–60.
33. Donia Baldacchino. “Nursing competencies for spiritual care.” Journal of Clinical Nursing 15
(2006): 885–96.
34. Rene van Leeuwen, and Barth Cusveller. “Nursing competencies for spiritual care.” Journal of
Advanced Nursing 48 (2004): 234–46.
35. Mikael Lundmark. “Attitudes to spiritual care among nursing staff in a Swedish oncology clinic.”
Journal of Clinical Nursing 15 (2006): 863–74.
36. Denise Miner-Williams. “Putting a puzzle together: Making spirituality meaningful for nursing
using an evolving theoretical framework.” Journal of Clinical Nursing 15 (2006): 811–21.
37. William M. Sullivan. “Medicine under threat: Professionalism and professional identity.”
Canadian Medical Association Journal 162 (2000): 1–7.
38. Josephine Attard, and Donia Baldacchino. “The demand for competencies in Spiritual care in
nursing and midwifery education: A literature review.” Revista Pistis Praxis, Teologia Pastorale
6 (2014): 671–91.
39. Gowri Anandarajah, and Ellen Hight. “Spirituality and medical practice: Using the HOPE
Questions as a practical tool for spiritual assessment.” American Family Physician 63 (2001):
40. Donia Baldacchino. “The nurse’s role in spiritual care: A comparative study between perceptions
of patients with first myocardial infarction and health carers in Malta.” In Nursing Today. Edited
by L. Beldean, U. Zeitler and L. Rogozea. Editura: Alma Mater, 2005, pp. 137–46.
41. Emily M. Cramer, and Kelly E. Tenzek. “The Chaplain profession from the employer
perspective: An analysis of hospice chaplain Job Advertisements.” Journal of Health Care
Chaplaincy 18 (2012): 133–50.
42. Linda Ross, Rene van Leeuwen, Donia Baldacchino, Tove Giske, Wilfred McSherry, Aru
Narayanasamy, Carmel Downes, Paul Jarvis, and Annemiek Schep-Akkerman. “Student nurses
perceptions of spirituality and competence in delivering spiritual care: A European pilot study.”
Nurse Education Today 34 (2014): 697–702.
43. Brenda Leonard, Elaine L. H. Shuhaibar, and Ruth Chen. “Nursing student perceptions of
intra-professional team education using high-fidelity simulation.” Journal of Nursing Education
49 (2010): 628–31.
Religions 2015, 6 610
44. Centre for the Advancement of Inter-professional Education (CAIPE). Inter-Professional
Education—A Definition. London: CAIPE Bulletin, 1997, vol. 13, p.19.
45. Health Professions Networks, Nursing and Midwifery, and Human Resources for Health.
Framework for Action on Inter-Professional Education and Collaborative Practice. Geneva:
W.H.O. Press, 2010. Available online:
10.3_eng.pdf (accessed on 10 May 2014).
46. Louisa Mcllwaine, Valentine Scarlett, Alan Venters, and Jean Ker. “The different levels of
learning about dying and death: An evaluation of a personal, professional and inter-professional
learning journey.” Medical Teaching 29 (2007): 151–59.
47. Marilyn Hammick, Della Freeth, Ivan Koppel, Scott Reeves, and Hugh Barr. “A best evidence
systematic review of inter-professional education: BEME Guide No 9.” Medical Teaching 29
(2007): 735–51.
48. Katherine Pollard, and Margaret E. Miers. “From students to professionals: Results of a
longitudinal study of attitudes to pre-qualifying collaborative learning and working in health and
social care in the United Kingdom.” Journal of Interprofessional Care 22 (2008): 399–416.
49. Robin Lennon-Dearing, Joseph A. Florence, Helen Halvorsin, and James T. Pollard. “An
interprofessional educational approach to teaching spiritual assessment.” Journal of Healthcare
Chaplain 18 (2012): 121–32.
50. Matthew S. Ellman, Dena Schulman-Green, Leslie Blatt, Susan Asher, Diane Viveiros, Joshua Clark,
and Margaret Bia. “Using online learning and interactive simulation to teach spiritual and
cultural aspects of palliative care to inter-professional students.” Journal of Palliative Medicine
15 (2012): 1240–47.
51. Tove Giske. “How undergraduate nursing students learn to care for patients spiritually in clinical
studies—A review of literature.” Journal of Nursing Management 20 (2012): 1–9.
52. Aru Narayanasamy. “ASSET: A model for actioning spirituality and spiritual care education and
training in nursing.” Nurse Education Today 19 (1999): 274–85.
53. Donia Baldacchino. Spiritual Care: Being in Doing. Blata l-Bajda: Preca Library, 2010.
54. Pamela P. Cone, and Tove Giske. “Teaching spiritual care—A grounded theory study among
undergraduate nursing educators.” Journal of Clinical Nursing 22 (2012): 1951–60.
55. Donia Baldacchino. “Spiritual Care Education of Health Care Professionals.Available online: (accessed on 22 May 2014).
56. Donia Baldacchino, Kristina B. Torskenes, Josette Borg, Mary Kalfoss, Aaron Tonna, Clifford
Debattista, Neville Decelis, and Rodianne Mifsud. “Spiritual coping of clients on rehabilitation:
A comparative study between Malta and Norway (Part I).” British Journal of Nursing 22 (2013):
57. Amanda J. Henderson, Joanna Briggs, Sue Schoonbeek, and Karen Paterson. “A framework to
develop a clinical learning culture in health facilities: Ideas from the literature.” International
Nursing Review 58 (2011): 196–202.
58. Ann Bradshaw. “Teaching spiritual care to nurses: An alternative approach.” International
Journal of Palliative Nursing 3 (1997): 51–57.
Religions 2015, 6 611
59. Josephine Attard, Donia R. Baldacchino, and Liberato Camilleri. “Nurses’ and midwives’
acquisition of competency in spiritual care: A focus on education.” Nurse Education Today 26
(2014): 1460–66.
60. Donia R. Baldacchino. “Teaching on ‘The Spiritual Dimension in Care’: The perceived impact
on undergraduate nursing students.” Nurse Education Today 28 (2008): 501–12.
61. Patricia Benner, and Molly Sutphen. “Learning across the professions: The clergy, a case in
point.” Journal of Nursing Education 46 (2007): 103–08.
62. Tove Giske, and Pamela Cone. “Opening up to learning spiritual care of patients: A grounded
theory study of nursing students.” Journal of Clinical Nursing 21 (2012): 2006–15.
63. Ann Purdie, Louisa Sheward, and Elaine Gifford. “Student nurse placements take a new
direction.” Nurse Education in Practice 8 (2008): 315–20.
64. Donia Baldacchino. “Caring in Lourdes: An innovation in students’ clinical placement.” British
Journal of Nursing 19 (2010): 352–66.
65. Graham Gibbs. Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Oxford
Polytechnic, 1988.
66. David Kolb. Experiential Learning: Experience as the Source of Learning and Development.
Englewood Cliffs: Prentice-Hall, Inc., 1984.
67. Dee Marie Zyblock. “Nursing presence in contemporary nursing practice.” Nursing Forum 45
(2010): 120–24.
68. Cleda Meyer. “Mentoring for spiritual caregiving: What factors enable nursing students or new
graduated to provide spiritual care?” Journal of Christian Nursing 22 (2005): 38–40.
69. Barbara Pesut. “The development of nursing students’ spirituality and spiritual care-giving.”
Nurse Education Today 22 (2002): 128–35.
70. Denise L. Mitchell, Marsha J. Bennett, and Linda Manfrin-Leder. “Spiritual development of
nursing students: Developing competence to provide spiritual care to patients at the end of life.”
Journal of Nursing Education 45 (2006): 365–70.
71. Aru Narayanasamy. “The impact of empirical studies of spirituality and culture on nurse
education.” Journal of Clinical Nursing 15 (2006): 840–51.
72. Joseph D. Cortis. “Meeting the needs of minority ethnic patients.” Journal of Advanced Nursing
48 (2004): 51–58.
73. Bruce D. Feldstein, Marita Grudzen, Art Johnson, and Samuel LeBaron. “Integrating Spirituality
and Culture with End-of-Life Care in Medical Education.” Clinical Gerontologist 31 (2008):
74. Corinne Lemmer. “Teaching the spiritual dimension of nursing care: A survey of US
baccalaureate nursing programs.” Journal of Nursing Education 41 (2002): 482–90.
75. Lynn Clark Callister, Elaine A. Bond, Gerry Matsumura, and Sandra Mangum. “Threading
spirituality throughout nursing education.” Holistic Nursing Practice 18 (2004): 160–66.
76. Elisabeth A. Rankin, and Mary B. DeLashmutt. “Finding spirituality and nursing presence: The
student’s challenge.” Journal of Holistic Nursing 24 (2006): 282–88.
77. Ana Maria Catanzaro, and Kathleen A. McMullen. “Increasing nursing students’ spiritual
sensitivity.” Nurse Educator 26 (2001): 221–26.
Religions 2015, 6 612
78. John Milliman, Andrew J. Czaplewski, and Jeffery Ferguson. “Workplace spirituality and
employee work attitudes. An exploratory empirical assessment.” Journal of Organisation
Change Management 16 (2003): 426–47.
79. Don Grant, Kathleen O’Neil, and Laura Stephens. “Spirituality in the Workplace: New Empirical
Directions in the Study of the Sacred.” Sociology of Religion 65 (2004): 265–83.
80. Jamil Sadeghifar, Mohammed Bahadori, Donia Baldacchino, Mehdi Radaabadi, and Mehdi Jafari.
“Relationship between Career Motivation and Perceived Spiritual Leadership in Health
Professional Educators: A Correlational Study in Iran.” Global Journal of Health Science 6
(2013): 145–54.
81. John Fisher, and David Brumley. “Nurses’ and carers’ spiritual wellbeing in the workplace.”
Australian Journal of Advanced Nursing 25 (2007): 49–57.
82. Joanna Crossman. “Conceptualising spiritual leadership in secular organizational contexts and its
relation to transformational, servant and environmental leadership.” Leadership & Organization
Development Journal 31 (2010): 596–608.
83. Judi Neal. Handbook of Faith and Spirituality in the Workplace—Emerging Research and
Practice. London: Springer, 2013, pp. 3–18.
84. Stephen G. Post, Christina M. Puchalaiski, and David Larson. “Physicians and patient
spirituality: Professional Boundaries, competency and Ethics.” American College of Psysicians,
American Society of Internal Medicine 132 (2000): 578–83.
85. Christina M. Puchalski. “Spirituality and health: the art of compassionate medicine.” Hospital
Physician 37 (2001): 30–36.
86. Dee W. Ford, Lois Downey, Ruth Engelberg, Anthony L. Back, and Curtis J. Randall.
“Discussing religion and spirituality is an advanced communication skill: An exploratory
structural equation model of physician trainee self-ratings.” Journal of Palliative Medicine 15
(2012): 63–70.
87. Michael Balboni, Adam Sullivan, Adaugo Amobi, Andrea C. Phelps, Daniel P. Gorman,
Angelika Zollfrank, and John Peteet, Holly P. Briggerson, Tyler J. Vanderweele, and Tracy A.
Balboni. “Why is spiritual care infrequent at the end of life? Spiritual care perceptions among
patients, nurses, and physicians and the role of training.” Journal of Clinical Oncology 31
(2013): 461–67.
88. Lesley W. Fry. “Towards a theory of spiritual leadership.” The Leadership Quarterly 14 (2003):
89. Gary Geroy, Mario Fernando, and Frederick Beale. “The spiritual dimension in leadership at
Dilmah Tea.” Leadership & Organization Development Journal 30 (2009): 522–39.
90. Mary Carolyn Cooper. “The intersection of technology and care in the ICU.” Advances in
Nursing Science 15 (1993): 23–32.
91. Louis W. Fry, Sean T. Hannah, Michael Noel, and Fred O. Walumbwa. “Impact of spiritual
leadership on unit performance.” The Leadership Quarterly 22 (2011): 259–70.
92. Jeanne Siddiqui. “The Therapeutic relationship in midwifery.” British Journal of Midwifery 7
(1999): 111–14.
93. Agneta Schreurs. Psychotherapy and Spirituality: Integrating the Spiritual Dimension into
Therapeutic Practice. London: Jessica Kingsley Publishers, 2002.
Religions 2015, 6 613
94. Jeffery Pfeffer. Business and the Spirit. Handbook of Workplace Spirituality and Organizational
Performance. New York: ME Sharpe, 2003, pp. 29–45.
95. John Arnold, Ray Randall, Joanne Silvester, Fiona Patterson, Ivan Robertson, Cary Cooper,
Bernard Burnes, Don Harris, Carolyn Axtell, and Deanne Den Hartog. Work Psychology.
Understanding Human Behaviour in the Workplace, 4th ed. Madrid: Pearson Education Limited,
96. William McEwan. “Spirituality in nursing.” Orthopaedic Nursing 23 (2004): 321–26.
97. Afsaneh Mohammadi, Zohreh Vanaki, and Ashraf Mohammadi. “Effect of Implementation of
Motivational Program Based on ‘Expectancy Theory’ by Head Nurses on Patients’ Satisfaction.”
Hayat 18 (2012): 47–60.
98. Ali Khan Khuwaja, Riaz Qureshi, Marie Andrades, Zafar Fatmi, and Nadia Kha Khuwaja.
“Comparison of job satisfaction and stress among male and female doctors in teaching hospitals
of Karachi.” Journal of Ayub Medical College, Abbottabad 16 (2003): 23–27.
99. Gilbert W. Fairholm. “Spiritual leadership: Fulfilling wholeself needs at work.” Leadership &
Organization Development Journal 17 (1996):11–17.
100. Ahmed Al-Rfou, and Khalaf Trawneh. “Achieve Competitive Advantage through Job Motivation.”
Journal of Social Sciences 20 (2007): 105–07.
101. George Handzo, and Harold G. Koenig. “Spiritual Care: Whose job is it anyway?” Southern
Medical Journal 97 (2004): 1242–44.
102. Christopher Levison. “Partners in care.” Nursing Management 12 (2005): 18–21.
103. Rene van Leeuwen, Lucas Tiesinga, Doeke Post, and Henk Jochemsen. “Spiritual care: Implications
for nurses’ professional responsibility.” Journal of Clinical Nursing 15 (2006): 875–84.
104. Cynthia Johnston, and Ann E. Mohide. “Addressing diversity in clinical nursing education:
Support for preceptors.” Nurse Education in Practice 9 (2009): 340–47.
105. Jason Azzopardi. “The sacredness of patient care.” Il-Mument 3 (2010): 13–15.
106. Linda Ross. “Spiritual care in nursing: An overview of the research to date.” Journal of Clinical
Nursing 15 (2006): 852–62.
107. Neil Cockell, and Wilfred McSherry. “Spiritual care in nursing: An overview of published
international research.” Journal of Nursing Management 20 (2012): 958–69.
© 2015 by the author; licensee MDPI, Basel, Switzerland. This article is an open access article
distributed under the terms and conditions of the Creative Commons Attribution license
... La revisión exhaustiva de la literatura identificó evidencia clave sobre el cuidado espiritual y el papel activo de los profesionales de enfermería en la satisfacción de las necesidades espirituales de los pacientes 30 . Por otro lado, se reconoce que los profesionales de la salud ignoran la dimensión espiritual, lo que amenaza el abordaje holístico del cuidado 31 ; si se considera la complejidad de los conceptos de espiritualidad y cuidado espiritual en los estudios revisados, se propusieron varios enfoques pedagógicos innovadores, que fueron implementados en varios proyectos de cursos de pregrado y posgrado para enfermeros y enfermeras de diferentes países y que demostraron un resultado positivo de las intervenciones. ...
... También es importante mencionar los estudios descritos en la literatura que, aunque no hayan propuesto métodos experimentales, han formulado temas para fortalecer la capacidad de atención espiritual a través de enfoques educativos integrados en las dimensiones teórica y clínica basados algunos en la teoría de Benner. 30 Los estudios de intervención en la educación del cuidado espiritual han mostrado cambios significativos en las habilidades de formación de los estudiantes y profesionales de enfermería, tales como estrategias de comunicación, evaluación y documentación de las necesidades espirituales de los pacientes y formulación de planes de atención de enfermería que se enfocan en cuidar a los pacientes y sus familias de manera integral. También en los resultados del análisis, las enfermeras informaron que se sentían mejor preparadas para los problemas espirituales y podían discutir estos problemas con los pacientes. ...
Full-text available
Highlights: El abordaje de la dimensión espiritual de los pacientes y sus familias cuando se encuentran en situación de enfermedad, vulnerabilidad o riesgo de morir es una necesidad que ha sido manifiesta por los pacientes. La educación en cuidado espiritual incluye la percepción y fortalecimiento de la propia espiritualidad de los estudiantes, y las temáticas de los conceptos de espiritualidad intrapersonal e interpersonal. Los contextos en los que se desarrollaron las intervenciones educativas en cuidado espiritual van desde ambientes netamente educativos, hasta escenarios de práctica clínica formativa. Las intervenciones educativas para fortalecer la competencia espiritual en estudiantes de enfermería muestran que la espiritualidad personal de los estudiantes es un predictor fuerte de la capacidad para proporcionar cuidados espirituales a pacientes y familias. Introducción: El cuidado espiritual puede considerarse un elemento central de la filosofía del cuidado holístico. Objetivo: Identificar investigaciones de intervención con perspectivas y estrategias educativas para el desarrollo de competencias en cuidado espiritual. Materiales y métodos: Revisión de la literatura en el período 2001-2021 de las bases de datos PubMed, ProQuest, Scopus, Lilacs y BVS (Biblioteca Virtual en Salud). Se siguieron las recomendaciones PRISMA y se basaron en parámetros definidos por Whittemore y Knafl para la identificación de problemas, búsqueda bibliográfica, evaluación y análisis de datos. Resultados: se encontraron 10 artículos de intervención publicados. Los entrenamientos relacionados con el desarrollo de habilidades para el cuidado espiritual fueron realizados en programas de formación superior del personal de enfermería. Las estrategias de instrucción son cursos específicos, sesiones cortas o programas a lo largo del plan de estudios. Las intervenciones muestran efectos sobre las habilidades y conocimientos. La espiritualidad individual de los estudiantes predice la capacidad de brindar atención espiritual. Conclusiones: Hay evidencia de estrategias para desarrollar la competencia de estudiantes y profesionales de enfermería en cuidado espiritual, aún son escasas las publicaciones sobre el tema, por lo que se necesitan nuevas y más rigurosas estrategias para desarrollar competencia en este enfoque de la disciplina de enfermería. Como citar este artículo: Torres Contreras Claudia Consuelo, Vargas Escobar Lina María, Triana Rodríguez Jorge Yecid, Cañon-Montañez Wilson. Competencia en cuidado espiritual en enfermería: Revisión integrativa de literatura. Revista Cuidarte. 2023;14(2): e2635.
... na przyglądaniu się swojej historii, swojej wartości, motywacji, która doprowadziła do wyboru zawodu medycznego, a także poszukiwaniu głębszego sensu pracy lekarskiej. Studenci zostają zaproszeni do tego, aby opowiedzieć, co nimi kierowało przy wyborze zawodu polegającego na pomocy cierpiącemu człowiekowi (Baldacchino, 2015). Przypominanie sobie o tym pragnieniu będzie szczególnie ważne, gdy praca zawodowa zacznie przytłaczać liczbą godzin, koniecznością obsługi skomplikowanych urządzeń czy nadmierną biurokracją. ...
... lub w domu starszej osoby mieszkającej samotnie. Zadanie polega na tym, aby studenci dowiedzieli się, w jaki sposób odwiedzane osoby radzą sobie z doświadczanym cierpieniem (Baldacchino, 2015). Podobny efekt można osiągnąć, prezentując opublikowane przypadki (case studies), jednak nic nie zastąpi spotkania z żywym człowiekiem, szczególnie w jego własnym domu, w którym może pokazać religijne przedmioty, które są dla niego pomocne. ...
Full-text available
Badania naukowe dostarczają coraz więcej informacji na temat wpływu duchowości na zdrowie jednostki oraz na system ochrony zdrowia. Scientific research provides more and more information on the impact of spirituality on the health of the individual and the health care system.
... Clinical nurses often overlook spiritual care or refer the patients to religious personnel. This may be the result of factors at an individual level (viewing spirituality as meeting patients' religious needs rather than an integrated element of nursing practice, for example), professional education levels (lack of nursing education on the meaning of spirituality and its differentiation from religion), and organizational level (a medical model of care delivery and a business model of managing the healthcare system) factors [21][22][23][24][25]. ...
... Each element of the course was designed to address specific content that was central to understanding spiritual care in nursing (Table 2) [11,21,26,[35][36][37]43,[49][50][51][52]. With consideration for the learning objectives, the content of the course contained the spiritual impact of illness; definitions of spirituality, religion, and spiritual care; talking about spiritual clues of patients and families; spiritual needs assessment; spiritual care nursing process; spiritual distress and wellbeing; spiritual care methods and skills; searching life's meaning and purpose, and individual spiritual reflection [13,22,31,[53][54][55][56]. Six experts on spiritual care practice, hospice and palliative care, and simulation were invited to evaluate the PowerPoint content and the spiritual care scenario using a 4-point Likert scale. ...
Full-text available
Across their lifespans, and in many clinical settings, patients have spiritual care needs. Many nurses lack competence related to providing spiritual care. Popular educational strategies, such as simulated educational programs and objective structured clinical examinations (OSCE), have not been widely adopted in nursing spiritual care education. The purpose of this study was to explore the effects of a scenario-based spiritual care course on spiritual care competence in nurses. This quasi-experimental study employed a repeated-measures pre-test/post-test design with assessments immediately before, immediately after, and 3 months post-intervention. Nurses providing direct patient care in diverse clinical settings were recruited from a large medical foundation in northern Taiwan. The intervention was a one day scenario-based spiritual care course and OSCE. The experimental group (n = 53) and controls (n = 85) were matched for their similar units, ages, working experience, and clinical ladder status. The Spiritual Care Competence Scale (SCCS), Spiritual Perspective Scale (SPS), Spiritual Care Perspective Scale-Revised (SCPS-R), and reflection logs were completed by both experimental and control groups. The Course Satisfaction Scale, OSCE Checklist, and Standardized Patient Feedback Scale (SPFS) were completed by the experimental group only. The experimental group had significantly higher SPS scores and self-evaluated SCCS scores, and lower SCPS-R scores (more positive spiritual perspectives), than controls at 3 months post-intervention. The experimental group showed significant within-subject effects at three time points on SPS scores, SCPS-R scores, and self-evaluated SCCS scores. Mean global performance of OSCE was 3.40 ± 0.91, and SP feedback indicated strengths and areas for improvement. In conclusion, the scenario-based spiritual care course effectively enhanced nurses’ spiritual care competence, competence, and skills. Blended education techniques can therefore enhance nurses’ ability to support patients with spiritual care needs.
... Spiritual awareness seems to enhance the attention given to what limits the implementation of spiritual care. Furthermore, professionals who value personal spirituality and therapeutic use of themselves can deliver more holistic care and surpass barriers to spiritual care [52]. ...
Full-text available
Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.
... To make the most of limited resources, it is essential to set priorities for projects in light of community needs and circumstances. Baldacchino (2015) claims that The effectiveness of socialization activities may be diminished due to a lack of access to educational and medical resources. To combat this, institutions of higher learning and healthcare providers should work together to expand patients' access to a full range of medical care options, including those related to sexual and reproductive health. ...
Full-text available
The socialization of education concerning early marriage in rural areas is the subject of this report. In many rural areas, girls are still getting married off at young ages, which has devastating effects on their futures as learners and on their health and safety. Community workshops, peer education programs, parental education, and media campaigns are all included in the report as viable socializing activities to encourage girls to continue their education and postpone marriage. Effective tactics, such as incorporating local leaders, partnering with schools and health centers, employing culturally relevant materials, monitoring and evaluation, are needed to put these efforts into action. To guarantee the success of these endeavors, however, it will be necessary to overcome obstacles including community opposition, scarce resources, and language and cultural divides. In order to enhance results for girls, families, and communities, the report emphasizes the necessity of a long-term commitment to supporting girls' education and delaying marriage.
... Scarce research has investigated this phenomenon and developed accurate criteria for integrating spiritual care in PC practice and education [36], thereby bridging the gap between theory and practice. To address this gap, the primary purpose of this project is to develop spiritual care competence recommendations for PC education and practice in Portugal and Spain. ...
Full-text available
Spiritual care requires understanding the spiritual experiences of patients and recognizing their resources and needs. Therefore, educators and practitioners should develop their knowledge and understanding in this regard. Spiritual care helps people overcome their anxieties, worries, and suffering; reduces stress; promotes healing; and encourages patients to find inner peace. To provide comprehensive and appropriate care while upholding human/ethical virtues, the spiritual dimension must be a priority. We aim to develop spiritual care competence guidelines for Palliative Care (PC) education and practice in Portugal and Spain. The study detailed in this protocol paper will include three phases. In phase I, the phenomenon will be characterized and divided into two tasks: (1) a concept analysis of "spiritual care competence"; and (2) a systematic review of interventions or strategies used to integrate spiritual care in PC education and practice. Phase II will entail a sequential explanatory approach (online survey and qualitative interviews) to deepen understanding of the perceptions and experiences of educators, practitioners, and patients/family carers regarding spiritual care in PC education and practice and generate ideas for the next steps. Phase III will comprise a multi-phased, consensus-based approach to identify priority areas of need as decided by a group of experts. Results will be used to produce guidelines for integrating spirituality and spiritual care competence within PC education and practice and synthesized in a white book for PC professionals. The value of this improved examination of spiritual care competence will ultimately depend on whether it can inform the development and implementation of tailored educational and PC services. The project will promote the 'spiritual care' imperative, helping practitioners and patients/family carers in their preparedness for End-of-Life care, as well as improving curricular practices in this domain.
Full-text available
A espiritualidade é uma característica individual e subjetiva que auxilia no enfrentamento de situações adversas, sendo um aspecto importante tanto para o paciente como para os profissionais de saúde no contexto da oncologia. Esta pesquisa teve como objetivo identificar o nível de espiritualidade dos profissionais de saúde e compará-lo com o nível de espiritualidade dos pacientes oncológicos com dor. Trata-se de um estudo quantitativo, descritivo e transversal, realizado em um hospital de médio porte, referência regional para o tratamento oncológico, e em uma instituição de apoio ao paciente com câncer localizada em um município do sul da Bahia. A amostra foi composta por 49 pacientes oncológicos, com dor, e que idealizou o tratamento pelo Sistema Único de Saúde, e 49 profissionais de saúde que trabalham no hospital do estudo. Para a avaliação do nível de bem-estar espiritual foi utilizada a Escala de Bem-Estar Espiritual, que é composta pelo escore total (EBE), e duas subescalas: Bem-Estar Religioso (BER) e Bem-Estar Existencial (BEE). A maioria dos pacientes adotou o BER alto, BEE moderado e EBE alto, resultado semelhante foi encontrado nos profissionais de saúde: BER alto, BEE moderado e alto e EBE alto. Foi encontrada uma associação na variável bem-estar existencial, indicando que na dimensão existencial os profissionais de saúde apresentam um nível alto de bem-estar significativo em comparação com os pacientes. Além disso, a religião dos pacientes foi associada às variáveis bem-estar religioso, bem-estar existencial e escore total do bem-estar. Foi verificado que os profissionais de saúde apresentavam um maior bem-estar espiritual do que os pacientes oncológicos na dimensão existencial. O nível de espiritualidade dos profissionais de saúde deste estudo foi elevado, porém não houve associação significativa com os pacientes oncológicos, que também apresentou um nível superior de espiritualidade.
Full-text available
Background & Aim: Spiritual well-being integrates other dimensions of human health. Nursing students as future nurses should be aware of their spiritual well-being and strive for their spiritual growth and development. The aim of this study was to determine the effect of spirituality-oriented educational program on spiritual well-being and spiritual development of nursing students. Materials & Methods: In this quasi-experimental study which was done in 2016, 50 nursing students of Khoy University of Medical Sciences were randomly selected and randomly assigned to experimental and control groups. For the experimental group, the intervention program was held in the form of four two-hour training sessions, but no intervention was performed in the control group. Data were collected using spiritual health and spiritual development questionnaires and analyzed by SPSS software using descriptive statistics and inferential tests including independent t-test and paired t-test which was considered statistically significant in case of P <0.05. Results: The mean age of students was 21.48 ± 1.89. There was no statistically significant difference between the experimental and control groups in the field of spiritual development and spiritual well-being before the educational intervention. After the intervention, there was a statistically significant difference in the mean score of spiritual development between the two groups (p= 0.005). However, there was no statistically significant difference in the mean score of spiritual well-being between the two groups (p> 0.05). Conclusion: Implementation of a spiritual-oriented educational intervention program was able to increase the spiritual growth and development of nursing students. So, it is suggested that spirituality-based educational programs be designed and implemented in the undergraduate curriculum.
Full-text available
Background & Aim: Implementation of the motivational program by nurse managers can improve nurses&apos performance and behaviour, provide better care for patients, and promote patients&apos satisfaction. This study aimed to determine the effect of implementation of the motivational program designed using "Expectancy Theory" by head nurses on patients&apos satisfaction. Methods & Materials: This was a quasi-experimental study conducted in medical and surgical units of two hospitals in Zanajn in 2011. Data were gathered using a patient satisfaction questionnaire. The reliability of the questionnaire was confirmed (α=0.72). Fourty participants were selected and allocated in two study groups. The groups were matched for some variables before the intervention. The motivational program was implemented in the intervention group for five months. The program had two designing and implementation phases including: 1) determining nurse managers&apos expectancies from nurses, assessing nurses&apos attitudes about valuable rewards, founding reward management committee and management improvement committee, and providing evaluation checklists for nurses&apos performance 2) implementing standards of nursing care and patient education by nurses, monthly evaluation of nurses by head nurses and collaborative members of the reward management committee, determining level of rewards based on the results of nurses&apos performance evaluation, and giving reward to nurses at the end of each month in a reward ceremony. Data were analyzed using the Paired t-test, Independent t-test, Mann-Whitney, and Chi-squared in the SPSS v.16. Results: There were no significant differences between the two groups at baseline dealing with the demographic variables. The results showed that patients satisfaction was significantly higher in the intervention group after the intervention (P
In today’s fast-paced economy competition is an issue of services and products. Much attention has been directed to a better service and the best product and how this can be achieved through utilising the human resources. This research paper identifies how job motivation, one of the important activities of HRM, can affect organisational success, and how it is important in achieving competitive advantage. This relationship has been empirically investigated. The data has been analyzed using SPSS. The results indicated a significant relationship between job motivation and competitive advantage.
While the field of management has developed as a research discipline over the last century, until the early 1990s there was essentially no acknowledgement that the human spirit plays an important role in the workplace. Over the past twenty years, the tide has begun to turn, as evidenced by the growing number of courses in academia and in corporate training, and an exponential increase in the publications emerging through creative interaction of scholars and practitioners in organizational behaviour, workplace diversity, sustainability, innovation, corporate governance, leadership, and corporate wellness, as well as contributions by psychotherapists, theologians, anthropologists, educators, philosophers, and artists. This Handbook is the most comprehensive collection to date of essays by the preeminent researchers and practitioners in faith and spirituality in the workplace, featuring not only the most current research and case examples, but visions of what will be, or should be, emerging over the horizon. It includes essays by the people who helped to pioneer the field as well as essays by up and coming young scholars. Among the questions and issues addressed: What does it mean to be a "spiritual" organization? How does this perspective challenge traditional approaches to the firm as a purely rational, profit-maximizing enterprise? Is faith and spirituality in the workplace a passing fad, or is there a substantial shift occurring in the business paradigm? How does this field inform emerging management disciplines such as sustainability, diversity, and social responsibility? In what ways are faith and spirituality in the workplace similar to progressive and innovative human resource practices. Does faith and spirituality in the workplace bring something additional to the conversation, and if so, what? The aim of The Handbook of Faith and Spirituality in the Workplace is to provide researchers, faculty, students, and practitioners with a broad overview of the field from a research perspective, while keeping an eye on building a bridge between scholarship and practice. © Springer Science+Business Media New York 2013. All rights reserved.
Spiritual coping, which may or may not contain religiosity, may enhance adaptation of clients with chronic illness. Part 1 of this article (Baldacchino et al. 2013) presented the research methodology of this cross-sectional comparative study, which explored the spiritual coping of clients with chronic illness receiving rehabilitation services in Malta (n=44) (lower limb amputation: n=10, chronic heart disease: n=9, osteoarthritis in an institution: n=10 and in the community: n=15) and Norway (n=16) (post-hip/shoulder surgery: n=5; chronic heart disease: n=5; chronic pain: n=6). Data were collected from seven purposive samples by focus groups. Roy’s adaptation model (1984) and Neuman’s Systems Model (2010) guided the study. Part 2 discusses the findings, which consist of one main spiritual coping theme and three sub-themes: ‘adopting religious coping strategies, relationship with God, and time for reflection and counting one’s blessings’. Commonalities were found in the findings except in one dimension, which was found only in the Malta group, that is, being supported by others with a similar condition. This difference may be a result of the environment in the rehabilitation centres, cultural, and geographical differences between the two countries. While considering the limitations of this study, recommendations are proposed to the rehabilitation and education sectors and further trans-cultural comparative longitudinal research with mixed method approach on various clients with acute, chronic and life-threatening illness.
This chapter is an introduction to and an overview of the Handbook for Faith and Spirituality in the Workplace. It provides a brief description of the spiritual context out of which the faith and spirituality in the workplace movement has emerged. The evolution of the history of management is reviewed from Taylor (Principles of scientific management, Harper, NY, 1911) to the current emergence of “Management, Spirituality and Religion” field of study. Next is a description of the design of this book, and then a list of key questions being addressed by the field are listed. The chapter concludes with a summary of the seven parts of the Handbook.
Objective The aim of the study was to investigate nurses' and pastoral carers' spiritual wellbeing (SWB) and how it relates to their workplace. Design The study design was a survey of total populations in selected health care services. Setting The setting was a public and a private hospital in a regional setting, and three hospices in major cities which had a religious affiliation. Subjects Responses were obtained from 154 (11%) nurses and 8 (6%) carers in the public hospital, 40 (7%) nurses in the private hospital and 16 nurses and 7 carers (17%) in the three hospices. Main outcome measure The Spiritual Health and Life Orientation Measure (SHALOM) was used to provide insights into staff ideals for spiritual wellbeing, as well as their lived experiences in relating with self, others, the environment and/ or God. The nurses' and carers' perceptions about how well clients are supported in these four domains of spiritual wellbeing in their workplace were also explored. Results The beliefs and worldview of health care staff influence their ideals for spiritual wellbeing (SWB) to a greater extent than age, gender, or workplace setting. These ideals markedly impact on their lived experiences which reflect their SWB. Ten percent of these staff showed spiritual dissonance in more than one of the four domains of SWB. The major finding of this study is the influence that nurses' and carers' personal experience has on the level of help they thought clients received from the services offered in their workplace. Those who are more fulfilled in relationships, with themselves, others, the environment and/or God, believe that clients receive greater help in these areas from the services provided in their workplace. Conclusion SHALOM is a useful indicator of four domains of SWB of health care staff who project their own lived experience onto the way they see clients having their spiritual wellbeing nurtured. This has implications for health care staff in the workplace.
This paper presents an approach to teaching spiritual care that is underpinned by a traditional philosophy of care as agape. In this approach spiritual care is considered a fundamental character of care, not a self-conscious addition. The caring function of the nurse is qualitatively differentiated from that of the religious minister, whose role is considered to be currently underestimated. From this perspective, teaching spiritual care to nurses is not so much achieved through theoretical or experiential analysis and reflection, but by following an established moral pattern; it is not taught so much as caught. It is argued that this traditional approach to spiritual care provides an alternative to current educational ideologies in nursing, and reflects patients' and nurses' own attitudes to – and expectations of – the spiritual dimension of care.