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

Quantitative studies have assessed nurses' attitudes toward and frequency of spiritual care [SC] and which factors are of influence on this attitude and frequency. However, we had doubts about the construct validity of the scales used in these studies. Our objective was to evaluate scales measuring nursing SC. Articles about the development and psychometric evaluation of SC scales have been identified, using, Web of Science, and CINAHL, and evaluated with respect to the psychometric properties and item content of the scales. Item content was evaluated by each of the five authors with respect to the following questions: Does the item (1) reflect a general opinion about SC instead of a personal willingness to offer SC; (2) reflect general psychosocial care instead of specific SC; (3) focus solely on religious care; (4) contain the words 'spiritual' (care/needs/health/strengths, etc.); and (5) contain multiple propositions, or have an unclear meaning? We found eight scales. Psychometric analysis of these scales was often meager and the items of all but one scale suffered from two or more of the five problems described above. This leads us to conclude that many quantitative results in this area are based on findings with questionable scales. Suggestions for improvements are provided

Spiritual care by nurses in curative oncology:a national, multicenter, mixed method study

Introduction: Spiritual care by nurses is often linked to palliative and terminal care. It is hardly known whether SC is also considered vital among nurses who care for patients who are treated with curative intent. Therefore, we have explored the level of and the experiences with spiritual care by nurses in curative cancer care.Methods: In this mixed-method study, nurses were recruited in eight hospitals in the Netherlands. A spirituality scale, a spiritual care competence scale and five questions on spiritual care were completed by 57 participants. Afterwards, the scores were quantitatively analyzed. Because of data saturation, qualitative analysis was limited to 31 semi-structured interviews, using content analysis.Results: The great majority of nurses indicated on the questionnaire that they frequently provide spiritual care. However, in interviews, the nurses described few examples of spiritual care. Nurses also indicated that they had not learned so much in providing spiritual care in their educational program; rather, they had learned it in clinical practice.Conclusions: As the questionnaire could be liable to socially desirable responding, we based our conclusions on the qualitative data, and concluded that spiritual care was rather modest among the nurses providing curative care in this stud

“Never at ease” – family carers within integrated palliative care: a multinational, mixed method study

Background Family carers manage a wide range of responsibilities in the lives and care of patients receiving palliative care. They fulfil multiple roles and perform activities within different settings. This has immediate consequences on family carers’ every-day lives. According to literature, family carers in palliative care are both part of the formal and informal care network, but also persons in need of support. This article aims to investigate 1) burdens and rewards associated with family caregiving and 2) what family carers find helpful in their contact with professionals from integrated palliative care initiatives (IPC-i) and other services. Methods Family carers looking after patients with cancer, chronic obstructive pulmonary disease or chronic heart failure were purposefully recruited at 22 IPC-i in Belgium, Germany, Hungary, the Netherlands and the United Kingdom in the course of the project “Patient-centred palliative care pathways in advanced cancer and chronic disease” (InSup-C). Semi-structured interviews (n = 156) and 87 quantitative questionnaires (CRA, POS, CANHELP Lite) were conducted with family carers. Interviews were analysed with transnationally agreed thematic codes (MAXQDA or NVivo). Statistical tests (SPSS) were carried out in accordance with the characteristic value of the items and distributions. Results On average, quantitative data showed moderate burden, but the qualitative findings indicated that this burden might be underrated. There is some evidence that IPC-i with well-developed professional care networks and communication systems relieved family carers’ burden by direct and indirect interventions; e.g. provision of night shift nurses or psychological support. Needs of family carers were similar in all participating countries. However, in all countries IPC-i mostly offered one-off events for family carers, lacking systematic or institutionalised support structures. Conclusions Data suggest that, most IPC-i did not pay enough attention to the needs of most family carers, and did not offer proactive care and access to supportive resources to them (e.g. training, respite care, access to resources). We recommend recognizing family carers as part of the ‘unit of care’ and partner in caregiving, to improve their knowledge about, and access to, and the support available