Modern health care recognizes the responsibility of the healthcare practitioner for providing holistic care (The Joint Commission, 2010). Such care includes addressing the spiritual needs of patients (The Joint Commission, 2010). However, in a pluralistic society, meeting the spiritual needs of diverse populations can present daunting and multifaceted challenges.
According to Coyne (2012), United States religiosity is much higher than that of other advanced nations. Religiosity refers to how strongly an individual is devoted to a specific religion, while religion refers to an individual’s beliefs. Research published by Pew Research (2015) revealed 77% of the United States adult population identifies with a religious affiliation. Religious beliefs and spirituality are intimately tied to an individual’s culture (Aist, 2012) and healthcare (Hammoud, Casey, & Fetters, 2005).
Patient-centered care is an essential principle of delivering quality care. (Ferguson, Ward, Card, Sheppard, & McMurtry, 2013; Veean, 2012). Review of literature indicates patients would be open to a conversation regarding spiritual care as part of their overall healthcare; however, many times spiritual care is not addressed. Healthcare consumers desire conversations about spirituality, increasing satisfaction with the healthcare experience (Williams, Meltzer, Arora, Chung, & Curlin, 2011). Palma (2013) suggests patients want healthcare providers to see the patient as a whole, not just a disease process.
Carron and Cumbie (2011) asserted “Spiritual care is an integral, but often neglected” in adult primary healthcare settings (Carron & Cumbie, 2011, p. 552). Spirituality has been richly discussed and well researched from the medical perspective (Tiew & Creedy, 2010). However, there has been significantly “less research examining spirituality from the patient’s perspective” versus research from the practitioner perspective (Pike, 2011, p. 743).
The central purpose of this study is to understand how spiritual care is perceived by patients in a healthcare interaction. Additional objectives of this qualitative study was to understand if patients desired inclusion of spirituality within their healthcare interaction, if patients would seek out same faith providers if provider faith was published, and if inclusion of a spirituality conversation would improve patient satisfaction of the healthcare interaction. All eligible members of a Secular Humanists group, Jewish Center, Islamic Center, and Wesleyan congregation were invited to participate from this mid-sized Midwestern community of 380,000 people. Subjects were invited to participate by purposeful, snowball sampling initiated by a designated lead in each group.
Twenty-two semi-structured interviews were audio recorded, transcribed, compared with research notes, void of personal identification, and assigned a letter. Analysis of the transcribed data allowed for the thick descriptive detail of the participants lived experience to stand out and themes to emerge (Creswell 2009, Creswell, 2013). Data was analyzed via constant comparison analysis (Leech & Onwuegbuzie, 2007; Creswell 2013).
Findings validate Carron and Cumbie (2011) assertion; spirituality is important to many adults. The data illustrates while over half of those interviewed were open a spiritual conversation, a mere 18% of individuals have experienced spirituality within a primary healthcare interaction. Seventy-five percent of those reporting having experienced a spiritual connection, had a common faith with the provider. The nursing profession is constantly evolving; however, nurses can create the future (Watson, 1999) by allowing for caring-healing moments that make a transpersonal connection with the patient.
This research contributed to the delivery of primary care by contributing to the understanding of the patient’s perspective of spiritualty in healthcare. Implications for healthcare practice include knowing the patient’s position for spirituality within the healthcare interactions. As spirituality is individually defined further inquiry on what specifically the patient would prefer for example: inquiring if they would like to add a spiritual advisor to their health care team; could be implemented in the primary care interaction. The implication for nursing practice is the awareness there are patients with varying degrees of wanting a conversation on spirituality.
The implication for healthcare practitioners is to be aware a majority of their patients are open to conversations regarding spirituality, so long as the conversation is not judgmental or evangelistic in tone. The spiritual conversation should seek to better understand the patient as a person, not as a disease state. The spiritual conversation should act to support the total care of the individual.
A key limitation of this study is the sample size. The small sample size generated by purposive sampling from a Secular Humanist community, Jewish community, Wesleyan community and an Islamic Mosque with in a Midwestern population pool of 380,000 (Sperling, 2013) may not be representative of other geographic areas. Transferability of these results does apply as the participants’ experiences are analyzed and common themes are identified; therefore the theoretical generalization applies (Melnyk & Fineout-Overholt, 2011).
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