Efficacy of a Collaborative, Spiritual Care Educational Intervention to Enhance Nurses' Spiritual Care Attitudes

Sunday, 17 November 2019: 2:25 PM

Cheryl A. Westlake, PhD, RN, ACNS-BC
Nursing PhD Program, Azusa Pacific University, Monrovia, CA, USA
Jane Pfeiffer, PhD, RN
Entry Level Masters Department, School of Nursing, Azusa Pacific University, San Bernardino,, CA, USA

Background and significance

Hospitalized patients frequently have unmet spiritual needs linked with poorer patient outcomes including depression (Pearce, Coan, Herndon, Koenig, & Abernethy, 2012), increased medical costs (Balboni et al., 2011), worse quality of life (Kang et al., 2012), and diminished quality (Astrow, Wexler, Texeira, He, & Sulmasy, 2007) and satisfaction with care (Johnson, Engelberg, & Curtis, 2014; Kang et al., 2012). These spiritual-care needs can be addressed by nurses, but the main barriers to spiritual-care provision include nurses’ attitudes about spiritual-care (Vance, 2001) and their perception they are inadequately prepared to discuss spiritual concerns with patients (McSherry & Jamieson, 2013) preventing them from competently addressing spiritual needs and care.

The Actioning Spirituality and Spiritual-Care Education and Training model that suggests self-awareness and spirituality can be integrated in educational programs to assist in values clarification and changed spiritual-care attitudes to augment nurses’ spiritual-care provision (Narayanasamy, 1999). Tested interventional formats have included 60 minutes to two-week face-to-face classes (O-Shea, Wallace, Griffin, & Fitzpatrick, 2011), a four-hour study unit on spiritual coping (Sandor, Sierpina, Vanderpool, & Owen, 2006), and 10-hours of self-study using a work-book and digital video disk (Taylor, Mamier, Bahjri, Anton, & Petersen, 2009). However, none have tested a collaborative, brief, two-hour class using values clarification and spiritual timeline exercises, and content regarding spirituality, spiritual needs, and spiritual-care interventions with case study application.

Purpose/Aims

The purpose of this study was to determine the effect of a collaborative (between a university nursing faculty member and the hospital’s nurse researcher) spiritual-care educational intervention on nurses’ spiritual-care attitudes and the relationships between demographics (age, gender, ethnic background, nursing education and experience, spiritual-care education in nursing school and through conferences, reading and continuing education, religious education in high school, and religious service attendance frequency) and nurses’ spiritual-care attitudes.

Methods

Following institutional review board approvals, a quasi-experimental, pre-post-intervention design was used to address the aims. Demographics were assessed with the Information about You and spiritual care attitudes with the Spiritual Care Perspectives Scale (Taylor, Highfield, & Amenta, 1999). Descriptive analysis, paired t-test, and univariate and multivariate correlational statistics were used.The majority of subjects [n=183 pre- and 103 post-intervention] were 46.2 (±1.31 years through conferences and continuing education. Subjects reported religious service attendance weekly (n=50, 27.5%). Nurses participated in an intervention that required reading an article about spiritual care in advance of attending a two-hour class about spirituality and spiritual care described above. With a sample size of 103, nine predictors and an observed R2 of 0.25, observed statistical power was 0.99 for a multiple regression.

Results

Spiritual care attitudes were statistically significantly improved by the intervention [pre: low (39.7±6.9), post: moderate (51.4±11.55, t test=-8.788, p<.001). Spiritual care attitudes pre-intervention were associated with older age (r=.24, p=.001), more nursing experience (r=.26, p<.001), less frequent religious services attendance (r=-.29, p<.001), more spiritual care education through conferences and continuing education (r =.19, p=.009) and explained 12.7% of the variability in spiritual care attitudes (4, 170, f=6.19, p<.001). Spiritual care attitudes post-intervention were associated with less religious education in high school (r=-.25, p=.03).

Conclusions

A collaborative two-hour class using values clarification and spiritual timeline exercises, and content regarding spirituality, spiritual needs, and spiritual-care interventions with case study application can change nurses’ spiritual-care attitudes and may change nurses spiritual-care provision and important patient outcomes.