Spiritual Self-Care for Health Care Providers: An Integrative Literature Review

Saturday, 16 November 2013: 3:35 PM

Mary Elaine Koren, RN, PhD
School of Nursing, Northern Illinois University, DeKalb, IL
Sonal Purohit, MBBS, DCH, MS
School of Nursing and Health Studies, Northern Illinois University, Dekalb, IL

Learning Objective 1: The learner will be able to describe common spiritual interventions to support the spiritual self-care of health care providers.

Learning Objective 2: The learner will be able to discuss recommendations for future spiritual self-care intervention studies.

The work of health care providers ranks among the most stressful jobs in America (Brinson, 2013). The causes of this job stress are multi-faceted with no easy solutions. Self-care measures that emphasize spiritual development maybe one approach to alleviate job stress; however, there is a paucity of empirical research on spiritual interventions for health care providers. We implemented an integrative review methodology (Whittemore & Knafl, 2005) to describe research that addresses the spiritual self-care of health care providers. Using the keywords “spirituality” and “health-care providers” the following databases were reviewed: Cumulative Index of Nursing and Allied Health Literature, EBSCO, Medline, PsycInfo, and Google Scholar. When the initial keywords yielded few results, the following keywords were used: “mindfulness-based stress reduction,” “yoga,”  “meditation,” “imagery,” “tai chi,” and “reiki.” Only refereed journal studies that tested spiritual interventions published within the past ten years were reviewed. Ten quantitative studies and five qualitative studies met the review criteria. The outcome variables most often measured included: burn-out, stress, anxiety, mindfulness, depression, compassion, quality of care, personal self-efficacy, and caring. All reported psychological outcome measures were significantly related to the interventions. Nearly half of the outcome measures represented negative health conditions. Only one study used a physiological measure (salivary cortisol levels) and found no significant changes following the intervention. The majority of studies used some form of Easwaran’s 8-point program of mindfulness. Most participants were female with over ten years of clinical experience. Sample sizes were small. We concluded that sustainability of the interventions is questionable, since few studies examined the effects of interventions beyond three months. Recommendations include more precise outcome measures, more diverse participants, and use of longitudinal data. Future studies framed by theory will provide a foundation for the design of a legacy of nursing practice that incorporates the most effective spiritual self-care interventions.