Research Project: Spiritual Care Provided by Registered Nurses

PROBLEM:  According to the holistic paradigm, the human being consists of body, mind, and spirit.  While the body and mind issues are well addressed in health care, it is the spiritual care that often remains a vague and elusive factor.  Holistic health is expected in the 21^st century.  It is not only expected by society generally, but also documented in publications by agency accreditation standards and professional codes.  Just adding “holism” to a philosophy statement or establishing spiritual care policies will not solve this problem.  Spiritual care is defined as a relational issue.  It has to do with the way people talk to one another.

 LITERATURE REVIEW: There is ample evidence in the literature that spiritual care provides increased resilience and promotes healing.  In a recent study of spiritual care received by terminally ill cancer patients, the 67% of the subjects reported religiousness to be very important, but 59.7% reported none or limited care from doctors, nurses, and chaplains.  In nursing education, spirituality is included in the curriculum, but a survey of faculty reveals uncertainty about what is to be taught.  A model course was not found. The literature shows a debate about whether it should be taught.  A study found nursing textbook pages devoted to spiritual issues ranged from 0% to 13% with few exceptions.  Studies about current nursing practices regarding spiritual care in the United States have not been found in the literature.  

 NEED: Of all groups of patients, the oncology group logically would be the first group one would expect to receive spiritual care.  If this group receives so little, then what of all of the other patients?  What are the barriers?  Educational programs and health care agencies typically are without well designed programs providing guidelines and policies about how nurses are to proceed.    

 PURPOSE: The purpose of this study is two-fold: 1) to survey the nurses from a wide variety of services concerning their rating of the spiritual care they are currently providing, and 2) to determine the degree to which a computer assisted instruction educational intervention influences nurses’ ratings of spiritual care.

 THEORETICAL BASIS: The Theory of Spiritual Care in Nursing Practice (Battey, 2009).

 DESIGN: 1) A survey will be conducted to determine the nurse subjects’ rating of the spiritual care they are currently providing with random assignment of subjects to the control and experimental groups.  The survey tool to be used Spiritual-Communication Satisfaction-Importance (SCSI) Questionnaire (Battey, 2009).

2) The Solomon four-group experimental design will be used (when possible) to determine the degree to which the educational intervention, Spirituality in nursing practices: A computer assisted instruction program & course manual (Battey, 2010), influences the perspectives of the subjects. 

3) The SCSI survey tool will be used again as a posttest for the subjects.

 SAMPLE: The study will consist of a convenience (volunteers) sample of 30 Registered Nurse staff from multiple clinical areas at each of several research sites a total of 200+ subjects.  Criterion for subject selection includes:

1)       Employed full time for one year at the agency research site.

2)       Involved in direct patient care within the past five years.

3)       Speak English as a primary language and English as a second language.

4)       Adhere to any religious/spirituality belief system.

5)       Be available to participate in this research project.

 FUNDING:  Primarily seeking funding for the services of a statistical consultant.  Two research sites have completed the research project, and three additional sites will initiate the study in August, 2011.  A pilot study has been completed at a California site.  Funding and resources are being provided by the research site agencies and by personal funding sources.  Funding has been sought from many foundations and organizational groups and agencies, but this study does not fall within current objectives.

 PRINCIPLE INVESTIGATOR: Bonnie W. Battey, Ph.D., R.N., Consultant in Nursing Education. (bwbattey@comcast.net; Phone 925-706-0442; Fax 925-706-0621)

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