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Objectives: This pilot study explores how healthcare leaders understand spiritual care and how that understanding informs staffing and resource decisions., Methods: This study is based on interviews with 11 healthcare leaders, representing 18 hospitals in 9 systems, conducted between August 2019 and February 2020., Results: Leaders see the value of chaplains in terms of their work supporting staff in tragic situations and during organizational change. They aim to continue to maintain chaplaincy efforts in the midst of challenging economic realities., Conclusions: Chaplains' interactions with staff alongside patient outcomes are a contributing factor in how resources decisions are made about spiritual care.

The Covid-19 pandemic has negatively affected the three basic needs of individuals. Faith-based organization leaders are carrying the additional weight of stewardship of members during these challenging times. Many Faith-based organization leaders feel a sense of responsibility to create environments where members feel a sense of belonging. Five considerations for Faith-based organization leaders hoping to increase belonging are discussed below. Specifically, low-cost options are presented that could be implemented in small-to-large Faith-based organizations.

Spirituality is a key focus and ethical obligation of nursing practice, but many nurses express uncertainty or discomfort with this aspect of their role. The purpose of this article is to explore the domains of religion, spirituality, and culture as commonly conceptualized by chaplains, as a framework for nurses to provide spiritual care interventions to patients in acute care hospitals. Using anecdotes and illustrations from palliative care practice, this article discusses the enhanced benefits to patients and families when spiritual needs are addressed, with specialty-level chaplain interventions, primary spiritual interventions provided uniquely by nurses, or interventions that require the cooperation of both professions. Lessons learned from the inpatient palliative care team experience can also apply to chaplaincy and nursing care for patients in settings beyond the acute care hospital and in disciplines beyond palliative care.

Purpose: This paper aimed to discover the requirements of hospital-based spiritual care for cancer patients., Methods: This study was a descriptive qualitative-exploratory research, in which 25 participants were selected through purposive sampling and had semi-structured interviews., Result: The data analysis revealed 3 themes and 8 sub-themes including fundamental requirements (changes in the attitudes and behaviors of the healthcare team), structural requirements (inter-professional collaborations, a reference system), and functional requirements (religious-spiritual, pastoral, psycho-spiritual, and supportive-spiritual care). In this study, the received topics have been related to the spiritual care which can help improve patient care., Conclusion: The results were added to the repertoire of knowledge about the spiritual needs of cancer patients. The results indicated that it is essential to get acquainted with the spiritual care requirements in the hospital and enforce them through inter-professional collaboration. Accordingly, the spiritual care program should be designed, implemented, and evaluated.

Diversity education in clinical training such as CPE is best developed in an interactive group context, guided by methods and approaches promoting mutual disclosure that includes the leader. Each member is invited to portray a web of meaning with cultural, spiritual and religious threads that comprise a personally knitted reality, a narrative foundational to identity and interaction. Differences between people in the training context challenge previously held notions, distribute authority in the group and foster open ended learning that enriches the activities of clinical supervision. This article describes group educational methods with case examples that foster spiritual/cultural competency, each member a person in context with the opportunity to be distinct and connected, a threshold for all other dimensions of diversity learning in pastoral practice.

Purpose of Review: The role of chaplains/spiritual care professionals and the importance of addressing spiritual needs within interdisciplinary oncology teams are in need of systematic review and critical appraisal. This review focuses on four key areas: basic concepts of spirituality within the healthcare domain; the relevance of spirituality within cancer care; the role of spiritual care within interdisciplinary cancer teams; and the current status of spiritual care professionals in interdisciplinary cancer teams., Recent Findings: Addressing cancer patient's spiritual issues is recognized as a component of comprehensive cancer care. Spirituality has a positive effect on subjective and emotional aspects of cancer patient's health, including quality of life, wellbeing and distress. Failing to address cancer patients spiritual needs impacts patient wellbeing, satisfaction with care, perceived quality of care and is associated with higher healthcare costs. Although a variety of disciplines address spiritual issues, spiritual care professionals are recognized by patients, clinicians, researchers and within best practice guidelines of national health councils as specialists within this domain., Summary: Spiritual care professionals are increasingly recognized as integral members of interdisciplinary oncology teams. However, the full integration of spiritual care professionals within the standard practice of oncology interdisciplinary teams is lacking, as spiritual care services continue to be treated as ancillary services within cancer care organizations.

This article deals with the Church of Sweden and the Church of Finland and their spiritual support for parishioners during their end-of-life phase. Support for the dying seemed uncommon in both countries, while most parishes offered support for the bereaved. The Finnish respondents expressed more confidence in their spiritual role than did the Swedes. This may have to do with the role of the churches in their respective countries and the varying geographies of death.

Although meeting patients' spiritual needs is important, many nurses are uncertain about what spiritual care involves and lack confidence in this area. This second article in a two part series on spirituality considers ways of addressing spiritual needs and provides an overview of the principles of assessment and implementation. Part 1 explored definitions of spirituality, the difference between religion and spirituality, and finding meaning in illness.

This article reports on a phenomenological study undertaken to explore the meaning of spiritual care as described by a group of palliative care professionals. The research process was informed by van Manen's (1990) hermeneutic phenomenological approach. Eight palliative care professionals (nurses, complementary therapists and pastoral carers) were recruited from a community palliative care agency in Melbourne, Victoria, which provided home-based palliative care. All participants were female and came from diverse ethnic backgrounds. Data were collected by in-depth conversational interviews and were analyzed thematically. Two themes emerged: 'a living nexus between spiritual care, spirituality and holism' and 'a world of relationships'. The findings of the study point to the need for healthcare professionals to incorporate spiritual care guidelines into practice in order for palliative care to be truly representative of holistic health care.

The African American church is held in the highest esteem by most African Americans. Although the influence of the African American church has been underestimated by physicians and nurses, it could be pivotal in optimizing health status among African Americans. Because of this influence, health care practitioners, including nurses, are now recognizing the important role that the African American church plays in improving the health status of individuals in the African American community. This article illuminates the health and health care concerns of the African American community by considering the traditional lack of equal access for this population and the role that the church can play in not only offering church-based health care services but also improving the health status of church congregations. Future roles of the African American church for improved health status are also suggested.

Faith community nursing, formerly known as parish nursing, is one model of care that relies heavily on older registered nurses (RNs) to provide population-based and other nonclinical services in community settings. Faith community nursing provides services not commonly available in the traditional health care system (e.g., community case management, community advocacy, community health education). With appropriate support, this model of nursing could be expanded into other settings within the community and has the potential to draw on the skills of experienced RNs to provide communities with services that address unmet health care needs.

Aim: The concept of spirituality is much discussed in the UK nursing literature, despite the fact that Britain is one of the most secular countries in the world, and steadily becoming more so. Here, I pose the following question: given this increasing secularization, what accounts for the current interest in spirituality among UK nurses?, Background: The literature on spirituality in nursing has blossomed in the last 10 years, and various attempts have been made to define 'spirituality', 'spiritual need' and 'spiritual care'. Most definitions distinguish between 'spirituality' and 'religion', acknowledging that the latter is more institutional, and theologically more restrictive, than the former; and they suggest that spirituality is universal, something which (unlike religion) all human beings share., Method: I draw on the sociology of religion - neglected, for the most part, in the nursing literature - to establish two main points. Firstly, that the UK and the USA are at opposite ends of the religion/secularity spectrum, implying that it is a mistake to assimilate USA and UK sources. Secondly, that the concept of spirituality, as currently understood, is of very recent origin, and is still 'under construction', having become separated from its associations with Christian piety and mysticism only since the 1980s., Conclusions: The extension of spirituality into secular domains is part of a professionalization project in nursing, a claim to jurisdiction over a newly invented sphere of work. For the time being, it remains an academic project (in the UK) as it is not one with which many clinicians identify. Relevance to clinical practice. What counts as 'spiritual need' or 'spiritual care' may not be the same in both countries, and UK clinicians are unlikely to welcome the role of surrogate chaplain, which their USA colleagues are apparently willing to embrace.

An electronic search was conducted on Medline for the years 1980-2005 identified 101 journal articles with the words "spiritual care" in their title, the majority of which were from nursing journals. Content analysis performed on 28 articles judged to be most relevant yielded 250 unique descriptions of interventions, which were subsequently consolidated to form 66 discrete interventions. Twenty five professional chaplains rated each item on the degree to which they considered it to be part of providing spiritual care to patients. The patterns of correlations among the interventions suggested that most of the items fell into ten major categories and a few minor categories, with only two of the major categories being explicitly religious in nature. The article discusses these categories within the context of pastoral care.

Women in abusive relationships have recognized the silence of religious institutions and clergy in addressing intimate partner violence. The old message, that women are to blame when family dysfunction occurs, remains evident in society. The objective of this qualitative study was to describe the experience of abused women attempting to decrease their spiritual distress and obtain spiritual guidance from their religious leaders. The findings revealed that clergy were not helpful in alleviating the women's spiritual distress or intervening in the violence. Four themes that epitomized the negative outcomes of the help-seeking behavior were spiritual suffering, devaluation, loss, and powerlessness.

A system of parish nursing allows patients to receive spiritual care integrated with their other needs. There are now 29 churches in the U.K. with at least one parish nurse.

Background: Spirituality is of particular importance in the lives of many older adults at the end of life. While the role of spirituality may differ among older adults, spirituality may offer a purpose and meaning toward the end of life and provides a framework for managing concerns and decisions at this time. Despite the increasingly evident role of spirituality in the United States, the spirituality of older adults has been neglected. Moreover, little research has been undertaken to determine how nurses may best help older adults improve spiritual health., Purpose: The purpose of this analysis was to investigate perceptions of spirituality and spiritual care among older nursing home residents at the end of life., Methods: A total of 26 older long-term care residents were surveyed using the Spirituality and Spiritual Care Rating scale from 2 faith-based nursing facilities to better understand residents' spirituality and perception of spiritual care., Findings: Descriptive statistics were used to analyze the participant's perceptions of spirituality and spiritual care. The 2 samples in this study received a mean score of 51.36 (SD = 5.99) with a range of 43 to 68, indicating moderately high views of aspects of spirituality and spiritual care among the sample, supporting spirituality as a framework for life. The sample reported on several interventions that nurses could use to support spirituality, including arranging visits with religious personnel, showing kindness, spending time listening to residents (presence), and showing respect for resident's needs., Implications: The results of the study provide information that may be used to increase knowledge and improve spiritual interventions for nursing home residents at the end of life.

Providing spiritual care is about tapping into the concept of spirituality: core meaning, deepest life meaning, hope and connectedness. The search for meaning, connectedness and hope becomes more significant as older people are faced with the possibilities of frailty, disability and dementia. Spirituality, ageing and meaning in life can be discussed in the context of an alternative view of "successful ageing". A model of spiritual tasks in older age can help explain the spiritual dimension and provide a starting point for spiritual assessment.

This article is a sequel to 'Spirituality in palliative care: what language do we need?' (Byrne, 2002). It looks at the language of pastoral care, its place in palliative settings and how it is regarded by patients and carers. Spirituality and spiritual need is multifaceted, and the various beliefs regarding the concept of spirituality and the spiritual needs of terminally ill patients are appraised, and the methods of spiritual assessment reviewed. The role of the chaplain in spiritual care is also assessed, and an ability to move beyond the boundaries of their own denominational position addressed. Several components of the language of pastoral care are identified.

Spirituality is essential to healthcare. It is that part of human beings that seeks meaning and purpose in life. Spirituality in the clinical setting can be manifested as spiritual distress or as resources of strength. Patients' spiritual beliefs can impact diagnosis and treatment. Spiritual care involves an intrinsic aspect of care, which underlies compassionate and altruistic caregiving and is an important element of professionalism amongst the various healthcare professionals. It also involves an extrinsic element, which includes spiritual history, assessment of spiritual issues, as well as resources of strength and incorporation of patients' spiritual beliefs and practices into the treatment or care plan. Spiritual care is interdisciplinary care-each member of the interdisciplinary team has responsibilities to provide spiritual care. The chaplain is the trained spiritual care expert on the team. Optimally, all healthcare professionals, including the chaplain, on the team interact with each other to develop and implement the spiritual care plan for the patient in a fully collaborative model.

Aim: The aim of this study was to generate a deeper understanding of the factors and forces that may inhibit or advance the concepts of spirituality and spiritual care within both nursing and health care., Background: This manuscript presents a model that emerged from a qualitative study using grounded theory. Implementation and use of this model may assist all health care practitioners and organizations to advance the concepts of spirituality and spiritual care within their own sphere of practice. The model has been termed the principal components model because participants identified six components as being crucial to the advancement of spiritual health care., Design: Grounded theory was used meaning that there was concurrent data collection and analysis. Theoretical sampling was used to develop the emerging theory. These processes, along with data analysis, open, axial and theoretical coding led to the identification of a core category and the construction of the principal components model., Methods: Fifty-three participants (24 men and 29 women) were recruited and all consented to be interviewed. The sample included nurses (n=24), chaplains (n=7), a social worker (n=1), an occupational therapist (n=1), physiotherapists (n=2), patients (n=14) and the public (n=4). The investigation was conducted in three phases to substantiate the emerging theory and the development of the model., Results: The principal components model contained six components: individuality, inclusivity, integrated, inter/intra-disciplinary, innate and institution., Conclusion: A great deal has been written on the concepts of spirituality and spiritual care. However, rhetoric alone will not remove some of the intrinsic and extrinsic barriers that are inhibiting the advancement of the spiritual dimension in terms of theory and practice., Relevance to Clinical Practice: An awareness of and adherence to the principal components model may assist nurses and health care professionals to engage with and overcome some of the structural, organizational, political and social variables that are impacting upon spiritual care.

Current accreditation and professional standards in health care reflect the importance of chaplaincy services to patients, families, the health care team, and the organization. However, inadequate spiritual assessment, the organizational structure and climate, and lack of understanding of the chaplain's role can prevent these services from being optimally utilized. Chaplains are trained extensively to provide spiritual care to patients, families, and staff as they assist in meeting the organization's mission to provide patient-centered care. Spiritual assessment is a tool for nurses to recognize patient's needs for spiritual intervention and chaplain referral. By collaborating with chaplains, nurses can help develop an organizational infrastructure capable of timely responsiveness to patients' spiritual needs.

After five years of supervising CPE modules in two different hospitals in South Africa, a chaplain supervisor reflects on how his Franciscan spirituality had impacted his supervisory ministry. He describes how he was able to narrow the impact to two defining Franciscan qualities: contemplation and compassion. This article explores the relationship between spirituality and clinical pastoral supervision. Then the Franciscan dimension of contemplation and compassion of Franciscan spirituality are considered. Finally some contours of a Franciscan spirituality of clinical pastoral supervision are described.

Patients' 'spirituality' is widely considered to be a factor that nurses need to consider in their assessments. But Jeanette Power suggests ways in which assessments can be undertaken, and questions whether one assessment tool can prove adequate in measuring the significance of spirituality in the lives of individuals, all of whom may interpret its meaning differently?

The purpose of this qualitative study was to explore spiritual care for dying nursing home residents from the perspectives of registered nurses, practical nurses, certified nursing assistants, advanced practice nurses, and physicians. Five major themes emerged: honoring the person's dignity, intimate knowing in the nursing home environment, wishing we could do more, personal knowing of self as caregiver, and struggling with end-of-life treatment decisions. Spiritual caring was described within the context of deep personal relationships, holistic care, and support for residents. Spiritual care responses and similarities and differences in the experiences of participants are presented. Education and research about how to assist residents and families as they struggle with difficult end-of-life decisions, adequate time and staff to provide the kind of care they "wished they could," and development of models that honor the close connection and attachment of staff to residents could enhance end-of-life care in this setting.

Dying children require special consideration when it comes to spiritual development. Pediatric nurse practitioners (PNPs) can be a pivotal influence in the manner in which a child progresses from sick child to dying child and an influence on the family at large during the process. The primary care PNP is uniquely positioned to have a premorbid knowledge of the spiritual development and needs of the child and family. The tertiary care PNP has a responsibility to provide continuing spiritual assessment and follow-up with referrals to appropriate professional staff and community resources for spiritual care. Childhood spiritual development within the context of the PNP's role in assessing and meeting the spiritual needs of the dying child is discussed.

For many people, the death of a loved one can result in feelings of shock, numbness or denial, even though they may have been expecting it for some time. Pastoral and spiritual care is a vital part of an authentic, holistic health care service. Nurses need to be aware of the needs of relatives and friends of the deceased and understand their role in practical matters such as death certificates, cremation forms and last offices.

Investigations of spiritual interventions for cancer patients are disproportionately few compared to the reported importance of religion to Americans. We report on the implementation and evaluation of a spiritual, community-based intervention developed with interdenominational community clergy. Approximately 1200 people attended a total of 3 gatherings: 2 at Roman Catholic and another at a Protestant Church. Respondents to questionnaires evaluating attendee characteristics and satisfaction (n = 209) were predominantly women (85%); 50% were patients and 45% were aged 60 years and older. Men were more likely to be currently under treatment for cancer, while women were more likely to be past patients or friends. Fewer than 2% felt anger or anxiety; attendees felt the service was very (90%) or somewhat (9.5%) helpful and expressed appreciation for cancer program clinician attendance and for hospital sponsorship of the event. Components in order of preference were prayer, music, Scripture, and litany. Logistic regression models reveal that music was most appreciated by previously treated patients, and prayer by currently treated patients. Secular healthcare systems can offer a religious service that comforts and links attendees to a broader community, including clergy and cancer program clinicians. Surveys can identify service components that appeal to differing groups and can facilitate service development.

Spirituality has been the subject of numerous journal articles and books in recent years. Research into this topic has been conducted in many spheres of nursing practice with the notable exception of military nursing. This article goes a small way to addressing the apparent lack of research into spirituality in a military nursing setting by summarizing the findings of one study into this significant area of nursing care. The findings are derived from a mixed method quantitative/qualitative study of registered nurses in the Royal Australian Air Force. The major finding indicated that two distinct concepts of "family" define the way in which this small group of nurses perceive, assess and implement care for the spiritual needs of their patients. These concepts comprise a traditional family structure and an extended military family structure that includes the person's unit and comrades-in-arms.

The Clinical Pastoral Education (CPE) model for the provision of spiritual care represents the emergence of a secularized professional practice from a religiously-based theological practice of chaplaincy. The transformation of hospital chaplaincy into "spiritual care services" is one means by which religious healthcare ministry negotiates modernity, in the particular forms of the secular realm of biomedicine and the pluralism of the contemporary United States healthcare marketplace. "Spiritual" is a label strategically deployed to extend the realm of relevance to any patient's "belief system:" regardless of his or her religious affiliation. "Theological" language is recast as a tool for conceptualizing the "spiritual lens:' Such moves transform chaplaincy from a peripheral service, applicable only to the few "religious" patients, into an integral element of patient care for all. Such a secularized professional practice is necessary to demonstrate the relevance and utility of spiritual care for all hospital patients in an era of cost-containment priorities and managed care economics.

This article uses a sibling metaphor to outline the relationship between science and spirituality. This metaphor forms the backdrop for exploring several directions in spiritual care research. It argues that science and functional spirituality were born as siblings and need to dance now without either estrangement or incest, intent on measuring the material effects of excellent pastoral care.