The primary purpose of this study was to explore and identify the meaning and importance of service for health professionals. Those who participated in this study are all registered nurses who each have between 10 and 40 years of clinical nursing and nurse lecturing experience. The participants each wrote two stories, one about the meaning of service and the other about the importance of service. Definitions of service generally suggest organised labour involving an act of help or assistance. Our intent was to understand what constituted service for each of us in the healthcare - and specifically the nursing practice/education - context.A secondary purpose of this qualitative research was guided by participatory and critical theory paradigms. Seven participants and I (as the initiating researcher) formed a co-operative inquiry group to undertake the research using a collaborative process. Within this method the leader and the group became co-participants and co-researchers. Nurses and women are identified as marginalised people and by honouring the principles of co-operative inquiry we were empowered through this process. While the initial data was analysed thematically by the lead researcher, the original 19 sub-themes were refined by participants into five themes.The findings of the participants are consistent with overseas studies on emotional labour and sentimental work. The five themes that emerged as the meaning of service are helping, giving, elements of service, acts of doing, and pride in work. Helping was defined as an attitude and an action, which often results in a spiritual connection. Giving involves stretching yourself, and altruistic behaviour that also incorporated a spiritual component. Five sub-themes merged to form the third theme elements of service; working with people, being a public servant, being a servant, need and duty. The complexity and hidden aspect of service work was expressed in acts of doing where being professional was paramount. The final theme, pride in work, acknowledged childhood conditioning and a sense of contributing to the greater good through our unique work as nurses. This study affirmed that service has much importance to those involved and deepened our understanding of the blend of meanings service expresses.

Inom den palliativa vården är vanliga symtom smärta och i synnerhet existentiell smärta. Obehandlad existentiell smärta får konsekvenser för graden av patientens lidande. Begreppet ”total pain” har haft stor betydelse för hospicerörelsen och palliativ medicin. Syftet med studien var att beskriva sjuksköterskors omvårdnad av patienter med existentiell smärta inom palliativ vård för att därmed kunna minska patientens lidande. En litteraturstudie har utförts där 13 vetenskapliga artiklar har analyserats. I resultatet framkom att för att kunna bedöma och bemöta existentiella behov måste sjuksköterskan ha kunskap om vilka de existentiella/andliga behoven är. För att kunna bedöma smärta finns ett  mätinstrument som kan användas för att lättare upptäcka existentiella/andliga behov. I artiklarna framkom att de existentiella/andliga behoven var: att ha en tro, bra relationer, känna meningen med livet, känna hopp och tröst, bli sedd och lyssnad på. Omvårdnadshandlingar som sjuksköterskan kan utföra för att minska patientens existentiella/andliga lidande visade sig vara: Att samtala och ha tid för patienten, holistiskt synsätt, skapa en kärleksfull miljö så att patienter kan känna hopp, inre frid och en mening med livet. Det ingår i sjuksköterskans ansvar att kunna se och möta de existentiella behoven och grunden i omvårdnaden är att samtala, kunna lyssna och ha tid för patienten. Mer utbildning, kunskap och forskning inom detta område behövs för att sjuksköterskan ska kunna utföra en helheltsvård och därmed kunna minska patientens lidande i livets slutskede. / Pain and in particular existential pain are common symptoms within the palliative care. Untreated existential pain has consequences for the degree of patient suffering. The concept of "total pain" has been crucial for the hospice movement and palliative medicine. The purpose of this study was to describe nurses caring for patients with existential pain in palliative care to reduce patient suffering. A literature review was performed including analysis of 13 scientific articles. The results showed that in order to assess and respond to the existential needs of patients the nurses must have knowledge about the existential/spiritual needs. To assess pain there is a measuring instrument which can be used to better detect existential/spiritual needs. The articles revealed that the existential/spiritual needs were: to have a faith, good relationships, know the meaning of life, have hope and comfort, being seen and listened to. Management that the nurse can do to reduce the patient's existential/spiritual suffering were: The importance of communication and having time for the patient, holistic approach, creating a loving environment so that patients can have hope, inner peace and a meaning of life. It is included in the nurse's responsibility to view and respond to the existential needs and the foundation of nursing is to converse, to listen and have time for the patient. More education, knowledge and research in this area are needed for the nurse to perform a holistic care and thereby reduce the patient's suffering in the terminally ill.

The primary purpose of this study was to explore and identify the meaning and importance of service for health professionals. Those who participated in this study are all registered nurses who each have between 10 and 40 years of clinical nursing and nurse lecturing experience. The participants each wrote two stories, one about the meaning of service and the other about the importance of service. Definitions of service generally suggest organised labour involving an act of help or assistance. Our intent was to understand what constituted service for each of us in the healthcare - and specifically the nursing practice/education - context.A secondary purpose of this qualitative research was guided by participatory and critical theory paradigms. Seven participants and I (as the initiating researcher) formed a co-operative inquiry group to undertake the research using a collaborative process. Within this method the leader and the group became co-participants and co-researchers. Nurses and women are identified as marginalised people and by honouring the principles of co-operative inquiry we were empowered through this process. While the initial data was analysed thematically by the lead researcher, the original 19 sub-themes were refined by participants into five themes.The findings of the participants are consistent with overseas studies on emotional labour and sentimental work. The five themes that emerged as the meaning of service are helping, giving, elements of service, acts of doing, and pride in work. Helping was defined as an attitude and an action, which often results in a spiritual connection. Giving involves stretching yourself, and altruistic behaviour that also incorporated a spiritual component. Five sub-themes merged to form the third theme elements of service; working with people, being a public servant, being a servant, need and duty. The complexity and hidden aspect of service work was expressed in acts of doing where being professional was paramount. The final theme, pride in work, acknowledged childhood conditioning and a sense of contributing to the greater good through our unique work as nurses. This study affirmed that service has much importance to those involved and deepened our understanding of the blend of meanings service expresses.

The aim of this thesis is to monitor the work of selected female orders in social service and healthcare and to classify the target groups that nuns work with. At the same time the thesis studies the interdigitation of spiritual life and the values of conventual order with practical nuns' work and it also monitors the experience of particular nuns relating to their work in ordinary life outside their community. An important aspect is also their concept of social work and healthcare with respect to their order and their concept with respect to secular concept. To meet the target of this thesis I have chosen a qualitative research method, particularly a half-structured dialogue method, which provided both free narration of individual nuns and possible further questions of the inquirer, which helped explain the details. In chapter "Results" there are portraits of each nun, created on the basis of half-structured dialogues. The portraits keep their authenticity, although redundant words were omitted and dialectal and colloquial expressions were translated into standard Czech. The main value of this thesis lies in the compact overview of induvidual institutions, where nuns work. These organizations are either own by particular congregations, which concern Sisters of Mercy of St. Borromeo and Congregation of the Mercy Sisters of the Third Order of St. Francis under the Protection of the Holy Family in Brno, to whom these organizations were returned in the 90s of the 20th century or the nuns work in organizations that are owned by someone else, which is the case of Daughters of Charity of st. Vincent de Paul. The significant value of this thesis lies in the complete number of nuns in particular congregations, the data are clearly written in the table, created on the basis of the study of all parts of the Catalogue of the male and female congregations in the Czech Republic. Table 12 shows the number of nuns in particular congregations from the end of the 90s of the 20th century till the year 2015. Table 13 shows the number of nuns in selected congregations who work in healthcare and social service at present.

Spiritual Care in Hospitals in the South Bohemian Region In contemporary holistic perspective, we see man as an integrated unity existing and functioning in four dimensions. These are biological, psychological, social and spiritual dimensions. All these spheres create a whole; they are inseparable and they influence each other. Therefore, caring for the ill can be characterized as a combination of these aspects {--} taking care of his biological needs, assistance in his social needs, identification and fulfilling of his psychological needs and help in meeting his spiritual needs. Spiritual needs are inherent in man{\crq}s nature and so it would be erroneous to suppose that they are present and pronounced only in people who are believers. The intensity of the urge to satisfy these needs changes during life. Research done on this topic has revealed that this kind of need intensifies in old age and illness. In some countries, it is already common that hospitals employ spiritual workers or hospital chaplains. In the Czech Republic, there has been a discussion going on regarding the introduction of the hospital chaplain function and several hospitals have one already. The goal of this work is to present an overview of the offer and ways of providing spiritual care in the individual hospitals in the South Bohemian region and to find out whether the offer of spiritual care in these hospitals corresponds with the needs and interest of the patients. The work should also find out what kind of spiritual assistance the patients are interested in {--} whether they would welcome if the hospitals employed their own chaplains or if regular visit of a clergyman suffice, and also, who should perform the role of the hospital chaplain {--} whether a clergyman or a qualified layman. The hypotheses will be verified through a quantitative research. To find out the intensity and kind of interest of patients in satisfying their spiritual needs and to ascertain the level of their satisfaction with offered services, a method of questionning will be used. The research will be conducted through a standardized questionnaire and a guided interview with patients who are unable to fill it in. Possible ways of satisfying spiritual needs will be assessed by the method of questionning through guided interviews with head nurses in the individual hospitals in the South Bohemian region.

Base Teórica: Nas duas últimas décadas houve um crescimento no número de estudos que abordam o tema espiritualidade em cuidados paliativos, ressaltando o impacto desta dimensão na qualidade de vida dos pacientes/famílias. A atenção às necessidades espirituais tem sido reconhecida como um importante aspecto de avaliação da qualidade assistencial nas instituições de saúde. Os estudos indicam que uma das principais barreiras para uma abordagem que inclua espiritualidade no cuidado tem sido a falta de preparo/educação dos profissionais de saúde. Objetivos: Desenvolver e avaliar a eficácia do uso de um módulo de educação sobre espiritualidade na atenção a pacientes/famílias em cuidados paliativos para os profissionais de saúde do Hospital de Clínicas de Porto Alegre (HCPA). Para alcançar este objetivo foi necessário na primeira etapa da pesquisa realizar o processo de adaptação/validação transcultural e avaliação das propriedades psicométricas da Spiritual Care Competence (SCCS) para o português falado no Brasil. Método: Na primeira etapa foi realizado um estudo de validação que seguiu os passos de Beaton: tradução para o português, retradução para o inglês, correção e adaptação semântica pelo comitê de especialistas, avaliação da clareza da versão pré-final e medidas psicométricas da versão final em português. Na segunda etapa foi realizado um estudo quase-experimental, do tipo pré-teste e pós-teste, a partir de uma abordagem quantitativa, com profissionais de saúde do HCPA. A coleta de dados foi realizada por meio de um questionário semiestruturado e da SCCS-versão brasileira. Resultados: Participaram da etapa de validação da SCCS 181 profissionais de saúde. Quanto à consistência interna, o alfa de Cronbach apresentou valor total de 0,92 e a média de correlação interitem foi de 0,29. O teste-reteste demonstrou que não houve diferença estatisticamente significante nas seis subescalas e o coeficiente de concordância intraclasse variou de 0,69 a 0,84, demonstrando a estabilidade da escala. Na etapa de uso do módulo de educação participaram 52 profissionais de saúde que atuam em cuidados paliativos no HCPA. Foram observadas diferenças significativas entre as medidas pré e pós-intervenção nas seguintes dimensões da SCCS - versão brasileira: avaliação e implementação do cuidado espiritual, profissionalização e melhoria da qualidade do cuidado espiritual, apoio e aconselhamento individualizado ao paciente (p<0,001) e encaminhamento (p=0,003). Conclusão: Estes dados indicam a qualidade das propriedades psicométricas da SCCS – versão brasileira para uso com profissionais de saúde. Quanto ao desenvolvimento e uso do módulo de educação permanente, os dados fornecem evidências preliminares, demonstrando os efeitos positivos do uso desta intervenção educativa no desenvolvimento das competências dos profissionais de saúde para uma abordagem integral, centrada no paciente/família e que contemple a atenção as suas necessidades espirituais e a sua participação no processo de tomada de decisão dos cuidados paliativos. Com base nos resultados deste estudo, sugere-se a necessidade da inclusão dos temas espiritualidade e cuidado espiritual nas bases curriculares e nos processos de educação permanente de instituições de ensino, assistência e pesquisa em saúde. / Theoretical Basis: Over the last two decades there has been an increase in the number of studies that address spirituality in palliative care, highlighting the impact of this dimension on patient/family quality of life. Attention to spiritual needs is recognized as an important aspect of evaluating the quality of care in health institutions. Studies indicate that one of the main obstacles to an approach which includes spirituality in palliative care has been the lack of preparation/education for healthcare professionals in relation to this issue. Objectives: Develop and evaluate the effectiveness of an education module on spirituality and spiritual care for patients/families under palliative care by healthcare professionals in Hospital de Clínicas de Porto Alegre. To achieve this objective it was necessary in the first stage of the research to carry out the cross-cultural adaptation/validation process and psychometric properties evaluation of the Spiritual Care Competence Scale for the Portuguese spoken in Brazil. Methods: During the first stage a validation study was conducted following the steps of Beaton: translation into Portuguese, back-translation into English, expert committee review for semantic equivalence, assessment of the clarity of the pre-final version, and evaluation of the psychometric properties of the final version in Portuguese. For the second stage, a quasi-experimental study, the pre-test and post-test type, from a quantitative approach, was carried out with health professionals of the HCPA. Data collection was conducted through the use of a semi-structured questionnaire and the SCCS - Brazilian version. Results: 181 health professionals participated in the validation stage of SCCS. Regarding the internal consistency, Cronbach's alpha showed a total value of 0.92 and the average inter-item correlation was 0.29. Test results demonstrated no statistically significant differences in the six subscales. The intraclass correlation coefficient ranged from 0.69 to 0.84, demonstrating the stability of the scale. Fifty-two healthcare professionals, who work in palliative care at HCPA, attended the education module. Significant differences were observed between pre and post-intervention in the following dimensions of SCCS - Brazilian version: assessment and implementation of spiritual care, professionalization and improving of spiritual care quality, personal support and patients counselling (p<0.001) and referral (p = 0.003). Conclusion: These data indicate the quality of the psychometric properties of SCCS - Brazilian version for use with health professionals. Through the development and use of the continuing education module, the results of this study provide preliminary evidence demonstrating the positive effects of using this educational intervention in developing the skills of healthcare professionals for a comprehensive approach centered on the patient/family including attention to their spiritual needs and their participation in the palliative care decision-making process. Based on the results of this study, we can suggest the necessity the inclusion of the theme of spirituality and spiritual care in curricular bases and in the continuing health education processes.

Base Teórica: Nas duas últimas décadas houve um crescimento no número de estudos que abordam o tema espiritualidade em cuidados paliativos, ressaltando o impacto desta dimensão na qualidade de vida dos pacientes/famílias. A atenção às necessidades espirituais tem sido reconhecida como um importante aspecto de avaliação da qualidade assistencial nas instituições de saúde. Os estudos indicam que uma das principais barreiras para uma abordagem que inclua espiritualidade no cuidado tem sido a falta de preparo/educação dos profissionais de saúde. Objetivos: Desenvolver e avaliar a eficácia do uso de um módulo de educação sobre espiritualidade na atenção a pacientes/famílias em cuidados paliativos para os profissionais de saúde do Hospital de Clínicas de Porto Alegre (HCPA). Para alcançar este objetivo foi necessário na primeira etapa da pesquisa realizar o processo de adaptação/validação transcultural e avaliação das propriedades psicométricas da Spiritual Care Competence (SCCS) para o português falado no Brasil. Método: Na primeira etapa foi realizado um estudo de validação que seguiu os passos de Beaton: tradução para o português, retradução para o inglês, correção e adaptação semântica pelo comitê de especialistas, avaliação da clareza da versão pré-final e medidas psicométricas da versão final em português. Na segunda etapa foi realizado um estudo quase-experimental, do tipo pré-teste e pós-teste, a partir de uma abordagem quantitativa, com profissionais de saúde do HCPA. A coleta de dados foi realizada por meio de um questionário semiestruturado e da SCCS-versão brasileira. Resultados: Participaram da etapa de validação da SCCS 181 profissionais de saúde. Quanto à consistência interna, o alfa de Cronbach apresentou valor total de 0,92 e a média de correlação interitem foi de 0,29. O teste-reteste demonstrou que não houve diferença estatisticamente significante nas seis subescalas e o coeficiente de concordância intraclasse variou de 0,69 a 0,84, demonstrando a estabilidade da escala. Na etapa de uso do módulo de educação participaram 52 profissionais de saúde que atuam em cuidados paliativos no HCPA. Foram observadas diferenças significativas entre as medidas pré e pós-intervenção nas seguintes dimensões da SCCS - versão brasileira: avaliação e implementação do cuidado espiritual, profissionalização e melhoria da qualidade do cuidado espiritual, apoio e aconselhamento individualizado ao paciente (p<0,001) e encaminhamento (p=0,003). Conclusão: Estes dados indicam a qualidade das propriedades psicométricas da SCCS – versão brasileira para uso com profissionais de saúde. Quanto ao desenvolvimento e uso do módulo de educação permanente, os dados fornecem evidências preliminares, demonstrando os efeitos positivos do uso desta intervenção educativa no desenvolvimento das competências dos profissionais de saúde para uma abordagem integral, centrada no paciente/família e que contemple a atenção as suas necessidades espirituais e a sua participação no processo de tomada de decisão dos cuidados paliativos. Com base nos resultados deste estudo, sugere-se a necessidade da inclusão dos temas espiritualidade e cuidado espiritual nas bases curriculares e nos processos de educação permanente de instituições de ensino, assistência e pesquisa em saúde. / Theoretical Basis: Over the last two decades there has been an increase in the number of studies that address spirituality in palliative care, highlighting the impact of this dimension on patient/family quality of life. Attention to spiritual needs is recognized as an important aspect of evaluating the quality of care in health institutions. Studies indicate that one of the main obstacles to an approach which includes spirituality in palliative care has been the lack of preparation/education for healthcare professionals in relation to this issue. Objectives: Develop and evaluate the effectiveness of an education module on spirituality and spiritual care for patients/families under palliative care by healthcare professionals in Hospital de Clínicas de Porto Alegre. To achieve this objective it was necessary in the first stage of the research to carry out the cross-cultural adaptation/validation process and psychometric properties evaluation of the Spiritual Care Competence Scale for the Portuguese spoken in Brazil. Methods: During the first stage a validation study was conducted following the steps of Beaton: translation into Portuguese, back-translation into English, expert committee review for semantic equivalence, assessment of the clarity of the pre-final version, and evaluation of the psychometric properties of the final version in Portuguese. For the second stage, a quasi-experimental study, the pre-test and post-test type, from a quantitative approach, was carried out with health professionals of the HCPA. Data collection was conducted through the use of a semi-structured questionnaire and the SCCS - Brazilian version. Results: 181 health professionals participated in the validation stage of SCCS. Regarding the internal consistency, Cronbach's alpha showed a total value of 0.92 and the average inter-item correlation was 0.29. Test results demonstrated no statistically significant differences in the six subscales. The intraclass correlation coefficient ranged from 0.69 to 0.84, demonstrating the stability of the scale. Fifty-two healthcare professionals, who work in palliative care at HCPA, attended the education module. Significant differences were observed between pre and post-intervention in the following dimensions of SCCS - Brazilian version: assessment and implementation of spiritual care, professionalization and improving of spiritual care quality, personal support and patients counselling (p<0.001) and referral (p = 0.003). Conclusion: These data indicate the quality of the psychometric properties of SCCS - Brazilian version for use with health professionals. Through the development and use of the continuing education module, the results of this study provide preliminary evidence demonstrating the positive effects of using this educational intervention in developing the skills of healthcare professionals for a comprehensive approach centered on the patient/family including attention to their spiritual needs and their participation in the palliative care decision-making process. Based on the results of this study, we can suggest the necessity the inclusion of the theme of spirituality and spiritual care in curricular bases and in the continuing health education processes.

The rise in modern nursing and nursing processes using holistic philosophies. When providing care it should be taken into account the biological, psychlogical, social, but also the spiritual needs of patients. Caring for spiritual needs is an integral part of comprehensive care. Providing spiritual care and psychological support are among the main activities of hospital chaplains. Their work is of great importance in overcoming all the difficulties that illness brings. They are part of a multidisciplinary collaboration in the treatment of patients without a distinct faith. The aim of the thesis is to find out the level of awareness of patients in the sphere of spiritual care, their expectations and their contribution. For the thesis I chose to collect data from a hospital through quantitative research using an anonymous questionnaire. The target group of my research will be 100 patients who are hospitalised in an intensive care unit with a minimum hospitala stay of 7 days. The goal of the work was fulfilled. The result of the research was confirmation that the spiritual care provided was reflected in their psychological state and also fulfilled the patients expectations. In the conclusion of my thesis I recommended some ways in which to improve the quality of care in the area of spiritual needs....

Background: It has been argued that nursing care shall be provided with a holistic approach where the human being is seen as one unit that contains body, mind, soul and spirit. The International Council of Nurses (ICN) states that patients’ spirituality shall be respected and that nurses therefore have to involve the spiritual dimension when caring for patients. Spirituality is subjective and by meeting patients’ spiritual needs and providing spiritual care interventions according to these needs, nurses can support patients and help them to find motivation in their sickness.  Aim: To describe Christian nurses’ experiences of spiritual care at a Christian hospital in Myanmar.  Method: A qualitative interview study with semi-structured interviews. Four Christian nurses with experience of spiritual care participated and in total six individual interviews were conducted. The data was analyzed using a qualitative content analysis, as described by Graneheim and Lundman.  Result: The result was divided into two categories: nurses’ view on spirituality and spiritual care and nurses’ experiences of spiritual care.  Discussion: The result is discussed using Lundmark’s definition of spiritual care as framework. The main focus is the religious approach to spiritual care. Both ethical dilemmas and positive outcomes of this approach are discussed. / Bakgrund: Det har argumenterats för att omvårdnad ska ges utifrån ett holistiskt perspektiv där människan ses som en enhet som innefattar kropp, sinne, själ och ande. Internationella rådet för sjuksköterskor (ICN) har slagit fast att patienters andlighet ska respekteras och att sjuksköterskor därför måste involvera den andliga dimensionen i vården av patienter. Andlighet är något subjektivt och genom att möta patienters andliga behov samt ge andlig omvårdnad i enlighet med dessa behov, kan sjuksköterskor ge stöd åt patienter och hjälpa dem att hitta motivation i deras sjukdom. Syfte: Att beskriva kristna sjuksköterskors erfarenheter av andlig/existentiell omvårdnad på ett kristet sjukhus i Myanmar. Metod: Kvalitativ intervjustudie med semi-strukturerade intervjuer. Fyra kristna sjuksköterskor med erfarenhet av andlig/existentiell omvårdnad deltog och totalt genomfördes sex individuella intervjuer. Datamaterialet analyserades genom en kvalitativ innehållsanalys som beskrivs av Graneheim och Lundman. Resultat: Resultatet delades upp i två kategorier; sjuksköterskors syn på andlighet och andlig/existentiell omvårdnad och sjuksköterskors erfarenheter av andlig/existentiell omvårdnad. Diskussion: Resultatet diskuteras med Lundmarks definition av andlig/existentiell omvårdnad som referensram. Störst fokus ligger på det religiösa förhållningssättet till andlig/existentiell omvårdnad. Både etiska dilemman och positiva aspekter av detta förhållningssätt diskuteras.

Thesis (MTh (Practical Theology and Missiology))--University of Stellenbosch, 2009. / The basic premise of this study is that a spiritual approach to care and support of people living with HIV, by means of a holistic pastoral model, would provide the Reformed Church of East Africa's Plateau Mission Hospital with an integrated dimension in their community-based care programme for people living with HIV/AIDS. This will go a long way in assisting the RCEA's diversification of the existing medical model, particularly in the Plateau Mission Hospital’s catchment area with its ever-increasing cases of infections, deaths, rejections, church-related stigma, orphans and vulnerable children. The researcher proposes the use of a spiritual model in dealing with PLWH in the Plateau Mission Hospital because this will help to address some of the unresolved theological issues that come to the fore when addressing matters concerning the health and illness of people living with HIV and AIDS. The researcher does this with acute awareness of the importance of integrating other approaches in the care and support of PLWH. For a holistic approach to be effected, the social development, medical, psychological and holistic systemic approaches to care must be considered. The holistic systemic approach used by the biomedical personnel and other caregivers should regard the person as a relational and social being acting within a cultural context. On the other hand, the biomedical model serves us with accurate diagnoses and sophisticated methods of treatment within which modern medicine is practiced. Similarly, the psychosocial model considers the influence of the social environment not only to the challenges that PLWH face, but also on the care they should receive. However, research has shown that there is an increasing need for holistic care in health care systems. This calls for the inclusion of spirituality within the developing bio-psycho-social approaches in addressing health and illness, particularly for people living with HIV and AIDS, in order for them to attain holistic healing. Plateau Mission Hospital, being a church-based institution within the jurisdiction of the RCEA’s southern presbytery, can be an effective vehicle for pastoral care of people living with HIV and AIDS. The organization is strategically placed and has the capacity (resource persons) to engage in a holistic ministry. The paper also aims at unlocking the RCEA’s resources to become more involved in all rounded existential issues of PLWH in the hospital’s catchment area. In this study, it is presupposed that, although the Hospital has a history of medical and social development work and chaplaincy office, it lacks emphasis on the spiritual dimension, and yet this focal point is important in terms of the immediate HIV/AIDS context at Plateau. The researcher established that the training that the personnel at the medical facility have undertaken promotes a clinical approach to all issues of health (prevention and treatment after prescription), even to people living with HIV/AIDS. Methodology. The first methodology for data collection that the research employed was literature review. In this case, library and church documents were reviewed to gather information on related matters. The areas reviewed were related to spirituality, care and healing in the context of HIV, pastoral care and theology in the context of HIV, and biomedical approaches in relation to the care of PLWH, and documentation (Plateau Hospital Reports, the RCEA’s constitution and Care Departmental Reports) on the RCEA’s approach to Hospital care to PLWH by means of the CBHC programme at the Plateau Mission Hospital in Eldoret. The websites were also consulted for purposes of data collection. The second method was conducting specific oral and written interviews with the Hospital’s CBHC staff, PLWH, congregational and church leadership on matters of the proposed spiritual care of PLWA. The areas interviewed were for the spiritual needs, those involved in the care and support of PLWH, improving existing interventions, the challenges encountered in the care for PLWH, the unfulfilled needs of PLWH and how spiritual care could improve the quality of the lives of PLWH. The third method of data collection was participant observation. The researcher was involved in the activities being studied. This method entailed participant observation during normal diaconal care activities in the RCEA’s Plateau parish congregations that the researcher implemented, for instance visiting people living with HIV/Aids, taking gifts to children affected by HIV. In meeting with volunteer caregivers during visits, while joining the CBHC team during follow-up meetings with PLWH in their homes, data was collected. The researcher had patient consultation during days for voluntary counseling and testing and informal meetings with volunteer caregivers. Presentation of the Thesis - Outline of Research This study is divided into five parts. Chapter 1 will examine the background to the study considering the problem statement, research questions, research objectives, hypothesis, justification, the scope of the research, the methodology used, limitations and delimitations. In Chapter 2 the paper will explore The Kenyan Scenario: Medical work and the involvement of the church within the community. This will cover the Kenyan national HIV updates, Uasin Gishu updates, Ainabkoi divisional statistics, the background to the Reformed Church of East Africa, Plateau Mission HIV ministry covering the psycho-social approach to community-based care of CBHC in the Reformed Church of East Africa in the Plateau Hospital catchment area. The paper will examine the medical care offered to people living with HIV/AIDS, such as the treatment of opportunistic diseases, administration of anti-retroviral drugs and the prevention of mother-to-child transmission and voluntary counseling and testing. The paper will also examine the social and developmental activities and services rendered to PLWA and the orphans and vulnerable children by means of compassionate care. CBHC networking with congregations, and Moi Teaching and Referral Hospital will also be highlighted. The paper will also highlight the gaps experienced as a result of the focus on medical and social developmental approaches to the care and support of PLWA and OVCs. Chapter 3 is largely the analysis of interview responses, and presents the findings of field research at the RCEA Plateau Mission Hospital’s selected area of study. This will indicate the seriousness of the unattended needs in this case the spiritual needs and the magnitude of the problem in the health facility but, by implication, affecting the church. This will need a change of stance, namely that of regarding HIV as a medical problem that the hospital needs to address, and view it as a collective need for all key players in church, hospital and community. Chapter 4 will look at the challenge HIV poses to the spiritual care of PLWH in Plateau Mission Hospital. The chapter will contain a literature review on the holistic approach in the care and support of people living with HIV. The section will look at understanding the needs of people living with HIV, pastoral care of people living with HIV, practical theology, biomedical and bio-psycho-social models in the care of PLWH. The study will also examine the relevance of God-images, systems approach, the role of the church and a spiritual care approach in the holistic healing for PLWH by means of pastoral care. Chapter 5 will conclude the paper and will shed light on the importance of the proposed approach to be integrated into the current strategy (pastoral care model with a spiritual-care approach). It is hoped that the recommendations that will be made at the end will strengthen the high demand for a holistic-care ministry to people living with HIV and the affected families in the RCEA Plateau Mission Hospital.