Philosophiae Doctor - PhD (Nursing) / Man is a bio-psycho-social-spiritual being, and his needs are informed by all these elements. The need for spiritual care in nursing education and practice is no longer a new concept in developed countries, nor even in some developing countries. However, in Nigeria, there is no consistent evidence of how spirituality is taught within the nursing curriculum nor how it is practised. The literature review also confirms that no existing set of rules or models for integrating spiritual care into the curriculum of nursing exists in the country. If nursing care is to be holistic, concerted attention must be paid to spiritual care, and to the training of nurses so that they can provide spiritual care within the context of holistic care for patients in the healthcare system. The main purpose of this academic work was to develop a model for the integration of spiritual care-giving into the nursing curriculum. This cross-sectional study used adapted modified Intervention Mapping (IM) strategies with a mixed method approach, to collect in-depth information.

A qualitative, grounded theory study was undertaken to explore and describe how nurses conceptualise spiritual nursing care, and how they integrate spiritual nursing care in practice. An in-depth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. Symbolic Interactionism was the philosophical base for the study. Data analysis was done through the use of the NUD*Ist computer soft ware programme version 4.0. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a process of open, axial and selective coding. Tech’s (1990:142-145) eight steps of analysis to analyse textual qualitative data was used until themes, categories and subcategories were identified and developed. Data analysis revealed that nurses had difficulty to differentiate spiritual nursing care from emotional, psychological or religious care. Nurses still felt inadequately prepared educationally on how to integrate spiritual nursing care in nursing practice. A Humane Care Model and practice guidelines were developed to guide nurses in clinical practice on how to provide such care. Recommendations proposed that the matter be taken up by nurse managers, educators and nurse clinicians to guide nurses in this regard. / Health Studies / D. Litt. et Phil. (Health Studies)

Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO databases were searched for the literature review. Keywords and phrases used included spirituality, spiritual nursing care, holistic health practices, inpatient, hospital, and preoperative care. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) II tool was used for data analysis. Interventions found in the literature to be supportive of spirituality included healing presence; providing effective communication; praying with the patient and family or facilitating other religious rituals; using the therapeutic self to be with the patient; listening to and exploring the patients' spiritual perspectives; and showing support and empathy through patient-centered caring, nurturing spirituality, and creating a healing environment. Employing these nursing actions might promote positive social change by contributing to a sense of well-being as patients find meaning and purpose in their illness and life overall, which will promote improved surgical outcomes and better patient satisfaction with care.

A qualitative, grounded theory study was undertaken to explore and describe how nurses conceptualise spiritual nursing care, and how they integrate spiritual nursing care in practice. An in-depth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. Symbolic Interactionism was the philosophical base for the study. Data analysis was done through the use of the NUD*Ist computer soft ware programme version 4.0. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a process of open, axial and selective coding. Tech’s (1990:142-145) eight steps of analysis to analyse textual qualitative data was used until themes, categories and subcategories were identified and developed. Data analysis revealed that nurses had difficulty to differentiate spiritual nursing care from emotional, psychological or religious care. Nurses still felt inadequately prepared educationally on how to integrate spiritual nursing care in nursing practice. A Humane Care Model and practice guidelines were developed to guide nurses in clinical practice on how to provide such care. Recommendations proposed that the matter be taken up by nurse managers, educators and nurse clinicians to guide nurses in this regard. / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis advisor: Jane M. Flanagan / Purpose: The purpose of this study was to explore nurses’ experiences of Watson’s Theory of Human Caring Caritas Process Three: Cultivation of One’s Own Spiritual Practices and Transpersonal Self, Beyond Ego-Self. Background: There is currently an inadequacy of spiritual care provided to patients and families in the ICU despite a significant articulated need. Nurses report discomfort with and a lack of preparation in providing spiritual care competently. Nurses with strong personal spiritual development are more likely to report comfort with spiritual caregiving and provide spiritual care. Watson’s Theory of Human Caring Caritas Process Three; Cultivation of One’s Own Spiritual Practice and Transpersonal Self, Going Beyond Ego-Self makes explicit the primacy of relationship between nurse spiritual development and transpersonal spiritual nursing care. However, the nature of spiritual development of nurses in the ICU remains unknown. Methods: A qualitative descriptive methodology with directed content analysis applying Watson’s Caritas Process Three was used to analyze data for this study. Results: Ten ICU Nurses provided evidence of the experience of Caritas Process Three. Five themes were identified in the analysis of data: Caritas nurses vary in their ability to move beyond ego-self, Personal spiritual practices serve as a barrier and/or facilitator to nurses’ ability to provide spiritual care, Critical illness as experienced by patients and families provided the opportunity for nurses to explore spirituality with other, The care environment serves as a barrier and/or facilitator to nurses’ personal spiritual growth, and Cultivation of spiritual practice and spiritual identity is integral to a life-long process of consciousness evolution. Conclusions: The findings of this study extend and inform Caritas Process Three of Watson’s Theory of Human Caring. Nurses in this study provide evidence for the primacy of personal spiritual development for the delivery of spiritual and transpersonal care for patients in the ICU. / Thesis (PhD) — Boston College, 2019. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Bakgrund: Att ge andlig omvårdnad ligger i sjuksköterskans ansvar. Trots alltmer forskning som visar att en tillfredställande andlig omvårdnad har positiv inverkan på hälsa, har detta dock ofta försummats inom vården. Begreppet andlighet kan ha olika betydelser och behöver därför uppfattas i sin bredd. Syfte: Beskriva vuxna patienters (18+) upplevelse av andlig omvårdnad inom somatisk slutenvård. Metod: En integrativ översikt bestående av nio kvalitativa originalartiklar från USA, Singapore, Kanada, Nederländerna, Iran och Australien. Data samlades genom CINAHL, Medline och manuell sökning. Analys gjordes efter inspiration av Friberg och Whittemore och Knafl analysmodeller. Resultat: Andlig omvårdnad kunde av patienterna upplevas positiv, negativ eller obefintlig beroende på olika faktorer. Patienterna i studien upplevde andlig omvårdnad genom att få möjlighet till uttryck av sin andlighet, genom att få möjlighet till relationer, genom att få ha sin värdighet i behåll och genom sjuksköterskans närvaro. Andlig omvårdnad ska utföras utifrån en personcentrerad vård eftersom uttryck av andlighet kan variera mellan individer. Slutsats: För att kunna prata om andlig omvårdnad behöver både personalen och patienter ha förståelse för vad andlighet kan innebära. Sjuksköterskan behöver få kunskap och verktyg för att lätt kunna införa andlig omvårdnad i sitt arbete och känna sig trygg med att utföra en holistisk vård dvs att se hela människan. Detta skulle resulterar i mer tillfreställda patienter.