Philosophiae Doctor - PhD (Nursing) / Literature attest that holistic approach to care is the best way to ensure that all human needs, including spiritual needs are taken care of. As such holistic approach to care accepts the notion of "wholeness" nature of the patient. However, in practice patient's holistic needs, which are essential for optimum health, are not routinely addressed when practicing nursing. This implies that regardless of the nurses doing their best to attend to patient's health needs, patients still do not achieve their required optimum health. Furthermore, in the face of good nursing education programmes, attempts to meet the patient's care needs as advocated, a gap still exists in rendering nursing services that truly promote health in a holistic manner. Confusion regarding the scope and holistic nature of nursing, relates not only to nursing organisations having failed to define nursing with clarity concerning the spiritual dimension of care; but they have also not succeeded in implementing nursing that is truly holistic. In this study, it is argued that where spiritual care aspects in nursing remain at the periphery, holistic nursing cannot be truly attained. According to Burkhardt and Hogan promoting one's spirituality within a nursing paradigm can be one way to promote and optimise health, particularly in response to illness. In view of the existing gap between teaching-learning of spiritual care and espoused theory of holistic nursing, a need to develop a theory that would guide and assist nurse educators and nursing students in the teaching and learning of spiritual care was imperative. The aim of this research was to generate a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution by answeringthe research question "how can a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution in the Western Cape be generated? Ethical procedures were applied in accordance to stipulations of the University Research Ethics Committee. The credibility of the study was ensured by application of Guba's model of trustworthiness for qualitative data.

Objective: To examine the discourses used by trainee and qualified clinical psychologists from the South West of England to manage discussions of spirituality and religion as they relate to clinical practice. Methods: Four focus groups were carried out with a total of 25 qualified and trainee clinical psychologists. Transcripts were analysed using discourse analysis. Results: Three key discourses were identified, giving insight into how cohorts of qualified and trainee clinical psychologists manage discussions of these difficult topics. These were: balancing medical and therapeutic discourses, particularly when discussing psychosis and religious or spiritual beliefs; positioning and the Other, including religion and spirituality as a proxy for talking about race; and negotiating what can or cannot be said, principally when sharing personal views. Conclusion: Ensuring that clinical psychologists have an awareness of the different discourses in use within the profession and how these may impact practice is important. Explicit discussion of the medical and therapeutic discourses likely to arise across different settings should be encouraged, including how these can constrain discussions around difficult topics such as spirituality and religion, race, and sexuality. Training should equip psychologists to have an awareness of othering, particularly in relation to religion or spirituality and race, and the potential effects this could have on power and engagement in therapy and broader work.

Despite the robust evidence that spiritual development begins in childhood, the relationship between adolescent spirituality and positive development outcomes has been largely overlooked; thus, while the positive impact of spirituality on development has been established again and again, the empirical data on childhood and adolescent spirituality remains limited (Peterson & Seligman, 2004; Stolzenberg, Blair-Loy, & Waite, 1995). This topic, however, may be especially relevant in such turbulent times in education and development, particularly in the backdrop of the recent surging interest in character education. Using data from 1,352 middle-school adolescents who live throughout Israel, the current study examines the following hypotheses: 1. Spirituality is a foundational facet of character, independent of interpersonal, intrapersonal and intellectual facets of character. 2. Spirituality is stable over time during adolescent development. 3. Spirituality is correlated with positive outcomes such as positive emotions, prosociality and life satisfaction, and with character strengths such as kindness, gratitude, perseverance, and perspective. 4. Changes in spirituality over time are related to changes in positive outcomes and character strengths. Variables were measured according to several previously validated scales, completed in this study by the Israeli middle-school adolescents. Data were analyzed using a common factor model, latent class analysis and latent growth mixture modeling. The results revealed four distinct dimensions of strength/character among middle school adolescents: spiritual, interpersonal, intrapersonal, and intellectual. The emergence of a statistically autonomous spirituality factor, incorporating the various aspects of spirituality measured in the current study, suggests that spirituality is a divergent aspect of youth character, and one of the foundational aspects of character. The findings also suggest that spirituality is stable over time. The current study suggests meaningful relationships between spirituality and positive emotions, life satisfaction, prosociality, interpersonal character (e.g., prudence, judgment, selfregulation, honesty, forgiveness, teamwork, humility), and intrapersonal character (e.g., zest, life orientation, humor, hope, perspective). Spirituality did not show meaningful relationships with intellectual character strengths. Lastly, these findings suggest that spirituality is longitudinally related to positive outcomes, and that adolescents with spiritual growth report the highest levels of positive emotions, life satisfaction, prosociality, and character strengths such as gratitude, kindness, honesty, perseverance, hope, and prudence, as well as the lowest levels of problems with peers. These findings suggest that spirituality is an important aspect of adolescent psychological development, both in terms of intrapersonal and interpersonal growth. Further research on this issue is warranted in order to determine whether the education of middle-school adolescents should include spirituality as a core tenet.

This dissertation is a qualitative case study exploring the understandings, beliefs, and practices of Youth Spoken Word Poetry (YSW) educators who work within the field of Hip Hop-Based Education (HHBE) and have grown from youth participants to adult professionals within an international YSW Network. This study examines how current YSW practitioners describe and understand their work, along with the multiple literacy practices they utilize related to spirituality and race. This study is framed by a sociocultural lens of education, includes a blend of qualitative research methods related to narrative approaches, and is inspired by literature grounded in Hip Hop-Based Education; Race and Education; and Spirituality and Education. It is a hope of this study that the findings lead to a more nuanced understanding of how HHBE functions within the landscape of education and impact how we approach HHBE moving forward. Major findings revealed that the participants describe themselves as racialized and spiritual beings in implicit and explicit ways. YSW participants in this study described the field of YSW as grounded in African American lineages and acknowledged that the field currently functions as pluralistic and multicultural. YSW participants describe spirituality as personal, collective, and transcendent experiences. Though participants defined spirituality differently, they described it as something that is present, naming it as an important factor to be considered when examining YSW practice. Core literacy practices participants engaged with and enacted within the YSW community related to race and spirituality included acknowledging their voice as something that was expressed individually, collectively, and universally and across time (past, present, and future). These findings highlight the value of communities that support: (1) Reflection, or honoring individual identities; (2) Refraction, or honoring Communities of Practice that shape our paths; and (3) Dispersion, or the use of stories to support dreaming, sharing, and revolutionizing the world as we know it.

Both artists and business executives state the importance of intuition in their professional practice. Current research suggests that intuition plays a significant role in cognition, decision-making, and creativity. Intuitive perception is beneficial to management, entrepreneurship, learning, medical diagnosis, healing, spiritual growth, and overall well-being, and is furthermore, more accurate than deliberative thought under complex conditions. Accordingly, acquiring intuitive faculties seems indispensable amid present day’s fast-paced multifaceted society and growing complexity. Today, there is an overall rising interest in intuition and an existing pool of research on intuition in management, but interestingly an absence of research on intuition in the field of art. This qualitative-phenomenological study explores the experience of intuition in both professional practices in order to show comparability and extend the base of intuition, while at the same time revealing what is unique about its emergence in art practice. Data gathered from semi-structured interviews and online-journals provided the participants’ experience of intuition and are presented through individual portraits, including an introduction to their work, their worldview, and the experiences of intuition in their lives and professional practice. Framing outcomes through concepts of psychology, neuroscience, philosophy, theology, noetic sciences, quantum physics, metaphysics, and art theory, resulted in the emergence of five themes that offered perspectives on the purpose of intuition, optimum conditions for intuiting, spiritual aspects of intuition, conduits for intuitive knowledge, and suggested connections between art and intuition. The findings of the study suggest that the artists experienced heightened levels of intuition that the business executives did not. Data indicate that experiences of intuition are enhanced through methods of quieting the mind, which can be found in Eastern practices and that show similarities to processes in art practice, such as transcendence, focus, non-attachment, visualization, a body-mind-spirit connection, and intention. The findings suggest that distinct qualities of art practice allow for alternative knowledge-making methods that can create preferable conditions for intuition to flourish in art education, such as generating inclusive dialog, increasing self-awareness, processing emotions, developing focus, refining the senses, and fostering ethicality, all of which may awaken and strengthen abilities of intuition.

In this dissertation, I examine three popular contemporary Japanese female writers—Yoshimoto Banana (b.1964), Ogawa Yoko (b.1962), and Kawakami Hiromi (b.1958), who all debuted after the peak of Japan’s bubble economy in the late 1980s. Focusing on the works of these three living authors, I investigate the ways in which they deal with the theme of spiritual and emotional healing, and how they are original in the world of Japanese literature. Since they are all women, in terms of feminist context, I also look into how differently they respond to the gender issues from the prior generation of female authors.<div><br></div><div>In Introduction, I begin with the examination of how prewar authors dealt with the theme of spiritual healing. Using Snow Country (1937) by the male writer Kawabata Yasunari and “A Floral Pageant” (1937) by the female author Okamoto Kanoko (1899-1939), I discuss the commonality of these two authors, apart from the evident disparities related to their difference in gender. Their stories both end with the description of their protagonist’s spiritual climax, associated with their transcendental leap from their everyday reality. Comparing those prewar authors, I discuss how differently the three contemporary authors approach the same topic. In terms of their common gender, I also address outstanding characteristics of feminist messages delivered by their previous generation of female authors from the postwar to the 1970s, and how our authors are different from the previous ones in terms of their interest in feminism and women’s issues.<br></div><div><br></div><div>Chapter 1 examines the novels of Yoshimoto Banana, the author who debuted before the other two. I begin with an analysis on how her interest in spirituality is related to the social background of the bubble-collapse period between the late 1980s and the early 1990s—in relation, in particular, to the healing boom and the impact of Aum Shinrikyō’s sarin gas attack on Tokyo Subways in 1995. With her critiques on the so-called shin shin shūkyō, newly established religious groups, she claims that spiritual healing should be based on one’s awakening of his or her connection with nature to be blessed. And she stresses and encourages with that awareness to live through everyday reality with hope.<br></div><div><br></div><div>Chapter 2 explores works of Ogawa Yoko. I analyze how she develops her theme of girlhood by examining her earlier works, which recurrently focus on her adolescent protagonists’ anxieties—their fear of separation from their girlhood and their frustration about moving into a sexualized female adulthood. At the end of this chapter, I examine Mīna’s March, a work, which extensively features a young protagonist’s girlhood and her days growing up. Ogawa implies that richness of girlhood—free from sexuality and gender tensions—is the key source for female mental growth.<br></div><div><br></div><div>Chapter 3 investigates stories of Kawakami Hiromi. I begin with an introduction of her essays, which show her core theme of “sakaime” (borderline realm). I examine her earlier stories about relationships between human and nonhuman characters, and as well as her later stories about relationships between two human characters. I consistently find that the “sakaime” opens her protagonists to an animistic vision of a human relationship with nature—a vision which human lives are part of nature’s vast, unsteady, and ever-changing life flows. Ultimately, the animistic sensitivity works for her protagonists’ inner growth.<br></div><div><br></div><div>In conclusion, I summarize the three authors’ differences and commonalities in spiritual and emotional healing and related topic such as female independence, individualities, and the human relationship with nature. I conclude that the three authors responded in a timely and effective manner to the needs of the readers in the contemporary society of Japan.<br></div>

O movimento ambientalista tem como um dos seus aspectos mais evidentes uma certa mística ou espiritualidade particular que tende a ser qualificada como \"ecológica\". Esta, por uma questão de filiação histórica, também se revela nos valores e pressupostos teóricos e práticos de algumas correntes da educação ambiental (EA), que na sua maior parte se constituíram no contexto anglosaxônico antes de se tornarem conhecidas em outros países. De maneira mais específica, contudo, no que tange ao campo da produção de conhecimento (meio acadêmico) da EA brasileira, enquanto temática central a dimensão da espiritualidade não tem merecido a mesma atenção que outras dimensões, como a política e a social. Esta tese, motivada pelo incômodo provocado por essa \"área de silêncio\", procurou refletir sobre o lugar da espiritualidade na educação ambiental, seus limites e possibilidades, fundamentando-se na problematização de três questões: (1) o conceito contemporâneo de espiritualidade; (2) o lugar da espiritualidade na educação; (3) a importância ancestral da natureza como fonte para a espiritualidade. Na primeira questão o objetivo foi: demarcar o significado que o termo espiritualidade tende a assumir atualmente, diferenciando-o de religião/religiosidade; discutir o conceito de espiritualidade laica ou imanente, conforme desenvolvido por alguns filósofos contemporâneos, e as noções de transcendência horizontal e imanência do sagrado, que sem negar a espiritualidade identificam-na como uma metadimensão da condição humana que pode ser cultivada a partir de perspectivas tanto seculares quanto místico-religiosas. Na segunda questão o objetivo foi: discutir um dos dilemas da educação moderna, que se vê pressionada entre o proselitismo religioso e o secularismo empobrecido, discutindo a possibilidade de uma educação do espírito que, através de valores laicos importantes para a coexistência e diálogo humano, reconheça a importância da busca (secular ou religiosa) pelo sagrado; apresentar os pressupostos da Educação Holística; discutir a importância da relação mestre-aprendiz em todo processo educativo e em particular no contexto de uma educação do espírito. Na terceira questão o objetivo foi: problematizar a dicotomia que opõe natureza sacralizada/dessacralizada no mundo moderno; discutir a espiritualidade do movimento ambientalista e em particular da Ecologia Profunda; apresentar propostas de religiosidades planetárias laicas; problematizar as condições para que religiosidades ecológicas se estabeleçam no cenário contemporâneo. Finalmente, no quarto capítulo, a partir das fundamentações anteriores e numa inflexão mais autoral, buscou-se: (1) problematizar a \"ausência em termos\" da espiritualidade e do sagrado nas pesquisas em educação ambiental no Brasil, considerando como hipóteses explicativas (a) a indiferença do meio acadêmico ao campo da espiritualidade, em parte por esta ainda ser associada às religiões organizadas e práticas neo-esotéricas no estilo Nova Era, e (b) à crescente influência da macrotendência crítica da EA, que ao enfatizar corretamente a importância das dimensões político-social para a práxis do campo, tendem a desconsiderar outras dimensões e em particular a da espiritualidade/sagrado, que por sua vez é relevante entre as correntes consideradas conservadoras; (2) sugerir alguns pontos fundamentais de convergência entre a noção de espiritualidade laica e as questões e temas da educação ambiental, elaborando-os a fim de discutir a vocação espiritual da EA e seu potencial \"iniciático\", na medida em que é capaz de desvelar elementos para uma transcendência imanente. Como conclusão, é discutida a relevância de uma educação ambiental que também valorize a dimensão espiritual no atual contexto de crescentes incertezas desse mundo reduzido que parece se tornar a marca do Antropoceno. / The environmental movement has as one of its most evident facets a certain mystique or particular spirituality which usually tends to be characterised as \"green\". Thus, as matter of historical association, this distinctive feature is also present in the standards as well as in the theoretical and practical assumptions of some current environmental education (EE) practices, which firstly shaped the Anglo-Saxon context before becoming known in other countries. More specifically, however, with respect to the academic mileu of the Brazilian EE, as a central theme the dimension of spirituality has not received the same attention as other dimensions, such as the political and the social. Motivated by this fact this thesis sought to examine the place of spirituality in environmental education, including its limits and possibilities. To achieve this aim, this thesis is supported by three guiding objectives as follows: (1) the contemporary concept of spirituality; (2) the place of spirituality in education; (3) the ancestral importance of nature as a source for spirituality. In the first objective the aim was to determine the current meaning carried by the term spirituality, focusing on differentiating it from religion and/or religiosity; this is followed by the introduction and discussion of the concept of secular or immanent spirituality as developed by some contemporary philosophers, as well as the horizontal transcendence and sacred immanence, wich without denying the role of spirituality identify it as a meta-dimension of the human condition that can be grown from both secular and mystical-religious perspectives. The second objective sought to discuss one of the dilemmas present in contemporary education, embodied by the contrast between religious proselytism and the impoverished secularism. This section also argues for the possibility of an education of the spirit which, through important secular values for coexistence and human dialogue, recognises the relevance of the individual search of both the secular or religious sacred practices. Within the second objective, this thesis then explores the assumptions of the Holistic Education examining the importance of the master-disciple relationship in any educational process, and in the context of an education of the spirit in particular. The aim of the third objective was to shed light on the dichotomy which opposes sacralised/desecrated facets of the nature in the contemporary world. The third objective also aims to discuss the spirituality of the environmental movement and of the Deep Ecology in particular; to examine current proposals of a secular planetary religiosity; and to further explore the conditions enabling ecological religiosities to be established in the contemporary society. Lastly, in the fourth chapter draws from the earlier theoretical foundations focusing on a more authorial inflection in order to: (1) discuss the \"absence in terms\" of spirituality and the sacred in research in environmental education in Brazil, considering as explanatory hypotheses (a) the indifference from academia to the field of spirituality, partly explained by the latter being often associated with organized religions and neo-esoteric practices commonly known as New Age, and (b) the growing influence of the EE macro-critical tendency, which properly emphasizes the importance of the political and social dimensions in the everyday practice but tend to ignore other dimensions, in particular the spiritual/sacred, which in turn is relevant among the conservative camps; (2) suggest fundamental points of convergence between the notion of lay spirituality and the issues and themes directly related to environmental education, focussing on the discussion of the EE spiritual vocation and its initiatory potential, in that it is able to reveal elements to an immanent transcendence. In conclusion, we discuss the importance of an environmental education that also values the spiritual dimension in the current context of increasing uncertainty which is part of the current dwindling social practices that seems to become the hallmark of the Anthropocene.

Background: The mental health of prisoners is of growing global health importance as prison populations increase exponentially. Though additional risks of mental disorder and poor mental wellbeing of prisoners are now better understood, women, especially those in low and middle income countries, and in regions outside North America and Europe are underrepresented in prison mental health studies. There is strong evidence of associations between religion and spirituality (RS) and mental health in the general population in North America and Europe. This thesis aims to measure and explain any associations between RS and depression and mental wellbeing among female prisoners in Chile. Methods: An explanatory sequential mixed methods approach comprised an initial quantitative study linked to a subsequent qualitative study. In the quantitative phase, 94 randomly sampled female prisoners in Chile participated in a pooled two-stage cross-sectional survey which collected data on background, mental health and RS variables. Mental wellbeing was measured using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Self-report depression data were collected and 40 prisoners were also administered the Mini International Neuropsychiatric Interview (MINI). RS variables included: affiliation, personal importance, involvement (frequency of attending services), benefits and beliefs. The design of the qualitative phase was informed by quantitative study findings. Six prisoners who had participated in the cross-sectional survey attended one of two focus groups. Individual in-depth interviews were conducted with 3 prison chaplains and 2 health professionals from the prison health centre. Topic guides for focus groups and interviews were used to facilitate discussions on the mental health and RS of female prisoners and to elicit views on selected findings from the quantitative study. Logistical regression techniques were used to statistically test the hypothesis of no association between RS and depression and mental wellbeing. Audio-recorded qualitative data were transcribed in Spanish and analysed thematically in English. Results: Of the 94 women, 11 (11.7%) reported a current professional diagnosis of depression, while major depression was confirmed in 13 (32.5%) of the 40 women assessed using the MINI. The women had a median WEMWBS score of 55 (IQR 43-61) out of 70. Religiosity was high among the sample with 86 (91.5%) women affiliated to mainstream Christianity and 69 (73.4%) who considered RS to be personally very important. In a sample of 40 women, frequency of attendance at RS services was significantly higher in prison than during the year prior to incarceration (Wilcoxon Sign Ranks Test Z=3.1; p < 0.002). No significant associations were found between depression and mental wellbeing, and the key RS variables. However, 61 (89.7%) women believed there was a connection between their mental health and spirituality. The qualitative data revealed differences within and between participant groups in understandings of mental health and RS terminology and concepts. Themes emerged around the prison determinants of mental health and the mental health effects of the female gender. Prisoners identified RS variables that influenced mental health which had not been measured in the survey. Explanations were found for the divergent survey results of the association between RS and mental health. The data showed how RS shapes prisoners' help-seeking behaviour and attitudes to mental health care. Conclusion: The association between RS and mental health among prisoners in Chile remains unclear but may differ from established patterns reported in non-prisoner populations. This a challenging area of study with an additional layer of complexity present in prison populations where there are high levels of religiosity and spirituality. Larger studies are needed to confirm the quantitative findings, while qualitative findings should lead to raised awareness of RS in the development of prison mental health strategies in accordance with the needs of a given population.

Introdução: Diversos instrumentos têm sido propostos na literatura internacional para medir atributos da religiosidade e espiritualidade. A Daily Spiritual Experience Scale (DSES) é um instrumento que busca acessar a dimensão espiritual por meio de experiências que se manifestam na vida diária, como gratidão, compaixão, paz interior, conexão com o transcendente, sem envolvimento com crenças ou comportamentos de uma religião específica. A DSES original e as versões para diferentes países, entre eles o Brasil, foram desenvolvidas e validadas com base na Teoria Clássica dos Testes (TCT). A Teoria da Resposta ao Item (TRI) é uma abordagem da Psicometria Moderna que complementa a TCT incluindo novos métodos para construção, validação e refinamento de instrumentos de medida, entre os quais destaca-se o Método de Rasch. Uma das grandes contribuições deste método é a obtenção de medidas intervalares, permitindo coletar dados de melhor qualidade. Objetivo: Avaliar as propriedades psicométricas da versão brasileira da Daily Spiritual Experience Scale, utilizando o Método Rasch. Método: Este estudo teve como base os dados coletados para a validação clássica da versão brasileira da DSES. Este instrumento e outro de caracterização da amostra foram aplicados por meio de entrevista a 179 pacientes internados em unidades de clínica médica e cirúrgica de dois hospitais, com idade mínima de 18 anos. A DSES é composta de 16 itens, considerados unidimensionais, que são respondidos em escala do tipo Likert variando de 1 a 6 pontos nos 15 primeiros itens e de 1 a 4, no item 16. Menores pontuações no escore total refletem maior freqüência de experiências espirituais. Os itens da DSES foram analisados individualmente quanto à unidimensionalidade e à independência local, com análises seqüenciais das propriedades de aditividade (comportamento das categorias de resposta), Invariância dos itens (Funcionamento Diferencial dos Itens DIF), objetividade específica (calibragem dos itens) e consistência interna (Person Separation Index-PSI). A análise de Rasch foi efetuada com o software RUMM2020. Resultados: Na análise inicial (ajuste dos itens ao modelo Rasch), a unidimensionalidade não foi confirmada e três itens apresentaram dependência local. Cinco itens mostraram categorias de respostas desordenadas, com melhora nos padrões de respostas após colapsar os limiares para quatro categorias. O item 7 pedir ajuda de Deus apresentou DIF em relação à religião e o item 14 aceitação dos outros, em relação a sexo e religião. A exclusão dos itens problemáticos e o ajuste nas categorias das respostas melhoraram o ajuste geral ao modelo. Quanto à objetividade específica, foi observado que os itens alcançaram as pessoas com maior frequência nas experiências espirituais. Embora necessite de alguns ajustes, a versão brasileira da DSES pode ser considerada como uma escala Rasch. Sugere-se a realização de novas pesquisas, em outros contextos e populações, para verificar se o instrumento preserva suas propriedades psicométricas quando analisado pelo método de Rasch. / Introduction: Several instruments have been proposed in the international literature to measure attributes of religiosity and spirituality. The Daily Spiritual Experience Scale (DSES) is an instrument that seeks to access the spiritual dimension through experiences that manifest in daily life, with no involvement with beliefs or behaviors of a specific religion. The original DSES and its versions for different countries, including Brazil, have been developed and validated based on Classical Test Theory (CTT). The Item Response Theory (IRT) is an approach of the Modern Psychometrics that complements the CTT including new methods for construction, validation and refinement of measuring instruments, among which stands out the Rasch method. A major contribution of this method is to obtain interval measurements, allowing the collection of better data. Objective: To evaluate the psychometric properties of the Brazilian version of the Daily Spiritual Experience Scale using the Rasch method. Method: This study was based on data collected for the classic validation of the Brazilian version of the DSES. This instrument and another for sample characterization were applied by interview to 179 patients with minimum age of 18, in clinical and surgical units of two hospitals. The DSES consists of 16 items, considered unidimensional, which are answered on Likert type scale ranging from 1 to 6 points in the first 15 items and from 1 to 4, in the item 16. Lower scores on the total score reflect a higher frequency of spiritual experiences. The DSES items were analyzed individually as the Unidimensionality and Local Independence, with sequential analysis of the properties of aditivity (pattern of the response categories), invariance (Differential Item Functioning - DIF), specific objectivity (calibration of the items) and internal consistency (Person Separation Index-PSI). Rasch analysis was performed using the software RUMM2020. Results: In the initial analysis (adjustment of the items to the model) the unidimensionality wasnt confirmed and three items showed local dependency. Five items showed disordered response categories, with improvement in the response patterns after collapsing thresholds for four categories. The item 7 ask for help from God had DIF related to religion and item 14 acceptance of others in relation to sex and religion. The exclusion of problematic items and fit into the response categories improved overall adjustment to the model. As for specific objectivity, it was observed that the items reached people with more often frequencies in spiritual experiences. Although it needs some adjustments, the Brazilian version of DSES can be considered as a Rasch scale. It is suggested to conduct further research in different contexts and populations to verify if the instrument preserves its psychometric properties when analyzed by the Rasch method.

Syftet med studien är att ge en överblick av begreppet spiritualitet genom att sammanfatta och beskriva det vetenskapliga kunskapsläget inom arbetsterapeutisk forskning. Som metod valdes en litteraturöversikt. I studien ingick 12 vetenskapliga artiklar som var både kvalitativa och teoretiska. Artiklarna söktes i Luleå universitetsbibliotek databaser. Utöver det genomfördes en manuell sökning. Resultatet visar på fyra huvudkategorier med underkategorier. Huvudkategorierna var; Spiritualitet ger mening och mål, Spiritualitet ger support och stöd, Spiritualitet som drivkraft till aktiviteter och Spiritualitet som grund till känslor. Resultatet visar att spiritualitet samspelar med den inre känslan hos en människa och det yttre görandet i en aktivitet. Spiritualitet har betydelse oavsett om trossystem finns eller inte. Slutsatsen av studien visar att spiritualitet är viktigt för människan. Det är av vikt att involvera spiritualitet i klientmötet för arbetsterapeuten eftersom spiritualitet är en viktig del för holism och humanism och som var för sig är grundläggande värdegrund för arbetsterapi. / The purpose of the study is to provide an overview of the concept spirituality by summarizing and describing the state of scientific knowledge in occupational therapy research. As method the study was designed as a literature review. The study included 12 scientific articles that were both qualitative and theoretical. Articles were searched in databases of library in Luleå University of Technology. In addition a manual search was conducted. The results show four major categories with subcategories. The main categories were: Spirituality gives meaning and purpose, Spirituality gives support and assistance, Spirituality as a force to activities and Spirituality as a foundation to emotions. The result shows that spirituality interacts with both the inner feeling within a human being and the external performance of an activity. Spirituality is important regardless of whether a belief system exists or not. The conclusion of the study shows that spirituality is important for humans. It is important to involve spirituality in a client meeting for the occupational therapists because spirituality is an important part of holism and humanism and separately is fundamental ideals for occupational.