Spirituality in the discipline of nursing has gained popularity over the past two decades. National and provincial nursing associations and colleges expect nurses to be educated in providing spiritual health assessments and interventions in order to provide holistic nursing care. There is a paucity of research in the nursing literature on the meaning of spirituality from the perspectives of individuals who experience chronic mental illness, specifically schizophrenia. Spirituality remains an elusive construct, challenging psychiatric nurse educators, researchers and practitioners in the development of nursing curricula to guide psychiatric nursing practice. The focus of this research study was to develop a substantive theory about the experience of spirituality among individuals living with schizophrenia using grounded theory methodology in the tradition of Glaser and Strauss (1967). Forty semi-structured interviews and four focus groups were conducted with 20 participants who self-reported to be diagnosed with schizophrenia. Findings: The substantive theory "spirituality as connection" indicates that spirituality for persons living with schizophrenia involves a dialectical process in which one strives to be connected to one's spiritual self (body-mind-spirit), significant others (family, friends, G o d / Higher Power, health care professionals), community (others living with a mental illness, others who are well, a faith community, the community in which participants lived), and nature, while at the same time experiencing situations and incidents that promote disconnection from these sub-themes. Strategies used by participants to achieve connection included: taking prescribed atypical anti-psychotic medications, maintaining their health and a healthy lifestyle, use of prayer / meditation, caring for self and others, and engaging in creative activities that added meaning to their life experiences. Among the 17 factors contributing to connection, exemplars are: reconnecting with one's spirit through prayer and meditation, attending drop-in centres for persons living with a mental illness, and walking / hiking in nature. Outcomes include feeling peaceful, love, contentment, being accepted and nurtured by others. Among the 14 factors contributing to disconnection, exemplars are: the effect of the illness on relationships with other people, the stigma of being in a psychiatric ward, being unemployed, and taking typical antipsychotic medications. Outcomes include feeling powerlessness, isolation, rejection and alienation.

Spirituality in the discipline of nursing has gained popularity over the past two decades. National and provincial nursing associations and colleges expect nurses to be educated in providing spiritual health assessments and interventions in order to provide holistic nursing care. There is a paucity of research in the nursing literature on the meaning of spirituality from the perspectives of individuals who experience chronic mental illness, specifically schizophrenia. Spirituality remains an elusive construct, challenging psychiatric nurse educators, researchers and practitioners in the development of nursing curricula to guide psychiatric nursing practice. The focus of this research study was to develop a substantive theory about the experience of spirituality among individuals living with schizophrenia using grounded theory methodology in the tradition of Glaser and Strauss (1967). Forty semi-structured interviews and four focus groups were conducted with 20 participants who self-reported to be diagnosed with schizophrenia. Findings: The substantive theory "spirituality as connection" indicates that spirituality for persons living with schizophrenia involves a dialectical process in which one strives to be connected to one's spiritual self (body-mind-spirit), significant others (family, friends, G o d / Higher Power, health care professionals), community (others living with a mental illness, others who are well, a faith community, the community in which participants lived), and nature, while at the same time experiencing situations and incidents that promote disconnection from these sub-themes. Strategies used by participants to achieve connection included: taking prescribed atypical anti-psychotic medications, maintaining their health and a healthy lifestyle, use of prayer / meditation, caring for self and others, and engaging in creative activities that added meaning to their life experiences. Among the 17 factors contributing to connection, exemplars are: reconnecting with one's spirit through prayer and meditation, attending drop-in centres for persons living with a mental illness, and walking / hiking in nature. Outcomes include feeling peaceful, love, contentment, being accepted and nurtured by others. Among the 14 factors contributing to disconnection, exemplars are: the effect of the illness on relationships with other people, the stigma of being in a psychiatric ward, being unemployed, and taking typical antipsychotic medications. Outcomes include feeling powerlessness, isolation, rejection and alienation. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Western health professions have historically struggled with the notion that spirituality could be studied empirically. This trend has changed in recent decades with there being a marked increase in the health literature pertaining to spirituality. For indigenous people spirituality is a fundamental attribute of their worldviews. Mäori, as the Indigenous people of Aotearoa, have always acknowledged the importance of wairua, (spirituality as defined by Mäori worldviews) to their health and well-being. This thesis aims to explore wairua as an important aspect of Mäori well-being from a psychological perspective. Two research goals underpin this thesis. The first goal involved developing an understanding of what Mäori mean when they talk about wairua. This was achieved through a qualitative study. While there are implicit shared understandings among Mäori regarding the nature of wairua, this study was one of the first attempts to make some of those shared understandings more explicit. The second goal involved investigating the relationship between an orientation to wairua and Mäori well-being using a newly developed measure. This was a quantitative study. Conceptualisations of wairua fell into four themes; direct descriptions, personal experiences, personal beliefs and Mäori worldviews. According to the qualitative information, wairua was described as a fundamental attribute that enables Mäori to engage with their reality; an intuitive consciousness. Through wairua Mäori identity is expressed, relationships are forged, balance is maintained, restrictions and safety are adhered to, healing is transmitted, and the connection between te ao wairua and te ao Mäori are maintained. These aspects of Mäori reality are inclusive and interconnected. The qualitative study information led to the formation of a 30 item self report measure named the Kia Ngawari ki te Awatea Orientation to Wairua measure. This measure was used to investigate the relationship between an orientation to wairua and Mäori health and well-being. The results showed that orientations to wairua had relatively modest associations with wellbeing when conceptualised and measured in a variety of ways. Due to the variability in the results, support for the overarching hypothesis of a relationship between wairua and well-being was mixed. A number of limitations were acknowledged with recommendations for future research offered. The findings of these studies have a number of implications for clinical psychological practice with Mäori clients.

The purpose of a study of spirituality and its relationship to the compliance of hemodialysis patients is to consider changing the approach of the treatment team in the dialysis setting. The interdisciplinary treatment team at the dialysis center consists of physicians, nurses, dietitians, and social workers. One of the many roles of the dialysis social worker is to facilitate the adjustment to and acceptance of the patient's need for dialysis.