Background Spirituality is within into every person even though the spiritual experience is always individual. Well-being and happiness are related to the amount of spirituality influencingone’s life. Patients spiritual distress and needs often emerge from their experience of suffering. Acknowledging patients’ spirituality needs, and possessing skills to meet suchneeds, are crucial to provide holistic care; unmet spiritual needs can could increase patient ́s suffering. Spiritual care is included in registered nurses’ responsibility, althoughthe focus and involvement of spiritual care, depends on their personal experiences. Aim The aim was to examine registered nurses’ experiences of meeting patients’ spiritual needsin a hospital setting in Peru. Method A qualitative design was performed with semi-structured interviews. Nine registered nurses were interviewed, the collected data was analysed with a qualitative content analysis. Findings Three categories were found in the analysis; Recognition of professional responsibilities in providing spiritual care, Integrating spiritual care into clinical practice and Impact of spiritual care. The findings show how holding a holistic view impacted the delivery of spiritual care. Conclusion It is difficult to use specific strategies to meet spiritual needs since needs areindividual. Meeting spiritual needs must always be done with respect for the patients’ waysof expressing their spirituality. Being available and listening are important elements ofmeeting patients’ spiritual needs. Spiritual care is recognised as an inseparable part ofholistic care and the involvement of spiritual care is essential for patients healing.

The National Institutes of Health recommends the development of conceptual models to increase rigor and improve evaluation in research. Validated models are essential to guide conceptualizations of phenomena, selection of variables and development of testable hypotheses. Structural equation modeling (SEM) is a methodology useful in model testing due to its ability to account for measurement error and test latent variables. The purpose of this study was to test a model of The Geriatric Cancer Experience in End of Life as adapted from Emanuel and Emanuel's framework for a good death using SEM. It was hypothesized that the model was a five-factor structure composed of clinical status, physical, psychological, spiritual and quality of life domains and that quality of life is dependent on the other factors. The sample was comprised of 403 hospice homecare patients. Fifty six percent were male, 97% were white with a mean age of 77.7. Testing of the model used AMOS statistical software. The initial five-factor model was rejected when fit indices showed mis-specification. A three-factor model with quality of life as an outcome variable showed that 67% of the variability in quality of life is explained by the person's symptom experience and spiritual experience. As the number of symptoms and the associated severity and distress increase, the person's quality of life significantly decreases (ß -0.8). As the spiritual experience increases (the expressed need for inspiration, spiritual activities, and religion) the person's quality of life significantly increases (ß 0.2). This is significant to nursing because the model provides a useful guide for understanding the relationships between symptoms, spiritual needs, and quality of life in end of life geriatric cancer patients and suggests variables and hypotheses for research. This study provides evidence for a strong need for symptom assessment and spiritual assessment, development of plans of care inclusive of symptom control and spiritual care, and implementation and evaluation of those plans utilizing quality of life as an indicator for the outcome of care provided by nurses.

This study was designed to identify the spiritual needs of multicultural Australians with a health problem, in order to understand the educational implications for health care professionals. The rationale for the research was supported by the Australian Council for Health Service (1997) requirement that health care professionals meet the spiritual needs of their patients and clients'. At the commencement of this study, no research had been published on what these spiritual needs might be. To discover what health care professionals needed to be taught in order to meet the spiritual needs of their patients, I required a suitable group of patients. Then, after identify their spiritual needs, I wanted to explore ways in which these needs could be met. For this to occur, I also needed to identify factors that would fulfill patients' spiritual needs or prevent them from being met. This research proceeded in two stages. The first involved collecting data from all spiritual groups in Western Australia. The second involved the recruitment and interviewing a small number of ex-patients to gain their perspective of health care related spirituality and needs. To gain data about the various spiritual groups in Western Australia, I wrote to all organisations and associations, asking for information and reference material. This data was analysed using HyperResearch (1995), and themes common to all spiritual groups were developed. The inter-relationship between these themes provided the framework for an emergent model of spirituality. / For the second part of the research which involved a case study of health care patients, a qualitative methodology was used. This approach enabled me to explore the phenomenon of spirituality from the perspective of eight participants, which involved identifying their spiritual needs, the care they desired, and the rite of passage they underwent when receiving health care. The qualitative methodology enabled me to explore the subject from a sensitive holistic perspective, and to protect the integrity of the participants. I wanted to know what patients understood about their spirituality and how spiritual care could be implemented not only in clinical practice but also into health care education programs. The participants' detailed subjective experience was especially important, because I wanted to know how they identified their spiritual needs, how they had requested their needs be met by health care professionals, and the extent to which health care professionals had reacted to those cues. I formulated an 'interpretive phenomenology research' design based on the philosophical writings of Heidegger and Bakhtin. Heidegger argued that people gain knowledge of a subject from their own subjective experience, and of the person being in their world (simultaneous past, present and future thoughts). Bakhtin stated that to bring about social change, the researcher needed to understand the social context of the people's language including their culture, politics, government-provided amenities (such as education and health care), employment and social interaction, both within and outside their communities in which they live. The eight participants were interviewed a number of times in order to explore the phenomenon of spirituality beyond the notions already published in the literature (i.e. from multicultural Australian's perspective). / They told of hospital or health care experiences that included: health care for childbirth, mental and psychiatric illnesses (depression, manic-depression, and anxiety), immunology (lymphoma), stroke, detoxification of alcohol, arthritis, coronary occlusion, hypertension, and peritonitis; surgical procedured/s such as repair of hernia, bowel obstruction, eye surgery, orchiopexy (removal of testes from inguinal canal into the scrotal sac), caesarian birth, appendectomy, and oophorectomy (removal of ovaries); treatments such as radiotherapy, chemotherapy, and physiotherapy; and hospital experiences in both large and small public and private acute hospitals, private and public mental health/psychiatric hospitals, intensive care and coronary care units. These situations demonstrate the diversity of contexts which people want their spiritual needs met. The study revealed that it is not only dying patients who have spiritual need; spiritual needs exist in widespread ordinary conditions and across a wide range of health care services. The eight participants - Ann, Athika, Garry, Red, Rosie, Scarlet, Sophie, and Tom (pseudonyms) - were drawn from many of the multicultural groups resident in Western Australia including Aboriginal, Chinese, English, European, Indian, and Irish peoples. Their spiritualities encompassed Judeo-Christian, Buddhist, Hindu, Pagan Romany, Society of Friends (Quaker), Humanist, Socialist, and Communist values and beliefs. The results of the research give insight into the eight participants' perspectives on being a person, their understanding of spirituality, perceived spiritual needs, their desired levels of spiritual care, and the rite of passage they experienced when undergoing health care treatment in hospital. / The participants' spiritual needs comprised of four categories: 'mutual trust', 'hope', 'peace' and 'love'. The levels of spiritual care spoke of desiring were: 'acknowledgement', 'empathy', and 'valuing'. Recommendations are given for health care professionals to provide spiritual care for the eight participants, and implications are considered for the spiritual education of future health care professionals in order to sensitise them to the wide range of healthcare related spiritual needs they might encounter in local multicultural communities. It is recognised that the scope of the implications is contingent on further research establishing the incidence of health-care related spiritual needs among the broader population of multi-cultural Western Australians. The richness and depth of the data and the very sensitive nature of the material that came from the eight people who shared their experiences with me has rendered this thesis an important document. The nature of the various incidents and situations they shared with me, I believe, demonstrated their preparedness to tell their story so that health care can be improved. On many occasions, I felt honoured that they had sufficient trust in me to enable them to report such deep and personal suffering. For example, Rosie told me of her mental torment and of not knowing if she was alive or dead; of how she burnt her legs to try to feel pain in order to see if she was alive. It was stories such as this that gave me the passion to write this thesis well in order to do justice to all people who want spirituality included in health care treatment.

Den andliga dimensionen ingår i den holistiska människosynen som sjuksköterskan skall utgå från. I Socialstyrelsens Kompetensbeskrivning för legitimerad sjuksköterska står det att sjuksköterskan ska ha förmåga att bemöta patienters andliga behov. Syftet med litteraturstudien var att belysa faktorer som påverkar sjuksköterskans bemötande av andliga behov. Polit och Becks (2012) niostegsmodell användes för litteraturstudien. Litteratursökning genomfördes i databaserna CINAHL och PubMed samt genom en manuell sökning. Därefter gjordes en kvalitetsgranskning enligt Forsberg och Wengströms (2013) protokollgranskning. Resultatet baserades på 15 artiklar. Efter dataanalysen redovisades resultatet i fem kategorier: Sjuksköterskans inställning till andlighet, tro och religion, Vårdrelationen, Kunskap, Miljö och Tid. Det finns ett samspel mellan faktorer som påverkar sjuksköterskans bemötande av andliga behov. Flera olika faktorer som religion, tro och egen andlighet influerade bemötandet. Sjuksköterskor uppgav att det var nödvändigt att bygga en tillitsfull nära relation med patienter för att bemötande av andliga behov skulle vara möjligt. Kunskapsbrist utgjorde ett av de största hindren och fortlöpande utbildning föreslogs för att uppnå förbättring i bemötande av andliga behov. Den fysiska och psykosociala miljön som råder där sjuksköterskor arbetade, samt tidsaspekten, kunde upplevas som influerande faktorer på bemötandet. Allt detta bidrog till att de andliga behoven hamnade i skymundan. Sjuksköterskans inre och yttre resurser ligger alltså till grund för hur hon bemöter andliga behov.

The diploma emphasizes the rediscovered holistic view of humans as bio-psycho-socio-spiritual beings, characterizing the spiritual dimension in a more detailed way and clarifying what the role of Christian denominations clergy may be in fulfilling spiritual needs of the clients. The theoretical part of the work deals with the spiritual dimension of a human in general, then it explains the term of religion regarding Christian roots of Europe and the position of spirituality among the needs of a human. It also deals with characteristics of possible spiritual needs of the clients, the role of clergy in fulfilling spiritual needs of the clients and the concept of sacramental care in selected Christian congregations. The work itself aims to characterize the ministry of clergy and its place in fulfilling spiritual needs of the clients. In the conclusion the author{\crq}s views of the field of spiritual needs of the diseased are presented as well as recommendations for practice.

The thesis deals with the spiritual dimension of man, spiritual needs from the perspective of legislation and social work in residential facilities for the elderly. In the introductory part of the work is defined the concept of human person, social work and social services, its principles and values. Furthermore, the work deals with the characteristics of old age and needs in old age The key chapter is spirituality in social work. Another important chapter of the thesis is a chapter entitled the concept of spiritual care in residential facilities, which brings a contemporary view of work with spiritual needs in social services. The next part deals with the concepts of care for the elderly. The final chapter brings summaries and measures into practice regarding spirituality and spiritual needs within social work and legislation.

While there is considerable international interest in the development of hospice and palliative care programs, as an alternative form of care for the terminally ill, there is minimal empirical research undertaken on the needs of recipients of these programs. Using a Q-sort, developed by the author, this research examined the relationship between individual patient's ranking of their needs, and the nurse's perception of the needs identified by individual patients in their care. A basic assumption of the study was that patients' needs could be categorised in four groups, namely spiritual, physical, emotional, and social. Consequently, the study also examined whether patients and nurses identified, as most important, needs from one group, more frequently than the other groups. The limited size of the sample placed severe restrictions on the analysis of results derived from this research. However, while no definite conclusions could be drawn from data obtained from the small sample, tentative analysis identified trends that may have proved significant had they continued in a larger sample.

The currenly growing preference for "active aging" aims to promote the longest possible physical and mental vitality. Caring for the spiritual development and spiritual needs of older people is usually thought to be a private matter, or an area within the competence of churches, and related to traditionally religious older people. With regard to the bio-psycho-socio-spiritual unity of the person, it is evident that spirituality ? and spiritual needs as its expression ? belong in the life of every individual, though it is primarily an individual experience linked to a particular personality and life history. Through spirituality they seek to answer questions relating to the purpose and pursuit of life, to higher values, to the processing of suffering and evil, and to some questions having eschatological character. This dissertation defines spirituality's everyday place on the path to a good life in old age. The empirical part of the dissertation is a qualitative study called Spiritual Needs in the Daily Life of the Elderly in Southern Bohemia. The first part shows the development of religiosity or spirituality of two dozen South Bohemians over seventy-five years, focusing on the period of early religious socialization, stages of working life under the rule of Communism, and the present form of religiosity or spirituality. The second part presents a possible typology of their fundamental spiritual needs: dignity, sense of continuity in ones life story, hope, faith and love. On the basis of these findings, recommendations are then put forward for pastoral, social, and geragogical practices.

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.

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....