Dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa: uma scoping review / Difficulties Of Nurses In The SpiritualCare Of The Palliative Person: A Scoping Review

Objetivo: Mapear a evidência científica relativa às dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa. Método: Estudo do tipo Scoping Review, com base nas recomendações PRISMA-ScR e do protocolo definido pelo Joanna Briggs Institute. Pesquisa em 4 bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), National Library of Medicine (PUBMED), Cummulative Index to Nursing and Allied Heath Literature (CINAHL) e Web of Science e considerados estudos dos últimos 5 anos. Resultado: Amostra final de 10 estudos. Foram identificadas várias dificuldades dos enfermeiros no cuidar espiritual da pessoa em situação paliativa, dos quais destacamos: falta de formação; falta de tempo; falta de reconhecimento; falta de confiança; evitamento; referenciação tardia; espiritualidade dos enfermeiros pouco desenvolvida; crenças diferentes. Conclusão: Foram identificadas múltiplas dificuldades sentidas pelos enfermeiros no cuidar espiritual, as quais passam quer por défices na formação, quer por défices organizacionais, quer por défices pessoais. (AU)

Objective: To map the scientific evidence concerning the difficulties faced by nurses in the spiritual care of palliative care patients. Method: Scoping Review, based on PRISMA-ScR recommendations and the protocol defined by the Joanna Briggs Institute. Search in 4 databases: Latin American and Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (PUBMED), Cumulative Index to Nursing and Allied Heath Literature (CINAHL) and Web of Science and considered studies from the last 5 years. Result: Final sample of 10 studies. Several difficulties were identified among the nurses in the spiritual care of palliative patients, namely: lack of training; lack of time; lack of recognition; lack of trust; avoidance; late referral; nurses' spirituality underdeveloped; different beliefs. Conclusion: We identified multiple difficulties experienced by nurses in spiritual care, either due to deficits in training, organizational deficits, or personal deficits.(AU)

Mapear la evidencia científica sobre las dificultades experimentadas por las enfermeras en la atención espiritual de pacientes en cuidados paliativos. Método: Scoping Review, basado en las recomendaciones PRISMA-ScR y en el protocolo definido por el Instituto Joanna Briggs. Búsqueda en 4 bases de datos: Latin American and Caribbean Literature on Health Sciences (LILACS), National Library of Medicine (PUBMED), Cumulative Index to Nursing and Allied Heath Literature (CINAHL) y Web of Science. Resultado: Muestra final de 10 estudios. Se identificaron varias dificultades entre las enfermeras en la atención espiritual de los pacientes paliativos, a saber: falta de formación; falta de tiempo; falta de reconocimiento; falta de confianza; evitación; derivación tardía; espiritualidad de las enfermeras poco desarrollada; creencias diferentes. Conclusión: Se identificaron múltiples dificultades experimentadas por las enfermeras en la atención espiritual, que pueden explicarse por déficits formativos, organizativos y personales.(AU)

Implementation Status of Palliative Care for Patients Died in Peking Union Medical College Hospital,2019 / 中国医学科学院学报

Objective To reveal the current situation of palliative care for patients who died in Peking Union Medical College Hospital,so as to guide the practice of palliative care for patients in terminal stage. Methods A retrospective study was conducted on patients who died in Peking Union Medical College Hospital from January 1,2019 to December 31,2019.The general clinical data of the patients,whether they received palliative care,and the treatment details including invasive rescue measures,symptom controlling,and psychological,social,and spiritual care status before dying were collected for descriptive analysis. Results A total of 244 inpatients died in 2019,including 135 males and 109 females,with an average age of (65.9±16.4) years (1 day to 105 years).Among the 244 patients,112 (45.9%) died of neoplastic diseases and 132 (54.1%) died of non-neoplastic diseases.Sixty-one (25.0%) patients received palliative care before death,and they were mainly distributed in internal medicine departments such as nephrology (100.0%),gastroenterology (80.0%),and geriatrics (72.7%).Twenty-nine patients received sound palliative care,with all symptoms under control and no invasive treatment before death,and twenty-six patients received psychological,social,and spiritual care.Compared with the patients who were not exposed to the concept of palliative care,the patients who received palliative care showed decreased probabilities of cardiopulmonary resuscitation (0 vs 20.2%;χ2=13.009,P<0.001),tracheal intubation (3.3% vs 48.6%;χ2=38.327,P<0.001),and invasive mechanical ventilation (4.9% vs 47.5%;χ2=33.895,P<0.001) and an increased probability of psychological,social,and spiritual care (54.1% vs 2.4%;χ2=91.486,P<0.001). Conclusion The concept of palliative care has a positive impact on the death of end-stage patients.Palliative care services can increase the probability of end-stage patients receiving psychological,social,and spiritual care and reduce the use of invasive treatment.

Atención de las necesidades espirituales y religiosas de pacientes por personal de salud: un modelo basado en el acompañamiento espiritual / Attention to the spiritual and religious needs of patients by health personnel: a model based on spiritual accompaniment

Resumen Los aspectos espirituales y religiosos han retomado su importancia en la atención de salud, en la búsqueda de una atención integral, digna y más humana, teniendo en cuenta además, los múltiples beneficios clínicos asociados. Sin embargo, el cuidado de las necesidades espirituales y religiosas, históricamente asumidas por capellanes religiosos y guías espirituales, actualmente, en forma paulatina, son considerados parte de las obligaciones de los equipos de salud, no sin la reticencia de los mismos y sin una manera clara de cómo hacerlo. El objetivo del presente trabajo es presentar la importancia de la atención de las necesidades espirituales y religiosas en el cuidado de salud y un modelo de atención basado en el acompañamiento espiritual.

In the search for comprehensive, dignified and more humane care, the spiritual and religious aspects have regained their importance in health care. Furthermore, the múltiple associated clinical benefits must also be taken into account. However, the care of spiritual and religious needs, historically undertaken by religious chaplains and spiritual guides, have gradually become considered part of the obligations of the health teams, in spite of their reluctance and without a clear way on how to do it. The objective of this work is to present the importance of attending to the spiritual and religious needs in health care and a care model based on spiritual accompaniment.

Effects of occupational sadness and perceived hospital ethical atmosphere on spiritual care ability of hospice nurses / 中国实用护理杂志

Objective:To investigate the current situation of spiritual care ability, occupational sadness, perceived hospital ethics of hospice nurses, and to analyze the impact of nurses' occupational sadness and perceived hospital ethics on nurses′ spiritual care ability.Methods:A total of 230 hospice nurses in Qingdao Eighth People′s Hospital, Qingdao Municipal Hospital and Qingdao Central Hospital (Qingdao Cancer Hospital) from March to June, 2021 were investigated by general information questionnaire, Spiritual Care Ability Scale, Sadness Experience Scale and Hospital Ethical Atmosphere Scale.Results:The scores of spiritual care ability, professional sadness and perceived hospital ethics of 230 hospice nurses were (70.59 ±13.35), (37.31 ±6.67) and (100.88 ±21.49) points, respectively. The results of regression analysis showed that receiving spiritual education ( β=0.26, P<0.05), professional sadness ( β=-0.08, P<0.05) and perceiving hospital ethical atmosphere ( β=0.63, P<0.05) entered the regression equation. Conclusions:The spiritual care ability of hospice nurses is at the medium level. Increasing spiritual education, taking measures to reduce occupational sadness and create a harmonious working atmosphere can improve the spiritual care ability of nurses to a certain extent and improve the quality of hospice care.

A study on the status quo and influencing factors of spiritual care needs among elderly stroke inpatients / 中国实用护理杂志

Objective:To investigate the status quo and influencing factors of spiritual care needs among elderly stroke inpatients, in order to provide reference for formulating targeted interventions.Methods:A total of 417 elderly stroke inpatients were selected in five Third-A hospitals from August 2021 to January 2022 by convenient sampling. The questionnaire was conducted using the General Data questionnaire, the Nurse Spiritual Therapeutics Scale (NSTS), the Stigma Scale for Chronic Illness (SSCI) and the Perceived Social Support Scale (PSSS). Multiple linear regression was used to analyze the influencing factors of spiritual care needs of elderly stroke inpatients.Results:The total score of NSTS among 417 elderly stroke inpatients was 31.98 ± 4.39. The dimension of highest and lowest average score were "create good atmosphere" (3.23 ± 0.58) and "help religion" (2.01 ± 0.62), respectively; the results of regression analysis showed that religious belief, education background, course, stigma, and social support were the main factors influencing spiritual care needs among elderly stroke inpatients ( t values were -6.54-7.11, P<0.05). Conclusions:The spiritual care needs among elderly stroke inpatients were moderate. It is suggested that nurses should strengthen their own spiritual care knowledge and ability, and take targeted spiritual care measures according to the individual characteristics and differences of patients, reduce their stigma, improve the social support, to meet their spiritual care needs to the greatest extent.

CiteSpace-based visualization analysis of researches on domestic spiritual care for patients with chronic diseases / 中国实用护理杂志

Objective:Visual analysis of the current research status, hotspots and frontier of spiritual care will provide reference for further research on spiritual and develop Spiritual care for patients with chronic diseases in China in the future.Methods:Using CNKI, Wanfang and VIP database as the data source, this paper uses Bibliometric method and CiteSpace software to carry out visual analysis from five aspects such as annual volume of literature, author of literature, institution of literature and high-frequency keywords.Results:A total of 167 literatures were included, and the volume of publications showed an increasing trend; the distribution of institutions and regions was uneven; the sources of journals were scattered; the cooperation between authors and institutions was lacking, the research hot spots and frontier are "spiritual care needs", "cancer patients", "spiritual health", "spiritual intervention" and "nurse's spiritual care ability".Conclusions:The research of spiritual care for chronic patients in China started late and developed slowly, and the depth and breadth of research need to be strengthened. In the future, we should strengthen the diversified scientific research cooperation and exchanges across authors, institutions and regions, draw on the experience and lessons of foreign research, building a theoretical system of spiritual care for patients with chronic diseases suitable for China's national conditions, and promote the scientific, diversified and high-quality development of spiritual care for patients with chronic diseases in China.

Spiritual Care Training Program’s Effects on Physicians’ Confidence, Self-reported Practice, and Attitudes in Caring for Terminally Ill Cancer Patients Who Express Meaninglessness

This study sought to evaluate how a training program on spiritual care affected physicians’ confidence, self-reported practice, and attitudes in caring for terminally ill cancer patients who express meaninglessness in living. Questionnaires were distributed to participating physicians before and after the training program. A total of 30 physicians completed the program. Confidence and self-reported practice regarding communication with terminally ill cancer patients who express meaninglessness significantly improved after the training: effect size, 1.3 (P=0.0001) and 1.2 (P=0.0001), respectively. Moreover, physician-reported helplessness significantly decreased (effect size, 0.8; P=0.0001) and positive appraisal and willingness to participate in caring for terminally ill cancer patients experiencing meaninglessness significantly improved (effect size, 0.8, P=0.0001; effect size, 0.4, P=0.0001, respectively). Overall, 96–100% of the participating physicians reported the program was useful for understanding the concept of spiritual care and for learning a practical approach for caring for such patients.

The Clinical Significance and Issues of Religious Involvement in Elderly Nursing Home: Interviews with Careworkers in Special Elderly Nursing Home

Purpose: We investigated into the effect of religious involvement in nursing homes on users, facility staff, and families to explore the clinical significance of the religious involvement from the viewpoint of nursing care workers. Method: A questionnaire survey and a semi-structured interviews were conducted with 12 nursing care staff at a special nursing home for the elderly. Result: Eight factors such as “extraordinariness” caused five effects such as “positive changes in mental state in everyday situations” for the users. Two factors such as “development of awareness of religion” had two effects such as “changes in personal view of religion” for the care staff. Also, a factor of “caring for the users on their deathbeds” had an effect of the “opportunity of mental care” for the families of the users. Conclusion: These findings suggest that the religious involvement may be beneficial not only to users but also to facility staff and families of the users.

Development of Dignity Individual Music Therapy Program “Your Important Melody”

Introduction: Although spiritual care is one of the challenges of palliative care, structured interventions are limited. We report on the original development of the Dignity Individual Music Therapy Program (DMT) incorporating the elements of Dignity Therapy (DT) for spiritual care. Program: Developed by a research group including a music therapist based on the experience of DT. Procedure: First, the patient selects important songs based on questions such as "When did you live the most in your life? Are there any songs that remind you of those days?" Next, a music therapist plays the music on a piano in a hospital room (individual concert). Encourage the patient to talk freely about their thoughts and life episodes after the performance. Discussion: Patients who have performed DMT have been very well received. Because it is a structured program, it can be implemented in various places. The utility and feasibility of spiritual care will be investigated.

Development of a Scale to Identify Spiritual Care Needs of Oncology Patients

Aim: The research was conducted to develop and analyze the validity and reliability of spiritual care need scale identifying the spiritual care needs of oncology patients living in Turkey. Method: The research was conducted at Oncology Training and Research Hospital with 290 patients who applied to the hospital for chemotherapy at the Day Treatment Centers. Content and construct validity tests were applied to evaluate the validity of the scale, and internal validity and time invariance tests are applied to evaluate the reliability of the test. Expert opinion was solicited to evaluate the content validity of the scale. Exploratory factor analysis was applied to test the construct validity. Results: As a result of factor analysis, 4 sub-dimensions consisting of 24 items were obtained. Sub-dimensions were named as “faith and spiritual practices”, “to be peaceful and secure until the end of life”, “love and support of relatives” and “informing about health”. Cronbach’s alpha value for the spiritual care needs scale was 0.867. According to testretest results, there is no time-dependent change in the spiritual care needs scale and its sub-dimensions. Conclusion: The analysis sets spiritual care need scale as a valid and reliable measurement tool.

Conocimientos sobre cuidados paliativos en un grupo de enfermeras en México / Palliative care knowledge in a group of nurses in Mexico / Conhecimento de cuidados paliativos em um grupo de enfermeiras no México

Objetivo: Evaluar los conocimientos que tiene el personal de enfermería del Hospital General Celaya sobre cuidados paliativos. Metodo: Estudio cuantitativo, descriptivo, observacional y transversal, llevado a cabo entre octubre del 2017 y enero del 2018 en un hospital de segundo nivel, en las áreas de medicina interna, unidad de cuidados intensivos, cirugía y urgencias, en las que se atienden pacientes con necesidad de cuidados paliativos; muestreo de tipo consecutivo con 40 enfermeras. Se utilizó el Cuestionario sobre conocimientos en cuidados paliativos por el personal de salud, de 34 ítems con respuesta de tipo dicotómica: verdadero o falso. Se respetaron los principios bioéticos para investigación en seres humanos y se mantuvo el anonimato de los participantes. Se calculó la media de respuestas correctas, su porcentaje y ANOVA para diferencia entre grupos. Resultados: en los conocimientos sobre cuidados paliativos, los participantes obtuvieron una media de respuestas correctas de 22,30 (mínimo de respuestas correctas = 16, máximo de respuestas correctas = 27) y un 65,58 % del conocimiento en cuidados paliativos. El porcentaje de conocimiento en cuidados paliativos más alto se obtuvo en la dimensión Familia (83,5 %) seguido de Espiritualidad (83,12 %); en cambio, la dimensión Conocimientos diversos fue la más baja con un promedio de respuestas correctas del 55,83 %. En cuanto a la media de respuestas correctas la más alta estuvo en la dimensión Familia (4,17) y la más baja en Conocimientos generales (2,92). Conclusiones: las enfermeras parti - cipantes poseen un conocimiento que puede mejorarse; sin embargo, es necesaria la formación en cuidados paliativos desde la educación básica hasta la de especialización.

Objective: To evaluate the level of palliative care knowledge of the nurses at the General Hospital of Celaya. Method: A quantitative, descriptive, observational and cross-sectional study was carried out from October 2017 to January 2018 in a second level hospital where patients receive palliative care in the areas of internal medicine, intensive care, surgery and emergencies. The study used a consecutive type sample with 40 nurses. The research used the "Question - naire on Knowledge of Palliative care by Health Personnel" with 34 items with a dichotomous, true or false, type of response. Bioethics principles for research in human beings were respected and the anonymity of the participants was maintained. The mean of correct answers, their percentage and ANOVA for difference between groups was calculated. Results: In the knowledge about palliative care, the partic - ipants obtained an average of correct answers of 22.30 (minimum of correct answers = 16, maximum of correct answers = 27) and 65.58 % of the knowledge in palliative care. The highest percentage of knowledge in palliative care was obtained in the Family dimension (83.5 %) followed by Spirituality (83.12 %); on the other hand, the Diverse Knowl - edge dimension was the lowest with an average of correct answers of 55.83 %. Regarding the average of correct answers, the highest was in the Family dimension (4.17) and the lowest in General knowledge (2.92). Conclusions: The participating nurses have knowledge that can be improved; however, training in palliative care from basic education to specialization is necessary.

Objetivo: avaliar o conhecimento da equipe de enfer - magem sobre os cuidados paliativos no Hospital Geral de Celaya. Método: estudo quantitativo descritivo, observa - cional e transversal, realizado de outubro de 2017 a janeiro de 2018, em um hospital de segundo nível, nas áreas de medicina interna, unidade de terapia intensiva, cirurgia e emergências, no qual pacientes com cuidados paliativos são atendidos; amostragem consecutiva com 40 enfer - meiras. Utilizou-se o "Questionário sobre conhecimento em cuidados paliativos por profissionais de saúde", com 34 itens com resposta dicotômica: verdadeiro ou falso. Levou-se em consideração os princípios bioéticos para pesquisa em seres humanos, mantendo o anonimato dos participantes. A média de acertos, a porcentagem e a ANOVA para diferença entre os grupos foram calculados. Resultados: nos conhecimentos sobre cuidados palia - tivos, os participantes obtiveram média de acertos de 22,30 (mínimo de acertos = 16, máximo de acertos = 27) e 65,58 % do conhecimento em cuidados paliativos. O maior percen - tual de conhecimento em cuidados paliativos foi obtido na dimensão Família (83,5 %) seguido de Espiritualidade (83,12 %); Por outro lado, a dimensão Conhecimento diverse foi a menor, com média de acertos de 55,83 %. Em relação à média de acertos, a maior foi na dimensão Família (4,17) e a menor em Conhecimentos gerais (2,92). Conclusão: os enfermeiros participantes possuem conhecimentos que podem ser aprimorados; No entanto, a formação em cuidados paliativos desde a educação básica até a especial - ização é necessária.

Cuidado espiritual: una mirada desde el modelo de manejo de síntomas y el cuidado paliativo / Spiritual care: A look from the perspective of the model of symptom management and palliative care / Cuidado espiritual: um olhar a partir do modelo de manejo dos sintomas e cuidados paliativos

Objetivo: describir el cuidado espiritual a partir de la revisión de literatura científica relacionada con el cuidado paliativo y su arti - culación con los componentes del modelo conceptual del manejo de síntomas de Patricia Larson y colaboradores. Metodología: revisión sistemática de la literatura científica sobre cuidado espiritual y paliativo, publicada entre el 2002 y el 2018, siguiendo los lineamientos de Ganong y teniendo en cuenta los componentes del modelo del manejo de síntomas de Patricia Larson y cola - boradores: experiencia del síntoma, estrategia de manejo del síntoma y resultado del manejo del síntoma. Resultados: de los 56 artículos identificados inicialmente, 50 cumplieron con los criterios de selección y se clasificaron según los componentes del modelo del manejo de síntomas. Se encontró conceptualización de espiritualidad, escalas de valoración, intervenciones y beneficios del cuidado espiritual en pacientes con necesidades paliativas. Conclusiones: el cuidado espiritual parte de percibir la experiencia del proceso de enfermedad o etapa de fin de vida, para identificar las necesidades espirituales de las personas a través de la valoración con escalas validadas y el uso de diagnósticos relacionados con la dimensión espiritual. Las estrategias de manejo que incluyen el cuidado espiritual comienzan con el acompañamiento y la escucha activa del paciente, de donde se derivan las intervenciones de segundo y tercer nivel descritas en la literatura. Se requiere preparación de los profesionales en enfermería para orientar planes de cuidado espiritual fundamentados desde el modelo que exponen Larson y colaboradores para el manejo de síntomas.

Objective: To describe spiritual care from the perspec - tive of scientific literature related to palliative care, taking into account the components of the Conceptual Model of Symptom Management, as stated by Patricia Larson and collaborators. Methodology: Systematic review, following Ganong's guidelines, of publications made between 2002 and 2018 that are related to spiritual care and palliative care and articulated with the components of Patricia Larson's Symptom Management Model: symptom experience, symptom management strategy, and result of symptom management. Results: Of the 56 articles initially identified, 50 met the selection criteria and were classified according to the components of the Symptom Management Model. We found conceptualization of spirituality, scales for its assess - ment, interventions and benefits of spiritual care in patients with palliative needs. Conclusions: Spiritual care starts with perceiving the experience during the disease process or end-of-life stage, and includes timely identification of spiri - tual needs, their assessment through validated scales, and the use of diagnoses related to the spiritual dimension. The management strategies involved in spiritual care start from the accompaniment and active listening to the patient, from which the second and third level interventions described by the literature are derived. It is necessary to prepare nursing professionals which guide management strategies through the use of the model of Larson and collaborators, to manage - ment of symptoms in clinical practice.

Objetivo: descrever cuidados espirituais a partir da revisão da literatura científica relacionada aos cuidados paliativos, levando em conta os componentes do Modelo Conceitual de Manejo dos Sintomas de Patricia Larson, e colaboradores. Metodologia: revisão sistemática, seguindo as orientações de Ganong, de publicações realizadas entre 2002 e 2018, relacionadas aos cuidados espirituais e cuidados paliativos, articuladas aos componentes do Modelo de Gerenciamento de Sintomas de Patricia Larson: experiência, estratégia e resultado do manejo do sintoma. Resultados: dos 56 artigos inicialmente identificados, 50 preencheram os critérios de seleção e foram classificados de acordo com os componentes do Modelo de Gerenciamento de Sintomas. Encontramos conceituação de espiritualidade, escalas para sua avaliação, intervenções e benefícios do cuidado espiritual em pacientes com necessidades paliativas. Conclusões: o cuidado espir - itual começa com a percepção da experiência do processo da doença ou do estágio final da vida, e inclui a identificação de necessidades espirituais, sua avaliação através de escalas validadas, e o uso de diagnósticos relacionados à dimensão espiritual. As estratégias de manejo que incluem o cuidado espiritual partem do acompanhamento e da escuta ativa do paciente, a partir dos quais derivam as intervenções de segundo e terceiro nível descrito na literatura. É necessário preparar e capacitar os profissionais de enfermagem que orientam as estratégias de gestão através do o modelo de Larson e colaboradores.

Percepção de mulheres com câncer de mama sobre o cuidado de Enfermagem à espiritualidade / Perception of women with breast cancer about the care of Nursing to spirituality

Introduction: Spirituality is an important aspect of caring people with cancer.Objective:To understand how women with breast cancer have perceived the spiritual care provided by nursing from the perspective of Transpersonal Care Theory. Methods:a descriptive, qualitative study with 14 women in chemotherapy treatment for breast cancer in a school hospital. The data were collected in 2015, using as an instrument the semi-structured interview. For analysis, it was used the Content Analysis, based on the theoretical framework of Transpersonal Care Theory. Results:the following topics emerged: (i) nursing and spiritual care: a relationship of trust; (ii) the environment and support as connection and spirituality. Final considerations:it is concluded that women perceive the nurse as a professional that promotes spiritual care, providing it with an environment that represents comfort and safety for the patients, as well as being available to explore inter-personality as a possibility of care in this human dimension.

Introdução:A espiritualidade é um importante aspecto do cuidado as pessoas com doenças oncológicas. Objetivo:compreender como as mulheres com diagnóstico de câncer de mama percebem o cuidado espiritual, prestado pela enfermagem, na perspectiva da Teoria do Cuidado Transpessoal. Métodos:pesquisa descritiva, qualitativa, realizada com 14 mulheres em tratamento quimioterápico para câncer de mama em um hospital-escola. Os dados foram coletados em 2015, utilizando-se, como instrumento, a entrevista semiestruturada. Para análise, utilizou-se a Análise de Conteúdo, fundamentada no referencial teórico da Teoria do Cuidado Transpessoal. Resultados:emergiram as seguintes temáticas: (i) a enfermagem e o cuidado espiritual: uma relação de confiança;(ii) o ambiente e o apoio como conexão e espiritualidade. Considerações finais:conclui-se que as mulheres percebem aenfermeiracomo uma profissional que promove cuidado espiritual, cabendo a ela proporcionar um ambiente que represente conforto e segurança para as pacientes, assim comomostrar-sedisponível a explorar a interpessoalidade como possibilidade de cuidado nessa dimensão humana.

Medical Care and Spiritual Care in the Practice of Hospice Care / 中国医学伦理学

Due to the complicated symptoms and predictable death, patients with advanced cancer are the main group of the hospice care service. With the pain and need of physical, psychological, mental and social when death approaching, individualized strategies should be developed according to each patient's condition, to help to alleviate their pains, provide spiritual care and improve the quality of life effectively. Through the analysis of the clinical practice of hospice care for a breast cancer patient, this article summarized the nursing experience in order to provide reference for the localized hospice care.

Spirituality and spiritual care in nursing: A literature review

@#<p style="text-align: justify;">Spirituality is a multifaceted concept with varied definitions. In the nursing literature, it is commonly described based on its significance in the lives of individuals. Exploring the perspectives of nurses, nursing students, and patients regarding spirituality and spiritual care is crucial to gain a sound understanding of how these concepts impact the nursing profession. This literature review explored the perspectives on spirituality and spiritual care of four population groups: nurse educators, nursing students, clinical nurses, and patients. A literature search was done using worldwide databases. The 84 articles included dealt with the perceptions of nurse educators, nursing students, clinical nurses, and patients regarding spirituality and spiritual care.</p><p style="text-align: justify;">The four main categories of perspectives from the nurse educators, nursing students, nurse clinicians, and patients yielded ten sub-categories: (a) meaning of spirituality and spiritual care, (b) role of spirituality and spiritual care in nursing practice, (c) role of nursing education in developing spirituality and spiritual care competence of nursing students, (d) manner of integrating spirituality and spiritual care in nursing curriculum, (e) methods of teaching spirituality and spiritual care, (f) manner of spiritual care delivery, (g) barriers and challenges to the teaching and learning of spirituality and spiritual care, (h) barriers and challenges to spiritual care delivery, (i) ways of enhancing nurse educators' competence in curricular integration and teaching spirituality and spiritual care, and (j) ways of enhancing nurses' competence in spiritual care delivery.</p><p style="text-align: justify;">Nurse educators, nursing students, clinical nurses, and patients presented similar and diverse perspectives, but they all recognized the significance of spirituality and spiritual care in the profession. The information derived from this study can contribute to the existing knowledge base and spur strategies at individual and institutional levels to enhance teaching and learning of the concepts, improve practice, and promote holistic care.</p>

Why Patients in Institutions with Religious Background Achieve ‘Good Death’ ? : Findings from National Bereavement Survey of 127 Hospice and Palliative Care Units

<p>Previous study reported that patients of institutions with religious background are more likely to achieve ‘good death’ than patients in non-religious institutions, although the reasons are unclear. This study aims to examine the reasons for this difference using a national survey of religious and non-religious institutions. We sent a self-administered questionnaire to 10,715 bereaved family caregiver and 133 hospice and palliative care units which cared for their family members prior to death. The questionnaire for bereaved families included the Good Death Inventory (GDI). The questionnaire for institutions included their religious affiliation and their subjective and objective provided care. In total, 7,286 bereaved families (68%) and 127 (95%) institutions including 23 religious end-of-life care institutions responded. We performed t-test and χ-square test to compare the GDI scores and provided care for religious and non-religious end-of-life care institutions. The GDI total score was significantly higher (p=0.01) in religious institutions compared to non-religious institutions. Items such as “providing many activities for seasonal events to the patients”, “providing more bereavement care”, “having facilities to practice their religion”, and “having regular visits from religious leaders”, were all reported more frequently in the religious institutions, and significantly associated with achievement of ‘good death’ (p<0.05 for all items). This study suggests that factors for achieving ‘good death’ are not only limited to providing religious care but also providing other forms of care, services, and activities that can enhance the patients’ ‘good death’.</p>

The Spiritism as therapy in the health care in the epilepsy / O Espiritismo como terapia no cuidado em saúde na epilepsia / Espiritismo como terapia en el cuidado de la salud en la epilepsia

ABSTRACT Objective: to present a brief history of Spiritism, the vision of epilepsy by Spiritism, and the potential of spirituality and religiosity care as complementary and coadjutants treatments in epilepsy. Method: this is a brief review about the impact of faith, spirituality, and religiosity, particularly the Spiritism philosophy as complementary treatment to neurological disorders (particularly focusing on epilepsy) and mental health. We conduct a review of published articles (about religion/spirituality and epilepsy) in the Pubmed and SciELO databases. Conclusion: the exercise of spirituality and religiosity can be a positive coping strategy to support the traditional therapy of patients with epilepsy and other neurological disorders. However, it is necessary to demystify myths and beliefs about the epilepsy and improve knowledge about this important health dimension among professionals, patients, and caregivers to explore their full treatment and supportive potential.

RESUMO Objetivo: apresentar uma breve história do Espiritismo, a visão da epilepsia pelo Espiritismo e o potencial dos cuidados de espiritualidade e religiosidade como tratamentos complementares e coadjuvantes na epilepsia. Método: trata-se de uma breve revisão sobre o impacto da fé, da espiritualidade, da religiosidade, particularmente da filosofia espírita, como tratamento complementar dos distúrbios neurológicos (particularmente com foco na epilepsia) e da saúde mental. Para isso, fizemos uma revisão, sobre religiosidade/espiritualidade e epilepsia, na base de dados do Pubmed e SciELO. Conclusão: o exercício da espiritualidade e da religiosidade pode ser uma estratégia de enfrentamento positiva para apoiar a terapia tradicional no tratamento de pacientes com epilepsia. No entanto, é preciso desmistificar mitos e crenças sobre a epilepsia e melhorar o conhecimento deste aspecto importante da dimensão da saúde entre profissionais, pacientes e cuidadores para explorar todo o potencial de tratamento e suporte.

RESUMEN Objetivo: presentar una breve historia del Espiritismo, la visión de la epilepsia por el Espiritismo, y el potencial de la espiritualidade y religiosidad como tratamientos complementarios y coadyuvantes de la epilepsia. Método: esta es una breve revisión del impacto de la fe, la espiritualidad y religiosidad, en particular la filosofía espiritual como tratamiento complementario de los trastornos neurológicos (centrada especialmente en la epilepsia) y la salud mental. Para esto, se realizó una revisión de la religiosidad/espiritualidad y la epilepsia en la base de datos PubMed y SciELO. Conclusión: el ejercicio de la espiritualidad y la religiosidad puede ser una estrategia de afrontamiento y tratamiento positivo para apoyar la terapia tradicional de los pacientes con epilepsia y otros trastornos neurológicos. Sin embargo, es necesario desmitificar muchas creencias sobre la epilepsia así como mejorar el conocimiento sobre este importante aspecto de la dimensión de salud entre profesionales, cuidadores y pacientes para explorar su potencial para el tratamiento y el apoyo.

Short Term Effects of Islamic Zikr on Anxiety, Stress, and Depression in Mothers of Children with Congenital Heart Disease.

Aim: We investigated immediate short- term effect of Islamic Allah’s remembrance on depression, stress and anxiety of mothers of the CHD patients. Study Design and Methodology: The Depression, Anxiety, and Stress Scales (DASS-21) questionnaire was used in a quasi- experimental study. Outcome variables measured before and after of intervention and compared using paired t-test. A total of 123 mothers were participated in this study. Results: Stress (P<0.0001), anxiety (P<0.0001), and depression (P<0.0001) were reduced significantly after using Islamic Allah’s remembrance. Conclusion: Islamic Allah’s remembrance has a considerable immediate short-term effect to reduce depression, anxiety and stress in mothers of the CHD patients.

Cuidado espiritual em enfermagem: contribuição para a educação acadêmica segundo o pressuposto filosófico de Callista Roy / Spiritual care in nursing: a contribution to academic education according to the philosophical assumption Callista Roy

O presente estudo teve como objetivos averiguar o entendimento dos discentes de enfermagem a respeito do processo de cuidar em enfermagem, averiguar qual o entendimento destes sobre o cuidado de enfermagem espiritual, identificar se é necessário oferecer aos pacientes um cuidado de enfermagem espiritual, a partir da compreensão destes, descrever se a proposta curricular desta instituição é desenvolvida na perspectiva de favorecer uma prática compromissada com o ser humano em sua totalidade, envolvendo o cuidado espiritual, bem como identificar se as pessoas cuidadas pelos discentes em estágio curricular apresentaram ou demonstraram ter um relacionamento mútuo com o mundo e com Deus. Trata-se de uma pesquisa de campo, de natureza descritiva, com abordagem qualitativa, tendo como escopo referencial uma teoria de enfermagem baseada no processo interativo proposta pela Drª. Callista Roy, que assume como pressuposto filosófico que as pessoas têm relacionamentos mútuos com o mundo e com Deus. A investigação foi realizada na Universidade Federal da Paraíba, vinculada ao Centro de Ciências da Saúde e ao Departamento de Enfermagem Clínica, precisamente no Laboratório de Técnicas de Enfermagem, localizado no município de João Pessoa/PB. Participaram desta pesquisa seis discentes de enfermagem do décimo período, selecionados pelos critérios de inclusão. Os dados foram coletados consecutivamente à aprovação desta pesquisa pelo Comitê de Ética, sob CAAE nº 35391514.3.0000.5188. Para tanto, no que concerne à coleta de dados, a mesma foi realizada no mês de outubro de 2014, sob orientação de um formulário contendo questões pertinentes aos objetivos do estudo, ressalvando que, para o registro dos dados, foi utilizado um sistema de gravação de áudio, previamente esclarecido conforme termo de consentimento. Já a técnica utilizada para este fim foi o grupo focal.

This study aimed to assess the understanding of nursing students about the process of nursing care, which determine the understanding of these on the spiritual nursing care, identify whether to offer patients a spiritual nursing care from the Understanding these, describe the proposed curriculum of this institution is developed in order to favor a committed practice with the human being as a whole, involving spiritual care, and identify if people cared for by students in traineeship presented or shown to have a relationship mutual with the world and with God. This is a field research, descriptive, with a qualitative approach, having as a scope a nursing theory based on interactive process proposed by Dr. Callista Roy, who takes as a philosophical assumption that people have mutual relationships with the world and with God. The research was conducted at the Federal University of Paraíba, linked to the Health Sciences Centre and Department of Clinical Nursing, precisely in Nursing Techniques Laboratory, located in the city of João Pessoa / PB. The study gathered six nursing students of the tenth period selected by the inclusion criteria. Data were collected consecutively to the approval of this research by the Ethics Committee, under CAAE No 35391514.3.0000.5188. Therefore, with respect to data collection, it was held in October 2014, under the guidance of a form containing relevant issues to the study objectives, pointing out that, for the record data, a recording system was used audio, previously clarified as consentimento. Já term the technique used for this purpose was the focal group.

Evaluación de una intervención educativa para fortalecer el cuidado espiritual en el personal de enfermería que trabaja con personas con enfermedad crónica / Evaluation of an educational intervention to strengthen spiritual care in nursing staff who work with people with chronic illness

Propósito: Evaluar la efectividad de la intervención educativa "Cuidado espiritual de enfermería: integralidad del ser humano en el cuidado" aplicada al personal de enfermería que trabaja con personas con enfermedad crónica, en modificar su nivel de percepción sobre la espiritualidad y el cuidado espiritual. Objetivos: Adelantar las pruebas psicométricas de la "Escala de evaluación de la espiritualidad y el cuidado espiritual", diseñar la intervención educativa de cuidado espiritual, medir el nivel de percepción de la espiritualidad y el cuidado espiritual del personal de enfermería antes y después de participar o no en la intervención. Metodología: El estudio se organizó en tres fases. (Fase 1): Corresponde a la evaluación psicométrica de la "Escala de evaluación de la espiritualidad y el cuidado espiritual". Para esto se realizó adaptación cultural, validez aparente, de contenido y de constructo, participando para esta última (n=183) enfermeras. (Fase 2): Se efectuó el diseño de la intervención educativa, de acuerdo con el modelo para el desarrollo de intervenciones en salud de Campbell, la perspectiva teórica de Boykin y Schoenhofer, McSherry, y la evidencia sobre el fenómeno de interés. (Fase 3): Corresponde a la evaluación de la efectividad de la intervención. Se planteó un diseño cuasi-experimental, con grupo control y experimental, así como evaluación pre y pos-prueba. Participaron (n=222) enfermeras y auxiliares de enfermería de 3 instituciones clínicas de Bogotá, quienes fueron seleccionadas a partir de un muestreo por conveniencia y asignación 1:1 para el grupo experimental (n=112) y control (n=110), previo cumplimiento de los criterios de inclusión. Resultados: En relación con la escala, esta muestra una validez de contenido por los expertos de (CVR') de 0.582 y un Índice de validez de contenido (CVI) de 0.919. La validez de constructo motivó el ajuste en la organización de algunos ítems en las 4 sub escalas. La consistencia interna para el total de la escala por Alpha de Cronbach fue de 0,733. Respecto a la intervención, los análisis señalan que fue efectiva en modificar el nivel de percepción de la espiritualidad y el cuidado espiritual total en el grupo experimental (p≤0,000), así como en las sub escalas percepción de la espiritualidad, cuidado espiritual y cuidado personalizado (p≤0,000). La percepción de la religiosidad no mostró cambios significativos (p≤0,061). Así mismo, comparando el grupo experimental con el grupo control, se demostró que la intervención fue efectiva en modificar la percepción total final de la espiritualidad y el cuidado espiritual y que dicha modificación fue estadísticamente significativa (p≤0,016); lo mismo sucedió en las sub escalas percepción de la espiritualidad, religiosidad y cuidado personalizado. Sin embargo, la percepción del cuidado espiritual final no presentó diferencias significativas al comparar el grupo experimental respecto al grupo control (p≤0,024). Otros hallazgos, son presentados en el cuerpo del documento.

Purpose: Assess the effectiveness of educational intervention "Spiritual care in nursing: wholeness of the human being in care", applied to nursing staff who work with chronic disease patients in modifying the perception on spirituality and spiritual care. Objectives: Advance psychometric tests of the "Spirituality and Spiritual Care Rating Scale" (SSCRS), design an educational intervention for spiritual care, measure the level of perception of spirituality and spiritual care provided by nursing staff before and after participation/non participation in the intervention. Methodology: The study was arranged in three phases. (Phase 1): corresponds to psychometric tests of "Spirituality and Spiritual Care Rating Scale". This was carried out through a cultural adaptation, face, content, and construct validity, this latter with the participation of (n=183) nurses. (Phase 2): the educational intervention was designed according to Campbell's framework for design and evaluation of complex interventions to improve heath, the theoretical perspective of Boykin and Schoenhofer, McSherry, and the evidence on the related phenomenon. (Phase 3): corresponds to the assessment on the effectiveness of the intervention. A quasi-experimental design was set forth with control and test groups, as well as pre-test and post-test. It included the participation of n=222 nurses and nurse assistants from 3 clinical institutions located in Bogotá, who were selected through convenience sampling and assigned 1:1 for the experimental group (n=112) and control group (n=110), with previous compliance of inclusion criteria. Results: In regard to the scale, it shows a content validity rate (CVR) by the experts of 0.582 and a content validity index (CVI) of 0.919. The construct validity motivated an adjustment in the organization of some items in the 4 sub-scales. The internal consistency reliability for the total scale by Cronbach's Alpha coefficient was 0,733. In relation to the intervention, statistical analysis demonstrated it was effective in modifying the global level of perception of spirituality and spiritual care in the experimental group (p≤0,000), as well as the sub-scales of perception of spirituality, spiritual care, and personalized care (p≤0,000). The perception of religiosity did not show significant changes (p≤0,061). Additionally, when comparing the experimental group with the control group, it demonstrated that the intervention was effective in significantly modifying the global final perception of spirituality and spiritual care (p≤0,016); as well as the sub-scales of perception of spirituality, religiosity, and spiritual care. However, the final perception of spiritual care did not show any significant differences when comparing the experimental group with the control group (p≤0,024). Other findings are presented in the body of the document.