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BACKGROUND: Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. AIM: To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. RESEARCH DESIGN: Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. ETHICAL CONSIDERATIONS: The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. FINDINGS: Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. CONCLUSIONS: Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses.
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AIM: To synthesize the best available research evidence regarding the effectiveness of spiritual intelligence educational interventions on spiritual intelligence and professional outcomes in nurses and nursing students. BACKGROUND: Spiritual intelligence is a form of intelligence with which individuals can deal with a crisis, alter situations, solve problems and achieve goals through a set of capacities and abilities. Possessing spiritual intelligence contributes to professional practice and competence in the workplace and has been seen to be beneficial for nurses and nursing students. Nursing interventions to teach and increase understanding of spiritual intelligence have been explored in the literature, but the effectiveness of spiritual intelligence training for nurses and nursing students remains uncertain. DESIGN: A systematic review and meta-analysis. DATA SOURCES: A three-step systematized search of sixteen electronic English and Persian databases was conducted to identify randomized and non-randomized trials published in English and Persian from January 2000 to November 2021. METHODS: The methodological quality of eligible studies was undertaken by two independent reviewers using the Medical Education Research Study Quality Instrument. Meta-analyses were undertaken where appropriate using STATA v16. RESULTS: Seven studies involving 512 participants were included. Pooled results demonstrated that those who received the educational intervention had significantly higher spiritual intelligence scores at 2 weeks (MD 13.38, 95 % CI: 5.76, 20.99) and one month follow up (MD 20.03, 95% CI: 6.61, 33.45) compared with those who did not. No difference in spiritual intelligence scores was observed among those who received spiritual intelligence education or life skills training (MD 7.52, 95 % CI -1.78, 16.82). Significantly higher communication skills (MD 5.41, 95 % CI: 2.16, 8.66), job satisfaction (MD; 11.30, 95 % CI: 8.63, 13.97) and spiritual care competence (MD; 28.55, 95 % CI: 26.08, 31.02) and decrease in overall stress (MD; 10.30, 95 % CI: 6.84, 13.76) among those who received the educational interventions were reported at the one-month follow-up. Significantly higher job satisfaction levels were also reported at 2-month follow-up among those who received the educational interventions (MD; 16, 95 % CI: 11.06, 20.94). CONCLUSIONS: The evidence from this review demonstrates that spiritual intelligence educational interventions have a positive effect on spiritual intelligence and professional outcomes in nurses and nursing students. We noted that the outcomes in the studies included were mostly measured at one-month follow-up and with subjective measures. Longer trials with objective measures are required to provide higher levels of evidence. The results of this review are largely based on single trials and were limited in terms of the number of outcomes. Conducting further trials is warranted to identify the influence of such education on various professional outcomes in nursing practice. TWEETABLE ABSTRACT: Systematic review and meta-analysis shows spiritual intelligence educational interventions have a positive effect on nurses' and nursing students' spiritual intelligence, work-related stress and professional practice.
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Students, Nursing , Humans , Intelligence , Job Satisfaction , WorkplaceABSTRACT
Background: The concept of spiritual intelligence was developed in 1997 based on philosophical theories and neurological evidence and introduced as the ultimate intelligence. Spiritual intelligence has been considered as one of the skills required by professionals and has recently gained traction within nursing practice. Understanding the role of spiritual intelligence and its association with professional nursing practice is crucial to creating knowledge in this area of inquiry. Objective: To identify the best available evidence of the spiritual intelligence level and its correlation with professional practice among nurses. Design: A systematic review and meta-analysis of observational studies were reported according to the PRISMA and MOOSE guidelines. The protocol for this systematic review was registered with PROSPERO with the identification CRD42021254881. Data Sources: Ten electronic English and Persian databases [Cochrane Library, Web of Science, Scopus, PubMed, CINAHL, Science Direct, Wiley Online Library, Magiran, SID, IranDoc] were searched to identify eligible studies, published in the English and Persian languages from January 2000 to May 2020. Review Methods: A systematized search strategy was used to include eligible published and unpublished observational studies that examined the spiritual intelligence level and its correlation with professional practice among nurses. Screening, quality assessments, data extractions, and analysis were undertaken using Joanna Briggs Institute methodology and carried out by two independent reviewers. Results: Thirty-five studies, with a total of 7301 nurses, were included. The mean score for spiritual intelligence in 29 studies and 5853 nurses was 0.63 (95% CI: 0.57-0.69, I2 = 99.97%). The Spiritual Intelligence Self-Report Inventory was the most frequently used instrument to measure spiritual intelligence. Most of the professional nursing outcomes represented a positive association with nurses' spiritual intelligence. The pooled positive correlation coefficients between spiritual intelligence and a professional nursing practice components including the art of nursing, competence, attributes of practice and, personal commitment were 0.34 (95% CI: 0.24, 0.43, I2 = 63.4%, 5 studies), 0.42 (95% CI: 0.25,0.56, I 2 = 62.2%, 2 studies), 0.32 (95% CI: 0.11, 0.50, I 2 = 92.2%, 5 studies) and 0.41 (95% CI: 0.34, 0.49, I 2 = 74.3%, 8 studies) respectively. Conclusions: The findings of this systematic review indicated a relatively high level of spiritual intelligence among nurses that was moderately associated with professional nursing practice. implementing strategies to promote spiritual intelligence levels among nurses is warranted.
