Patients of parish nurses experience renewed spiritual identity: a grounded theory study.

AIM: This article is a report of a study of the process that patients of parish nurses experience when they are provided spiritual care in Christian churches, a context where patients and nurses share a common set of values. BACKGROUND: Many studies have explored hospitalized patients' views and experiences of spiritual care. However, little is known about the spiritual changes that patients experience as they receive care from parish nurses. METHODS: The grounded theory method was used to explore what patients of the parish nurses experienced in spiritual care. Half of the participants were interviewed in 1999-2001 at the time of the parish nurse interviews, and half in 2005. Audiotapes were transcribed verbatim. Constant comparative methods were used to analyse the incidents of receiving spiritual care. FINDINGS: Theoretical memos described how the 'main concern' of the patients to resolve their health challenge resulted in changes to their spiritual identity. Phases in the change process included: facing a health challenge, finding a safe place, releasing burdens, changing perspectives and joining or rejoining the family of faith. The essence the patients experienced was an enhanced understanding of who they were in God/Christ. CONCLUSION: The patient's spiritual challenge is to re-conceptualize the self (as one who is known and loved by God) in the context of a particular health challenge. Spiritual care helps them find a new equilibrium in faith.

Spiritual care in Christian parish nursing.

AIM: This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. BACKGROUND: Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. METHOD: Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. FINDINGS: From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. CONCLUSION: The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.