Strengths and challenges with spiritual care: Student feedback from the EPICC Spiritual Care Self-Assessment Tool.

AIM: To explore qualitative data from students' self-reported competencies in spiritual care gathered during testing of a student self-assessment tool based on the EPICC Spiritual Care Education Standard. DESIGN: Reflexive thematic analysis of qualitative data from a multinational study on validating a new self-assessment tool. METHODS: The EPICC Spiritual Care Education Standard for competency in spiritual care was developed to enhance nurses' and midwives' ability to provide spiritual care by creating a baccalaureate education standard for spiritual care competencies. Spiritual care researchers then developed a self-assessment tool to raise student awareness of spirituality and track personal and professional growth in spiritual care competency. The EPICC Spiritual Care Competency Self-Assessment Tool, tested at eight universities in five countries, provided many opportunities for student comments, resulting in rich qualitative data presented here. RESULTS: Themes related to strengths, weaknesses and areas for improvement. Identified strengths were similar across countries: caring attitudes, general knowledge of caring and compassion and good communication skills. Weaknesses/challenges touched on spirituality as overlooked in some cultures but part of life for others, complex questions were hard to understand, and self-assessment tools are common for some and rare for others. Areas for improvement included need for knowledge of religious and other deeply held beliefs and for greater spiritual assessment skills. Similarities across countries related to basic training in communication and compassionate care for nurses globally. Differences lay in the challenges and/or barriers for spiritual care and may relate to cultures within countries and/or university test sites. RELEVANCE TO CLINICAL PRACTICE: The Tool raises awareness of spirituality among students and working nurses, providing an accessible way to self-check personal and professional growth in spiritual care competencies, which increases student and nurse capacity to become more knowledgeable and skilled in facilitating spiritual care, thus be role models for students at the intersection of spirituality and health.

Developing and testing the EPICC Spiritual Care Competency Self-Assessment Tool for student nurses and midwives.

AIMS AND OBJECTIVES: To develop and psychometrically test a self-assessment tool that measures undergraduate nursing and midwifery students' perceptions of spiritual care competence in health care practice. BACKGROUND: Spiritual care is part of nurses/midwives' responsibility. There is a need to better benchmark students' competency development in spiritual care through their education. The EPICC Spiritual Care Education Standard served as groundwork for the development of the EPICC Spiritual Care Competency Self-Assessment Tool. DESIGN: Cross sectional, mixed methods design. A STROBE checklist was used. METHODS: The Tool (available in English, Dutch and Norwegian) was developed by an international group. It was tested between July-October 2020 with a convenience sample of 323 nursing/midwifery students at eight universities in five countries. The Tool was tested for validity using Kaiser-Meyer-Olkin (KMO) test, exploratory and confirmatory factor analysis, one-way ANOVA and independent samples t test. The reliability was tested by Cronbach's alpha coefficient. Qualitative data were analysed using thematic analysis. RESULTS: The KMO test for sampling adequacy was 0.90. All, but two, items were related to the same factor. Cronbach's alpha coefficient for the Tool was 0.91. Students found the Tool easy to use, and they gained new insights by completing it. However, students felt that some questions were repetitive and took time to complete. CONCLUSIONS: The Tool has construct and discriminant validity, and high internal consistency (is reliable). In addition, students found the Tool useful, especially in early stages of education. RELEVANCE TO CLINICAL PRACTICE: The Tool affords student nurses and midwives the opportunity to self-evaluate their knowledge, skills and attitudes about spirituality and spiritual care. The Tool offers students, educators and preceptors in clinical practice a tangible way of discussing and evaluating spiritual care competency.

Comorbid patterns of anaemia and diarrhoea among children aged under 5 years in Ghana: a multivariate complex sample logistic regression analysis and spatial mapping visualisation.

BACKGROUND: Anaemia and diarrhoea are known independent causes of under-five morbidity and mortality. This study sought to investigate predictors of comorbid patterns of anaemia and diarrhoea using the 2014 Ghana Demographic and Health Survey (GDHS). METHODS: The study employed analysis of secondary data from the 2014 GDHS. We performed a multivariate complex sample logistic regression and spatial analysis. RESULTS: The weighted prevalence of comorbid anaemia and diarrhoea was 9.28% with the highest burden (16.45%) found in the Upper West region. Independent predictors (risk factors) of comorbid patterns of anaemia and diarrhoea were children aged 6-23 mo (OR=2.17, 95% CI 1.42 to 3.33), male gender (OR=1.50, 95% C1 1.04 to 2.16), history of fever (OR=4.37, 95% CI 2.94 to 6.50) and living in a household with two children aged <5 y (OR=1.80, 95% CI 1.14 to 2.84). Protective factors were having a father with secondary or higher education (OR=0.57, 95% CI 0.33 to 0.97), living in a household with ≥6 members (OR=0.46, 95% CI 0.28 to 0.75) and living in a richer household (OR=0.38, 95% CI 0.16 to 0.89). Surface maps revealed inter-regional and subregional variations. CONCLUSION: The study shows that the independent predictors of comorbid patterns of anaemia and diarrhoea among children aged <5 y in Ghana are age, gender, history of fever, the number of children aged <5 y in the household, parental education, household size and household wealth. The study identified zones to be targeted for cost-effective policy interventions.

Trends in the proportionate mortalities attributed to noncommunicable diseases in sub-Saharan Africa for the period 2000 to 2016.

Noncommunicable diseases (NCDs) remain a growing global health issue and sub-Saharan Africa (SSA) is no exception. Using secondary data obtained from the World Bank on 48 SSA countries, we describe the trends in the proportionate mortalities attributed to NCDs in SSA between 2000 and 2016. The baseline proportionate mortalities attributed to NCDs in SSA increased from 22.49% in 2000 to 33.69% in 2016, representing about 11% increase. The trend was replicated across the low-, middle-, and high-income countries in SSA. The highest change in the NCD mortalities in low-income SSA countries was seen in Eritrea where NCD mortalities increased from 19.3% in the year 2000 to 45.2% in 2016. In Rwanda, it rose from 24.8% to 44% during the same period. Ghana, a lower-middle-income country, also witnessed an increase from 27.3% in 2000 to 42.7% in 2016. The general increasing trend in the burden of NCD mortalities in SSA implies the need for higher prioritization of NCD prevention and control initiatives. There is a need for a greater contribution of nontraditional stakeholders in health through a multi-sectoral approach. We also recommend integrating NCD prevention and control strategies into existing public health structures being used for communicable disease control.