Spiritual care interventions for palliative care patients: A scoping review.

OBJECTIVES: To identify and map spiritual care interventions to address spiritual needs and alleviate suffering of patients in the context of palliative care. METHODS: A scoping review using the PRISMA ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was conducted according to the JBI (Joanna Briggs Institute) guidelines. The search was conducted from October 2022 to January 2023 using 9 electronic databases and gray literature. Studies on spiritual care interventions in palliative care were included. Disagreements between the 2 reviewers were resolved by discussion or a third reviewer. RESULTS: A total of 47 studies were included in this review. All selected articles were published between 2003 and 2022. In total, 8 types of spiritual care interventions were identified to assess spiritual needs and/or alleviate suffering: conversations between the patient and a team member, religious practice interventions, therapeutic presence, guided music therapy, multidisciplinary interventions, guided meditation, art therapy, and combined interventions with multiple components such as music, art, integrative therapy, and reflection. SIGNIFICANCE OF RESULTS: Our study identified few spiritual care interventions in palliative care worldwide. Although this review noted a gradual increase in studies, there is a need to improve the reporting quality of spiritual care interventions, so they can be replicated in other contexts. The different interventions identified in this review can be a contribution to palliative care teams as they provide a basis for what is currently being done internationally to alleviate suffering in palliative care and what can be improved. No patient or public contribution was required to design or undertake this methodological research.

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)

Competencies for quality spiritual care in palliative care in Latin America: from the Spirituality Commission of the Latin American Association for Palliative Care.

Spiritual care is an essential part of quality palliative care. However, the literature regarding spiritual care competencies in Latin America is limited. Herein we propose the basic quality standards for spiritual care in palliative care according to best professional practices and provide a common vocabulary and required competencies for quality clinical spiritual care. Both elements, quality standards and a common vocabulary, are part of an essential step implementing continuous educational initiatives among interdisciplinary palliative care teams in Latin America. Members of the Spirituality Commission of the Latin American Association for Palliative Care and three members of independent professional palliative care organizations identified and reviewed our proposed spiritual care competencies and created a consensus document describing the competencies for general spiritual care. In the context of palliative care in Latin America, general spiritual care is provided by members of interdisciplinary teams. We proposed six competencies for high-quality general spiritual care and their observable behaviors that every member of an interdisciplinary palliative care team should have to provide quality clinical spiritual care in their daily practice: (I) personal, spiritual, and professional development; (II) ethics of spiritual care; (III) assessment of spiritual needs and spiritual care interventions; (IV) empathic and compassionate communication; (V) supportive and collaborative relationships among the interdisciplinary team; and (VI) inclusivity and diversity.

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.

Spiritual Resources of Family Members of Patients in Palliative Care in Brazil.

Although religiosity is a strong feature of Brazilian people, the integration of spirituality in palliative care (PC) has been a challenge for health care professionals. In order to evaluate the spiritual resources used by family members of patients in PC, this work presents the results of the research carried out with 50 family members. The Satisfaction with Life Scale, Centrality of Religiosity Scale, Spiritual/Religious Coping Scale, Religious and Spiritual Struggles Scale, and Attachment to God Inventory were applied. The prevalence of positive spiritual/religious coping was very high (76%) or high (6%). There was a strong correlation between positive spiritual/religious coping and centrality of religiosity (r = 0.805; SD = 0.87). There was a moderate negative correlation between the avoidant attachment to God and centrality of religiosity (r = -0.611; SD = 1.24) and positive spiritual/religious coping (r = -0.575; SD = 1.37). There was a moderate positive correlation between the anxious attachment to God and spiritual struggles (r = 0.515; SD = 0.76) and negative spiritual/religious coping (r = 0.555; SD = 0.616). These results suggest that spiritual/religious resources are present in family members of patients in PC. These resources have been mostly ignored by the multidisciplinary team. Findings provide an evidence base for training health care professionals to better integrate spirituality in PC settings.

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.

Spirituality in the continuing education of healthcare professionals: An approach to palliative care.

OBJECTIVE: A major barrier to the adoption of an approach that integrates spirituality into palliative care is the lack of preparation/education of healthcare professionals on the topic. This study aimed to evaluate the effectiveness of a continuing education activity for healthcare professionals addressing spirituality and spiritual care provision to patients and families within palliative care. METHOD: We conducted an intervention study using a quantitative pre- and posttest design in a convenience sample of 52 healthcare professionals. Participants completed the Brazilian version of the Spiritual Care Competence Scale before and after attending a four-hour continuing education activity. RESULT: Significant differences were observed between pre- and postintervention scores in the following dimensions: assessment and implementation of spiritual care, professionalization and improving the quality of spiritual care, personal support, and patient counseling (p < 0.001), and referral (p = 0.003). SIGNIFICANCE OF RESULTS: The results of this study provide preliminary evidence of a positive effect of this educational intervention on the development of the competences needed by healthcare professionals to deliver a comprehensive approach centered on the patient/family, which includes attention to spirituality and spiritual care in the decision-making process.

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.

Cross-cultural validation of the Brazilian version of the spiritual care competence scale.

OBJECTIVE: This study describes the cross-cultural validation and psychometric evaluation of the Spiritual Care Competence Scale - Brazilian Portuguese version. This reliable and valid instrument is recommended in the literature to measure the outcomes of the education process in the development of spiritual care competences. METHOD: This is a cross-sectional validation study following the stages proposed by Beaton et al.: translation into Portuguese, back translation into English, expert committee review for semantic equivalence, assessment of the clarity of the pre-final version, and evaluation of the psychometric properties of the final version in Portuguese. Health professionals working at a public hospital in South Brazil participated in the different stages of this study.ResultRegarding internal consistency, total Cronbach's alpha was 0.92 and the mean inter-item correlation was 0.29. The test-retest procedure showed no statistically significant differences in the six subscales. The intraclass correlation coefficient ranged from 0.67 to 0.84, demonstrating the stability of the scale.Significance of resultsThe results support the psychometric quality of the scale and indicate that the adapted instrument is a valid and reliable scale with good internal consistency for measuring spiritual care competencies of health professionals in Brazilian healthcare settings.

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.

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.

Collage technique may provide new perspectives for Alzheimer patients by exploring messages from their inner world / Técnica de colagem pode dar novas perspectivas para pacientes com doença de Alzheimer através da exploração do seu mundo interior

Abstract: Although the collage art technique has been introduced as a psychotherapeutic method, it has not been fully applied in dementia. Objectives: To analyze characteristics of the collage articles produced by patients with Alzheimer's disease (AD). Methods: Twenty AD patients were asked to select and place several clippings as they wished. The MMSE was used for cognitive assessments. Results: Simplification and poor organization in their articles were found. The themes of one patient were found to change according to behavior. We discussed the images of the articles, especially spiritual images in the early stage and family images in the later stage. Conclusions: We concluded that the collage technique could provide new perspectives for dementia patients by exploring messages from their inner world.

Resumo: Embora a técnica de colagem tenha sido introduzida como um método psicoterapêutico, ela não foi totalmente aplicada em demência. Objetivos: Analisar as características de trabalhos de colagens feitos por pacientes com doença de Alzheimer (DA). Métodos: A 20 pacientes foi solicitado que selecionassem e colocassem peças que apreciassem. O MEEM foi utilizado para avaliação cognitiva. Resultados: Simplificação e organização pobres foram encontradas. Nós demonstramos um paciente cujos temas foram mudando em relação ao comportamento. Nós discutimos as imagens dos artigos, especialmente imagens espirituais no estágio precoce e imagens familiares no estágio tardio. Conclusões: Nós consideramos que a técnica de colagem poderia dar novas perspectivas na demência, explorando a mensagem do mundo interior.

Collage technique may provide new perspectives for Alzheimer patients by exploring messages from their inner world.

Although the collage art technique has been introduced as a psychotherapeutic method, it has not been fully applied in dementia. OBJECTIVES: To analyze characteristics of the collage articles produced by patients with Alzheimer's disease (AD). METHODS: Twenty AD patients were asked to select and place several clippings as they wished. The MMSE was used for cognitive assessments. RESULTS: Simplification and poor organization in their articles were found. The themes of one patient were found to change according to behavior. We discussed the images of the articles, especially spiritual images in the early stage and family images in the later stage. CONCLUSIONS: We concluded that the collage technique could provide new perspectives for dementia patients by exploring messages from their inner world.

Embora a técnica de colagem tenha sido introduzida como um método psicoterapêutico, ela não foi totalmente aplicada em demência. OBJETIVOS: Analisar as características de trabalhos de colagens feitos por pacientes com doença de Alzheimer (DA). MÉTODOS: A 20 pacientes foi solicitado que selecionassem e colocassem peças que apreciassem. O MEEM foi utilizado para avaliação cognitiva. RESULTADOS: Simplificação e organização pobres foram encontradas. Nós demonstramos um paciente cujos temas foram mudando em relação ao comportamento. Nós discutimos as imagens dos artigos, especialmente imagens espirituais no estágio precoce e imagens familiares no estágio tardio. CONCLUSÕES: Nós consideramos que a técnica de colagem poderia dar novas perspectivas na demência, explorando a mensagem do mundo interior.