Session 4
Religion, Spirituality and Health Care Professionals
Chair: Donia Baldacchino
1. Development and Measurement of Spiritual Care Competences in Nursing
René van Leeuwen
The discussion about spiritual care in (mental health) nursing is specifically focusing on competence development of nurses and the role of nursing education. Important issues in that discussion are: what nursing competences should be developed in the area of spiritual care, how should they be teached in nursing education and how can competence development among nurses be measured?
The aim of this oral presentation is to present:
- The Spiritual Care Competence Scale (SCCS) as a valid and reliable tool to measure nurses’ competences in delivering spiritual care
- Results of the use of the SCCS in research in nursing practice and nursing education to date
The Spiritual Care Competence Scale contains 27 items which measures competences within three domains of nursing professional behavior: personal reflection and communication, evidence based practice and policy development.
This tool is used in different research studies within different care setting in different countries among pre- and post-registered (student) nurses. This studies showed the SCCS as a valid and reliable tool for measuring spiritual care competencies. The psychometric quality of the instrument proved satisfactory. The results give insight in specific factors that influence the personal and professional development of nurses in spiritual caregiving.
In the presentation a specific focus will be pointed on the similarities and differences in competence development in spiritual care between mental health nurses and nurses in other health care settings (hospital, home care). An overview of results of the studies will be presented and its impact on further development of mental health nurses’ competences in spiritual care will be discussed.
Reference: René van Leeuwen, Lucas J Tiesinga, Berrie Middel, Doeke Post and Henk Jochemsen (2009) The validity and reliability of an instrument to assess nursing competencies in spiritual care. Journal of Clinical Nursing, 18, 2857-2869.
PowerPoint slides of the presentation (PDF)
2. Neither Meditation nor Faith as a Resource are Related to Nurses´ Stress, Burnout and Cool Down Reactions, but their Conscious Presence and Self-control
Arndt Büssing, Carina Schoppe
Quality of Life, Spirituality and Coping, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Germany
Background: Nurses are confronted with increasing stress and work burden which may result in symptoms of emotional exhaustion and emotional withdrawal from their patients. Can specific facets of spirituality buffer against cool down reactions, burnout and reduced work engagement, and finally contribute to nurses´ life satisfaction?
Aim: To answer these questions, we analyzed the influence of different facets of spirituality (i.e., religious denomination, having hold in God as a religious measure, and frequency of meditation as a non-religious spiritual practice, and conscious presence and self-control [CPSC]) on demand variables (i.e. stress perception) and reactions (i.e., cool down, burnout), internal resources (i.e. self-efficacy expectation, work engagement), and life satisfaction.
Methods: Cross-sectional study enrolling 916 nurses (mean age 41±12 years; 81% women; 84% Christians, 5% other, 11% no religious affiliation). Applied standardized instruments were Cool Down Index (CDI), MBI, PSS, UWES, BMLSS, SES, and conscious presence and self-control (CPSC) scale.
Results: Their faith as a resource of hope and orientation is for 20% very important, for 30% important, for 27% less important, and for 23% not at all important. Most do not meditate (74%), 9% once per month, 9% once per week, and 7% daily. None of the tested variables differed significantly with respect to religious denomination (F<2.0; n.s.). Having faith as a resource correlated weakly with meditation frequency (r=.22). However, neither frequency of meditation nor importance of faith as a resource showed relevant associations with the tested demands and resource variables. Instead it was CPSC which was strongly related to nurses´ self-efficacy expectation (r=.62), moderately to life satisfaction (r=.45) and work engagement (r=.36), and negatively to stress perception (r=-.45), burnout (r=-.45) and cool down reactions (r=-.36) on the one hand.
Conclusions: CPSC as a person related measure of situational awareness was negatively related to nurses´ demands and stress reactions, and positively with intrinsic resources, while neither meditation frequency nor faith as a resource showed relevant associations. The intentions might be high that nurses have to provide spiritual care to their patients, too; yet one has to be aware of their risk to run empty. Thus, external stressors have to be changed to hold the motivation and high standards of professional work, and their internal resources have to strengthened, too. Whether CPSC is a buffer against or only related to demands and stressors remains to be shown.
3. Mental Health Professionals’ Beliefs about Addressing Religious and Spiritual Issues in Psychotherapy
Jaclin Freire, Carla Moleiro
Religiosity and spirituality have been increasingly recognized as important dimensions on people’s lives around the world, contributing to personal and moral development; improving people’s physical and psychological well-being and even their healing process. These last indicators have demonstrated that, when in suffering or psychological distress, religious (and spiritual) clients tend to recover faster and with better outcomes when mental health professionals accurately integrate their clients' religious beliefs and practices in psychotherapy. However, working with culturally and religiously diverse people/groups can be a challenge for both the psychotherapist and the client.
The main goal of this research is to contribute to the discussion and development of specific competencies for mental health professionals, with special focus on Portuguese professional setting, where there is a lack of adequate training on how to integrate or adjust psychotherapeutic interventions according to client's religious/spiritual beliefs and practices.
This paper will present the final results of two studies conducted with mental health professionals. One is a qualitative study with 17 mental health professionals (Clinical Psychologists, Psychiatrists and Psychotherapists), and the second one a quantitative study, where 215 mental health professionals were surveyed. Qualitative data were analysed using thematic analysis using the software MAXQDA 11, and quantitative data were analysed using SPSS Statistics 20. The main goal of these two studies was to describe the current clinical practice, regarding particularly how and when mental health professionals integrate and work (or not) with religious and spiritual clients and/or issues.
Results include mental health professionals’ overall attitudes toward integration of religiosity and spirituality into therapy; their self-awareness concerning their own religious and spiritual values and their attitudes toward their clients; and the strategies used to integrate religiosity and spirituality into psychotherapy. Reflections and implications for clinical practice will be offered as to why bringing religion and spirituality into the mental health field is important.
4. The Phenomenon of Organizational Burnout Doctors Chosen Specialization and their Methods of Coping
Michal Bajko
Background: Health care workers workplace is recognised as stressful and dangerous environment that often causes a negative effect on the doctors and nurses performance, physical health and psychological well-being of medical staff. In these adverse work conditions a burntout syndrome is really common problem among medical staff.
Aim: Organisational burnout is real problem in group of health care workers. Doctor’s and nurse’s work is very responsible and their tasks need to be in high quality due to patients health and life. The main aim of these research is to define and minimize the risk of health care workers burnout.
Method: Stress, coping and organisational burnout were examined among 256 doctors of different specializations such as internists, surgeons, oncologists and dentists from hospitals and clinics from Tricity and Warsaw area. Stress was assessed using the a PSS-10 scale and KSOP (Questionary of subjective work evaluation). Coping was assessed using the MiniCope Inventory. Organisational burnout was assessed with Ch. Maslach MBI inventory (Maslach Burnout Inventory). Statistical methods included Wilcoxon Test and Chi Square analysis.
Results: The highest levels of work burnout manifest men internists doctors. In the opposite the lowest level of burnout were found in group of women oncologists. The most two common coping methods in men doctors group are sense of humour and blame of themselves. In women doctors group were found as the most commonly used religious behaviours and also blame of themselves.
Conclusions: Resuming above results, the most heavily loaded with burnout group of doctors are men who are internists. It may be due to using coping methods set to avoid the stressful situations.
5. Education for the Spirituality of Metally Ill People
Hubert Kaszynski, Katarzyna Ornacka, Jan Klimek, Justyna Berlinska
The focus point of the paper is to present the results of preevaluative research on the assumptions and program of an interdisciplinary course intended for students of social work who plan to take up in their professional work the issues related to the spirituality of mentally ill people. The research team comprises representatives of three centres in Krakow: The Pontifical University of John Paul II in Kraków, Jagiellonian University, Rectoral Church of Our Lady of Czestochowa at the Jan Babinski Specialist Hospital in Kraków and people who have experienced emotional crisis. On the basis of the preliminary findings of the study, the authors discuss three selected issues which are crucial for the spiritual education in social work with mentally ill people. The first issue are the axiological consequences of 20th-century eugenics, including the annihilation of mentally ill people, for contemporary marginalisation and stigmatisation of spiritual and Sacrum experiences of mentally ill people. Another issue is related to the anti- stigmatising function of a direct contact with mentally ill people who share their understanding of the place of spirituality in the recovery process. The third one is the educational method in the field of eclectic approach to spirituality of a mentally ill person, for which the theoretical basis is personalistic philosophy, the methodological basis is an interpretative approach and the applicative basis is participatory action research.