This paper aims to explore the meaning of spirituality in relation to nursing care using concept synthesis. Walker and Avant give three ways in which concept synthesis can occur: discovering new dimensions to old concepts, searching for similarities and discrepancies among sets of related concepts, and observing previously undescribed phenomena. It is the first two of these methods which have been used here. The phenomena that emerged from a reading of the literature around spirituality were meaning, presencing, empathy/compassion, giving hope, love, religion/transcendence, touch and healing. These phenomena were studied in order to sort them into fewer categories. They all appeared to be products of a relationship, some physical (presencing, touch and healing), and others emotional (meaning, empathy/compassion, hope, love, and religion/transcendence). Some of the phenomena appeared to fit in both categories, especially healing, which could be of a physical or emotional/spiritual nature. Once the two main categories had been arranged, it was obvious that a split between psyche and soma was not appropriate for labelling the spiritual dimensions of nursing care, as the original definition of spirit was something which motivated the body. Spiritual care is inseparable from physical, social and psychological care because together they form the whole (Bradshaw 1994 p. 282). The two categories were then collapsed into one and given the label 'connection'.

There is much anxiety regarding the transfer of adolescents with chronic illness to adult services. Transfer of patients can be haphazard if the transition has not been planned. Problems and obstacles to transition have been identified and discussed by various authors. The purpose of this small study was to explore the views and needs of health care professionals from one National Health Service trust regarding the transition of care for adolescents with a chronic condition from children's to adult services and to identify possible ways to improve the current services for this particular group of young adults. The sample comprised 40 health care professionals, nurses from the children's department and adult ward, doctors, psychologists, physiotherapists and pharmacists currently working in the same hospital trust. A postal survey was conducted. The data were analysed using descriptive statistics and content analysis. The main findings suggest that there is a need for a planned transition programme, supported by a clinical protocols and a specialist unit for adolescents. Health care professionals' views of patients and family/carers' needs and how such needs may be met were identified.