Aims: To discover how nurses understand spirituality and spiritual care and what affects nurses’ understanding of these terms. Method: A literature search was conducted in CINAHL Plus, MEDLINE, and Google Scholar for research articles dated between 2010 and 2018 that were published in English. Using the Critical Appraisal Skills Program checklist for systematic reviews, nine articles met the inclusion criteria for this review. Most of these articles reported quantitative studies. Results: Although nurses recognize the importance of spirituality and spiritual care in nursing and have ascribed a diversity of meanings, there remains some confusion about what these terms mean. Several influences have been identified as shaping nurses understanding of spirituality and spiritual care, including education, nurses’ own spirituality or religious beliefs, age, years of clinical experience, and place of employment. Conclusions: This review identifies the need for further studies using qualitative approaches to investigate how nurses’ construct their understanding of spirituality and spiritual care and the dominant discourses nurses draw from to inform their understanding using qualitative approaches. Relevance to Clinical Practice: The insights gained by this review may be of value to nurse educators, managers, and policy makers in nursing education and the development of policies and practice guidelines.
Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non-denominational public hospital and a faith-based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study.Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers.
Substance use disorders are common among people living with HIV (PLWHA), and PLWHA with untreated substance use are less likely to receive antiretroviral therapy (ART) or achieve viral suppression when ART is prescribed. Integrated behavioral and medical interventions are one approach used to treat complex chronic illnesses, including HIV and substance abuse (SA). As the potential benefit for integrated HIV-substance abuse treatment is recognized, the number of providers attempting to integrate care is growing. Integrated care models can range from coordinated to colocated to fully integrated models. Providers need a better understanding of these implementation options for HIV-substance abuse treatment and how they impact providers of different disciplines. Between April and November 2006, interviews exploring the process of implementing an integrated HIV-substance abuse intervention were completed with clinic staff at three diverse HIV clinics in North Carolina. Key differences in implementation between sites were found. The degree of integrated care between sites ranged from colocated to integrated, and clinic staff perceived each integrated model to have advantages and disadvantages. Recommendations for implementing HIV-SA integrated care are made.
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