Factors influencing nurse spiritual care practices at the end of life: A systematic review

Abstract

Objectives The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients. Methods A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses’ spiritual/existential care practices toward adult end-of-life patients. Results The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions and goals, and environmental context and resources. Significance of results A range of personal, organizational, and patient-related factors influence nurse provision of spiritual/existential care to end-of-life patients. This complete list of factors can be used to gauge a unit's conduciveness to nurse provision of spiritual/existential care and can be used as inputs to nurse competency frameworks.

Nurse Spiritual Care Therapeutics Scale

“…Several literature reviews are available as there is a growing body of evidence about spiritual care within palliative and end-of-life contexts 10,17-20 . Batstone and colleagues' 18 synthesis of nursing research (1 of 11 studies were about palliative care nurses) is especially relevant.…”

“…Although nurses often accept that spiritual care is beneficial, they often describe it as a challenging aspect of care requiring considerable caution and sensitivity. [10][11][12] Nursing textbooks and literature provide descriptions of various spiritual care interventions or practices-or therapeutics. 13 An integrative review of 59 empirical and philosophical articles in the nursing literature synthesized the attributes of nurse-provided spiritual care.…”

“…8 However, findings from several surveys indicate that according to patients and nurses, these spiritual care practices are infrequent. 10,14 For example, in a study of Bostonian nurses (n = 114) providing care for persons with incurable cancer, nurses were asked whether they provided 8 different spiritual care interventions to their previous 3 patients. Depending on the intervention, these nurses reported providing it between 1% and 8% of the time.…”

“…Nurses reported that barriers to spiritual care include lack of time, privacy, competence, training, fear of proselytizing, and uncertainty regarding the nurse's role in providing spiritual care. 10,14,15 In general, nurses accept the spiritual care generalist role. 7 The importance of this role, however, may be more substantially valued among nurses (and other health care providers) providing palliative or hospice care.…”

“…1,2 Several literature reviews are available as there is a growing body of evidence about spiritual care within palliative and end-of-life contexts. 10,[17][18][19][20] Batstone and colleagues' 18 synthesis of nursing research (1 of 11 studies were about palliative care nurses) is especially relevant. They categorized findings from their review as threefold support: that of the spirit (ie, nurses' holistic lens), soul (ie, spiritual care occurring within the patient-nurse relationship), and body (ie, tangible ways to offer spiritual care).…”