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- Translation and adaptation of the Spirituality and Spiritual Care Rating Scale in portuguese palliative care nursesPublication . Martins, Andreia Raquel; Pinto, Sara; Caldeira, Sílvia; Pimentel, FranciscoTheoretical framework: The knowledge on spirituality in Nursing has increased in Portugal, but there is still low evidence on the nurses’ perception of this dimension of care, as well as limited instruments in portuguese which allow measuring related phenomena. The Spirituality and Spiritual Care Rating Scale (SSCRS) allows assessing the nurses’ perception of spirituality and spiritual care. Objectives: To translate, adapt and validate the SSCRS into portuguese in a sample of portuguese palliative care nurses. Methodology: Methodological study using a sample composed of 94 palliative care nurses. Results: The original structure of the 17-item scale was maintained during the scale validation process. A Cronbach’s alpha between 0.59 and 0.69 in the subscales and 0.76 in the total scale was obtained. These values are indicators of the scale’s reasonable reliability to be used in the population under study. Conclusion: The portuguese version of the SSCRS proved to be a reliable scale with content validity to assess the nurses’ perception of spirituality and spiritual care.
- Depression and spiritual distress in adult palliative patients: a cross-sectional studyPublication . Velosa, Teresa; Caldeira, Sílvia; Capelas, Manuel LuísPalliative care patients have been associated with a high probability of having depression and spiritual distress. However, there is a gap in research about the clinical indicators that can promote an effective differential diagnosis of depression and spiritual distress. This study aimed to identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care. An observational and cross-sectional study was conducted in 2016 in a Portuguese primary care unit. From a General Practitioners patients’ file of 1457 adult patients, a sample of 30 palliative patients was recruited throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp12) scales, which were sealed in opaque envelopes. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. The prevalence of depression was 23% (n = 7), while the prevalence of spiritual distress was 23% (n = 7). Four patients (13%) fulfilled both the depression and the spiritual distress criteria. Depression and spiritual distress seem to be both linked to the spiritual dimensions of the human being, but seem to differ in the dimensions of suffering and pharmacologic treatment.
- Spirituality in nursing: an overview of research methodsPublication . Martins, Helga; Romeiro, Joana; Caldeira, SílviaSpirituality has been widely considered important for patients’ health and for healthcare practice and is related to connectedness, meaning in life, and transcendence. Research concerning spirituality is growing rapidly, and the implementation of spiritual care should be based on evidence. This literature review aims to describe the methods that have been used in nursing research focusing on spirituality. The electronic search on databases through EBSCOhost identified 2091 citations, and a total of 231 studies were included. The methods used in research on spirituality in nursing are mostly quantitative (52.4%), but some are qualitative (42.8%) and mixed (4.8%). Regarding the quantitative research, most studies are observational (90.9%), and these are mainly descriptive (82.7%) and correlational (17.3%). Most studies used a cross-sectional design (98.7%), and few used longitudinal design (1.3%). The qualitative research is descriptive (39.4%), phenomenological (26.3%), and grounded theory (14.1%). Research on spirituality in nursing is based on both main paradigms (quantitative and qualitative), but also on mixed methods. Studies have mainly been conducted using cross-sectional designs when compared to longitudinal designs. The latter seem to constitute a gap in nursing knowledge and evidence regarding the changes of spirituality over time, which is particularly important for nurses’ delivery of spiritual care.
- Nursing diagnosis of ‘‘spiritual distress’’ in women with breast cancer prevalence and major defining characteristicsPublication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília de; Vieira, MargaridaBackground: Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. Objective: The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis ‘‘spiritual distress,’’ as classified according to NANDA International, among women with breast cancer. Methods: This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring’s clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. Results: A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. Conclusions: The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse’s role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. Implications for Practice: The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.
- A systematic literature review toward the characterization of comfortPublication . Pinto, Sara; Caldeira, Sílvia; Martins, José CarlosComfort integrates the taxonomies and the classifications of nursing knowledge. Its meaning is not yet clear, although it is an important construct from which theories are developed. This article aims to analyze comfort in nursing scientific literature. The results highlight a particular interest in comfort at crisis situations such as illness, palliative care, or intensive care. Comforting seems to be a complex intervention. More studies are needed to achieve its operational assimilation and implementation in clinical practice, as well as the evaluation of its efficiency and effectiveness.
- Spiritual care: the nurses’ experiences in the pediatric intensive care unitPublication . Nascimento, Lucila C.; Alvarenga, Wylliane A.; Caldeira, Sílvia; Mica, Tâmisa M.; Oliveira, Fabiane C. S.; Pan, Raquel; Santos, Tabatha F. M.; Carvalho, Emília C.; Vieira, MargaridaPhysical aspects of disease management are often more evident than those related to spirituality or spiritual care. Spirituality may appear more crucial in pediatric intensive care units (PICUs) when patients are experiencing serious illness or end-of-life situations. This paper describes the meaning of spirituality according to nurses who had worked in PICUs and how they provide spiritual care to children and their families. It is an exploratory research using a qualitative approach, including interviews with eleven PICU nurses. Data were analyzed using thematic analysis; two themes were identified: meanings of spirituality and religiosity according to nurses, and the provision of spiritual care to children in the PICU and their families. The interviewed nurses recognized the importance and value of spiritual care and are aware that spiritual needs are considered to be of significantly less importance than physical treatments. Spiritual care was mainly focused on the children’s families; the nurses justified the absence of spiritual care to children, based on lack of time and children’s age and level of consciousness. These results highlight a deficiency in spiritual care in PICUs and demonstrate the need for improved knowledge and demonstrate the need to not only raise awareness of the spiritual dimension of children, adolescents, and their families, but also to enhance discussion and improve general knowledge on the importance of spirituality in the treatment regimen to provide effective holistic care.
- The effect of prayer on patients’ health: systematic literature reviewPublication . Simão, Talita Prado; Caldeira, Sílvia; Carvalho, Emilia Campos deAbstract: There is increasing interest regarding prayer in healthcare. Prayer is an activity related to spirituality and religion. Positive outcomes have been identified regarding spirituality in health. This study aims to investigate the effects on patients’ health of using prayer. A systematic literature review was conducted in May 2015 and updated in November 2015. Electronic and international databases were searched and the inclusion criteria were based on PICOS: (Population) patients of any age and any clinical situation, (Intervention) all types of prayer, (Comparison) ordinary care, (Outcomes) any health change, (Study type) randomized clinical trials. Neither timeframe nor limitation in language were considered. A total of 92 papers were identified and 12 were included in the review. Prayer was considered a positive factor in seven studies, and several positive effects of prayer on health were identified: reducing the anxiety of mothers of children with cancer; reducing the level of concern of the participants who believe in a solution to their problem; and providing for the improved physical functioning of patients who believe in prayer. Prayer is a non-pharmacological intervention and resource, and should be included in the nursing holistic care aimed at patients’ well-being.
- PO04 – Metasynthesis approach in paediatric nursing literature: a scoping reviewPublication . Romeiro, Joana; Caldeira, SílviaIntroduction: Metasynthesis is defined as the synthesis of qualitative research. Despite the growing interest in this approach in adult nursing literature, it is not clear how it has been used in paediatric nursing literature. Aims: To characterize the scientific production using metasynthesis in paediatric nursing literature. Methods: A scoping review was conducted across eight international databases and three Portuguese nursing web journals. Results: A total of 25 papers were included. First was published in 1998, most frequents phenomena were parenting and experiences of parents in several health contexts. Metasynthesis (n=10) and meta-meta-ethnography (n=8) were most frequent. Noblit and Hare (1988) framework was most cited and sample ranged from 3 to 47 original studies. Discussion: Metasynthesis research is providing evidence to nursing practice mostly in neonatal and intensive care regarding parenting. Conclusions: Metasynthesis is being use in paediatric nursing, but in specific contexts and phenomena. Other qualitative research should be analyzed toward metasynthesis.
- Effect of the “spiritual support” intervention on spirituality and the clinical parameters of women who have undergone mastectomy: a pilot studyPublication . Guilherme, Caroline; Ribeiro, Gabriela Roberta; Caldeira, Sílvia; Zamarioli, Cristina Mara; Oliveira-Kumakura, Ana Railka de Souza; Almeida, Ana Maria; Carvalho, Emília Campos deThis study aimed to evaluate the effect of the spiritual support intervention on spirituality and the clinical parameters of women who have undergone mastectomy. This is a pilot study of a randomized clinical trial. The spiritual support intervention was composed of meditation, guided imagery, music, and respiratory relaxation. The outcomes were: spirituality, blood pressure, heart rate, and oxygen saturation. A total of 27 patients were recruited for the study (intervention group, n = 13; control group, n = 14) (Clinical Trials: NCT 01866670/CAE: 00896312.0.0000.5393). The intervention helped patients with breast cancer to increase expression of their spirituality (p = 0.040) and it also decreased heart rate on the first (p = 0.038) and third day (p = 0.017). There was a difference in oxygen saturation on the second day in the control group (p = 0.039). Patients reported that their participation in the research was positive. This intervention had an effect on the sample of women who had undergone mastectomy.
- Users of the Public Bathhouse of Alcântara: health profile diagnosisPublication . Figueiredo, Amélia Simões; Resende, Ana; Ferrito, Cândida; Rabiais, Isabel; Caldeira, SílviaBackground: The community outreach project of the Universidade Católica Portuguesa, which involves the public bathhouse of Alcântara, started out of the need to identify its users. Objectives: To characterize the users’ socio-demographic and health profile and describe their use of social and health resources. Methodology: A cross-sectional descriptive study, of quantitative nature, was conducted with the application of a questionnaire to a sample of 145 participants. Results: The typical user is male, single, aged 25-35 years and lives alone (21%). This user goes to the public bathhouse two to three times per week. Most of the users (58.3%) have no bathroom, 29.7% are homeless, 35.2% are not registered in any health care center, and 24.8% have mental disorders. Conclusion: The typical bathhouse user is of working age, was born in Lisbon and in the Portuguese-speaking African Countries, and has no source of income. The main reasons leading to the use of the public bathhouse are the economic difficulties, the homeless condition, and the lack of sanitary conditions.