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  • Construction and evaluation of an educational video: nursing assessment and intervention of patients’ spiritual needs
    Publication . Rodrigues, Juliane Cristina; Miranda, Talita Prado Simão; Fulquini, Francine Lima; Guilherme, Caroline; Caldeira, Sílvia; Carvalho, Emilia Campos de
    Spirituality is particularly important in health and illness transitions and is a fundamental dimension of healthcare. However, nurses often feel underprepared to provide spiritual care and the use of dynamic and interactive strategies, such as educational videos, can facilitate the development of this competency in undergraduate education. This study aimed to construct and evaluate an educational video lasting 10 min and 52 s for nursing students concerning the assessment of patients’ spiritual needs. The methodological study was based on the pre-production, production, and post-production phases of the video with an evaluation of the comprehension and comprehensiveness of the content. The results demonstrated the pre-production phase was considered appropriate by the judges and allowed the phase of production of the educational video, considered an educational resource by 100% the experts. Nursing students were enrolled in the evaluation and 75% considered the content and the learning experience useful for their future roles as nurses. So, the educational video was considered a tool that facilitated deepening knowledge about spirituality and motivated students to assess spirituality in clinical practice.
  • Translation and adaptation of the Spirituality and Spiritual Care Rating Scale in portuguese palliative care nurses
    Publication . Martins, Andreia Raquel; Pinto, Sara; Caldeira, Sílvia; Pimentel, Francisco
    Theoretical 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 study
    Publication . Velosa, Teresa; Caldeira, Sílvia; Capelas, Manuel Luís
    Palliative 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 methods
    Publication . Martins, Helga; Romeiro, Joana; Caldeira, Sílvia
    Spirituality 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 characteristics
    Publication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília de; Vieira, Margarida
    Background: 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.
  • Spiritual care: the nurses’ experiences in the pediatric intensive care unit
    Publication . 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, Margarida
    Physical 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.
  • Effect of the “spiritual support” intervention on spirituality and the clinical parameters of women who have undergone mastectomy: a pilot study
    Publication . Guilherme, Caroline; Ribeiro, Gabriela Roberta; Caldeira, Sílvia; Zamarioli, Cristina Mara; Oliveira-Kumakura, Ana Railka de Souza; Almeida, Ana Maria; Carvalho, Emília Campos de
    This 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.
  • Spiritual needs of Brazilian children and adolescents with chronic illnesses: a thematic analysis
    Publication . Alvarenga, Willyane de Andrade; Machado, Júlia Rezende; Leite, Ana Carolina Andrade Biaggi; Caldeira, Sílvia; Vieira, Margarida; Rocha, Silvana Santiago da; Nascimento, Lucila Castanheira
    Purpose: To identify the spiritual needs of children and adolescents with chronic illnesses and how these needs are met by health professionals during hospitalization. Design and methods: A qualitative descriptive study was developed with 35 children and adolescents, between 7 and 18 years old, diagnosed with cancer, cystic fibrosis, and type 1 diabetes. Interviews with photo-elicitation were conducted during the hospitalization at a Brazilian public pediatric hospital. Findings were treated using thematic analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed for quality reporting. This research was approved by a research committee. Results: Two themes emerged. The first, entitled ‘Spiritual needs’, encompasses five types of needs: (1) need to integrate meaning and purpose in life; (2) need to sustain hope; (3) need for expression of faith and to follow religious practices; (4) need for comfort at the end of life; and (5) need to connect with family and friends. The second theme was the ‘Definition of spiritual care’. Conclusions: Children and adolescents with chronic illnesses have spiritual needs while in hospital. Meeting these needs is essential for finding meaning, purpose and hope in the experience of living with chronic illnesses and at the end of life, based on their faith, beliefs and interpersonal relationships. But, these needs have not been fully addressed during hospitalization. Practice implications: These results emphasize the need to implement spiritual care when caring for hospitalized pediatric patients, which includes addressing spiritual needs.
  • Spiritual distress: proposing a new definition and defining characteristics
    Publication . Caldeira, Sílvia; Carvalho, Emília Campos; Vieira, Margarida
    Objective To identify the definition and defining characteristics (DCs) of spiritual distress (00066). Method Integrative literature review. Results Thirty-seven articles and 35 DCs were identified. Spiritual distress as a response to health problems in the context of nursing care is different from an impaired ability to experience and integrate meaning in life. Conclusions The diagnosis misses some DCs that emerged from the literature review and lacks comprehensiveness. The domain and the class are reductionist toward its meaning. The taxonomy lacks a spiritual domain to include this and other diagnoses currently dispersed in other domains. Implications for Practice Further content and clinical validation is needed, as well as an assessment, to determine the diagnosis' class and domain.
  • De um novo paradigma na gestão dos enfermeiros: a espiritualidade no local de trabalho
    Publication . Caldeira, Sílvia; Calapez Gomes, Ana; Frederico, Manuela
    Contexto: A espiritualidade no local de trabalho é um tema emergente na área da gestão de recursos humanos, porém, com uma evidente escassez em enfermagem. Os enfermeiros trabalham em ambientes que favorecem a vivência espiritual e, também por isso, deverão ser cuidados pelos seus gestores como seres espirituais. Objectivos: Explorar e compreender a percepção dos enfermeiros acerca da espiritualidade no local de trabalho. Método: Aplicou-se um questionário contendo uma escala de avaliação da espiritualidade no local de trabalho (Rego, Cunha e Souto, 2007a). A amostra foi constituída por 40 enfermeiros a frequentar o curso de complemento de formação. Resultados: A espiritualidade no local de trabalho é percepcionada como “moderada” nas dimensões: sentido de comunidade na equipa, alinhamento do indivíduo com os valores da organização, alegria no trabalho e oportunidades para a vida interior, sendo “alta” na dimensão relacionada com “o sentido de préstimo à comunidade”. Conclusões: Embora de natureza exploratória, este estudo permitiu conhecer que este fenómeno é percebido pelos enfermeiros e, como tal, deverá ser atendido pelos gestores. A liderança espiritual poderá trazer mais criatividade, compromisso, comunicação e adopção de comportamentos éticos às equipas de enfermagem. Este estudo é um contributo para a continuação da investigação nesta área.