In July 1993, the Scottish Highlands Centre for Human Caring sponsored a conference with the title Exploring the Spirituality in Caring. The papers given at the conference and included in this volume are offered as a contribution to the debate that must take place in nursing and in the wider context of health care provision. Ann Bradshaw's paper puts the debate in context arguing that nursing is fundamentally a loving response to the human being created in the image of (...) God. (shrink)

Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed (...) as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care. (shrink)

McGovern, Kevin The Catholic bishops of England and Wales have issued a guide to the spiritual care of the dying person. It reminds us that spiritual care is an essential part of holistic palliative care, and that every health professional has a role to play in the provision of spiritual care.

Dying patients have more than medical needs. In fact, what they feel most sharply, whether or not they are religious, are spiritual concerns. The Christian theological virtues of faith, hope, and charity, properly interpreted and translated to reflect the universal concerns with which they are connected, provide a starting point.

Ars moriendi, or The Art of Dying, was a highly influential fifteenth-century text designed to guide dying persons and their loved ones in Catholic religious practices at a time when access to priests and the sacraments was limited. Given recent challenges related to the coronavirus pandemic, there is a heightened need to offer additional forms of guidance related to death and dying. This essay examines the content of the Ars moriendi and considers how key principles from the work apply to (...) the current context. The Ars moriendi, in its direct approach to the salvation of souls and thoughtful treatment of struggles faced by dying persons, offers a much-needed supplement to typical approaches to death and dying today. (shrink)

In the last two decades, studies on the relationship between spirituality and health have grown significantly in the International literature. In Brazil, the debate on this subject has reached greater visibility since 2009, mainly in the health sciences, with the appearance of the term "spiritual care". In theology, studies on spiritual care in the health care context are still scarce. This paper aims to contribute to the broadening of this reflection. Firstly, spiritual care (...) is approached from scientific publications in Portuguese language. Second, the interdisciplinary spiritual care model is presented as a holistic approach to patient care and consequences of applying a spiritual care model are outlined. The newly defined role of the hospital chaplains, pastoral counselors and spiritual caregivers is also discussed. As a conclusion, the paper mentions the main challenges going along with interdisciplinary spiritual care, especially those concerning the training of health care professionals. (shrink)

H. Tristram Engelhardt, Jr.; Generic Chaplaincy: Providing Spiritual Care in a Post-Christian Age, Christian bioethics: Non-Ecumenical Studies in Medical Morali.

Spiritual care is a profession in transformation. It is evolving from a denominationally bound profession into a specific kind of healthcare profession. In the Netherlands, as elsewhere, debates are going on about the introduction of standards in public services such as health care. Many spiritual counsellors oppose standardization of spiritual care. Most importantly, standards seem to conflict with their sanctuary position as well as with the ?theory of presence? that many spiritual counsellors adhere (...) to. A questionnaire was distributed among spiritual counsellors asking them about the nature and number of standards they work with and the positive and negative effects of these standards on their daily work. This exploratory study shows that only a few spiritual counsellors work with standards. It also reveals that those who work with standards are neutral to positive about the ways in which standards influence their work. In particular, spiritual counsellors working with standards state that doing so does not conflict with their sanctuary position, nor with their ?being present?. The responses suggest that it does not seem to be standards as such but rather the social setting within which the standards are used that determines the effects that standards have on the content and quality of spiritual care. The paper concludes with some recommendations and suggestions for further investigation. (shrink)

abstract: Despite the maturing and formalizing of Buddhist-Christian studies as an academic discipline, its practical and pastoral implications are insufficiently addressed. Most of the practical literature to date addresses spiritual care, broadly conceived, within a narrow range of sources and theories. This scoping study identifies three primary resources offered to providers of spiritual care by scholars of Buddhist-Christian studies: an expanded theoretical base for assessment and interpretation, practices for caregiver formation and cultivation, and guidance for (...) class='Hi'>care with spiritually fluid people. Scholars of Buddhist-Christian studies could make at least four additional contributions to chaplaincy and spiritual care: a revised telos of care, attention to care as a site of spiritual practice, criteria for salutogenic spiritualities, and refined practices for interreligious and postcolonializing care. These potential contributions require the discipline to carefully consider methodological issues and broaden its range of sources. (shrink)

The interdisciplinary book series Studies in Spiritual Care (SCC) publishes international research ranging from studies on specific aspects of Spiritual Care to programmatic contributions to the self-understanding of this new practice and research area. The series is of interest to professionals working in the field as well as to students, researchers, and scholars from the fields of medicine, pastoral care, psychotherapy, and social work.

In German-speaking countries the term spiritual care becomes more and more popular, not only in the realm of palliative care but also amongst pastoral care takers. In this article I argue that favouring of the term 'spiritual care' is not only a tribute to the changing situation in German-speaking countries, but also a way pastoral care takers want to deal with the challenges they face in a secular, multicultural society. I will discuss whether (...) the use of the term 'spiritual care' is a way to 'lower the profile' of pastoral care and trying to be less explicit about the institution the pastors represent and the worldview they hold. This might look like an easy escape but does not foster the interaction in a multi-cultural space. (shrink)

The problem for many troubled youths seeking help within a Christian context is that their need for meaningful connections and spiritual growth is attached to relationships with their significant others. When needs of attachment are not adequately met due to the effect of an insecure attachment working model in a relationship with God, the teen may end up leaving the faith community seeking a new caregiver or regress into spiritual struggles, depression, anxiety, self-doubt and other negative emotions. This (...) paper responds to the issues associated with youth attachment behaviour towards God using a caregiving theology that draws on the 'power of two' through incarnational creativity and pneumatological ecclesiology. This proposed theology first supplements the work of the pastoral counsellor to create a transformative container through which young people, already within a redemptive Christian community, can grow spiritually and deepen their relationship with God. Secondly, pastoral juxtaposition targeting the spiritual needs of hurting youths serves to create a magnet space within the church community that models incarnational love, pastoral care and support for young people by entering their world order to reframe their personal stories of grief, abandonment and insecurity through creative means. Finally, we theologise that pastoral juxtaposition also integrates the power of the Holy Spirit, as the ultimate caregiver in times of conflict, into each youth's unique journey of faith and healing. Implications of this pastoral theology are discussed and applied to everyday life. (shrink)

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. (shrink)

On ancient maps unexplored lands were simply labeled ‘there be dragons’ indicating the fear that attends the unknown. Despite three decades of theoretical and empirical work on spirituality in nursing, evidence still suggests that nurses do not feel competent to engage in spiritual care. In this paper I propose that one of the reasons for this is a theory–theory gap between religion and spirituality. Generalized anxiety about the role of religion in society has led to under‐theorizing in nursing (...) about religious care. As a result, when religion and spirituality overlap at the point of care, nurses are left without the substantive knowledge required for practice. Robust religious theorizing should include thick accounts of lived religion and integrative work that enables nurses to understand commonalities across religions that are relevant to practice. As a starting point to this integrative work, nurses can be introduced to the nature and lexicon of lived religion, religious perspectives on suffering, and religious reasoning that holds meaning and mystery in tension. Such an approach will better prepare them for the realities of practice where the complexities of spirituality and religion come to play. (shrink)

Peter Kevern believes that the cognitive science of religion (CSR) provides a justification for the idea of spiritual care in the health services. In this paper, I suggest that he is mistaken on two counts. First, CSR does not entail the conclusions Kevern wants to draw. His treatment of it consists largely of nonsequiturs. I show this by presenting an account of CSR, and then explaining why Kevern's reasons for thinking it rescues ‘spirituality’ discourse do not work. Second, (...) the debate about spirituality‐in‐health is about classification: what shall count as a ‘spiritual need’ and what shall count as ‘spiritual care’. It is about the politics of meaning, an exercise in persuasive definition. The function of ‘spirituality’ talk in health care is to change the denotation of ‘spiritual’, and attach its indelibly religious connotations to as many health‐related concepts and practices as possible. CSR, however plausible it may be as a theory of the origins and pervasiveness of religious belief, is irrelevant to this debate. (shrink)

Increasing attention is being paid to spirituality in nursing practice. Much of the literature on spiritual care uses the nursing process to describe this aspect of care. However, the use of the nursing process in the area of spirituality may be problematic, depending upon the understandings of the nature and intent of this process. Is it primarily a descriptive process meant to make visible the nursing actions to provide spiritual support, or is it a prescriptive process (...) meant to guide nursing actions for intervening in the spirituality of patients? A prescriptive nursing process approach implies influencing, and in some cases reframing, the spirituality of patients and thereby extends beyond general notions of spiritual support. In this paper we discuss four problematic assumptions that form the basis for a prescriptive approach to spiritual care. We conclude that this approach extends the nursing role beyond appropriate professional boundaries, making it ethically problematic. (shrink)

Background:The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings.Objectives:This study aimed to evaluate Iranian nurses’ perceived professional competence in spiritual care, the relationship between perceived competence and nurses’ personal characteristics, and barriers to provide spiritual care.Research design:A cross-sectional study was conducted in the year 2014.Participants and research context:The study population consisted of nurses working in teaching hospitals in Kashan (...) city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses’ competencies in spiritual care.Ethical considerations:A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent.Results:Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses’ overall score of competence in spiritual care and receiving training on spiritual care, nurses’ position, and the ward they worked in.Discussion:Confirming the findings of the international literature, this study puts light on the situation of nurses’ perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context.Conclusion:Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care. (shrink)

Quantitative studies have assessed nurses’ attitudes toward and frequency of spiritual care [SC] and which factors are of influence on this attitude and frequency. However, we had doubts about the construct validity of the scales used in these studies. Our objective was to evaluate scales measuring nursing SC. Articles about the development and psychometric evaluation of SC scales have been identified, using, Web of Science, and CINAHL, and evaluated with respect to the psychometric properties and item content of (...) the scales. Item content was evaluated by each of the five authors with respect to the following questions: Does the item (1) reflect a general opinion about SC instead of a personal willingness to offer SC; (2) reflect general psychosocial care instead of specific SC; (3) focus solely on religious care; (4) contain the words ‘spiritual’ (care/needs/health/strengths, etc.); and (5) contain multiple propositions, or have an unclear meaning? We found eight scales. Psychometric analysis of these scales was often meager and the items of all but one scale suffered from two or more of the five problems described above. This leads us to conclude that many quantitative results in this area are based on findings with questionable scales. Suggestions for improvements are provided. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare personnel (...) working in mental health institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Deep Listening and Virtuous Friendship:Spiritual Care in the Context of Religious MultiplicityDuane R. BidwellA monk asked Zen master Yunmen: “What is the teaching of the Buddha’s entire lifetime?” Yunmen answered:“An appropriate response.”1In a pivotal scene from the 1988 film A Fish Called Wanda, con artist Wanda Gershwitz is fed up—finally—with her partner, Otto West. When his jealousy and ersatz intellectualism repeatedly jeopardize their attempts to steal $20 (...) million in diamonds, Wanda yells: “Now let me correct you on a few things, okay? Aristotle was not Belgian. The central message of Buddhism is not ‘Every Man for Himself.’ And the London Underground is not a political movement. Those are all mistakes, Otto, I looked them up.”2 It’s a funny moment, of course. But Otto’s (mis)understanding of Gautama’s teaching demonstrates a challenge in translating a spiritual-religious tradition from one cultural setting to another. Too often, and usually without intention, we are like Otto; we colonize and domesticate unfamiliar ideas, assimilating them into our existing worldview instead of experiencing and accommodating their challenging differences. Otto’s facile appropriation of Buddhism confirms rather than confronts his pre-critical, individualistic, and perhaps Darwinist worldview. A Buddhist caregiver might say that Otto was not “listening deeply” to the myriad voices that shaped his perspective.Similar hazards face someone writing about deep listening in relation to religious multiplicity.3 Deep listening, as a caring practice, “belongs” to the emerging field of Buddhist contemplative care,4 in which it has a technical (although perhaps undertheorized) usage richly informed by Buddhist thought and practice. But when I reflect as a pastoral theologian and spiritual caregiver trained in the Christian traditions of cura animarum, the cure or care of souls, deep listening can become unmoored from its origins. Someone marinated in the discourses and practices of Christian care can easily and perhaps unintentionally conflate deep listening with classic Christian [End Page 3] concepts of care such as the ministry of presence, the practice of unconditional positive regard,5 and the giving of oneself to God for the sake of the care seeker. Although I identify as a Buddhist Christian, habitual Christian views shape my thinking the way a canyon or streambed shapes the flow of water; unless I am attentive to the ways that Buddhist thought and practice seek fissures and carve new channels through the sediment of Christian spiritual care, I risk appropriating or erasing the practices that Buddhist caregivers call deep listening.Mindful of these waters, I want to immerse myself and readers in a particular question: In the context of spiritual care, what happens at the confluence of deep listening and a practitioner’s multiple religious voices? In responding to this question I have three aims: to describe deep listening, to provide a theoretical and experiential account of deep listening in the context of religious multiplicity, and to suggest an image from the Pāli canon that can help practitioners engage religious multiplicity in ways that minimize harm, increase compassion, and realize wisdom. A particular moment in spiritually integrative psychotherapy serves as a touchstone for my reflection; thus, I begin where the canyon creates a slender and fast-moving channel for deep listening: psychotherapy with Julie.6violence, karma, and compassionAt twenty-seven years of age, Julie was a soft-spoken, biracial graduate student who radiated mindful presence. She identifies as Asian American, and with her shaved head and tendency to wear dark colors and dramatic scarves, she might seem a typical LA hipster to other passengers on the commuter train she rode to and from our appointments. One year before our psychotherapeutic work, Julie had been beaten and raped by a boyfriend; subsequent thoughts of suicide led to a brief hospitalization. At that time she was assigned diagnoses of bipolar II and post-traumatic stress disorders. Daily, she swallowed a powerful mood stabilizer; monthly, she visited a psychiatrist. The symptoms of bipolar disorder, substance abuse, addiction, schizophrenia, depression, and suicide were present in her extended family. Julie sought counseling because of tension between what she called her “Buddhist identity” and the mental health diagnoses assigned to her. She said she... (shrink)

Readers have much to consider when evaluating Greenblum and Hubbard’s conclusion that ‘physicians have no business doing theology’.1 The two central arguments the authors offer are fairly convincing within the confines they set for themselves, the provisos they stipulate and their notions of ‘privacy’ and ‘public reason’. However, I would ask readers to consider two questions, the answers to which I believe the authors leave opaque. First, what is theological negotiation? Second, what makes chaplains the singular group of healthcare professionals (...) responsible for theological negotiation? In this Commentary, I explore these questions not with the goal of rejecting the authors’ conclusion, but rather with the goal of highlighting relevant considerations when evaluating the authors’ central tenets. First, I would like readers to consider Greenblum and Hubbard’s descriptions of theological negotiation. They categorise theological negotiation into metaphysical, normative and alternative responses, and hold that this kind of negotiation is, for the most part, impermissible for healthcare professionals, save chaplains.1 The examples of Dr Chatterjee and Dr Thompson expand theological negotiation to include instances where physicians add a theological veneer to their clinical recommendations. In both the examples, the physician has made the case for accepting or rejecting a certain intervention—for Dr Chatterjee, accepting …. (shrink)

Children themselves place a high value on their own spiritual care when in hospital. However, the spiritual care of children in hospital is often overlooked. Hospitalisation and medical procedures can be traumatic and overwhelming for children, they often see hospitalisation as punishment for something they did wrong and they can even experience spiritual distress during illness and suffering. The spiritual care of hospitalised children should thus be a priority to help these children making (...) sense of pain and suffering, and assisting them to connect with a loving and forgiving God. Spirituality namely influences a diverse range of human concerns such as beliefs about illness and health, fears, relationships with family and friends and the experience of pain and suffering. Unfortunately, children often harbour misconceptions precisely in these areas. This article will draw directly on the given that children are concrete thinkers, yet able to have an understanding of holiness and God as the Holy One, if they receive the right guidance. The study will explore children’s spirituality and the way in which they experience holiness in the healthcare environment from a nursing science perspective. (shrink)

O cuidado espiritual é considerado um aspecto intrínseco às boas práticas de cuidados paliativos. Contudo, este é um desafio a profissionais de saúde. Há carência de propostas cientificamente embasadas e não religiosas para identificar e atender as necessidades existenciais/espirituais de pacientes e familiares. Este artigo tem como objetivo apresentar uma ferramenta de cuidado espiritual denominada Modelo Diamante ou _Ars Moriendi_, desenvolvida por um pesquisador holandês que a concebeu a partir de elementos extraídos de sua pesquisa empírica. O modelo é teoricamente (...) baseado em estruturas antropológicas não morais e não religiosas e está aberto a pessoas de uma variedade de origens culturais e religiosas. Tanto capelães quanto equipes multidisciplinares podem usar essa ferramenta hermenêutica. Ela ajuda a melhor compreender e atender as necessidades espirituais de pacientes e familiares nas dimensões que envolvem autonomia, sofrimento, relacionamentos, questões pendentes e esperança. A apresentação do Modelo Diamante ao público brasileiro também é um convite para testá-lo e avaliá-lo em estudos futuros que investiguem a espiritualidade em cuidados paliativos no Brasil. (shrink)

Ethics, religion, and spirituality -- Spirituality in care -- Spirituality and ethics -- Love -- The community of care : fit for purpose -- Values, virtues, and the patient -- Challenging faith -- Spirituality and the domain of justice.

In this discussion paper we consider the influence of ethnicity, religiosity, spirituality and health literacy on Advance Care Planning for older people. Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of advance care planning by this group across a number of countries where advance care planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions. (...) Health literacy issues have been identified as one of the main reasons for a communication gaps between physicians and their patients in discussing end-of-life care, where poor health literacy, particularly specific difficulty with written and oral communication often limits their understanding of clinical terms such as diagnoses and prognoses. This then contributes to health inequalities given it impacts on their ability to use their moral agency to make appropriate decisions about end-of-life care and complete their Advance Care Plans. Currently, strategies to promote advance care planning seem to overlook engagement with religious communities. Consequently, policy makers, nurses, medical professions, social workers and even educators continue to shape advance care planning programmes within the context of a medical model. The ethical principle of justice is a useful approach to responding to inequities and to promote older peoples’ ability to enact moral agency in making such decisions. (shrink)

The practical aspect of ancient philosophy has been recently made a focus of renewed metaphilosophical investigation. After a brief presentation of three accounts of this kind developed by Martha Nussbaum, Pierre Hadot, and Michel Foucault, the model of the therapeutic argument developed by Nussbaum is called into question from the perspectives offered by her French colleagues, who emphasize spiritual exercise (Hadot) or the care of the self (Foucault). The ways in which the account of Nussbaum can be defended (...) are then discussed, including both a ‘negative’ defense, i.e. the indication of the weaknesses of Hadot and Foucault’s proposals, and a ‘positive’ one focused on the points in which Nussbaum can convincingly address doubts about her metaphilosophical account. In response to these analyses, some further remarks made by Hadot and Foucault are discussed in order to demonstrate that their accounts are not as distant from Nussbaum after all. Finally, a recent metaphilosophical study by John Sellars together with a therapeutic (medical) model developed by the author of the present article are suggested as providing a framework for potential reconciliation between all three accounts discussed and a resource for further metaphilosophical studies. (shrink)

Religiously affiliated colleges and universities typically take spiritual formation and soul care very seriously and are usually intentional about the spiritual and religious development of not only their students but of their faculty and staff as well. The religious tradition, size of the campus community, financial and other resources, along with the will of senior administrators, donors, trustees, and the general university community all determine how these interests and agendas are nurtured and developed as well as the (...) kinds of programing offered. The purpose of this article is to highlight the strategies to support and nurture spiritual formation and soul care at Santa Clara University, a Catholic and Jesuit university in the heart of Silicon Valley, with elements of this care found at most, if not all, Jesuit higher education institutions throughout the nation and world. At Santa Clara, the Ignatian Center is the primary, although not the only, home for these spiritual formation and soul care offerings and will be highlighted here. (shrink)

This article examines a model of formation within higher education that is committed to educationally based spiritual formation, desiring to see students formed as people who love God and neighbor, devoting their lives to redemptive labor in the world. Deeply influenced by the evolving relationship between the department, the institution, and the broader evangelical culture, the Christian Formation and Ministry department of Wheaton College seeks to equip students with the theological and theoretical foundation, the personal maturity of character and (...) faith, and the practical ministry skills necessary to lead and participate in the formational and caring mission of the church in the world. Wheaton College’s unique approach to teaching spiritual formation and soul care in both their undergraduate and graduate programs is examined through a historical context of the department, a liberal arts and learning-centered approach to education that includes biblical foundations, philosophical framework, pedagogy, and teaching curriculum and assessment. (shrink)