Subscales of the rating scale of spirituality and spiritual care 3.2.2 Scale of spirituality and religious attitude and practice. Differences between religion and spirituality Spirituality and rating scale of spiritual care 5.3.1 Importance of spirituality 5.3.2 Spiritual care. The main focus of the hospice movement in its early stages was the treatment of cancer patients, but over time HIV and AIDS became a greater threat to countries around the world.
Until recently, most patients cared for by healthcare professionals in hospices suffered from cancer. Therefore, it is important to understand hospice health professionals' perceptions of spirituality and spiritual care.
Context of the Study
Health care in the South African context
It is based on a model developed for the needs of cancer patients in the UK. Today, palliative care is an integral part of the treatment of people living with HIV and AIDS. The South African government has declared nurses to be the backbone of the health system (Democratic Nursing Organization of South Africa (DENOSA), 2005).
Meeting the patient's physical needs would become a priority over meeting their spiritual needs. It is therefore clear that religion is an important part of culture in South Africa.
The cultural context of spirituality
A South African study by Mahlungulu (2001) shows that the role of nurses in spiritual care is based on compassion for human suffering, pain and acceptance of the patient as a unique being. According to South African census statistics, almost 76% of South Africa's population is Christian, followed by Hindus, Muslims, Jews and Buddhists. Narayanasamy (1993) supports this idea and states that spirituality encompasses the needs of believers and non-believers; therefore, it is not limited to a religious context.
This author concludes that spiritual care can be most profound and effective when it is not tied to a particular belief system. With the emergence of the enormous HIV/AIDS epidemic affecting all sectors of South African society, it is imperative that research focusing primarily on palliative health workers working in a culturally diverse country receives greater priority and attention .
Personal importance of spirituality
According to Bassett (2002), spiritual care and caring are difficult concepts to define, but identifies these as being a vital, central and unifying core of healthcare. Puschalski's (1999) studies of spirituality and dying found it important for healthcare professionals to allow a moment of silence for prayer with the patient. There were different categories of health professionals within the palliative care setting to make up the sample, these will be explained later in this chapter.
The role of spirituality in the personal life of healthcare workers and its integration into their professional life. The manner in which spirituality and spiritual care are conceptualized and defined by hospice health professionals will have important implications for the nursing profession.
CHAPTER TWO
A more positive assessment of nurses' spiritual care focuses on nurses who work with the terminally ill, such as oncology care and hospice care. These particularities have been identified as special considerations in the provision of spiritual care (Grant et al., 2004). A review of the literature shows that there are few local studies that address issues of spirituality and spiritual care specifically in South Africa.
Two South African studies (Mahlungulu, 2001 & Bhagwan, 2002) focusing on spirituality, spiritual care and religion were conducted. Nurses' and health professionals' understanding of spirituality is important to understanding how nurses can provide effective spiritual care to the dying individual.
CHAPTER THREE
The SSCRS was tested for reliability and the 17-item SSCRS used in the study demonstrated adequate internal consistency reliability according to McSherry et al (2002). For example, I believe that spirituality is finding meaning in the good and bad events of life (McSherry et al., 2002). The five items measuring “spiritual care” appear to reflect central themes of spiritual care that have been identified in the literature.
This scale measures the relationship of spirituality to the physical and mental health of the individual and the well-being of the community. This scale measures the role of spirituality in the development of the respondent's professional identity. The questions in the semi-structured interview schedule were presented to the research participant in a sensitive and non-threatening manner.
The research participants had the right to participate in, refuse to participate in, or decline participation in the study. To determine if the questions were clear and if the nurses had difficulty understanding them. The selected nurses had agreed to participate in the study once they met the criteria set by the researcher for participation in the study.
A conversation was held with the nurses to get their opinion on the questions included in the questionnaire. Account was taken in terms of the inputs, observations and concerns given by the respondents. Times and dates were then assigned to the researcher depending on the schedule and availability of the nurses from the various hospices.
CHAPTER FOUR Results
Summary
In general, spirituality has been seen as the worship of a supernatural being who provides inner peace and meaning to life. Spiritual care, on the other hand, is about their interactions with the patient, treating the patient with dignity and respect. Study participants considered themselves spiritual and that spirituality was relevant in their personal lives.
When considering health professionals' perceptions of spirituality and spiritual care, religion could not be ignored, as the study participants interpreted religion and spirituality as closely related concepts.
CHAPTER FIVE
Spirituality and Religious Attitude and Practice Scale .1 Spirituality in professional health work
From the analysis of the Spirituality and Religious Attitude and Practice scale, it was clear that the respondents believed that the spiritual aspects were more important than the religious aspects. The overall results for the subscale examining the personal importance of spirituality showed that respondents generally felt that spirituality was essential in their daily lives. The integration of spirituality and professional practice, the need for education regarding spirituality and the relationship between spirituality and professional identity were not seen as separate issues by the respondents in this study.
The responses obtained showed that health professionals believed that integrating spirituality and professional practice was important, but felt that they lacked the skills to do so. The vast majority of participants had received little or no training in spirituality and spiritual care, and it is clear that there is a great need to educate hospice caregivers at the interface of spirituality and therapy. Narayanasamy (2006) found the impact of empirical studies of spirituality and culture on nursing education to be positive.
Therefore, Harding and Higginson (2005) emphasized the importance of the level of care and identified two levels: at the provider level and at the patient level. Because all hospices included in this study were faith-based, participants were aware of the desirability of integrating religion and religiously derived interventions into clinical practice. Hospice workers discovered that they could discriminate against patients who did not have the same religion as them.
The findings of this study indicate that hospice workers understood that there was a fundamental difference between spirituality and religion, but the concept of spirituality could not be clearly distinguished. Spirituality was found to be important in the respondents' personal lives, with spiritual aspects being more important than religious aspects. Hospice employees felt that connecting spirituality and professional practice was important and that spirituality played a key role in the development of their professional identity.
CHAPTER SIX
Recommendations, Limitations and Conclusions
Recommendations
A model developed by Bennett (1986) that could be used to create awareness of the wide diversity of cultures in the South African context is Bennett's model of intercultural sensitivity. recognizing the presence of diverse cultural differences within the individual's environment. The third stage, minimizing other cultures in order to protect one's own cultural identity, is for the individual to learn more about his own culture in order to place it in the context of society. The fourth stage, cultural acceptance, suggests that the individual must accept cultural issues and differences.
The fifth phase, Adaptation to cultural differences, the individual should be able to operate successfully within another culture. This is where the individual is armed with sufficient knowledge of their own and another culture. The final stage, Integration of Full Cultural Awareness in everyday interactions, the individual is able to move competently between the different cultures.
The sample from each hospice was not representative of the hospices, as not all individuals were willing to participate in the study. The majority of those who participated in this study were of the Christian faith, making it difficult to generalize how all healthcare professionals (regardless of their faith) incorporated spirituality and spiritual care into their professional and personal lives. Despite the above limitations, the present study provides useful insights into how healthcare professionals view spirituality and spiritual care and the role these factors play in both their personal and professional lives.
In conclusion, this study has shown that both nurses and healthcare providers understand that there is a difference between spirituality and religiosity, but the limitation they face on a daily basis is the lack of understanding of what these concepts mean. In the various hospices that participated in the study, there were professional nurses who were unwilling to participate and upon further investigation it was found that of those who refused to participate were not of the dominant religion (Christianity). The limitation of this study is therefore that it did not take into account the individuals who may have felt threatened when expressing their personal beliefs.
QUESTIONNAIRE
