Abstract
The increasing evidence that spirituality is a critical component for promoting health and well-being has made spirituality more significant to nursing practice. However, although nurses’ perceptions of spirituality have been studied in western countries, there has been little research on this topic in Southeast Asian countries where religions other than Christianity predominate. This study explores Malaysian nurses’ perceptions of spirituality and spiritual care and examines associations between socio-demographics and their perceptions. The Malaysian Nurse Forum Facebook closed group was used for data collection with 208 completed the online survey. The participants considered that spirituality is a fundamental aspect of nursing. Nonetheless, half of the respondents were uncertain regarding the use of the spiritual dimension for individuals with no religious affiliation. Significant differences were found between educational levels in mean scores for spirituality and spiritual care. There was also a positive relationship between perception of spirituality and spiritual care among the respondents. Despite the positive perceptions of nurses of spirituality in nursing care, the vast majority of nurses felt that they required more education and training relating to spiritual aspects of care, delivered within the appropriate cultural context.
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Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., et al. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of Pain and Symptom Management, 48(3), 400–410. https://doi.org/10.1016/j.jpainsymman.2013.09.020.
Baldacchino, D. R. (2006). Nursing competencies for spiritual care. Journal of Clinical Nursing, 15(7), 885–896. https://doi.org/10.1111/j.1365-2702.2006.01643.x.
Baldacchino, D. R. (2011). Teaching on spiritual care: The perceived impact on qualified nurses. Nurse Education in Practice, 11(1), 47–53. https://doi.org/10.1016/j.nepr.2010.06.008.
Belcher, A., & Griffiths, M. (2005). The spiritual care perspectives and practices of hospice nurses. Journal of Hospice & Palliative Nursing, 7(5), 271–279. https://doi.org/10.1097/00129191-200509000-00014.
Burkhardt, M., & Nagai-Jacobson, M. (2013). Spirituality and health. In B. Dossey & I. Keegen (Eds.), Holistic nursing: A handbook for practice (6th ed., Vol. 721–749). Jones & Bartlett: Burlington, MA.
Carr, T. J. (2010). Facing existential realities: Exploring barriers and challenges to spiritual nursing care. Qualitative Health Research, 20(10), 1379–1392. https://doi.org/10.1177/104973231037237.
Carson, V. B., & Stoll, R. (2008). Defining the indefinable and reviewing its place in nursing. In V. B. Carson & H. G. Koenig (Eds.), Spiritual dimension of nursing practice (pp. 3–32). West Conshohocken, Pennsylvania: Templeton Foundation Press.
Cetinkaya, B., Azak, A., & Dundar, S. (2013). Nurses’ perceptions of spirituality and spiritual care. Australian Journal of Advanced Nursing, 31(1). Retrieved from http://www.ajan.com.au/Vol31/Issue1/1Azak.pdf.
Chan, M. F. (2009). Factors affecting nursing staff in practising spiritual care. Journal of Clinical Nursing, 19(15–16), 2128–2136. https://doi.org/10.1111/j.1365-2702.2008.02690.
Chan, M. F., Chung, L. Y. F., Lee, A. S. C., Wong, W. K., Lee, G. S. C., Lau, C. Y., et al. (2006). Investigating spiritual care perceptions and practice patterns in Hong Kong nurses: Results of a cluster analysis. Nurse Education Today, 26(2), 139–150. https://doi.org/10.1016/j.nedt.2005.08.006.
Christensen, K. H., & Turner, D. S. (2008). Spiritual care perspectives of danish registered nurses. Journal of Holistic Nursing, 26(1), 7–14. https://doi.org/10.1177/0898010107301869.
Clarke, J. (2009). A critical view of how nursing has defined spirituality. Journal of Clinical Nursing, 18(12), 1666–1673. https://doi.org/10.1111/j.1365-2702.2008.02707.x.
Cooper, K. L., Chang, E., Sheehan, A., & Johnson, A. (2013). The impact of spiritual care education upon preparing undergraduate nursing students to provide spiritual care. Nurse Education Today, 33(9), 1057–1061. https://doi.org/10.1016/j.nedt.2012.04.005.
Ellis, H. K., & Narayanasamy, A. (2009). An investigation into the role of spirituality in nursing. British Journal of Nursing, 18(14), 886–890. https://doi.org/10.12968/bjon.2009.18.14.43358.
Friedman, L. C., Barber, C. R., Chang, J., Tham, Y. L., Kalidas, M., Rimawi, M. F., et al. (2010). Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting. Journal of Cancer Education, 25(3), 343–348. https://doi.org/10.1007/s13187-010-0048-3.
Gallison, B. S., Xu, Y., Jurgens, C. Y., & Boyle, S. M. (2013). Acute care nurses’ spiritual care practices. Journal of Holistic Nursing, 31(2), 95–103. https://doi.org/10.1177/0898010112464121.
Gebhardt, M. C. (2008). Rehabilitation nurses’ experiences providing spiritual care. Spirituality and Health International, 9(4), 230–240. https://doi.org/10.1002/shi.353.
Han, J., & Richardson, V. E. (2010). The relationship between depression and loneliness among homebound older persons: Does spirituality moderate this relationship? Journal of Religion & Spirituality in Social Work: Social Thought, 29(3), 218–236. https://doi.org/10.1080/15426432.2010.495610.
Haque, A., & Masuan, K. A. (2002). Perspective: Religious psychology in Malaysia. The International Journal for the Psychology of Religion, 12(4), 277–289. https://doi.org/10.1207/S15327582IJPR1204_05.
Hussey, T. (2009). Nursing and spirituality. Nursing Philosophy, 10(2), 71–80. https://doi.org/10.1111/j.1466-769X.2008.00387.x.
IndexMundi. (2014). Malaysia demographics profile 2014. Retrived from http://www.indexmundi.com/malaysia/demographics_profile.html.
Kasmo, M. A., Usman, A. H., Mohamad, Z., Yunos, N., & Wan Hassan, W. Z. (2015). Perception about God and religion within the Malaysian society. Mediterranean Journal of Social Sciences, 6(1), 246. https://doi.org/10.5901/mjss.2015.v6n1s1p246.
Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of Clinical Nursing, 23(21–22), 3197–3205. https://doi.org/10.1111/jocn.12566.
Koenig, L. B., & Vaillant, G. E. (2009). A prospective study of church attendance and health over the lifespan. Health Psychology, 28(1), 117–124. https://doi.org/10.1037/a0012984.
Löfmark, A., & Wikblad, K. (2001). Facilitating and obstructing factors for development of learning in clinical practice: A student perspective. Journal of Advanced Nursing, 34(1), 43–50. https://doi.org/10.1046/j.1365-2648.2001.3411739.x.
Lundberg, P. C., & Kerdonfag, P. (2010). Spiritual care provided by Thai nurses in intensive care units. Journal of Clinical Nursing, 19(7–8), 1121–1128. https://doi.org/10.1111/j.1365-2702.2009.03072.x.
McSherry, W., & Cash, K. (2004). The language of spirituality: An emerging taxonomy. International Journal of Nursing Studies, 41(2), 151–161. https://doi.org/10.1016/S0020-7489(03)00114-7.
McSherry, W., Draper, P., & Kendrick, D. (2002). The construct validity of a rating scale designed to assess spirituality and spiritual care. International Journal of Nursing Studies, 39(7), 723–734. https://doi.org/10.1016/S0020-7489(02)00014-7.
McSherry, W., & Jamieson, S. (2011). An online survey of nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(11–12), 1757–1767. https://doi.org/10.1111/j.1365-2702.2010.03547.x.
McSherry, W., & Jamieson, S. (2013). The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 22(21–22), 3170–3182. https://doi.org/10.1111/jocn.12411.
Mitchell, M., & Hall, J. (2007). Teaching spirituality to student midwives: A creative approach. Nurse Education in Practice, 7(6), 416–424. https://doi.org/10.1016/j.nepr.2007.02.007.
Molzahn, A. E., & Sheilds, L.(2008). Why is it so hard to talk about Spirituality? The Canadian Nurse, 104(1), 25–29. Retrived from http://www.ncbi.nlm.nih.gov/pubmed/18286982.
O’Shea, E. R., Wallace, M., Griffin, M. Q., & Fitzpatrick, J. J. (2011). The effect of an educational session on pediatric nurses’ perspectives toward providing spiritual care. Journal of Pediatric Nursing, 26(1), 34–43. https://doi.org/10.1016/j.pedn.2009.07.009.
Ozbasaran, F., Ergul, S., Temel, A. B., Aslan, G. G., & Coban, A. (2011). Turkish nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(21–22), 3102–3110. https://doi.org/10.1111/j.1365-2702.2011.03778.x.
Penman, J., Oliver, M., & Harrington, A. (2009). Spirituality and spiritual engagement as perceived by palliative care clients and caregivers. Australian Journal of Advanced Nursing, 26, 29–35. Retrieved from: http://www.ajan.com.au/Vol26/26-4_Penman.pdf.
Pinto, S., March, P. D., & Pravikoff, D. (2008). Spiritual needs of hospitalised patients (Evidence-based care sheet). Retrieved from https://commons.wvc.edu/mwolcott/nurs100/Document%20Library/The%20Spiritual%20Needs%20of%20Hospitalized%20Patients.pdf.
Plotnikoff, G. (2007). Integrating spiritual assessment and care. In D. Rakel (Ed.), Integrative medicine (2nd ed., pp. 1171–1175). Toronto, Ontario: Canada Saunders.
Pope, M., Musa, M., Singaravelu, H., Bringaze, T., & Russell, M. (2002). From colonialism to ultranationalism: History and development of career counseling in Malaysia. The Career Development Quarterly, 50(3), 264–276. https://doi.org/10.1002/j.2161-0045.2002.tb00902.x.
Raosoft. (2004). Sample size calculator. From http://www.raosoft.com/samplesize.html.
Rassool, G. H. (2000). The crescent and Islam: Healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. Journal of Advanced Nursing, 32(6), 1476–1484. https://doi.org/10.1046/j.1365-2648.2000.01614.x.
Ronaldson, S., Hayes, L., Aggar, C., Green, J., & Carey, M. (2012). Spirituality and spiritual caring: Nurses’ perspectives and practice in palliative and acute care environments. Journal of Clinical Nursing, 21(15–16), 2126–2135. https://doi.org/10.1111/j.1365-2702.2012.04180.x.
Ross, L., van Leeuwen, R., Baldacchino, D., Giske, T., McSherry, W., Narayanasamy, A., et al. (2014). Student nurses perceptions of spirituality and competence in delivering spiritual care: A European pilot study. Nurse Education Today, 34(5), 697–702. https://doi.org/10.1016/j.nedt.2013.09.014.
Sachedina, A. (2012). Islam. In M. Cobb, C. M. Puchalski, & B. Rumbold (Eds.), Oxford textbook of spirituality in healthcare practice. New York: Oxford University Press.
Tavakol, S., Dennick, R., & Tavakol, M. (2011). Psychometric properties and confirmatory factor analysis of the Jefferson scale of physician empathy. BMC Medical Education, 11, 54. https://doi.org/10.1186/1472-6920-11-54.
Tiew, L. H., Creedy, D. K., & Chan, M. F. (2013). Student nurses’ perspectives of spirituality and spiritual care. Nurse Education Today, 33(6), 574–579. https://doi.org/10.1016/j.nedt.2012.06.007.
Tiew, L. H., & Drury, V. (2012). Singapore nursing students’ perceptions and attitudes about spirituality and spiritual care in practice: A qualitative study. Journal of Holistic Nursing, 30(3), 160–169. https://doi.org/10.1177/0898010111435948.
Timmins, F. (2014). Spiritual dimensions of care: Developing an educational package for hospital nurses in the republic of ireland. Holistic Nursing Practice, 28(2), 106–123. https://doi.org/10.1097/HNP.0000000000000015.
Timmins, F., Murphy, M., Neill, F., Begley, T., & Sheaf, G. (2015). An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks. Nurse Education Today, 35(1), 277–282. https://doi.org/10.1016/j.nedt.2014.05.008.
Welch, J. L., Jeffries, P. R., Lyon, B. L., Boland, P, D. L., & Backer, J. H. (2001). Experiential learning: integrating theory and research into practice. Nurse Educator, 26(5), 240–243. Retrieved from http://journals.lww.com/nurseeducatoronline/Abstract/2001/09000/Experiential_Learning__Integrating_Theory_and.14.aspx.
Wong, K. F., Lee, L. Y. K., & Lee, J. K. L. (2008). Hong Kong enrolled nurses’ perceptions of spirituality and spiritual care. International Nursing Review, 55(3), 333–340. https://doi.org/10.1111/j.1466-7657.2008.00619.x.
Wu, L.-F., & Lin, L.-Y. (2011). Exploration of clinical nurses’ perceptions of spirituality and spiritual care. Journal of Nursing Research, 19(4), 250–256. https://doi.org/10.1097/JNR.0b013e318236cf78.
Young, C., & Koopsen, C. (2011). Spirituality, health, and healing: An integrative approach. Sudbury, Massachusetts: Jones and Bartle.
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The study was approved by the Monash University Human Research Ethics Committee (MUHREC) under the category of low-risk studies (Project Number: CF15/857-2015000383). Participation in this online survey was fully voluntary and anonymous with no explicit incentives provided for participation. Implied consent was applied for this study, in which the submission of the online survey indicated the participant’s consent to take part in the study. Participants were allowed not to answer any part of the survey without penalty. However, it was not possible to withdraw data, as the data provided by particular participants could not be identified once the online survey was submitted.
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Atarhim, M.A., Lee, S. & Copnell, B. An Exploratory Study of Spirituality and Spiritual Care Among Malaysian Nurses. J Relig Health 58, 180–194 (2019). https://doi.org/10.1007/s10943-018-0624-0
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DOI: https://doi.org/10.1007/s10943-018-0624-0