Research Article, J Nurs Patient Care Vol: 2 Issue: 1
Exploring the Definition of Spirituality from BSN Students in Taiwan
Ya-Lie Ku*, Wen-Jane Cheng and Wan-Ping Yang
Department of Nursing, Fooyin University, Taiwan
*Corresponding Author : Ya-Lie Ku
Associate Professor, Department of Nursing, Fooyin University, No.151, Chin-Hsueh Rd, Ta-Liao District, Kaohsiung City 83102, Taiwan
E-mail: [email protected]
Received: March 22, 2017 Accepted: April 17, 2017 Published: April 14, 2017
Citation: Ku Y, Cheng W, Yang W (2017) Exploring the Definition of Spirituality from BSN Students in Taiwan. J Nurs Patient Care 2:1.doi: 10.4172/2573-4571.1000112
Because a nurse’s structured spiritual care may be different from that of a nursing student, the motivation of this study was to explore the definition of spirituality from the BSN students. This narrative study was supported by National Research Grant (MOST 103-2511-S-242 -001) with IRB approving by number FYH-IRB- 103-08-02 and conducted a teaching model of a spiritual nursing course for BSN program from August, 2014 to July, 2015. For BSN program, 36 nursing students would like to sign the consent form with 64.2% participating in the study out of 56 samples. The categories for the definition of spirituality included themselves, others, faith, soul, integration as well as the skills of listening, empathy, and accompanying for understanding the empty spaces of others and trying best to fulfill those spaces. The final definition of spirituality from the BSN students was the relationship among themselves, others, faith, soul. This study only explored the definition of spirituality, but lack of studies on the spiritual care from the nursing student's point of view. Since the literature has indicated the difficult teaching of spiritual care on nursing students due to many different factors, the author suggested to develop the nursing curriculum of training nursing students to self-aware and develop own and the patients's spiritual care by using various teaching strategies and activities.
Keywords: Spirituality; Nursing students
Nursing is a professional discipline of connecting science and art; however, this era greatly emphasized on evidences-based knowledge, and ignored the human-being holistic care. Lin proposed the majority of medicines are based on nature science, but nursing is major on human science, and how to improve the human characteristics of own professional as the reflection of nursing education . The process of improving human education in nursing from inner to outside life change could go through three stages of self-reflecting process, including involved into the situation, reflecting themselves, and external dialogue .However, spirituality is the essential component for life change and how to lead nursing students to explore their own spirituality and assist their spiritual growing was the motivation of this study.
The benefits of improving spirituality for nursing students as Papazisis et al. identifying the majority of 123 nursing students with a strong religion and/or spiritual beliefs which was positively correlated with increased self-esteem and negatively correlated with depression and stress strongly. Additionally, Ko et al. found 41 nursing students self-perceived that their spiritual status and the abilities in spiritual nursing care for elders have significantly improved and by reflection, nursing students could cherish their life after completing the course of spiritual nursing for elders .
Purpose of the Study
This study was to explore the definition of spirituality from the BSN students in Taiwan.
For the concept of spirituality from the scholars, McBrien concept analyzed the spirituality and indentified the attributes including the belief and faith, inner strength and peace, connectedness, as well as the antecedents of core life events and searching for meaning, and the consequents with the sense of hope and self-transcendence . Similarly, the definitions of spirituality were related to three common points of human being’s spirituality including life purpose and meaning, the tendency of human being’s values, and transcend of human beings’ themselves .
Additionally, Yang et al. conducted the concept analysis of spiritual well-being and identified four defined attributes as happy feelings, assurance of self-worth, an open and accepted interpersonal relationship, and with internal energy . Furthermore, it also related to the abilities experiencing and integrating the life meaning and purpose through themselves, others, art, music, literature, nature, or/ and with the connection of God by transcending own . However, Agrimson et al. concept analyzed the spiritual crisis and defined as a unique grieving or loss with the lack of life meaning, approaching a turning point of the significant life change .
For the concept of spirituality from the nursing students’ point of view, Mooney et al. divided 100 nursing students into 10 small groups followed by a visit to the National Gallery of Ireland to choose a piece of art work that they perceived to be spirituality and defined spirituality as the universal and individual concept . While Wallace et al. integrated spirituality into the undergraduate nursing curriculum and identified a significant improved spiritual knowledge and attitudes among 34 senior nursing students before and after the curriculum, including awareness of self, values, perspectives or balance, connection, coping, wellbeing, finding meaning or purpose and hope as their definitions of spirituality .
Additionally, Shores et al. described spiritual perspectives of 120 nursing students and identified their comments about the relationship with God and other people . Similarly, Wehmer et al. reported the spiritual experiences from the 126 nursing students as being thankful for blessings, having the motivation to be close to God, feeling a selfless caring for others, and identifying comfort in own religion and spirituality through conventional and unconventional spiritual activities .
In addition to the relationship with themselves, others, and God, Campesino et al. further found the cultural difference of identification about spirituality among 223 Latino and 101 Non-Latino college students due to the previous group participating in more spiritual activities . Again, although Wu et al. explored the perceptions of spirituality and spiritual care as clear among 239 nursing students; however they did not consider religious as the factor influencing the spiritual needs of their patients . Even though Hsiao et al. have identified that the religion affected their spiritual health, health promoting behaviors, and school performance among 128 senior nursing students . Furthermore, Fok et al. identified the confusion about the definition of spirit among 62 nursing students and thought the physical, psychological, and spiritual aspects as related to each other in achieving a healthy spirit .
In summary, no matter the literature identified the clear or non-clear definition of spirituality from the nursing students, all definitions about spirituality either from the scholars or nursing students were in terms of the relationship with themselves, others, and God through different kinds of spiritual activities. However, there is the inconsistent finding about religious beliefs which could or could not impact the spirituality probability due to the cultural differences. Furthermore, nursing students considered the spirituality was not the single concept, but it interrelated to the physical and psychological aspects.
This narrative study was supported by National Research Grant (MOST 103-2511-S-242 -001) with IRB approving by number FYH-IRB- 103-08-02 and conducted a teaching model of a spiritual nursing course for BSN program from August, 2014 to July, 2015. During spiritual nursing BSN course, 56 nursing students wrote their definitions of spirituality after the teaching unit of introduction spirituality.
For BSN program, 36 nursing students would like to sign the consent form with 64.2% participating in the study out of 56 samples. The categories for the definition of spirituality included themselves, others, faith, soul, integration as well as the skills of listening, empathy, and accompanying for understanding the empty spaces of others and trying best to fulfill those spaces. The final definition of spirituality from the 36 BSN students was the relationship among themselves, others, faith, soul. For the definition of spirituality among themselves, 36 BSN defined spirituality as the life attitude, life value, existence meaning, and it will be impacted by experiences, growing background, inner realization and insight no matter when, where, good or bad mood which would make the unique themselves based on the different point of view. For the definition of spirituality among others, 36 BSN defined spirituality as gaining contented through getting along with others by using inner spirituality to communicate and analyze the meaning of others’ talks during the process of interpersonal interaction.
For the definition of faith among others, 36 BSN defined spirituality as religious beliefs, belonging, life value and meaning, self-fulfilled through psychology depending on religious faith approaching spiritual peace. For the definition of soul among others, 36 BSN defined spirituality as the original thoughts and behaviors and everyone has own soul; otherwise he/she only is a empty body and soul must alive own life in the empty body, even comforting own soul and let emotion stable and look at things as beautiful, peaceful, and successful. Additionally, for the definition of integration, 36 BSN defined spirituality as the harmony relationship among themselves, others, God, nature environment approaching balance and spiritual health status. Finally, 36 BSN defined spirituality as the skills of listening, empathy, and accompanying for understanding the empty spaces of others and trying best to fulfill those spaces.
Overall, the definition of spirituality from 36 BSN was the relationship among themselves, others, faith, and soul and original soul would be different based on their experiences and growing background. Spiritual well-being could make us look at things full of perfect, peace, success and with interaction of emotion; otherwise it could not gain spiritual health status and even impact our daily life. People could reach spiritual peace and emotion stable through connection of religion and faith, interaction process with others by the methods of listening, empathy, and accompany to understand inner needs of others and have their spirituality contented.
The definition of spirituality from the BSN students in Taiwan included the relationship with themselves, others, and God, which was similar to the definition of spirituality from the scholars and nursing students in the literature. However, the definition of soul in this study finding from nursing students was unique and different from the literature, and without soul, people could not be alive, just exist a dead body. Additionally, the extra finding about definition of spirituality from the BSN students was that they would try to fill the empty inner needs by using the skills of listening, empathy, and accompany, which were the assessment skills of spiritual care for the patients.
However, a lack of studies found on the concept of spiritual care for nursing students, Tiew et al. conducted a literature review of student nurses’ spiritual education perspectives and identified no study about investigating the barriers influencing spiritual understanding and care in practice . Lately, Chen et al. explored the difficulties of spiritual care among 35 nursing students in practicing hospice care, including hurrying to do something, insensitivity in communication, lack of clinical experiences, religious factors and self-limitation, while the factors to promote spiritual care included the ambient stimulation, good learning models, the self-reflection of nursing attitude and complement each other in peers, as well as the living in the real moments, love and devotion for parents in time, self-respect and having courage to face life, learning thanksgiving and forgiveness, re-awareness of death and nursing value played in transitions of spirituality for student nurses . Except for the hospice care, Lin et al. integrated spiritual care concepts into obstetric nursing clinical practicum by associate degree 6-8 nursing students who have experienced the change of physical, psychological, and spiritual aspects from the pregnancy mothers; in that reflecting their own values and existential meaning, which could promote their spirituality and professional essences .
Conclusion and Suggestions
In conclusion, the final definition of spirituality from the BSN students was the relationship among themselves, others, faith, soul. Additionally, spirituality was defined as the skills of listening, empathy, and accompanying for understanding the empty spaces of others and trying best to fulfill those spaces. However, this study only explored the definition of spirituality, but lack of studies on the spiritual care from the nursing students’ point of view. Since the literature has indicated the difficult teaching of spiritual care on nursing students due to many different factors, even though two studies have explored the spiritual care in the hospice unit and obstetric nursing clinical practicum, the authors still suggested to develop the nursing curriculum of training nursing students to selfaware and develop own and the patients’ spiritual care by using various teaching strategies and activities in the future.
- Lin YT (2008) Therapeutic discourse: On the intersubjective nurse-patient relationship. Hu Li Za Zhi 55: 14-19.
- Chiang HH (2002) Constructing ethical approaches through nursing practice. Journal of Nursing 49: 20-24.
- Papazisis G, Nicolaou P, Tsiga E, Christoforou T, Sapountzi-Krepia D (2014) Religious and spiritual beliefs, self-esteem, anxiety, and depression among nursing students. Nurs Health Sci 16: 232–238
- Ko JK, Lee PY, Ku YL (2014) Action teaching methods to teach the course of spiritual nursing for elders to nursing students. Veteran Nursing 31: 12-19.
- McBrien B (2006) A concept analysis of spirituality. Br J Nurs 15: 42-45.
- McSherry W (2001) Spirituality in the Nursing Application, Taiwan.
- Yang CT, Yen SY, Chen JO (2010) Spiritual well-being: A concept analysis. Hu Li Za Zhi 57: 99-104.
- Kao CH (2012) Spiritual Distress. NANDA-I nursing diagnoses: Definitions & classification 2012-2014. Taipei City, Taiwan.
- Agrimson LB, Taft LB (2008) Spiritual crisis: a concept analysis. J Adv Nurs 65: 454-461.
- Mooney B, Timmins F (2007) Spirituality as a universal concept: Student experience of learning about spirituality through the medium of art. Nurse Educ Pract 7: 275-284.
- Wallace M, Campbell S, Grossman SC, Shea JM, Lange JW, et al. (2008) Integrating spirituality into undergraduate nursing curricula. Int J Nurs Educ Scholarsh 5: 1-13.
- Shores CI (2010) Spiritual perspectives of nursing students. Nurs Educ Perspect 3: 8-11.
- Wehmer MA, Quinn Griffin MT, White AH, Fitzpatrick JJ (2010) An Exploratory study of spiritual dimensions among nursing students. Int J Nurs Educ Scholarsh 7: 1-10.
- Campesino M, Belyea M, Schwartz G (2009) Spirituality and cultural identification among Latino and non-Latino college students. Hisp Health Care Int 7: 72-79.
- Wu LF, Liao YC, Yeh DC (2012) Nursing student perceptions of spirituality and spiritual care. J Nurs Res 20: 219-227.
- Hsiao YC, Huang SY, Chen MY (2007) A study of the relationships between religion, spiritual health and health promoting behavior. Journal of Evidence-Based Nursing 3: 271-279.
- Fok S, Luk L (2013) The perception of health spirit of a group of student enrolled nurses in Hong Kong. Macau Journal of Nursing 12: 30-34.
- Tiew LH, Creedy DK (2011) Student nurses; spiritual education perspectives: a literature review. Singapore Nursing Journal, 38: 39-54.
- Chen JO, Yang CT (2013) Exploring student nurses' transitions on spiritual accompanying in practicing hospice care. Journal of Anesthesiology and Neurology 18: 39-50.
- Lin SY, Lee HC, Hsiao YC (2015) Integrating spiritual care concepts into obstetric nursing clinical practicum. Midwifery Journal 57: 7-19.