English title dissertation Towards nursing competencies in spiritual care
Name PhD (surname first) Leeuwen, René van
Doctor is (has been) nurse
Date of promotion 13/02/2008
University Rijksuniversiteit Groningen
Promotores Prof. dr. H. Jochemsen, Prof. dr. D. Post, Dr. L.J. Tiesinga
Abstract (English)


Chapter 1
This dissertation starts with an introduction of the subject of this study and the description of the following research questions that have been investigated:
1. How has the connection between spirituality and physical health been investigated and what are the results of that investigation?
2. In what way do spiritual aspects affect patients during physical illness and treatment?
3. What competencies do nurses need to provide spiritual care?
4. How do nurses handle spiritual aspects in health care practice? Are there recognizable nursing competencies for the delivery of spiritual care?
5. How can nursing competencies for the delivery of spiritual care be assessed?
6. What are the effects of an educational programme for student nurses on the development of competencies for the delivery of spiritual care?
7. What are the learning effects of a specific educational method called ‘reflective learning groups’ on the development of competencies to provide spiritual care?
Chapter 2
This chapter describes a study of the connection between spirituality and health in physical healthcare. It outlines the results of a systematic analysis of 31 medical and nursing-related studies concerning the cohesion and relationship between spirituality and health in the physical healthcare sector.
Chapter 3
This chapter describes a focus group study of aspects of spirituality concerning illness. For this purpose experiences of patients, nurses and hospital chaplains in oncology, cardiology and neurology within the context of Dutch somatic health care explored.
Chapter 4
This chapter describes a competency profile which was derived from literature. The profile consists of the following three core domains with six core competencies:
• awareness and use of self:
o handling own values, convictions and feelings in their professional relationships with patients of different beliefs and religions
o address the subject of spirituality with patients from different cultures in a caring manner
• spiritual dimensions of the nursing process
o collect information about the patient’s spirituality and identifies the patient’s need
o discuss with patients and team members how spiritual care is provided, planned, and reported.
o provide spiritual care and evaluates it with the patient and team members.
• and assurance and quality of expertise
o contribute to quality assurance and improving expertise in spiritual care in the organisation.
This competency profile may help to structure future care, research and education in spiritual care by nurses. Implications of the work for future research and education are discussed.
Chapter 5
This chapter gains insight into the spiritual aspects of nursing care within the context of healthcare in the Netherlands. In Dutch nursing literature the spiritual dimension is becoming more and more a focus of attention. The sample was made up of the specialist fields of cardiology, oncology and neurology and divided into groups of patients, nurses and hospital chaplains within the context of Dutch somatic health care.
Chapter 6
This chapter describes the development of an instrument to measure nursing competencies in spiritual care, the Spiritual Care Competence Scale (SCCS). This resulted in an instrument consisting of six core domains of spiritual care-related nursing competencies. These domains were labelled as:
• assessment and implementation of spiritual care (Cronbach’s α 0.82)
• professionalization and improving quality of spiritual care (Cronbach’s α 0.82)
• personal support and patient counselling (Cronbach’s α 0.81)
• referral to professionals (Cronbach’s α 0.79)
• attitude towards patient’s spirituality (Cronbach’s α 0.56)
• communication (Cronbach’s α 0.71)
Chapter 7
This chapter describes the results of a study regarding the effectiveness of an educational programme for nursing students on developing competence in the provision of spiritual care and factors that might influence the effects. Studies consistently suggest that nurses’ competencies in relation to spiritual care are impoverished because of poor role preparation.
Chapter 8
This chapter describes the learning effects of thematic peer-review discussion groups on developing nursing students’ competence in providing spiritual care. It also discusses the factors that might influence the learning process. The method of peer review is a form of reflective learning based on the theory of experiential learning.
Chapter 9
This final chapter provides a general discussion of the dissertation.

Download dissertation (English) DISLEEUWENDEF130208.pdf