Student nurses perceptions of spirituality, spiritual care, and spiritual care competency: a prospective, longitudinal, correlational European study

Background. Nurses and midwives care for people at some of the most vulnerable moments of their lives, so it is essential that they have the skills to give care which is compassionate, dignified, holistic and person-centred. Holistic care includes spiritual care which is concerned with helping people whose beliefs, values and sense of meaning, purpose and connection is challenged by birth, illness or death. Spiritual care is expected of nurses/midwives but they feel least prepared for this part of their role. How student nurses/midwives can be prepared for spiritual care is the focus of this study.
Objectives. 1.To describe undergraduate student nurses/midwives perceptions of spirituality/spiritual care, their perceived competence in giving spiritual care and how these perceptions change over time. 2. To explore factors contributing to development of spiritual care competency.
Methods. Prospective, longitudinal, multinational, correlational survey design. A convenience sample of 2193 undergraduate nursing/midwifery students (69% response rate, dropping to 33%) enrolled at 21 universities in 8 countries completed questionnaires capturing demographic data (purpose designed questionnaire) and measuring perception of spirituality/spiritual care (SSCRS), spiritual care competency (SCCS), spiritual wellbeing (JAREL) and spiritual attitude and involvement (SAIL) on 4 occasions (start of course n=2193, year 2 n=1182, year 3 n=736, end of course n=595) between 2011-2015. Data were analysed using descriptive, bivariate and multivariate analyses as appropriate.
Results. Perceived competency increased significantly over the course of students’ study which they attributed to caring for patients, events in their own lives and teaching/discussion in university. Two factors were significantly correlated with perceived spiritual care competency: perception of spirituality/spiritual care, where a broad view was preferable, and personal spirituality, where high spiritual wellbeing (JAREL) and spiritual attitude and involvement (SAIL) scores were preferable.
Conclusions. Our study is limited by a high attrition rate common to longitudinal research, but we have provided the first international evidence that perceived spiritual care competence is developed in undergraduate student nurses/midwives and that students’ perceptions of spirituality and personal spirituality contribute to that development. Implications for teaching and learning and student selection are discussed.