Nurses' perceptions and competencies about spirituality and spiritual care: A systematic review and meta-analysis

Abstract

Objective: To identify and synthesize nurses' perceptions of spirituality and spiritual care and their spiritual care competencies.

Design: A systematic review and meta-analysis of observational studies.

Data sources: The electronic databases PubMed, EMBASE, Web of Science, CINAHL, ProQuest, Scopus, CNKI, and WANFANG were systematically searched from the inception of each database to April 19, 2023.

Review methods: Two reviewers independently completed the selection of included studies and data extraction. The Agency for Healthcare Research and Quality (AHRQ) checklist was used to assess the methodological quality of the included studies. The study outcomes were meta-analyzed using STATA 15 software. Predefined subgroup analyses were conducted to explore differences in spiritual care competencies among nurses across religious affiliation and education levels.

Results: Thirty-five cross-sectional studies conducted in 11 countries and territories met the inclusion criteria, with 17,786 participants. The meta-analysis revealed that the pooled mean scores for spirituality and spiritual care perceptions and spiritual care competencies were 3.62 (95 % CI: 3.41-3.83) and 3.46 (95 % CI: 3.28-3.63), respectively. Nurses with no religious affiliation had inferior spiritual care competencies (3.24) than nurses with religious affiliation (3.31); nurses with a master's degree or above had the greatest spiritual care competencies (3.59), while nurses with an associate's degree had the least (3.31).

Conclusion: Nurses' perceptions and competencies about spirituality and spiritual care were moderate, and both needed to be improved, especially among nurses with no religious affiliation and low education levels. Nursing educators and leaders need to emphasize both theory education in the spiritual dimension and dedication to training in spiritual care practice, as well as provide nurses with targeted teaching and training to improve their competency in addressing the spiritual needs of their patients.

Keywords: Competency; Meta-analysis; Nurses; Perception; Review; Spiritual care; Spirituality.