Evaluation of Spiritual Care Competency following an Advanced Practice Nursing Program. Caryn Scheinberg Andrews Abby Kra Friedman

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1 Evaluation of Spiritual Care Competency following an Advanced Practice Nursing Program Caryn Scheinberg Andrews Abby Kra Friedman

of Nursing at Hebrew University at Hadassah 2. Sponsorship or research funds None 3.

2 Disclosure Caryn Andrews No (potential) conflict of interests 1. Relations that could be relevant for the meeting Simmons College, Henrietta Szold School of Nursing at Hebrew University at Hadassah 2. Sponsorship or research funds None 3. Payment or other (financial) remuneration Simmons college funded conference trip 4. Shareholder None 5. Other relation None

3 Faculty Disclosure Criteria Faculty Name Information Caryn Scheinberg Andrews, PhD, FNP-BC, RN Conflict of Interest Employer Sponsorship/Commercial Support Faculty Name none Simmons College; Henrietta Szold School of Nursing at Hebrew University at Hadassah none Abby Kra Friedman, MSN, CNM, WHNP, RN Conflict of Interest Employer Sponsorship/Commercial Support none Simmons College; Henrietta Szold School of Nursing at Hebrew University at Hadassah Trip to ICN NP/APN sponsored by Simmons College and The Rabinowitz Fund at Hadassah SON at Hebrew University

4 Session Goal & Learning Objectives Session goals: To describe a workshop on spiritual care in a graduate nursing education program (MA/APN). To describe use of the Spiritual Care Competency Scale 4 and its use in evaluating efficacy of the workshop before and after the mandatory workshop Learning Objectives: Define spiritual care Compare the differences between spirituality, religiosity, and spiritual care competence Explore the utilization of competency tools as effective methods for evaluating teacher

5 Background: Spiritual care education Generally not included in BSN or MA/APN education in Israel The undergraduate nursing curriculum at Hadassah School of Nursing presently is increasing awareness of spiritual care in nursing Currently, the graduate program includes a pilot workshop on spiritual care in its curriculum as part of APN education In planning curriculum for the clinical master s program (not NP program) we were looking to teach core education components that were pertinent across all clinical tracks Important for all tracks of nursing speciality: Oncology, women s health, geriatrics, forensics, pediatrics, critical care, neonatal Not only for palliative care

6 Developing competence in spiritual assessment Tools were presented to MSN(Israeli MA/APN) students to be used for spiritual assessment in preparation for providing APN care Students perceptions of competence were surveyed before and after the workshop This study looked at building competence in using spiritual assessment tools to provide spiritual care

7 Spirituality A sense of connectedness with the universe, a higher power, G-d.

oneself, for faith support, perhaps for rites or prayer or sacrament or simply for a sensitive

8 Spiritual care That care which recognizes and responds to the needs of the human spirit when faced with trauma, ill health or sadness and can include the need for meaning, for self worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament or simply for a sensitive listener. (Royal College of Nursing pocket guide: spirituality in nursing care, 2011: RCN Online

9 Spiritual care Relatively new idea in Israel 3 Few institutions have designated non-religious providers of spiritual care 1 Some institutions are now introducing the concept of non-religious spiritual care providers based on the holistic worldview of quality of life 3 This workshop explored finding ways to help nurses help patients and families build strength to endure the challenges of hospitalization and illness This would bolster the student confidence.

10 Build trust Purpose of the workshop Stimulate sensitivity Connect with inner feelings Decrease barriers Build to concept trust Evoke emotion Connection to advanced practice nursing Caryn Andrews & Abby Kra Friedman 2018

11 Tools to access spirituality Storytelling Prayer Spirituality Videos Music Art Poetry

12 Religiosity vs. Spirituality

13 Spirituality vs. Religion Spirituality: Self-transcendence Yearning to find our place or meaning in the world A connection to a Higher Power 1. A sense of meaning in life Religion Associated with an affiliation with a specific faith, group, and set of practices 2.

14 Understanding that spirituality is not religiosity Questions to assess religiosity: Are you Jewish? Christian, Muslim? How religious are you? Do you pray every day? How many times a day? Do you keep kosher or halal or eat special foods for religious reasons? Questions to assess spirituality: When things are hard, who do you turn to for support? What are your sources of hope, strength, support, and peace? Are you part of a group that gives you support? Would you like me to call them for you? Is there a favorite picture you carry- do you want to tell me about it?

15 Tools for spiritual evaluation

18 Methods Descriptive survey method for students taking a workshop on spirituality The survey is based on the Spiritual Care Competence Scale 1,4,5 Forward and backward translated from English to Hebrew Workshop sample included 28, however only 17 completed the before and after survey Sample included Jewish, Christian, and Muslim second-year MA/APN students

19 Spiritual care competency scale 1,4

20 Spiritual care competency scale 1,4

21 Spiritual care competency scale 1,4

22 Results: Demographics Age Sample percentage % % % Gender Sample Percentage Men % Women % Total % % Total %

23 Translated SCCS reliability 4 Competency Items # Hebrew Translated SCCS Cronbach's alpha Original English SCCS Cronbach's Alpha Assessment Professionalisation and improving the quality of spiritual care Personal support and patient counseling Referral Attitude towards patient spirituality Communication Total 27

24 Mean scores time 1 & 2-2 months apart N=17 Assess time1 Assess time2 Prof time1 Prof time2 Support time 1 Support time 2 Refer time 1 Refer time2 Attitude time1 Attitude time2 Commu time 1 Commu time 2 Mean Range P <.05 Caryn Andrews & Abby Kra Friedman 2018

25 P <.05 Caryn Andrews & Abby Kra Friedman 2018 Paired sample T test N=17 Mean Significance Assess time1 Assess time Prof time1 Prof time Support time 1 Support time Refer time 1 Refer time Attitude time1 Attitude time Commu time 1 Commu time

26 Conclusion The Dutch study done on a much larger sample of Christian nursing students (BA level) only showed significance in one subscale Yet our study was done on multi-religious and multicultural group of experienced advanced practice nursing students (MSN level) and using paired samples T test and test-retest procedure, both show significant difference between subscale scores for time 1 and time 2 for all categories except for communication The Hebrew version of the SCCS shows promise as a tool for assessing nursing competencies in spiritual care in Israel Although the Dutch study did not show change endured over time, our study showed change over time over a 2 month period However, there should be an additional assessment after a more significant period of time

27 Impact on the Evaluation of Education Programs Competency - A new way to evaluate education Teacher is not graded on how much student likes them but on whether student learns material and expresses competency Not just skill competence- can also be conceptual - how to assess a patient s spiritual needs

28 Education Implications Addressing spiritual distress is becoming an integral part of palliative care and hospice treatment even in Israel Hadassah s school of nursing recognizes the educational importance of teaching spiritual care as part of the nursing process in all realms of patient care - not just palliative care Recommendation - Adding this competency to the curriculum enhances the notion that APN care is holistic and contributes another dimension to the multidisciplinary approach to patient care

29 Thank you! Let us all be united and connected together! (Koolulam, 2018 with permission) You shout it out, But I can t hear a word you say. I m talking loud, not saying much. I m criticized, but all your bullets ricochet. You shoot me down, but I get up. Titanium... I m bulletproof, nothing to lose, Fire away, fire away Ricochet, take your aim, Fire away, fire away. Shoot me down but I won t fall. I am titanium. I am bulletproof, I am titanium.

Spirituality and end of life care

Spirituality and end of life care Assessment Who am I? Why spirituality matters in end of life care A back-to-front, post lunch presentation Dr. Simon Harrison TSSF Pastoral Care Lead, RD&E Vice President, College of Health Care Chaplains