Date of Award
2025
Degree Name
Doctor of Philosophy (College of Arts and Science)
Schools and Centres
Arts & Sciences
First Supervisor
Associate Professor Megan Best
Second Supervisor
Professor Sandra Lynch
Third Supervisor
Professor Jane Philips
Abstract
Background. Despite there being many models for how spiritual care should ideally be provided to patients at end of life, the way nurses actually provide spiritual care often departs from ideal.
Aim. To understand why nurse spiritual care practices for patients at end of life vary.
Method. The project was conducted in four phases using an emergent, sequential mixed-method design. A systematic review in Phase 1 identified factors that influence nurse spiritual care practices for patients at end of life. Using qualitative data obtained from a general sample of nurses, Phase 2 uncovered nurses' understandings of spiritual care work and the relation of that understanding to their practice. Phase 3 focused on a quantitative analysis of the relationships between nurses' understanding of spiritual care and nurse characteristics data (such as personal spirituality and education). Phase 4 examined whether the findings of Phases 2 and 3 would apply in a sample of palliative care nurses.
Results. The project uncovered a taxonomy comprising four distinct understandings, or models, of spiritual care among nurses: (1) active management of the patient experience; (2) responsive facilitation of the patient's wishes; (3) accompaniment of the patient on the dying journey; and (4) empowering co-action with the patient. The models incorporate different bundles of spiritual care practices. The models can be ordered in terms of competence and are somewhat related to level of personal spirituality, frequency of spiritual care provision and experience in caring for the dying (whether on-the-job or formal training).
Conclusion. Nurses' ascriptions to different spiritual care models: explain variations in spiritual care practices; suggest a way to assess and develop spiritual care competence; and present as descriptive models of spiritual care ethics that guide practice.
Publication Details
Di Mascio, R. (2025). Nurses' Models of Spiritual Care: Towards Understanding Variations in Practice [Doctor of Philosophy (College of Arts and Science)]. The University of Notre Dame Australia. https://researchonline.nd.edu.au/theses/469