The SPIRIT Study: Spirituality in the Intensive Care Unit
CCCF ePoster library. Bone N. Oct 31, 2016; 150917; 38
Nigel Bone
Nigel Bone
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Topic: Survey or Interview (quantitative or qualitative)

The SPIRIT Study: Spirituality in the Intensive Care Unit

Bone N1,  Toledo F1, Hoad N2, Swinton M2,3, Cook D 2,3
Spiritual Care Department, St. Joseph's Healthcare Hamilton, Canada
2 Critical Care Department, St. Joseph's Healthcare Hamilton,  Canada
Department of Clinical Epidemiology and Biostatistics, McMcaster University, Hamilton, Canada


Introduction: Published literature shows that nurses routinely work with spiritual care clinicians, and make referrals to a Spiritual Care Department, most often at the end of life. However, data are sparse on the impact of spiritual care on critical care nurses after making referrals to the Spiritual Care Department for the family of a patient who is dying or has just died.

Objectives: Our overall objective was to explore the experiences of critical care nurses when they make a referral to the Spiritual Care Department for the family of a patient who is dying or has just died. Our specific aims were to further understand: a) the impact of spiritual care on ICU nurses b) how nurses understand the role of spiritual care and c) whether new approaches to providing spiritual care might be desirable in the Intensive Care Unit.

Methods: SPIRIT is a qualitative descriptive study with data collected through in-person semi-structured qualitative interviews in a 21 bed ICU at St. Joseph’s Healthcare Hamilton.  Purposive sampling was used to select nurses who had experience with referrals to the Spiritual Care Department. Inclusion criteria were a minimum of: a) 5 years of experience as an ICU nurse b) 5 patient deaths under nurse’s care in the ICU and c) 5 initiated referrals to Spiritual Care Department. Interviews were digitally recorded, transcribed verbatim and anonymized. Conventional content analysis was used to analyze transcripts and codes were derived directly from the data. To develop the preliminary list of codes, 5 transcripts were double coded by 3 investigators. The coding structure was developed by consensus through meetings as analysis proceeded.

Results: We interviewed 21 ICU nurses. Five main categories emerged from the data: (1) Nurses value spiritual care in critical care practice. (2) Some nurses are confident providing spiritual care while most prefer and appreciate consulting professionally trained spiritual care clinicians. (3) Spiritual care staff work collaboratively with the ICU team at the end of life. (4) Having spiritual care clinicians work with patients and families facilitates the exploration of spiritual distress, while nurses sometimes provide a similar supportive role in addition to their other professional tasks. (5) Nurses find that the collaboration between critical care and spiritual care contributes to positive end of life experiences for all persons involved.  

Conclusions: Spiritual care is considered by ICU nurses to be an essential aspect of the holistic care of critically ill patients. Nurses value the support that spiritual care clinicians provide to patients, families and other clinicians. Nurses working in this ICU find making referrals to the Spiritual Care Department a positive experience, contributing importantly to patient and family centered care at the end of life in today’s spiritually diverse society. 


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