Spirituality in palliative care

Duhovno blagostanje čovjeka ima velik utjecaj na njegovo sveukupno zdravlje. Duhovnost i duhovno blagostanje od posebne su važnosti kod palijativnih i terminalnih bolesnika te iz tog razloga duhovna skrb predstavlja važan dio palijativne skrbi. Zadaća medicinske sestre je pomoći bolesniku u aktivnostima koje pridonose mirnoj smrti, stoga je njezina uloga također i primjena duhovne skrbi bolesnika. Duhovna zdravstvena skrb uključuje pružanje poštovanja, utjehe, slušanje bolesnika, ulijevanje nade, zajedničke molitve i držanje bolesnika za ruku. Duhovne potrebe se teže primjećuju od fizičkih potreba, jer su višestruke i teže mjerljive. To su potrebe bolesnika za ljubavlju i povezanosti, nadom i mirom, značenjem i svrhom, odnosom s Bogom i prihvaćanjem umiranja. Bolesnici s neprepoznatim duhovnim poteškoćama imaju povećan rizik od slabijih psiholoških ishoda, oslabjele kvalitete života i smanjenog osjećaja duhovnog mira. Duhovna podrška je vrlo važna i medicinska sestra treba biti spremna razgovarati o duhovnim pitanjima, ako bolesnik to želi. Za to je potrebno educirano osoblje koje prepoznaje važnost duhovne skrbi i ima vještine da pomogne bolesniku u rješavanju duhovnih problema. Cilj istraživanja bio je uvidjeti primjenjuju li medicinske sestre duhovnu skrb u praksi, koje su njihove sposobnosti u pružanju duhovne skrbi te je li u sestrinskoj profesiji potrebna dodatna edukacija o duhovnoj zdravstvenoj skrbi. Istraživanje je provedeno putem aplikacije „Google obrasci“ s konstruiranim anketnim upitnikom u svrhu ovog istraživanja. U istraživanju je sudjelovalo 151 sudionika, od kojih su 94% činile osobe ženskog spola. Statistička analiza podataka dobivenih iz ankete pokazala je da medicinske sestre znaju da je duhovna skrb njihova domena rada, ali nemaju dovoljno znanja kako bi istu primijenile u praksi. Medicinske sestre imaju poštovanja prema bolesnikovim duhovnim i vjerskim uvjerenjima te nastoje ne nametati svoja gledišta u vezi toga. Međutim, medicinske sestre ne znaju kako poboljšati duhovnu skrb u praksi, što je dodatni pokazatelj za potrebom edukacije medicinskih sestara o duhovnoj skrbi. Pokazalo se da medicinske sestre koje su praktični vjernici bolje shvaćaju važnost duhovne skrbi i imaju veće kompetencije za pružanje iste. Najkompetentnije za pružanje duhovne skrbi su diplomirane medicinske sestre ili magistre sestrinstva. Što ukazuje na to da edukacija medicinskih sestara uvelike utječe na njihovu kompetentnost za pružanje duhovne skrbi. Dobiveni rezultati govore da je potrebno poboljšati edukaciju o duhovnoj skrbi u obrazovanju i osposobljavanju medicinskih sestara te da je istu potrebno uvrstiti u kurikulum obrazovanja medicinskih sestara.Person's spiritual well-being has a great impact on its overall health. Spirituality and spiritual well-being are of particular importance to palliative and terminal patients, and for this reason spiritual care is an important part of palliative care. Nurses’ task is to assist the patient in activities that contribute to a peaceful death, so their role is also to provide the spiritual care to patient. Spiritual care includes providing respect, comfort, listening to the patient, instilling hope, praying together, and holding the patient’s hand. Spiritual needs are harder to notice than physical needs because they are multiple and more difficult to measure. Spiritual needs include patients’ need for love and connection, hope and peace, meaning and purpose, relationship with God, and acceptance of dying. Patients with unrecognized spiritual needs have an increased risk of poorer psychological outcomes, impaired quality of life, and decreased sense of spiritual peace. Spiritual support is very important, and the nurse should be prepared to discuss spiritual issues, if the patient desires so. This requires skilled staff who recognizes the importance of spiritual care and has the skills to help patients solve spiritual problems. The aim of the research was to find out whether nurses apply spiritual care in practice, what are their abilities in providing spiritual care and whether additional education on spiritual health care is needed in the nursing profession. The research was conducted through the application "Google Forms" with a constructed survey questionnaire for the purpose of this research. The study involved 151 participants, of whom 94% were females. Statistical analysis of the data obtained from the survey showed that nurses know that spiritual care is their domain of work, but they do not have enough knowledge to apply it in practice. Nurses have respect for the patient's spiritual and religious beliefs, and they try not to impose their views on patients. However, nurses do not know how to improve spiritual care in practice, which is an additional indicator of the need for nurses’ education in spiritual care. It has been shown that nurses who are practical believers have better understanding of the importance of spiritual care and have greater competencies to provide the same. The most competent to provide spiritual care are graduate nurses or masters of nursing. Which indicates that nurses’ education greatly affects their competencies to provide spiritual care. The obtained results show that it is necessary to improve nursing education on spiritual care and it should be considered to include it in the curriculum of nursing education