靈性概念於護理個案報告應用之文獻評析

Analysis of Literature on Applied Spiritual Concept in Nursing Case Reports

背景：護理人員自許能提供全人照護，然靈性照護於臨床護理實際應用情形仍有待探討。
目的：分析護理個案報告中對靈性相關照護之特性，以做為護理人員提供靈性照護時之參考。
方法：搜尋台灣期刊電子資料庫，選擇護理問題中涵蓋「靈性」問題之個案報告，利用內容分析與描述性統計方法，分析整理文本呈現之特質。
結果：從1995年至2012年共38份文本屬於靈性個案報告，病人特質以癌症(73.7%)及臨終(65.8%)居多。靈性評估項目以宗教相關(類別、信念與行為)居多(76.3-81.6%)，其他評估項目包括：人際問題、死亡態度、生命意義與罹病態度等。提供之靈性照護內容以協助病人獲得宗教資源、人際關係的維持與重建、生命意義的追尋為主，護理方式主要為「以關懷之心陪伴病人」及「鼓勵從事靈性與宗教活動」。
結論/實務應用：靈性是全人照護重要一環，靈性議題於護理個案報告已逐漸受到重視，多數護理人員肯定靈性照護的價值。未來應提供實用靈性評估指引與靈性相關的在職教育，以充實護理人員靈性照護能力。

Background: Nurses expect that they can provide some level of holistic care to patients. However, the application of spiritual care in clinical nursing has thus far been unknown.
Purpose: The purpose of this study was to analyze the characteristics of spiritual nursing case reports so that the results of this study could serve as a reference for nurses in the provision of spiritual care.
Methods: We selected spiritual nursing case reports from the index to Taiwan Periodical Literature System. Content analysis and descriptive statistics were used to analyze the attributes of the relevant literature.
Results: Thirty-eight case reports, published between 1995 and 2012, were analyzed. In the reports, 73.6% of patients had a cancer diagnosis, and 65.8% were at terminal stage. Almost all of the content of spiritual assessment was religion-related (76.3%?81.6%), covering religious affiliation, religious belief, and religious behaviors. The other assessment items included relationships, attitudes toward death, the meaning of life, and attitudes toward mobility. The strategies of spiritual care aimed to assist patients in receiving the appropriate religious resources, to maintain and rebuild relationships, and to search for a purpose to patients’ lives. The approaches to spiritual care included accompanying the patient with caring, and encouraging the patients to maintain their spiritual and religious activities. 　　
Conclusions/implications for practice: Spirituality was a key component for holistic care. The nursing case reports showed that spiritual issues have gradually become more respected, and almost all of the nurses supported the value of providing spiritual care to patients. We should therefore assist nurses to enhance their spiritual care abilities by providing spiritual assessment tools and constructing spiritual-related education programs.