Martha Meraviglia

Critical Analysis of Spirituality and its Empirical Indicators Prayer and Meaning in Life

Spirituality for holistic nursing is defined after a critical analysis of the literature. Spirituality is defined as the experiences and expressions of one’s spirit in a unique and dynamic process reflecting faith in God or a supreme being; a connectedness with oneself, others, nature or God; and an integration of all human dimensions. Prayer and meaning in life are described as empirical indicators for appraising spirituality. Prayer is an indicator of the defining attribute of connectedness with God, and meaning in life is an outcome of spirituality.

The Effects of Spirituality on Well-Being of People With Lung Cancer

PURPOSE/OBJECTIVES To examine the effects of spirituality on the sense of well-being of people with lung cancer. DESIGN Descriptive, correlational study. SETTING Urban and rural oncology and radiation centers. SAMPLE 60 adults ranging from 33-83 years of age. Most participants had non-small cell lung cancer and were female, Caucasian, and older than 50. METHODS Participants completed a questionnaire composed of six survey instruments: Life Attitude Profile-Revised, Adapted Prayer Scale, Index of Well-Being, Symptom Distress Scale, a background information sheet, and a cancer characteristics questionnaire. Correlations among study concepts were examined, and multiple regression analysis was used to determine the effects of spirituality. MAIN RESEARCH VARIABLES Meaning in life, prayer activities and experiences, symptom distress, and psychological well-being. FINDINGS Higher meaning in life scores were associated with higher psychological well-being and lower symptom distress scores. Higher prayer scores were associated with higher psychological well-being scores. Regression analysis indicated that meaning in life mediated the relationship between functional status and physical responses to lung cancer and explained 9% of the variance in symptom distress. Prayer mediated the relationship between current physical health and psychological responses and explained 10% of the variance in psychological well-being. CONCLUSIONS Aspects of spirituality, meaning in life, and prayer have positive effects on psychological and physical responses in this group of people with lung cancer. IMPLICATIONS FOR NURSING This research provides knowledge about spirituality and sense of well-being to guide the care of people with lung cancer.

Effects of Spirituality in Breast Cancer Survivors

PURPOSE/OBJECTIVES To examine the effects of spirituality (meaning in life and prayer) on a sense of well-being among women who have had breast cancer. DESIGN Descriptive, correlational, cross-sectional. SETTING Rural and urban communities in central Texas. SAMPLE Convenience sample of 84 women, 34-80 years of age diagnosed less than one year previously (36%), within the previous one to five years (38%), and more than five years previously (26%). METHODS The study approach consisted of completing a questionnaire assessing personal and cancer characteristics, aspects of spirituality (meaning in life and prayer), and physical and psychological responses to breast cancer. MAIN RESEARCH VARIABLES Meaning in life, prayer, and physical and psychological responses to breast cancer. FINDINGS Meaning in life was positively related to psychological responses and negatively related to physical responses. Prayer was positively related to psychological well-being. Women with higher prayer scale scores reported lower education levels, less income to meet their needs, and closer relationships with God. Meaning in life mediated the impact of breast cancer on physical and psychological well-being. CONCLUSIONS Strong relationships exist among spirituality and personal and cancer characteristics. Meaning in life mediated the effects of breast cancer on well-being in breast cancer survivors. IMPLICATIONS FOR NURSING The findings support healthcare providers encouraging women diagnosed with breast cancer to explore their spirituality as an effective resource for dealing with the physical and psychological responses to cancer.

The Expect Respect Project: Creating a Positive Elementary School Climate

The Expect Respect Project, a violence prevention program, was developed to reduce the incidence of bullying and sexual harassment by creating a positive school climate in which inappropriate behaviors are not tolerated and staff members respond consistently to incidents. The project implemented an educational intervention for students, parents, and staff members on expecting respect in student relationships and strategies for responding to inappropriate student behaviors. This article describes the educational intervention and evaluation of the project. Findings from the project showed a significant increase in awareness of bullying following the educational intervention. Bullying was reported to have occurred in areas with less adult super-vision such as the playground, cafeteria, hallway, and buses. Students thought staff would respond to inappropriate behaviors by telling students to ignore verbal bullying or sexual harassment. In contrast, staff at the elementary schools thought adults would respond to inappropriate behaviors by telling the bully to stop, calling his or her parents, or giving a specific punishment.

Prayer in people with cancer

The purpose of this study was to adapt an instrument to assess prayer activities, experiences, and attitudes for people with cancer. A cross-sectional correlational research design was used to study 32 adults (24 women and 8 men) at 3 urban oncology and 2 radiation clinics. The prayer scale was adapted for people with cancer by the author, reviewed by measurement and content experts, and tested by administration to 32 people with a variety of cancers. Expert review supported the content validity of the adapted instrument. Instrument subscales had acceptable reliability for internal consistency. The 3 prayer scale subscales were moderately correlated to perceived relationship with God. Results demonstrated that high scores on the frequency of prayer subscale were associated with low levels of education and functional status and high presence of metastasis at diagnosis. Reports of more prayer activity were related to low levels of functional status. Additionally, those reporting low levels of physical health status had more prayer experiences. The prayer scale is a sensitive instrument for assessing prayer activities, experiences, and attitudes of people with cancer. Prayer is a valuable internal resource, which can lessen the effect of cancer.

Maintenance of skin integrity as a clinical indicator of nursing care.

OBJECTIVE: To assess maintenance of skin integrity in hospitalized patients as a clinical indicator of quality nursing care. DESIGN: Descriptive correlational study. SETTING: 17 acute care urban and rural hospitals in Texas. PARTICIPANTS: 723 hospitalized patients from 33 medical-surgical units. MAIN OUTCOME MEASURES: Pressure ulcers since admission and nursing care practices per unit. MAIN RESULTS: Overall prevalence of pressure ulcers since admission (4.7%) was lower than previously reported for acute care settings. Prevalence of pressure ulcers in hospitalized patients (10%) was higher than found in the Texas Nurses Association feasibility study (3.7%). The skin integrity ratio was strongly correlated for several unit variables, including number of beds per unit (r = 0.623) and average daily census per unit (r = 0.909). Benchmarking data across units showed that units with subjects that maintained skin integrity had a lower percentage of patients assessed on admission and performed daily assessments less frequently than did the units with subjects that did not maintain skin integrity. In addition, the units with subjects that maintained skin integrity classified fewer patients as at risk for pressure ulcer development and did not implement a skin care protocol for these patients. CONCLUSION: Patients who developed a pressure ulcer after admission were older and had more risk for pressure ulcers than those who maintained skin integrity. Benchmarking data detected various differences in nursing care. Significant relationships between study variables demonstrate the importance of assessing clinical indicators to monitor nursing care. Outcomes such as skin integrity, pressure ulcer since admission, and nosocomial ratio represent the quality of nursing care.