Purpose
This study investigated the effects of spiritual well-being on the self-care practices of people undergoing hemodialysis with hope as a mediator. Methods Using convenience sampling, 126 people undergoing hemodialysis were recruited from April 17th to July 15th, 2022 for a cross-sectional survey. Data were collected using the Spiritual Well-Being Scale, Hope Scale, and Self-Care practices Scale and analyzed using descriptive statistics and Pearson’s correlation coefficient. In addition, multiple regression analysis was performed to analyze the mediating effect using Baron and Kenny’s three-step method. Results The mean scores for spiritual well-being, hope, and self-care practices were 75.67, 51.37, and 128.82 respectively. There were significant correlations between the three variables. In step 1, spiritual well-being had a statistically significant positive effect on hope (β=.59, p<.001) (R²=37.8%). In step 2, spiritual well-being had a significant positive effect on self-care practices (β=.31, p<.001) (R²=14.6%). In step 3, the direct effect of spiritual well-being on self-care practices was not significant when the mediating variable hope was introduced; hope was observed to have a complete mediating effect (β=.36, p<.001) on the relationship between spiritual well-being and self-care practices (Sobel test: Z=3.18, p<.001). Conclusion Based on these results, hope enhancement can help in self-care practices, and hope can also be promoted through spiritual well-being resources. Thus, it is necessary to develop a holistic nursing program that includes spiritual care to promote spiritual well-being and hope for improving self-care practices in people undergoing hemodialysis.

Citations

• The Mediating Effects of Symptom Experiences on the Relationship between Body Image and Quality of Life among Hemodialysis Patients in a Single Center
  Yaki Yang
  Healthcare.2024; 12(17): 1779.     CrossRef

Purpose
This study investigated the effects of spiritual well-being on the cognitive function of elderly people, focusing on the mediating effects of health-promoting behaviors and depression.
Methods
Using convenience sampling, 136 elderly people were recruited from October 2018 through February 2019 for a cross-sectional survey. Data were collected through the Spiritual Well-Being Scale, Health-Promoting Lifestyle Profile, Geriatric Depression Scale, Everyday Cognition, and Montreal Cognitive Assessment and analyzed using descriptive statistics and correlation. Mediation analysis was also conducted using Hayes’ PROCESS macro (Model 4).
Results
The mean scores for spiritual well-being, health-promoting behaviors, depression, objective cognitive function, and subjective cognitive function were 60.96, 108.09, 18.58, 19.49, and 63.35. The mediation effects in step 1 indicated that spiritual well-being had a statistically significant positive effect on health-promoting behaviors (B=0.32, p<.001) (R² =32.0%) and a significant negative effect on depression (B=-0.09, p=.001) (R² =31.0%). In step 2, spiritual well-being had a significant negative effect on subjective cognitive function (B=-0.12, p=.007) (R² =23.0%). In step 3, the direct effect of spiritual well-being on subjective cognitive function was not significant when the mediating variables (healthpromoting behaviors and depression) were introduced. Health-promoting behaviors (B=-0.18, p=.047) and depression (B=0.41, p=.008) had complete mediating effects on the relationship between spiritual well-being and subjective cognitive function.
Conclusion
These findings suggest that there is a need to develop and implement nursing strategies that can improve spiritual well-being, and to develop a holistic nursing intervention that considers depression and health-promoting behaviors, when applicable, to improve cognitive function in elderly people.

Citations

• Analysis of the Domestic Research Trends on Spiritual Health
  Gyeong-Hye Choi
  Journal of Korean Association for Qualitative Research.2023; 8(2): 189.     CrossRef

Purpose
The purpose of this study was to construct and test a hypothetical model of clinical nurses’ spiritual nursing care based on the theory of planned behavior. Methods From May 1 to May 31, 2019, data of 289 nurses working at a university hospital were collected and analyzed. Results The goodness-of-fit of the final model was at a good level (TLI=.90, CFI=.91, SRMR=.06, RMSEA=.06). The intention toward spiritual nursing was directly affected by attitude, subjective norm, and perceived behavior control toward spiritual nursing. Spiritual nursing care was both directly and indirectly affected by attitude, subjective norm, perceived behavioral control, and intention toward spiritual nursing. These variables accounted for 76.6% of the intention to spiritual nursing and 44.5% of spiritual nursing care. Conclusion Clinical nurses’ spiritual nursing care can be improved by intention, attitude, subjective norm, and decreased perceived behavioral control toward spiritual nursing. Therefore, it is necessary to improve the job of nursing, create an environment for spiritual nursing, and develop and implement various education programs.

Citations

• Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis
  Hyun-Jin Cho, Kyoungrim Kang, Kyo-Yeon Park
  BMC Nursing.2024;[Epub]     CrossRef
• A Structural Model for Aggression in Middle School Students in Korea: Based on Ajzen’s Theory of Planned Behavior
  Sook Jang, Hye Young Ahn
  International Journal of Environmental Research and Public Health.2023; 20(2): 1576.     CrossRef

Purpose
This study aimed to examine the effect of pain, anxiety, depression, perception dignity, and spiritual well-being on hospice patients’ attitudes toward dignified death. Methods: A total of 130 terminal cancer patients admitted to hospice ․ palliative care institutions in Korea participated in the study. Data were collected using self-report questionnaires and analyzed using descriptive statistics, an independent t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression using SPSS Statistics 26.0. The assessment tools were the Brief Pain Inventory, Hospital Anxiety and Depression Scale, Perception of Dignity Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, and Attitudes toward Dignified Death Scale.
Results
The mean scores were as follows: 5.25 for pain, 11.98 for anxiety, 14.56 for depression, 22.12 for spiritual well-being, 14.38 for perception of dignity, and 93.12 for attitudes toward dignified death. The results of the hierarchical multiple analysis revealed that spiritual well-being (β=.36, p<.001) was predictive of the attitudes toward dignified death (R² =.13, p<.001).
Conclusion
Spiritual well-being is associated with hospice patients’ attitudes toward dignified death. The results highlight the necessity to develop effective nursing intervention programs that promote spiritual well-being for hospice patients’ attitudes toward dignified death.

Purpose
This study was conducted so as to determine a hypothetical model concerning factors affecting breast cancer patients' resilience. Methods: Data were collected via a self-administered questionnaire from 212 patients with breast cancer between July 25 and August 24, 2020. The data were analyzed using SPSS/WIN 20.0 and AMOS 21.0. Results: The model supported 7 of the 11 presented hypotheses for all participants. Test results indicated that “hope”, “uncertainty”, and “symptom experience” all directly affected participants' resilience, and that “uncertainty” also affected participants', “depression” and “hope”. “Spiritual well-being” affected participants' sense of “hope” and “symptom experience”. Of these variables, “hope” had the strongest direct influence on resilience across all participants. “Uncertainty” was found to directly and indirectly affect participants, whereas “spiritual well-being” indirectly affected the resilience of all participants. “Uncertainty” and “spiritual well-being” indirectly affected the resilience of all participants. Conclusion: These results suggest that management strategies to enhance breast cancer patients' resilience should address patients' uncertainty, spiritual well-being, hope, and symptom experience.

Citations

• Resilience-related Breast Cancer: A Concept Analysis
  Fitria Endah Janitra, Nur Aini, Anggi Lukman Wicaksana
  Nurse Media Journal of Nursing.2023; 13(1): 31.     CrossRef

Purpose
This study was intended to clarify the concept of spiritual distress in cancer patients using the hybrid model of Schwarz-Barcott and Kim. Methods: The hybrid model was used to clarify the dimension, attributes, and definition of spiritual distress. In the theoretical phase, a systemic literature review of nursing and other disciplines was conducted. In the fieldwork phase, individual in-depth interviews were held with six cancer patients. In the final analytic phase, the results of the theoretical and fieldwork phases were integrated after comparing and reviewing. Results: The concept of spiritual distress was analyzed in three domains: a changed relationship with God, a changed relationship with the self, and a changed relationship with others. Also, 10 attributes were clarified. The changed relationship with God domain had two attributes: “low connectedness in relationship with God” and a “feeling of guilt”. The changed relationship with the self domain had five attributes: “loss of self-identity”, “changed meaning of life”, “loss of inner peace”, “dwelling on the cause of unsloved suffering”, and “avoidance of confronting death”. The changed relationship with others domain had three attributes: “shrunk relationships”, “the feeling of being unloved and unforgivable”, and “burden on family”. Conclusion: The concept of spiritual distress in patients with cancer encompasses multidimensional domains and 10 attributes. To assess spiritual distress in patients with cancer based on the findings of this study, it is necessary to develop a suitable spiritual distress assessment scale.

Citations

• The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients
  Jin Sook Kim, Il-Sun Ko, Su Jin Koh
  Journal of Korean Academy of Nursing.2022; 52(1): 52.     CrossRef
• A Concept Analysis of Stress in Hemodialysis Patients
  Bomi Kim, Hyeyoung Kim, Jisun Lee
  Korean Journal of Adult Nursing.2021; 33(6): 601.     CrossRef

PURPOSE
The purpose of the study was to describe the structural relationship of meaning in life, spirituality, hope, intrinsic religious orientation, and self-esteem among middle-aged adults.
METHODS
The sample included 344 participants between the ages of 40 and 60, who resided in one of four cities. The collected data were analyzed using SPSS 21.0, descriptive statistics and AMOS 20.0 which uses structural modeling to test whether the hypothesized model fits the collected data.
RESULTS
Middle-aged adult's spirituality was found to have a significant direct effect on meaning in life. Further, middle-aged adult's reported hope, intrinsic religious orientation, and self-esteem had a direct effect on spirituality. Lastly, self-esteem had a direct effect on hope.
CONCLUSION
The findings from the study indicated that spirituality was the best predictor of meaning in life among middle age. In addition, hope, intrinsic religious orientation, and self-esteem did not have a direct effect on the meaning in life, but had a indirect effect through spirituality.

PURPOSE
This study was to test a structural model of spirituality and the quality of life of stroke survivors' caregivers in order to provide guidelines for the development of intervention and strategies to improve their quality of life.
METHODS
Data were collected from 133 family caregivers of stroke patients who were hospitalized in C university hospital located in Seoul. Data collection using survey questionnaires was done from May, 2013 to February, 2014.
RESULTS
Fitness of the hypothetical model was appropriate. Physical component of quality of life of family caregivers is directly affected by two variables (51.5%), burden and depression. Mental component of quality of life of family caregivers is directly affected by three variables (77.6%), depression, burden, and functional dependence of patients. Depression as well as burden were directly affected by spirituality and functional dependence of patients respectively. Thus, spirituality directly affected depression and burden and indirectly affected the quality of life of family caregivers.
CONCLUSION
Therefore, spiritual intervention to improve the stroke caregivers' quality of life might be necessary to support and strengthen their spirituality as a mediating variable that can contribute to decreasing their depression and burden.

Citations

• Factors Influencing the Quality of Life of Family Caregivers of Stroke Patients: A Cross-Sectional Survey
  Ji-Hye Lee, Mi Sook Jung
  Journal of Korean Academy of Fundamentals of Nursing.2023; 30(4): 479.     CrossRef
• Factors Influencing Family Caregivers' Self-management of Acute Stroke Survivors
  Ji Yeon Lee, Hee Kyung Chang
  Korean Journal of Adult Nursing.2018; 30(6): 669.     CrossRef

PURPOSE
This study was to identify the impact of spiritual wellbeing and social support on the depression among middle-aged women. Descriptive study design was used.
METHODS
The subjects completed the structured questionnaires: the 'Spiritual Well-being Scale', developed by Paloutzian & Ellison, 'the Social Support Scale' developed by Park, and 'the CES-D Scale' developed by Radloff. Data were collected from 216 middle aged women in B metropolitan city and J city. The data were analyzed using t-test, ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regressions.
RESULTS
Participants with higher depression had lower scores for spiritual wellbeing (r=-.57, p<.001) and lower scores for social support (r=-.49, p=.011). The influencing factors on depression were spiritual wellbeing, social support, and utilization of spare time. These variables were explained 46% of the variance in depression.
CONCLUSION
The depression of the middle-aged women can be reduced when spiritual wellbeing and social support are improved. Therefore, we suggested to develop nursing intervention programs in order to improve spiritual wellbeing and social support of middle-aged women for reducing their depressions.

Citations

• The Relationship between Marital Satisfaction and Spiritual Well-Being of Chinese Older Adults: The Mediating Effect of Psychological Security and Aging Expectations
  Longxing Tang, Yachi Yang, Zhiwei An, Yalian Huang, Ping Tang
  Behavioral Sciences.2024; 14(10): 949.     CrossRef
• Experiences on Psycho-social Health Support of Middle-aged Women
  Jeong-Soo KIM, Euna PARK
  JOURNAL OF FISHRIES AND MARINE SCIENCES EDUCATION.2019; 31(5): 1432.     CrossRef
• A study on Symptom Experience, Spiritual Well-Being, and Depression in Patients Undergoing Hemodialysis
  Ju Yeon Song, Pok-Ja Oh
  Journal of the Korea Academia-Industrial cooperation Society.2016; 17(5): 660.     CrossRef
• Factors Influencing Middle-aged Women's Depression
  Hung Sa Lee, Chunmi Kim, Dohyun Lee
  Korean Journal of Health Promotion.2016; 16(1): 1.     CrossRef
• Sociopsychological factors associated with depressive symptoms among some urban middle-aged men and women: focused on social support and stress coping strategy
  Seo-Heui Jeon, Kyoung Ok Park
  Korean Journal of Health Education and Promotion.2015; 32(3): 43.     CrossRef

PURPOSE
The purpose of this study was to investigate the effect of a spirituality/hope promoting program on fighting spirit, helplessness, anxiety, and self-care behaviors. METHODS: A nonequivalent control group pretest- posttest design was used. Study subjects were 22 cancer patients undergoing chemotherapy for the experimental group and 31 for the control group. The experimental group received a 4-week intervention, 30-50 minutes a day weekly. Variables were measured at baseline, 4 and 8 weeks later. Fighting spirit and helplessness were measured by MAC(Mental Adjustment to Cancer) and anxiety was measured by Hospital Anxiety and Depression scale. Self-care behaviors scale developed by Oh et al.,(1997) was used.
RESULTS
The experimental group revealed significantly more fighting spirit(t=-4.10, p=.000). more self-care behaviors(t=-5.91, p=.000). and less helplessness(t=3.94, p=.000). No difference, however, was found in anxiety between the two groups(t=.24, p=.861).
CONCLUSION
These results suggested positive effects of a spirituality/hope intervention program. Helplessness decreased mainly through an increase in fighting spirit. Self-care behaviors increased mainly through an decrease in helplessness and increase in fighting spirit.

PURPOSE
This study examined the effects of spirituality promoting intervention for the stomach and colon cancer patients.
METHOD
A quasi-experimental design was used. Data collection was carried out from April 2004 to June, 2004 at a cancer center in Korea. The intervention included pray, meditation, group education and discussion for coping with cancer. The experimental group were received a 1-hour intervention per week for 6 weeks, while the control group received usual care. Data collection was done at pre and post intervention. The degree of spirituality was measured by the Korean version of WHOQOL-SRPB pilot test(WHO Quality of Life-Spirituality, Religiousness and Personal Beliefs pilot test) Module, and social support was measured using scores on a PRQ 85(Personal Resources Questionnaire). Fighting spirit was measured by the scores of MAC(Mental Adjustment to Cancer) scale.
RESULTS
The experimental group showed significant increase in the scores of social support and fighting spirit compared to those in the control group after the intervention. There were no significant changes in terms of the spirituality score compared to the baseline score in the experimental group and the control group.
CONCLUSION
This intervention appeared to be effective in increasing social support and fighting spirit, which considered to be very helpful in cancer adjustment.

PURPOSE
The purpose of this study was to examine the relationship between spirituality and a fighting spirit among the patients with cancer. METHODS: The participants were 223 patients diagnosed stomach, colorectal or breast cancer, and who were in chemotherapy or follow up care. The study design was cross-sectional at the time of the data collection. The degree of spirituality was measured by the Korean version of WHOQOL Spirituality, Religiousness and Personal Beliefs (SRPB) Pilot Test Module, and fighting spirit was measured by the scores of Mental Adjustment to Cancer(MAC) scale. RESULTS: The score of love appeared to be higher in the patients with follow up care than the patients with treatment(p<0.05) and the score of believing was much higher in patients with recurrence than the patients without (p<0.05). There was a statistically significant correlation among hope, believing, love, forgiveness and acceptance, and fighting spirit. In the multiple regression analysis, hope and believing explained much variance of the fighting spirit. CONCLUSION: These finding showed that the more hopeful and believing patients with cancer had higher scores of fighting spirit, which was known to be one of the most active coping style in adjusting to cancer.

PURPOSE
All nurses should provide spiritual care for their clients. It is especially important to care spiritually for cancer patients facing the crisis of life. Therefore, the purpose of this study is to analyze the concept of spirituality which is one of the basic concepts for spiritual care in cancer patients. METHOD: The subjects of this study were 8 cancer patients; 2 Christians,3 Buddhists, and 3 persons who did not have any religion. The data was collected and analyzed by Hybrid Model. RESULT: The results of this study were as follows: Dimensions of spirituality(vertical dimension connected with the absolute being, horizontal dimension related to others, existential dimension related to seeking of meaning), attributes of spirituality(dynamic process strengthened in suffering due to struggle with cancer, connectedness with the absolute being or will and belief in oneself, transcendence of reality, meaning and purpose of life, future oriented), outcomes of spirituality(intrinsic, behavioral). CONCLUSION: The spirituality of cancer patients is manifested differently by his(her) religion, age, past experiences and burden of family, and is able to be strengthened with cancer. Therefore, nurses should recognize that diagnosis and deterioration of cancer is not only a spiritual crisis but can be a good chance for spiritual growth, as well.

The purpose of this is to understand the aspect of human spirituality and its general meaning to nursing practice. This conceptual analysis has been defined thus : 1) spirituality is a basic human attribute 2) spirituality gives meaning to life 3) spirituality is a relationship between the omnipotent and the supernatural. Spirituality assumes these : 1) all human beings possess a spiritual nature 2) it is the source of human power 3) it assumes mutual relationship between the individual and others 4) conviction etc. And the result of spirituality leads to : 1) petition 2) peacefulness 3) hope 4) love between the self and the surrounding others and etc. The experience of the spirituality refers to the relationship between the self, others, and with the environment as well as the relationship with God. And that positive and assertive mentality and attitude will result in a desirable spiritual relationship between the caregiver(the nurse and the receiver.