Date of Award

Fall 2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Faut Callahan, Margaret

Second Advisor

McCarthy, Donna O.

Third Advisor

Hughes, Ronda G.

Fourth Advisor

White-Traut, Rosemary

Abstract

Holistic nursing care embraces the physical, psychological, and spiritual needs of the patient and family, thereby providing support and reducing suffering. Nurses’ spiritual care can improve the well-being and quality of life of children with cancer by assisting them to find meaning in their lives. At the end of life, spiritual care assists children in coping with their diagnosis, suffering, and losses. There are distinct deficiencies in education that lead nurses to feel unprepared to provide spiritual care to children. This study employed a prospective, longitudinal design to evaluate the potential effects of an online spiritual care educational program on pediatric oncology nurses’ attitudes towards and knowledge of spirituality/spiritual care and their competence to provide spiritual care to children with cancer at the end of life. Narayanasamy’s Actioning Spirituality and Spiritual Care Education and Training in Nursing (ASSET) model framed this design, for this model offers distinct strategies to guide spiritual care education. Participants included 112 pediatric nurses who provide care to children with cancer. Online multimedia content was supplemented with an asynchronous discussion forum. One-way repeated-measures analysis of variance compared scores on nurses’ attitudes towards and knowledge of spirituality/spiritual care at baseline, immediately after completion of the program, and three-months later. Analyses indicated a very large effect over time. One-way repeated measures analysis of variance compared scores of nurses’ spiritual care competence at baseline, immediately after a participant’s completion of the program, and three-months after a participant’s completion of the program. There was a very large effect over time on nurses’ level of spiritual care competence. Linear regression found a positive relationship between the total change score in nurses’ attitudes towards and knowledge of spirituality/spiritual care and the total change score in nurses’ level of spiritual care competence. Online spiritual care educational initiatives may exert a meaningful effect on pediatric oncology nurses’ knowledge, attitudes, and competence to provide spiritual care. The ASSET model provides a useful framework for conceptualizing and investigating the effects of spiritual care educational initiatives. Results from this study address a gap in knowledge to advance nursing education and serve as a foundation for further investigation.

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