Questionnaire Checklist for Student Nurse Respondents

Dear Respondent,

The undersigned is conducting a study regarding “Assessment of the Spiritual Nursing Care
Competencies of BSN Students” in partial fulfilment of the requirements of the course Doctor of
Philosophy in Nursing. The purpose of the study is to assess the spiritual nursing care competencies of
BSN students in the universities and colleges of nursing in Region 1. The researcher sees the importance
of determining the strengths and weaknesses of student nurses in the aspect of spiritual care. In so doing,
they may be provided with the appropriate knowledge and relevant training to assist them in the render of
effective and efficient spiritual nursing care.

May I please solicit your utmost participation by accomplishing this questionnaire. Please do not leave
any item unanswered. Rest assured that all data gathered shall be treated with utmost confidentiality.

Thank you.

Sincerely yours,

EPIFANIA MARLENE R. PURISIMA

Ph D in Nursing Candidate

PART I: Socio-Demographic Profile

Direction: Please answer all the items. You may place a checkmark (√) on the space
provided.

Year level: Level 2 Level 3 Level 4

School Category: Government

Private

School’s Accreditation Level: No accreditation

Level 1
Level 2
Level 3

Enrolled Spiritual Care Nursing as an Elective Subject (for Level 4 only): Yes
No
PART II: Spiritual Nursing Care Competencies
 The following statements are related to your knowledge, values and skills about spiritual
nursing care.

A. Knowledge on Spiritual Care Nursing

The following statements are related to knowledge competencies on spiritual care nursing
which deals with specific information in order for a student nurse to provide spiritual care for patients.
Please put a check mark (√) to your corresponding answer.

YES NO

1. Spirituality is a multidimensional phenomenon that involves a belief in

a relationship with some higher power or divine being and is influenced
by life experiences, coping skills and individual belief systems.
2. To implement spiritual care, nurses need to be skilled in establishing a
trusting nurse-client relationship.
3. Clients have the right to receive care that is irrespective of their
individual spiritual and religious values.
4. Nurses need to follow ethical guidelines for providing spiritual care, and
not to impose personal beliefs or practices on clients.
5. The spiritual needs of clients and support persons often come into
focus only at a time of illness.
6. Spiritual distress is reflected in various behaviors including depression,
anxiety, verbalization of unworthiness, and fear of death.
7. All clients need to be screened for spiritual needs, however, only those
who indicate needs require a pertinent, in-depth assessment.
8. The nursing process which includes assessing, diagnosing, planning,
implementing and evaluating can only be applied to physical health
and not to spiritual health.
9. The level to which nurses nurture and care for themselves influences
their ability to function effectively in their healing role with their client.
10. Spiritual care is very much dependent upon the personal attributes and
qualities displayed by the nurse in the interaction and dealings with
patients.
11. Non-therapeutic communication and interpersonal skills assist
nurses in meeting the needs of the human spirit.
12. Nursing interventions that promote spiritual health are limited to
offering ones presence and supporting the client’s religious
practices.
13. The initial spiritual assessment should collect information not only
about spiritual beliefs and practices affecting health, but also about how
the client desires spiritual care from the health care team.
14.Spiritual care is not just about religious beliefs and practices.
15.Just as individuals develop physically, cognitively and morally, they
also develop spiritually. Thus in providing spiritual care, it is important
to consider individual’s life stage.
B. Spirituality/Spiritual Values
The following statements are related to spirituality/ spiritual values. These are the important
and lasting beliefs or ideals of a nurse that have a major influence on behavior and attitude and may
serve as personal guidelines in the render of spiritual care. Please put a check mark ( √) on the column
that best describes your spirituality/spiritual values where:

1 – Strongly Disagree, the student nurse intensely opposes the statement on spirituality or spiritual
values.; requires spiritual enhancement
2 – Disagree, the student nurse contests the statement on spirituality or spiritual values
3 - Uncertain, the student nurse is undecided whether to agree or disagree to the statement on
spirituality or spiritual values
4 – Agree, the student nurse approves the statement on spirituality or spiritual values; ethically
meets acceptable ethical criteria of spiritual care
5 – Strongly Agree, the student nurse intensely approves the statement on spirituality or spiritual
values; excellently conforms with morals and ethics of spiritual care

I believe that… 1 2 3 4 5
1. nurses can provide spiritual care by arranging a visit by the hospital
Chaplain or the patient’s own religious leader if requested.
2. nurses can provide spiritual care by showing kindness, concern and
cheerfulness when giving care.
3. spirituality is concerned with a need to forgive and a need to be
forgiven.
4. spirituality involves only going to Church/Place of Worship.
5. spirituality is not concerned with a belief and faith in a God or
Supreme being.
6. spirituality is about finding meaning in the good and bad events of
life.
7. nurses can provide spiritual care by spending time with a patient
giving support and reassurance especially in time of need.
8. nurses can provide spiritual care by enabling a patient to find
meaning and purpose in their illness.
9. spirituality is about having a sense of hope in life.
10.spirituality is to do with the way one conducts one’s life here and
now.
11. nurses can provide spiritual care by listening to and allowing
patients time to discuss and explore their fears, anxieties and
troubles.
12.spirituality is a unifying force which enables one to be at peace with
oneself and the world.
13.spirituality does not include areas such as art, creativity and self -
expression.
14.nurses can provide spiritual care by having respect for privacy,
dignity and religious and cultural beliefs of a patient.
15.spirituality involves personal friendships, relationships.
16.spirituality does not apply to Atheists or Agnostics.
17.spirituality includes peoples’ morals.
*With permission from McSherry (2011)
C. Spiritual Nursing Care Skills
The following statements are related to competencies on spiritual care nursing practice or
skills. These are the abilities and capacities acquired through deliberate, systematic, and sustained
effort to smoothly and adaptively carry out spiritual nursing care activities and functions. Please put a
check mark (√) on the column that best describes your skills on spiritual nursing care where:

1 – Poor, the student nurse performance does not meet acceptable criteria of rendering spiritual
nursing care; requires improvement
2 – Satisfactory, the student nurse has marginal performance but not sufficient enough to
adequately meet acceptable criteria of rendering spiritual nursing care.
3 – Very Satisfactory, the student nurse performs in conformity with the acceptable criteria of
rendering spiritual nursing care; skills are sufficient enough to carry out tasks
precisely and right.
4 – Outstanding, the student nurse has excellent performance; skills exceptionally exceed
acceptable criteria of rendering spiritual nursing care

In rendering spiritual care… 1 2 3 4

I assess my patient by…
1. determining my patients’ spiritual beliefs and practices and
ascertaining those that are most important to him .
2. verifying the presence of religious items of my patients such as
rosary beads, Buddha beads, bible, etc.
3. examining how my patient’s spiritual beliefs and practices affect his
coping.
4. taking into consideration the dietary preference of my patients based
on one’s faith (e.g. as a Muslim, Jehovah’s Witness, Adventist).
5. asking patient about presence of spiritual support or counselor
which he may be regularly meeting and determine his any desire for
a visit from them.
6. asking patient about how he may like to receive support on
spirituality from the health care team.
7. ensuring sensitivity on my patient’s behaviour, verbalization, affect,
attitude and interpersonal relationships which may provide cues to
spiritual and religious preferences, strengths, concerns or distress.
I formulate nursing diagnosis on my patients’ spiritual problems by…
1. utilizing the North American Nursing Diagnosis Association
(NANDA) approved nursing diagnoses in labelling the spiritual
needs of my patients.
2. considering that spiritual problems may provide the diagnostic label
which can either be spiritual distress, readiness for enhanced spiritual
well-being and risk for spiritual distress.
I design plan of care for my patient by…
1. establishing desired outcomes of spiritual care which are short,
measurable, attainable, realistic and time-bounded.
2. identifying interventions to help my patient achieve the overall goal
of maintaining or restoring spiritual well-being.
3. devising ways to assist my patient in achieving a sense of hope
 through attaining spiritual strength, serenity and satisfaction.
4. formulating means to help patient draw on and use inner resources
more effectively and find meaning of existence and present
situation.
5. considering and recognizing my spiritual limitations.
I implement spiritual nursing care by…
1. seeing to it that I am physically present and available to help client
determine religious and spiritual choices.
2. providing quiet time for meditation, prayer, and relaxation.
3. asking how to be most helpful, then actively listen, reflect, and seek
clarification.
4. holding my patient’s hand or placing my hand gently on arm (if
comfortable with touch) to make him feel that I am available to help
him
5. helping my patient develop and accomplish short-term goals and
tasks.
6. providing appropriate religious materials, artifacts, or music as
requested.
7. providing privacy for patient to pray with others or to be read to by
members of own faith.
8. orienting patient and family to hospital unit including the directions
to hospital chapel.
9. making use of therapeutic communication whenever I provide
spiritual care to my patient.
10. providing spiritual care to all my patients regardless of their
condition.
11. referring patient to spiritual advisor of choice.
12. referring patient for counseling, therapy, support groups, or hospice.
13. coordinating spiritual care in multidisciplinary consultation.
14. accomplishing written nursing reports in the spiritual functioning of
my patients. (Eg. Stipulation of spiritual care in FDAR
documentation)
I evaluate spiritual nursing care rendered by…
1. utilizing the measurable desired outcomes developed during the
planning stage to determine whether goals or desired outcomes have
been achieved.
2. appraising effectiveness of spiritual care with the patient and
healthcare team.