IMPACT OF SPIRITUAL NURSING CARE IN ALLEVIATING PATIENT ANXIETY AS

PERCEIVED BY NURSES IN THE TACLOBAN CITY HOSPITAL

A Research Proposal

Presented to

The Faculty of the College of Nursing

Colegio de Sta. Lourdes of Leyte, Foundation, Inc.

Tabontabon, Leyte

In Partial Fulfillment

of the Requirements for the Subject

Nursing Research 2

By:

Angieliquie Laei A. Mejilla

Danica James E. Nalda

Rose S. Quirante

Shane Frances T. Saborrido

Elaiza Margarita C.Tinos

JULY 2022

1
 TABLE OF CONTENTS

Page

TITLE PAGE ………………………………………………………………………………….i

TABLE OF CONTENTS …………………………………………………………………….ii

CHAPTERS

1 INTRODUCTION …………………………………………………………1

Background of the Study……………..……………………… 1

Statement of the Problem…………………………………… 3

Research Hypothesis ..……………………………………… 3

Significance of the Study ……………………………….….. 5

Scope and Delimitations of the Study.………………….... 6

Theoretical Framework …………………………..………….. 7

Conceptual Framework…………………………………….…8

Definition of Terms ………………………………………….. 9

2 REVIEW OF RELATED LITERATURE

Related Literature ………………………………………………10

Related Studies …………………………………………………13

3 RESEARCH METHODOLOGY

Research Design ……………………………………………… 16

Research Locale…………………………………………….....

2
 Respondents of the Study…………………………………..….

Research Instrument.……….…………………………………

Data Collection…. .…………………………………………....

Statistical Treatment of Data ………………………………….

APPENDICES

A. Research Instrument ……………………………..

B. Letter

C. Letter

REFERENCES …………………………………………………………….

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 CHAPTER 1

INTRODUCTION

This chapter aims to provide the readers of the research foundation and purpose.

The part includes the research background of the study, statement of the problem, the

scope and limitations of the study, the significance of the study, and the definition of

terms. The theoretical framework and conceptual framework are also presented in this

chapter that supports the overall study.

Background of the Study

Anxiety is one of the psychological complications of some certain diseases in

patients and it is due to various factors. Since this complication leaves undesirable

effects on physical and mental health and also on the patients’ quality of lives, one of

the main nursing cares is using various strategies to reduce the anxiety. Experience of

living with a disease shows spirituality creates purpose and meaning in life for patients.

Spiritual care, as part of nursing care for patients with other diseases or from

diverse populations, has not been widely studied. In addition, nursing education does

not routinely include the teaching of spiritual care. Nurses want to give spiritual care but

their preparation may be lacking; other barriers such as role confusion and increased

workload and lack of time may prevent them from giving spiritual care (Piles, 1990).

Health care researchers have suggested a correlation between better mental and

physical health and a person’s spirituality or religious practices (Koenig, 2002). Indeed,

using spiritual and religious resources gives patients and families strength to cope

during

4
a crisis (Kloosterhouse & Ames, 2002). Given that little is known about nurses’

experiences with spiritual care, one wonders how spiritual care is given (Taylor, 2005),

what the experience means to nurses, and how the experience affects nurses and their

future actions like how a positive experience could encourage the nurse and others to

give spiritual care.

Patient studies confirm that spiritual care can be positive. Hermann (2001) and

Sellers (2001) conducted qualitative studies and found that patients desired the

inclusion of spirituality by nurses. Moreover, although many nurses would agree that

spiritual care is a nursing responsibility, a disparity exists between that belief and the

actuality of giving spiritual care (Dettmore, 1985; Piles, 1990)

Early studies indicated that the lack of attention to the spiritual needs of patients

in most health care centers leads to increased anxiety, decreased hope, spiritual

isolation, and finally, an increase in the length of treatment (Kim et al. 2012). Therefore,

professional nursing should pay special attention to this dimension of health, as spiritual

care is the basis of a holistic nursing and is considered as a legal duty which should be

performed by nurses (Shoja et al. 2013).

Accordingly, the present study aimed to investigate the impact of spiritual nursing

care in alleviating patient anxiety as perceived by nurses in the Tacloban City Hospital.

5
Statement of the Problem

This study aims to provide an in-depth understanding of the impact of spiritual

nursing care in alleviating patient anxiety as perceived by nurses in the Tacloban City

Hospital.

To be specific, the researchers aim to scrutinize the selected participants’:

1. Demographic profile of the respondents;

1.1. Age

1.2. Gender

1.3. Status of Employment

1.4. Wards where assigned?

2. View and experiences on spiritual nursing care and its effectiveness in

alleviating patient anxiety.

3. Challenges thus far encountered while using spiritual nursing care in

alleviating patient anxiety.

4. Strategies utilized to cope with the challenges encountered while using

spiritual nursing care in alleviating patient anxiety.

Significance of the Study

The outcome of the study will provide basis for:

To the Nursing Students. The results and findings of the study will serve as

enlightenment and provides additional knowledge and awareness to nursing students in

6
improving nursing care while integrating the significance of spiritual nursing care on

alleviating patient’s anxiety.

To the Nurses. Their opinions will be heard as a basis to provide innovative and

improved about the spiritual nursing care in alleviating patient’s anxiety.

To the Future researchers. Result of the study will also serve as springboard to

all young researchers to conduct another studies related to impact of spiritual nursing

care in alleviating patients’ anxiety as perceived by nurses.

Hypothesis of the Study

This study anticipates the hypotheses that:

1. There is no significant difference in using spiritual nursing care to alleviate the

patient’s anxiety, and

2. There is no significant relationship between spiritual nursing and anxiety in

accordance with the nurses.

Scope and Limitations of the Study

This research will be focusing on the impact of spiritual nursing care in alleviating

patients’ anxiety and its effectiveness, advantages and disadvantages. The study will be

limited only for the Nurses of Tacloban City Hospital.

The study is all about the impact of spiritual nursing care in alleviating patients’

anxiety and its effectiveness on the side of nurses. The study will be conducted to

determine the factors and opinions of the nurses in Tacloban City Hospital.

7
Theoretical Framework

This study is anchored on A Middle-Range Theory of Spiritual Well-Being in

Illness. A middle-range theory of spiritual well-being in illness emphasizes by Parish

Nursing: Healthcare Ministry Within the Church (2018) that spirituality is useful in

orienting the practice of any nurse carrying out holistic care, which includes attention to

the needs of body, mind, and spirit, Such a theoretical orientation is important especially

for nurses caring for those experiencing long-term chronic illness, life-threatening and

terminal illness., as well as any illness or injury that affects an individual’s personal

and/or professional life goals.

The major theme in the theoretical framework of the Parish Nursing: Healthcare

Ministry Within the Church, 2003 is that spiritual care can help the nurses with patient

that has illness whether physical and mental to assess and evaluate its spiritual needs

and if warranted, to institute appropriate spiritual care interventions.

8
 Conceptual Framework

Personal Faith Severity of Illness Stressful Life Events

Belief in God’s Existence Emotional
Peace in Spiritual Beliefs Degree of Sociocultural
Confidence in God’s Power Functional Impairment Financial
strength from the Faith Belief’s
Trust in God’s Providence
Spiritual Contentment
Finding Spiritual
Satisfaction with faith Meaning in the
Feeling of Closeness to God Experience of
Lack of Fear Illness Spiritual
Reconciliation Well-Being
Security in God’s Love in Illness
Faithfulness

Religious Practice
Support of Faith Community
Affirmation in Worship Social Support
Encouragement of Spiritual Companions
Consolation from Prayer Family
Communication with God Through Friends
Religious Practices Caregivers

Figure 1. Conceptual Framework of Spiritual Care in Illness.

The impact of these spiritual and religious attitudes and behaviors on one’s

finding spiritual meaning in illness may also be mediated by such potentially intervening

variables as severity of illness, degree of functional impairment, social support, support

of family, friends, and/or caregivers; and current stressful life events: emotional,

sociocultural, and/or financial.

9
Definition of Terms

Important terminologies mentioned in this study that can pose confusion and

vagueness are listed below in hopes for clarify and understanding.

a. Dictionary Definitions- the definition taken from dictionary

b. Operational Definitions- definition based on our study.

a. Spirituality. Involves the recognition of a feeling or sense of belief that there is

something greater than myself.

b. Spirituality. It defines elements such as higher power, feeling of connectedness

purpose and meaning in life, relationships and transcendence.

a. Spiritual care. It attends to a person’s spiritual or religious needs.

b. Spiritual Care. It is believed to be a major part of the nurse’s role.

a. Spiritual Nursing Care. It defines for caring for the human spirit thorough the

development of caring relationships and interconnectedness between the nurse and the

patient to promote spiritual health.

b. Spiritual Nursing Care. It consists of nursing methods or activities that rely on the

provision of company or care, listening, or religious activities that correspond to patient’s

beliefs to help them to achieve better physical mental, social and spiritual health,

a. Holistic. Characterized by comprehension of the parts of something as intimately

interconnected and explicable only by reference to the whole.

b. Holistic. It is an approach characterized by the treatment of the whole person rather

than just symptoms of a disease.

a. Holistic Care. It means to provide support that looks at the whole person, not just

their mental health needs.

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b. Holistic Care. It refers to the provision of care to patients that are based on a mutual

understanding of their physical, psychological, emotional and spiritual dimensions.

CHAPTER 2

REVIEW OF RELATED LITERATURE

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 This chapter provides collective related literatures and relevant studies aiming to

enrich the research foundation.

Related Literature

According to Dr. Rachel Harrad (2019), Spiritual wellbeing has important

implications for an individual’s health and wellbeing. Whilst the provision of spiritual care

and assessment of spiritual needs is a vital part of the nurse’s role, literature suggests

that nurses do not always engage in spiritual care with their patients or assess their

spiritual needs. This review aims to ascertain wider reasons for this inconsistent spiritual

care delivery by nurses to their patients.

14 measures relating to spiritual care and assessment were identified covering

the key domains of: ‘Beliefs and values and attitudes around spiritual care,’ ‘Frequency

of provision or extent to which they provide spiritual care or willingness,’ ‘Respondents’

level of knowledge around spirituality and spiritual care,’ ‘Ability to respond to spiritual

pain,’ and ‘Multiple Domains: beliefs and attitudes around spirituality and spiritual care,

amount of preparation, training and knowledge, spiritual care practices, perceived ability

and comfort with provision and perceived barriers to provision.

According to by Parish Nursing: Healthcare Ministry Within the Church (2018)

that spirituality is useful in orienting the practice of any nurse carrying out holistic care,

which includes attention to the needs of body, mind, and spirit, Such a theoretical

orientation is important especially for nurses caring for those experiencing long-term

chronic illness, life-threatening and terminal illness., as well as any illness or injury that

affects an individual’s personal and/or professional life goals.

12
 According to Mohsen Adib Hajbaghery (2014) Spiritual care has positive effects

on individuals’ stress responses, spiritual well-being (ie, the balance between physical,

psychosocial, and spiritual aspects of self), sense of integrity and excellence, and

interpersonal relationships. Spiritual well-begin is important for individual's health

potential and the experience of illness/hospitalization can threaten optimum

achievement of this potential. Professional nursing embraces spiritual care as a

dimension of practice. There are many indications that spiritual care is considered to be

a nursing responsibility but there is a lack of role clarity.

Related Studies

According to the study of The Effect of Spiritual Care on Perceived Stress

and Mental Health Among the Elderlies Living in Nursing Home by Mohammad Heidari

et al. (2019), Spiritual care is a unique aspect of nursing care, which cannot be replaced

by psychological, social, or religious care, and responds to basic human questions such

as meaning in life, pain, suffering, and death. The spiritual care facilitates the medical

communication, and the nurses can create the power and spiritual support among the

individuals and improve their interactions with other family members, environment,

nature and superior power by encouraging them to recall the past and emphasizing the

special events (Heidari et al. 2017). Early studies indicated that the lack of attention to

the spiritual needs of patients in most health care centers leads to increased anxiety,

decreased hope, spiritual isolation, and finally, an increase in the length of treatment

(Kim et al. 2012). Therefore, professional nursing should pay special attention to this

13
dimension of health, as spiritual care is the basis of a holistic nursing and is considered

as a legal duty which should be performed by nurses (Shoja et al. 2013).

The study shows that a significant percentage of the elderlies (68.88%) in the

intervention group reported their perceived stress at a high level before the

implementation of the spiritual care and 60% of the elderlies in the control group

reported that at a high level. As the perceived stress level in both groups did not differ

before the implementation of spiritual care (X2 = 1.13 and P = 0.45). After implementing

the spiritual care, the majority of the elderlies (62.22%) in the intervention group had the

low perceived stress level and the majority of the subjects (64.44%) in control group had

high perceived stress level. Therefore, after performing spiritual care, there was a

significant difference at the perceived stress level of both groups (X2 = 3.22 and P =

0.001) (Table 2). Regarding the mental health level, results demonstrated that the mean

score obtained from the general health questionnaire was 10.95 ± 27.2. Additionally, the

comparison of the mental health in the intervention and control groups before and after

implementing the spiritual care illustrated that before implementing the spiritual care in

the intervention and control groups, 51.11% and 57.77% of the participants were

suspected to have general disorder, respectively. Based on the results, before the

spiritual care implementation, no significant difference was not observed between both

groups in terms of mental health (X2 = 11.23 and P = 0.72). After implementing the

spiritual care, there was a significant difference in mental health level of both groups, as

in the intervention and control groups, 31.11% and 53.33% of the participants were

suspected to have general disorder.

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 Based on the results, the spiritual care has been effective in reducing the

perceived stress and increasing the mental health of the elderlies living in the

sanatorium. Therefore, the mental health of elderlies can be increased by applying

programs tailored to the needs of the elderlies and incorporating spiritual care

interventions in the care program in the therapeutic and rehabilitation centers. Thus, all

institutions and organizations with important goals like healthy elderly should pay more

attention to the importance of the role of spiritual health in the care to maintain the

mental health. In the same vein, they can take an important step in achieving their

therapeutic and care objectives by knowing the spiritual needs and encouraging the use

of spiritual interventions to implement holistic care.

According to the study of Nurses' Experience of Giving Spiritual Care by Belinda

Deal (2010), Using spiritual and religious resources gives patients and families strength

to cope during a crisis, but nurses often do not offer spiritual care (Kloosterhouse &

Ames, 2002). The purpose of this phenomenological study was to explore nurses" lived

experience of giving spiritual care. A descriptive phenomenological approach was used

to interview 4 nurses. Data were analyzed using Colaizzi’s (1978) phenomenological

method. Five themes were identified: spiritual care is patient-centered, spiritual care is

an important part of nursing, spiritual care can be simple to give, spiritual care is not

expected but is welcomed by patients, and spiritual care is given by diverse caregivers.

Spiritual care is an integral part of nursing and nurses can support patients with spiritual

interventions.

The importance of spirituality ascribed by the nurses is supported by research

about nurses giving spiritual care (Carroll, 2001; Stranahan, 2001; Taylor, Highfield, &

15
Amenta, 1994). According to the participants, spiritual aspects of care should be

initiated by the patient and be patient-centered not nurse-centered. The nurse-client

journey through spiritual care was documented by Kociszewski (2003). Spiritual care

appears to be beneficial to the patients when a shared belief is noted. The nurse can

support the patient with spiritual interventions such as time spent with them, listening,

and if they request, praying with them. Spiritual care is an integral part of nursing.

16
 CHAPTER 3

RESEARCH METHODOLOGY

This chapter presents the research design, locale, participants and sampling

procedure, research instrument validation, data gathering procedure, ethical

considerations and reflexivity statement, and analysis of data. The purpose of this

chapter is to give clear plan map on how will the researchers systematically aim to meet

the goal of the study.

Research Design

The researchers will be using qualitative approach of research in a descriptive

type of research method. The data will be gathered through the use of survey-gathering

materials in order to provide a clearer representation of problem to the respondents.

The data will include survey questionnaire and other things than can record

documentation in the conduct of this study.

As instruments, the researchers will use of the quantitative approach, since the

study is more than just knowing the impact of spiritual nursing care in alleviating patient

anxiety but the effectiveness that takes to their advantages in coping with anxiety using

the spiritual nursing care.

17
Research Locale

The study will be conducted at Tacloban City Hospital. Located at Marasbaras,

Figure 1. Map of the exact location of Tacloban City Hospital

(picture taken from Google Map https: google.map./

Figure 2. Physical View of Tacloban City Hospital

(picture taken from https: google.com/ /)

18
Respondents of the Study

This study will need the active participation of selected Nurses from Tacloban

City Hospital. The participants will be selected according to the following criteria:

1. Must be a Registered Nurse

2. A nurse who works in Tacloban City Hospital

3. Willing to participate

Research Instrument

In order to gather more relevant data about the study, the researcher will use

survey questionnaires to gather the data and the respondent’s opinion about the topic.

Under which, the researchers will conduct online survey amidst the COVID-19

pandemic to collect data from the respondents regarding the study. The online sruvery

will be conducted because that will be the only way allowed to gather data through

online in order to prevent the harm of the virus. The online survey will obtain the

necessary data coming from the respondents they will be related and have a valid and

relevant data align with the topic.

Data Collection

The researchers will choose some of the Nurses from Tacloban City Hospital

that will be considered in the study which is the impact of spiritual nursing care in

alleviating patient anxiety as a whole. A randomized procedure will be conducted in

choosing 50 Nurses of Tacloban City Hospital despite of their gender.

19
 In order to determine the samples for this study, the researcher will choose and

ask permission to the head of Tacloban City Hospital and to the Nurses. The researcher

will also be considering the referrals of other people who are more appropriate to

provide opinions about the study as well as volunteering nurses of Tacloban City

Hospital.

Statistical Treatment of Data

To be able for the researchers to generate a result, statistical tools must be used

to evaluate the gathered data. Conducting a statistical analysis helps the researchers to

conduct a meaningful result which will give to all the gathered data. The researchers

used the statistical tools is the z-test which is used to analyze two different population

which variables are unknown.

The formula for z-test is:

´ x−µo
z=
σ /√ n

wherein: ´ x=mean of the sample

µo = mean of population

σ=standard deviation of population

n= no. of observation

20
 Chapter 4

PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter presents the results, the analysis and interpretation of data gathered

from the answers to the questionnaires distributed to the field. The said data were

presented in tabular form in accordance with the specific questions posited on the

statement of the problem.

1. Demographic Profile of the Respondents

Table 1. Age of the Respondents

Age Frequency Percentage Rank

50-60 3 6% 4

40-49 9 18% 3

30-39 28 56% 1

20-29 10 20% 2

Total 50 100%

Results in the table above shows that 6% of the respondent has the age of 50-60

answered the questionnaire, 18% from the age of 40-49, 56% from the age of 30-39

and 20% from the age of 20-29. Therefore, most of our respondents came from 30-39 of

age answered our questionnaire.

21
 Table 2. Gender of the Respondents

Gender Frequency Percentage Rank

Male 8 16% 2

Female 42 84% 1

Total 50 100%

According to the table above, 84% of the respondents were female that

answered the questionnaire while 16% from the Male. Therefore, most of our

respondents are female that answered our questionnaire.

Table 3. Status of Employment of the Respondents

Status of Frequency Percentage Rank

Employment

Regular 31 62% 1

Probationary 0 0% 3

Contractual 19 38% 2

Total 50 100%

Results in the table above shows that 62% of the respondent are regular

employee in Tacloban City Hospital while 19% of them are contractual. No one from the

respondent is under probationary. Therefore, most of our respondents are regular

employees that answered our questionnaire.

22
 Table 4. Wards where assigned among the Respondents

Wards where Frequency Percentage Rank

assigned

Medical Ward 39 78% 1

ER 11 22% 2

Total 50 100%

Results in the table above shows that 78% of the respondent are assigned in

medical ward at Tacloban City Hospital while the remaining 22% came from the ER.

Therefore, most of our respondents are from medical ward that answered our

questionnaire.

2. Challenges thus far encountered while using spiritual nursing care in

alleviating patient anxiety.

Figure 1. Efforts to maintain the religious principles and integrate spiritual

nursing care to meet the spiritual care needs of hospitalized patients.

14%
4 - Frequently
39%
3- Occasionally

47% 2- Rarely
1- Never

23
 Results above shows the percentage of respondents experienced its efforts to

maintain the religious principles and integrate spiritual nursing care to meet the spiritual

care needs of hospitalized patients as one of the challenges they usually encountered.

47% of the respondents occasionally encounter the said situation while utilizing spiritual

nursing care. 39% of them frequently encountered, and 14% were rarely experienced.

No one from the respondents had never experienced the problem.

Hence, most of the nurses in Tacloban City Hospital are occasionally having a

hard time to maintain the religious principles and integrate spiritual nursing care to meet

the spiritual care needs of hospitalized patients due to the possible factors such as

nurses' lack of time to provide and to promote the spiritual care as regards to patients’

needs especially in a busy hospital setting.

Figure 2. Belief that spiritual nursing care is apart from nursing

duty.

14% 20%
4 - Frequently
3- Occasionally
2- Rarely
67% 1- Never

24
 Results above shows the percentage of respondents believed that spiritual

nursing care is apart from nursing duty as one of the challenges they usually

encountered. 67% of the respondents occasionally encounter the said situation while

utilizing spiritual nursing care. 19% of them frequently encountered, and 14% were

rarely experienced. No one from the respondents had never experienced the problem.

Hence, most of the nurses in Tacloban City Hospital are occasionally believed

that spiritual nursing care is apart from nursing duty as one of the challenges they

usually encountered due to the possible factor such as the lack of clear guidelines for

the nurse's role in providing spiritual care; a lack of training and education on spirituality

for pre- and post-registration nurses and the lack of role clarity.

Figure 3. Lack of awareness about the patient’s religion or spiritual care

needs.

22% 4 - Frequently
3- Occasionally
2- Rarely
78% 1- Never

Results above shows the percentage of respondents that answered the lack of

awareness about the patient’s religion or spiritual care needs as one of the challenges

25
they usually encountered. 47% of the respondents occasionally encounter the said

situation while utilizing spiritual nursing care. 14% of them frequently encountered, and

14% were rarely. No one from the respondents had never experienced the problem.

Hence, most of the nurses in Tacloban City Hospital stated that lack of

awareness about the patient’s religion or spiritual care needs as one of the challenges

they usually encountered due to the possible factor the lack of clear guidelines for the

nurse's role in providing spiritual care; a lack of training and education on spirituality for

pre- and post-registration nurses, and the lack of time to inquire the patients’ belief.

Figure 4. Spiritual care is perceived not vital on alleviating patient’s anxiety

24% 4 - Frequently
28%
3- Occasionally
2- Rarely
1- Never
48%

Results above shows the percentage of respondents that answered the spiritual

care is perceived not vital on alleviating patient’s anxiety as one of the challenges they

usually encountered. 48% of the respondents occasionally encounter the said situation

while utilizing spiritual nursing care. 28% of them rarely encountered, and 24% of them

26
were frequent experienced. No one from the respondents had never experienced the

problem.

Hence, most of the nurses in Tacloban City Hospital stated that spiritual care is

perceived not vital on alleviating patient’s anxiety as one of the challenges they usually

encountered due to the possible factor the difficulty in defining spirituality; the lack of

clear guidelines for the nurse's role in providing spiritual care; nurses' lack of time to

provide spiritual care; and a lack of training and education on spirituality for pre- and

post-registration nurses.

Figure 5. Belief that spirituality is personal and not included in dealing with

patients.

22% 4 - Frequently
3- Occasionally
2- Rarely
78% 1- Never

Results above shows the percentage of respondents believed that spirituality is

personal and not included in dealing with patients as one of the challenges they usually

encountered. 47% of the respondents occasionally encounter the said situation while

utilizing spiritual nursing care. 14% of them frequently encountered, and 14% were

rarely. No one from the respondents had never experienced the problem.

27
 Hence, most of the nurses in Tacloban City Hospital stated that spiritual care is

perceived not vital on alleviating patient’s anxiety as one of the challenges they usually

encountered due to the possible factor the difficulty in defining spirituality; the lack of

clear guidelines for the nurse's role in providing spiritual care; nurses' lack of time to

provide spiritual care; and a lack of training and education on spirituality for pre- and

post-registration nurses.

3. Strategies utilized to cope with the challenges encountered while using

spiritual nursing care in alleviating patient anxiety

Figure 6. I talk to or communicate with the patient while considering and

respecting their personal spiritual beliefs.

22% 4- Always
3- Often
2- Sometimes
78% 1- Never

Results above shows that 78% of the respondents always utilized this strategy to

cope up with the challenges they encountered while utilizing spiritual nursing care.

Meanwhile, 22% of them often used this strategy and no one from the respondents

answered sometimes and never.

28
 Hence, most of the nurses in Tacloban City Hospital always communicate with

their patient while considering and respecting their personal spiritual beliefs. It provides

compassionate care and to be attentive to all suffering of their patients—physical,

emotional, and spiritual aspects.

Figure 7. I maintain a holistic approach to patients and view them as a whole;

comprises of mental, emotional, physical, social, and spiritual aspects.

14% 4- Always
3- Often
22%
64% 2- Sometimes
1- Never

Results above shows that 64% of the respondents always utilized this strategy to

cope up with the challenges they encountered while utilizing spiritual nursing care. 22%

of them often used this strategy while 14% of them sometimes used. No one from the

respondents had never utilized the strategy.

Hence, most of the nurses in Tacloban City Hospital always maintain a holistic

approach to patients and view them as a whole; comprises of mental, emotional,

physical, social, and spiritual aspects. It provides compassionate care and to be

attentive to all suffering of their patients. Addressing the holistic needs of the patient

requires the nurse to address emotional as well as physical needs.

29
 Figure 8. I recognized that spiritual nursing care is important and helpful in

alleviating patient’s anxiety and in dealing with them.

14% 4- Always
3- Often
2- Sometimes

86% 1- Never

Results above shows that 86% of the respondents always utilized this strategy to

cope up with the challenges they encountered while utilizing spiritual nursing care. 14%

of them often used this strategy and no one from the respondents answered sometimes

and never utilized the strategy.

Hence, most of the nurses in Tacloban City Hospital always recognized that

spiritual nursing care is important and helpful in alleviating patient’s anxiety and in

dealing with them. Meeting the spiritual care needs of the patient can lead to physical

healing, reduction of pain, and personal growth. Nurses providing spiritual care

experience lower stress and less burnout.

Figure 9. I recognized that spiritual belief is part of the patient and contributes to

the patient’s healing, recovery, and preserving patient’s dignity.

10% 4- Always
3- Often
2- Sometimes
30
90% 1- Never
 Results above shows that 90% of the respondents always utilized this strategy to

cope up with the challenges they encountered while utilizing spiritual nursing care. 10%

of them often used this strategy and no one from the respondents had sometimes and

never utilized the strategy.

Hence, most of the nurses in Tacloban City Hospital always recognized that

spiritual belief is part of the patient and contributes to the patient’s healing, recovery,

and preserving patient’s dignity. It provides compassionate care and to be attentive to

all suffering of their patients and meeting the spiritual care needs of the patient can lead

to physical healing, reduction of pain, and personal growth.

Figure 10. I know that religious care is part of nursing duty and not apart on

rendering care to patients.

14% 4- Always
3- Often
22%
64% 2- Sometimes
1- Never

Results above shows that 64% of the respondents always utilized this strategy to

cope up with the challenges they encountered while utilizing spiritual nursing care. 22%

31
of them often used this strategy while 14% of them sometimes used. No one from the

respondents had never utilized the strategy.

Hence, most of the nurses in Tacloban City Hospital always know that religious

care is part of nursing duty and not apart on rendering care to patients. They knew that

spirituality helps patients cope with stress, make crucial medical decisions, and

improves their quality of life.

Chapter 5

SUMMARY, CONCLUSION, AND RECOMMENDATION

This chapter presents the summary, the interpretations and conclusions based

on the results of the survey, and the researchers’ recommendations to help improve

future research surveys on the impact of spiritual nursing care in alleviating patient

anxiety.

Summary

32
 The study aimed to provide an in-depth understanding of the impact of spiritual

nursing care in alleviating patient anxiety as perceived by nurses in the Tacloban City

Hospital. Specifically, the study answered the following:

1. Demographic profile of the respondents;

1.1. Age

1.2. Gender

1.3. Status of Employment

1.4. Wards where assigned?

2. View and experiences on spiritual nursing care and its effectiveness in

alleviating patient anxiety.

3. Challenges thus far encountered while using spiritual nursing care in

alleviating patient anxiety.

4. Strategies utilized to cope with the challenges encountered while using

spiritual nursing care in alleviating patient anxiety.e. Strategies utilized to cope with the

challenges encountered while using spiritual nursing care in alleviating patient anxiety.

The researcher focuses on the impact of spiritual nursing care in alleviating

patient anxiety as perceived by nurses in the Tacloban City Hospital. The researcher

identifies the challenges and strategies by the 50 respondents in terms of using spiritual

nursing care in alleviating patient anxiety.

The research instrument used in the study was the survey questionnaires to

gather the data and the respondent’s opinion about the topic. Under which, the

33
researchers conducted an online survey amidst the COVID-19 pandemic. The online

survey was able to obtain the necessary data coming from the respondents which is

related and have a valid and relevant data align with the topic.

The researchers used the descriptive method in explaining, analyzing and

classifying the data. This instrument helped the researchers to describe and interpret

the problem and analyzing relationship of variables, testing hypothesis and the

development of generalization. The errors were analyzed and tallied with the use of

frequency distribution, percentage, ranking, and analysis of variance.

The findings of the study in the online survey revealed that the most frequent

problem of the nurses of Tacloban City Hospital encountered are lack of awareness

about the patient’s religion or spiritual care needs and the belief that spirituality is

personal and not included in dealing with patients. Some problems they occasionally

encountered were maintaining the religious principles and integrate spiritual nursing

care to meet the spiritual care needs of hospitalized patients, the belief that spiritual

nursing care is apart from nursing duty, and the spiritual care is perceived not vital on

alleviating patient’s anxiety

On the other hand, the strategy they always used to cope up with these problems

is to talk to or communicate with the patient while considering and respecting their

personal spiritual beliefs.

Conclusion

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 After the statistical treatment and analysis of the collected data, the following

conclusions were arrived at:

1. Profile of the respondents

1.1 The most number of respondents are 30-39 years old with a frequency

of 28 (or 56%). Meanwhile, the least number of respondents with a

frequency of 3 or 6% are 50-60 years old.

1.2 The majority of the respondents are female with a frequency of 42 (or

84%) of total respondents. 8 or 16% of the respondents are male.

1.3 31 or 62% of the respondent are regular employee in Tacloban City

Hospital while 19% of them are contractual. No one from the respondent is under

probationary.

1.4 Majority of the respondents are assigned in medical ward with a

frequency of 39 (or 78%). The remaining 11 respondents (or 22%) came from the

ER.

2. The respondents stated that the most frequent problem they encountered are

the lack of awareness about the patient’s religion or spiritual care needs and the belief

that spirituality is personal and not included in dealing with patients. Some of it are only

occasionally encountered including maintaining the religious principles and integrate

spiritual nursing care to meet the spiritual care needs of hospitalized patients, the belief

that spiritual nursing care is apart from nursing duty, and the spiritual care is perceived

not vital on alleviating patient’s anxiety.

35
 3. The respondents stated that the strategy they always used to cope up with

these problems is to talk to or communicate with the patient while considering and

respecting their personal spiritual beliefs.

Based on the result of this study, it can be concluded that there was a

significant impact of spiritual nursing care in alleviating patient’s anxiety. This

intervention should be recommended for nurses to apply spiritual approach in their

nursing care.

Recommendations

In the light of the findings of the study, the following recommendations are

proposed:

1. This research study suggests that awareness regarding the patient’s religion or

spiritual care needs is necessary in maintaining efforts in utilizing religious

principles and for the integration of spiritual approach in nursing practice in order

to meet the spiritual care needs of their patients.

2. One of the major problems encountered by the respondents relates to their

belief that spirituality is personal and not included in dealing with patients.

Therefore, this research study suggests that a part of dealing with the patient

holistically, is knowing and learning that spiritual beliefs of the patient is personal

yet, part of the patient in which may affect the patient’s perception of health or

illness.

36
 3. This research study also suggests that integration of Spiritual Nursing Care in

the field of nursing practice is necessary in alleviating patient’s anxiety and must

be part of a holistic approach to patient.

4. While knowledge, skills, attitude, and hospital support were all acknowledged by

the respondents as the factors that highly affect spiritual nursing care, future

studies should be conducted to know more about the topic.

Appendix A

SURVEY QUESTIONNAIRE

Research Title: IMPACT OF SPIRITUAL NURSING CARE IN ALLEVIATING

PATIENT ANXIETY AS PERCEIVED BY NURSES IN THE TACLOBAN CITY
HOSPITAL
Part I. – Demographic Profile of the Respondent
Directions: Kindly check the appropriate box or supply the following:
Respondent’s Name: _________________________________ Age: ______
Gender: Male Female
Status of Employment: Regular Probationary Contractual
Ward Where Assigned: ____________________

37
Part II. – Challenges encountered while utilizing spiritual nursing care.
Directions: For the problems encountered while utilizing spiritual nursing care that are listed
below, please indicate for each item how often you experience them at work or in the field of
nursing practice. Write a check mark (√) for your answer.

Legend: 4 – Frequently 3 – Occasionally 2 – Rarely 1 – Never

Frequency
Statement
4 3 2 1
Efforts to maintain the religious principles and integrate spiritual
1. nursing care to meet the spiritual care needs of hospitalized patients.        
2. Belief that spiritual nursing care is apart from nursing duty.        
Lack of awareness about the patient’s religion or spiritual care
3. needs.        
4. Spiritual care is perceived not vital on alleviating patient’s anxiety        
Belief that spirituality is personal and not included in dealing with
5. patients.        
6. Others (specify)        

Part III. – Strategies Utilized to Cope with the Challenges Encountered

Directions: Please indicate below the frequency that you perform the following strategies that are
listed below by writing a check mark (√) in the appropriate column for each of the following
items:

Legend: 4 – Always 3 – Often 2 – Sometimes 1 – Never

Extent of Practice
Statement On Spiritual Care
4 3 2 1
I talk to or communicate with the patient while considering and
1. respecting their personal spiritual beliefs.        
I maintain a holistic approach to patients and view them as a whole;
comprises of mental, emotional, physical, social, and spiritual
2. aspects.        
I recognized that spiritual nursing care is important and helpful in
3. alleviating patient’s anxiety and in dealing with them.        
I recognized that spiritual belief is part of the patient and contributes
4. to the patient’s healing, recovery, and preserving patient’s dignity.        
5. I know that religious care is part of nursing duty and not apart on        

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 rendering care to patients.
6. Others (specify)        

Thank you very much for your participation and cooperation.

Appendix B

Letter

COLEGIO DE STA. LOURDES OF LEYTE FOUNDATION, INC.

COLLEGE OF NURSING
Tabontabon, Leyte

June 7, 2022

MRS. LILIA TISTON-GALES

Dean, College of Nursing
CSLLFI, Tabontabon, Leyte

Dear Madam,

39
We plan to conduct a research study entitled IMPACT OF SPIRITUAL NURSING CARE IN
ALLEVIATING PATIENT ANXIETY AS PERCEIVED BY NURSES IN THE
TACLOBAN CITY HOSPITAL in partial fulfillment of the academic requirements of the
subject Nursing Research 2 for SY 2021-2022. In view of this, we would like to request your
approval to allow us to conduct the study in Tacloban City Hospital where we will be
interviewing our respondents.

We thank you in anticipation of a favorable action on this request.

Sincerely yours,

ANGIELIQUIE LAEI C. MEJILLA DANICA JAMES E. NALDA

ROSE S. QUIRANTE SHANE FRANCES T. SABORRIDO

ELAIZA MARGARITA C. TINOS

Approved:

MRS. LILIA TISTON-GALES

Dean, College of Nursing

Appendix C

Letter

COLEGIO DE STA. LOURDES OF LEYTE FOUNDATION, INC.

COLLEGE OF NURSING
Tabontabon, Leyte
June 7, 2022

DR. JOEDINA GUMAGAY

Chief of Hospital
Tacloban City Hospital
Tacloban City

Dear Dr. Joedina Gumagay,

40
Greetings of Peace and Goodwill!

The undersigned 3rd year Nursing students of CSLLFI wish to conduct a research study entitled
IMPACT OF SPIRITUAL NURSING CARE IN ALLEVIATING PATIENT ANXIETY
AS PERCEIVED BY NURSES IN THE TACLOBAN CITY HOSPITAL in partial
fulfillment of the academic requirements of our subject Nursing Research 2 for SY 2021-2022.

In connection with this, we respectfully seek your permission to conduct interviews with selected
staff nurses of your hospital in order to gather the data that we need. Please rest assured that we
will comply with existing health protocols, and any information we will gather will be treated
with utmost confidentiality and will be used solely for the purpose of this research.

Should you need any clarification, please do not hesitate to approach or to contact us
09505983587. We thank you in anticipation of your cooperation and support for our research
project.

Sincerely yours,

ANGIELIQUIE LAEI C. MEJILLA DANICA JAMES E. NALDA

ROSE S. QUIRANTE SHANE FRANCES T. SABORRIDO

ELAIZA MARGARITA C. TINOS

Noted by:

MRS. LILIA TISTON-GALES

Dean, College of Nursing
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