Spiritual Nursing Care in Malaysia

Hospital
Mohd Said Nurumal PhD, RN
Associate Professor
Department of Critical Care Nursing
Kulliyyah of Nursing
International Islamic University Malaysia

mohdsaid@iium.edu.my
 Concepts
• Nowadays, the topic of spirituality is broadly
recognised by healthcare providers and
understanding the spiritual and religious
beliefs and practices of patients is seen as
essential.

Burkhardt and Nagai-Jacobson 2013; Carson and Stoll 2008

• The concept of spirituality can be explained as
‘‘an umbrella term’’.
McSherry and Jamieson 2011, p. 1761
• Because of the variety of personal meanings,
connections and explanations that people use
to describe and make clear their
understanding of this spiritual needs.
• There are wide range of opinions that may be
related to spirituality.
• For instance, religiosity and faith may be the
sole influence on spirituality of some
individuals.
• While for others spirituality is more associated
with personal philosophy or individual
attitudes to life and beliefs.
• The various approaches to spirituality highlight
that this concept is not simply about people
with a religious affiliation and those without.
• Because spirituality is a whole and
comprehensive concept.
• In addition, anything associated with ‘‘spiritual
is always viewed as morally or aesthetically
Hussey 2009, p. 73
 Spiritual Care in Nursing
• Spiritual care in nursing is integral to holistic
health promotion
• Studies by healthcare researchers have shown
that there is an association between mind,
body, wellness and individual spirituality or
religious practices.

Han and Richardson 2010;Koenig and Vaillant 2009

• The application of spiritual and religious
resources to patients and families gives them
strength during a time of intense difficulty.
Friedman et al. 2010
• Nurses feel more comfortable in providing spiritual
care when the care is provided repeatedly and
their own sense of spirituality is strong.
• Nevertheless, it appears that there is a
contradiction for some nurses between personal
values and professional responsibilities.
• The clarification between professional and
personal boundaries is critical in order to enable
nurses to be more competent and confident in
providing spiritual care.
McSherry and Jamieson 2013
 Competency in Spiritual Care
Competency in spiritual care refers to nurses'
ability to assess and provide interventions to
meet the complicated spiritual needs of patients
in collaboration with the multidisciplinary health
care team

Attard, Baldacchino, & Camilleri, 2014;Ebrahimiet al., 2017

 Spiritual Care in Malaysia
• Spiritual Intelligence from Islamic Philosophy
Perspectives
• Is a religious intelligence that can be
developed by strengthening the belief and
belief in God which comprises seven domains.
 7 domains
• al-ruh,
• al-qalb,
• al-nafs,
• al-aql,
• tauhid,
• ibadah, and
• akhlak
Elmi & Zainab, 2014
 Seven steps

• A sincere desire to draw close to God (ikhlas)

• To be a true spiritual companion / companion
(bay'ah),
• To learn and to understand spiritual intelligence,
• Simplicity and contentment (zuhd),
• Striving to practice (mujahadah),
• Remembering God and praying to Him, and
• Self-examination and self-control (muraqabah)
Hussain,2014
 Spiritual Intelligence in Nursing
• Nurses’ spiritual intelligence (SQ) is an
important factor in helping nurses make
decisions about whether to provide spiritual
care to patients or not.
• Encountering spiritual distress between nurses
and patients can also lead to positive spiritual
development by practicing self-reflection.
• The search for meaning is a very important
element in the formation of spiritual memory.
• A memory filled with spiritual experiences
means leading to greater spiritual well-being
of nurses.
• This process of self-reflection can also enhance the
nurse's spiritual intelligence (SQ) level.
• Strong spiritual intelligence (SQ) can support nurses'
ability to identify patients' spiritual needs and thus
providing spiritual care.
Burkhart & Hogan, 2020; Ruder, 2013; Yang & Mao, 2007
• Exploring and promoting the spiritual elements among
nurses can contribute to the implementation of
innovative care in nursing, health, healing and human
potential.
• In the direction of complementary therapy
and integrated care, it is imperative for nurses
to evaluate their spiritual intelligence (SQ).
• This assessment can explore the latent traits
within a nurse that can be fundamental to the
quality of holistic care.
• There are also instruments built in the Islamic
perspective but sources are drawn from Shiite hadiths
and figures in which they contradict the sociology and
teachings of the Muslim-Sunni community in Malaysia.
• Due to this difference in opinion and the source of
reference that contradicts the teachings of Islam in
Malaysia.
• The spiritual intelligence (SQ) instrument that is built
from the Islamic perspective which suits the local
context is required.
 In Malaysia context
• To develop reliable instrument for measuring
the spiritual intelligence of Muslim nurses in a
pioneer worship-friendly hospital.
Treatment

Scientific
Proficient
Technical Competence
Detached
Robotic
Cold
Care

Warm
Time
Presence
Valued
Accepted
Recognise the person
Scientific and Artistic
Scientific
• Proficient
• Technical
Competence
• Detached
• Robotic
• Cold

Artistic
• Warm
• Time
• Presence
• Valued
• Accepted
• Recognise the person
 Barriers
• Physical - sense, loss of ability to communicate.

• Environmental - lack of privacy, quiet rooms.

• Psychological - fears taboos, our own insecurities,

dementia

• Economic - not enough staff, time, money for

resources

• Educational - lack of training insight into the concept

 Skills Required
• Self Awareness - introspection - we need to reflect upon
ourselves identifying our own personal and unique spirituality.

• Counselling and interpersonal skills - we need to be able to

relate confidently to individuals.

• Trust building - establish a rapport and therapeutic relationship

with patients.

• Non judgmental (if this is possible) be accepting and tolerant

acknowledging we are a unique.

• Education - we need to develop our knowledge and

understanding of the concepts of spirituality.
Advancing Spirituality in Care

Individualit
Integrated
y

Inter/intra-
Inclusivity
disciplinary
“It is Food for the Soul...”: The Preliminary
Findings of an Investigation on the Malaysian
Critical Care Nurses’ Perceptions in Spiritual
Care
 Introduction
• Evidence shows that critically ill patients and their
family members have spiritual needs in the intensive
care unit (ICU).
• Spirituality is an abstract concept and difficult to
define, making its aspects of care provided by the
ICU clinicians suboptimal.
• This study is a preliminary report of a qualitative
study that was conducted to explore the perceptions
of the ICU nurses on spirituality and care that they
gave patients and their family members.
 Method
• Interviews and group discussions were
conducted with nurses who worked in a 25-
bed ICU of a tertiary government hospital in
Malaysia.
• Data from them discussions were recorded
and transcribed, and thematic analysis was
used to generate codes and themes.
 Results
• A total of 18 nurses were included in this
study.
• The central theme was the interfaith
connection, emerged through three themes:
– spirituality and illness are interconnected to
healing,
– classification of spiritual care interventions in ICU,
and
– intercepting barriers.
 Discussion
• Nurses deemed spiritual care as beneficial to
critically ill patients and their family members.
• Barriers to spiritual care can be overcome with
a model of ICU spirituality.
 Discussion
• Further research is needed to explore the
experiences of critically ill patients and their
family members in receiving care in the ICU,
particularly in addressing their spiritual needs.
• Further studies should also include the
perceptions of other professionals in the ICU
to develop a concise model of spirituality and
spiritual care in the ICU context.
 Issues
• What they lack is confidence and education.
 Conclusion

• Spiritual health care is a complex and subjective, however it is

central to the notion of holistic practice.

• There is no authoritative definition of the term spirituality.

• Spirituality requires awareness on the health care

professionals part.

• Spirituality is not only to be associated with institutional

religion since it consists of many components.

• Many health care professionals already possess many of the

skills required to take the initiative in dealing with spiritual
issues.
Thank You