European collaboration EPICC research into Spirituality Ren van

European collaboration: EPICC research into Spirituality René van Leeuwen NSM Symposium - June 16 th 2017

Education • • Recent reports about standards in nursing and healthcare Inconsistences in nursing/midwifery pre-registration education Surveys – nurse asking for more educational preparedness to deal with spiritual issues Pilot/main study: competence improves, but what education does really contribute? RCN Survey 79. 3% of nurses felt that nurses do not receive sufficient education and training in spirituality (Mc. Sherry, 2010). 79. 9% indicate that spirituality and spiritual care should be addressed within programmes of nurse education

Spiritual Care Competences van Leeuwen et al. (2004; 2009); Attard (2015) Perspective Quality and Policy P Practice Caring Proces P Person Attitude and Communication P Education: Reflective Cooperative Situational

Dr. Linda Ross, Wales - Prof. Wilfred Mc. Sherry, UK - Prof. Donia Baldacchino, Malta - Prof. Tove Giske, Norway - Dr. René van Leeuwen

European Spirituality in Nursing and Midwifery Research Network (ESNMRN) • Start 2003: Networking and Collaboration in Research • Bi-annual Student Conference: Spiritual Care in Nursing/Midwifery • 7 th Conference: Copenhagen • September 21: Pre-conference for educators and researchers • September 22 – 23 : Student Conference: Spiritual Care: ‘A Resource in Nursing’ http: //diakonissestiftelsen. dk/spiritualcare

Working definition: consensus based - broad Spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred • • The spiritual field is multidimensional: Existential challenges (e. g. questions concerning identity, meaning, suffering and death, guilt and shame, reconciliation and forgiveness, freedom and responsibility, hope and despair, love and joy). Value based considerations and attitudes (what is most important for each person, such as relations to oneself, family, friends, work, things nature, art and culture, ethics and morals, and life itself). Religious considerations and foundations (faith, beliefs and practices, the relationship with God or the ultimate). European Association for Palliative Care (EAPC), 2011.

Collaboration in research • 1. How do student nurses’/midwives’ perceive spirituality and spiritual care and how does this change over time? • 2. How competent do they perceive themselves to be in spiritual care delivery and how does this change over time? • 3. What factors contribute to spiritual care competency?

2 STUDIES 1. Pilot Study: 2010, 6 universities, 4 countries, cross-sectional, multinational, survey design, n=531

2. Main study: 2011 -15, funded by RCN • Longitudinal, multinational, survey • 2193 undergraduate nurses/midwives • 22 universities in 8 countries (Wales UK, England UK, Scotland UK, Malta, Netherlands, Norway, Sweden, Denmark) 2193 students (from possible 3175) took part in yr 1 (69%) 595 students (from possible 1821) took part at end (33%) (non-paired) 351 students took part both at start and end (paired)

What? Item to be measured Measure selected Individual characteristics Demographic questionnaire Perceptions of spirituality & spiritual care Spirituality & Spiritual Care Rating Scale (SSCRS, Mc. Sherry 1997, 2002) Competency Spiritual Care Competency Scale (SCCS, van Leeuwen et al 2009) Spiritual wellbeing JAREL Spiritual well-being Scale (Hungelman et al 1996) Connectedness to self, environment/ others, transcendent Spiritual Attitude and Involvement List (SAIL, Meezenbroek, Garssen & van der Berg, 2008)

Sample Female 88 Nursing 96 Under 21 yrs 56 Secular universities 73 Religious 67 Christian 62 Practised life view daily/weekly 59 Any life event 57 (54% negative)

Perception spirituality/spir care (SSCRS) (n=351, p<0. 01)

Do students who start with narrow view spir. improve? Yes, their scores increase by 0. 4 However, they do not catch up with the high scoring students 4 4 3. 6 4. 1 3. 7 SSCRS low (<3. 5) at start study 3. 3 start of study SSCRS high (>3. 5) at start study second year third year end of study

Subscales spiritual care competence

Do students who start with low competency improve? Yes, their scores increase by 0. 8 And they almost catch up with the high scoring students 3. 9 3. 7 4 3. 8 4. 1 3. 9 SCCS low (<3. 5) at start study SCCS high (>3. 5) at start study 3. 1 start of study second year third year end of study

Factors that contribute to spiritual care competency Important factors are… Personal interest in spirituality Broad view of spirituality School factors / curriculum items Caring for patients

Factors contributing to learning (n=351) 90 80 70 60 50 40 30 20 10 0 ol ty n n u a te c g i hin rsi ive m ign s as t en y sit o ch t s s a n n u dis s cu sio i ns r ive r re s els nt ite g l din ea tu ra or r ca f ing ie at p od e m ol se r ing e ing k or w Year 1 Year 2 w i cl ith l in a nic to uc dis l ne str n rso n sio it w ns sio us c dis d stu n a alu ev t en m in ev e s nt a on s er y p em c pla fe l li tio er th h o ith s w ts en pe g rin ca s cu Year 3 rs

r. Enhancing Nurses’ Competence in Providing Spiritual Care through Innovative Education and Compassionate Care

Output + Methodology O 1 Establishing and sustaining the EPICC Network (e. g. website/social media) O 2 Developing a Standard for Spiritual Care Education and Toolkit O 3 Evaluating, refining and disseminating the Standard for Spiritual Care Education and Toolkit Qualitative evaluation based upon the principles of Action research and Co. Production Erasmus+ KA 2 Grant Agreement Number: 2016 -1 -UK 01 -KA 203 -024467

Who is taking part? • 6 EPICC Strategic Partners: steering group • 25 EPICC Participants: nurse educators drawn from countries and institutions mainly across Europe. Working on consensus, implementation and evaluation of a standard for spiritual care education + toolkit • EPICC Participants +: representatives from allied health professionals, patient and public groups, students and professional regulatory bodies. Attend events to get informed about and reflect on outcomes

Countries represented England – Scotland – Wales - Northern Ireland – Croatia – Norway – Netherlands – Poland – Turkey – Ireland – Malta – Denmark - Germany – Belgium – Ukraine – Greece China – Malaysia - Thailand Wide range of cultural, ethnic and religious worldviews

Meetings Transnational Steering Group Meetings (Viaa University, Netherlands): 2017, 2018 Multiplier Events: 1) 2017 – Staffordshire University 2) 2019 – University of South Wales Teaching and Learning Events: 1) 2017 – Viaa University, Netherlands 2) 2018 – University of Malta

Developing a Standard for nursing/midwifery spiritual care education (pre-registration) 1. Consensus Based: 2 steps method (Delphi-technique): competences, learning outcomes, learning strategies (incl. teachers role), assessment (2017) 2. Implementation (elements of) the standard in nursing/midwifery pre-registration educational practice (2018) 3. Qualitative evaluation and dissemination (2019)

Know more about Visit our website: http: //epiccproject. wixsite. com/epicc Or visit Multiplier Event 1 st and 2 nd of July 2019 University of South Wales

Thank you for your attention