Misamis University Ozamiz City College of Nursing

Students Perceptions On Elective Nursing And the Degree Of Care Rendered to Patients

CHAPTER 1

INTRODUCTION

BACKGROUND OF THE STUDY

Spiritual Nursing care in todays world plays an important role of the healing process of a person. It is clearly stated in the Encyclicals written by the Catholic Pontiff Blessed John Paul the Great Gadium et Spes that man made of a body and a soul. There is unity in it. The physical body of a person composed the sum of the material world and the soul component sums the spiritual dimension. No one can separate these facts from each other. For the body needs the soul; as well as the soul needs the body. Soul is directly referred to us the innermost aspect of the human being that is valued much in him. The body is then also valued for it structured the human being that it is him. Thus in all aspects of care this dimension (Spirituality) should not be set aside but rather must be given also emphasis. People are spiritual beings, and the spiritual domain, as an element of holistic nursing care, is multifaceted. Nurses work with their patients in close quarters and hence get to understand them and feel the patients psychological, emotional, physical and spiritual condition. Patience is by far the most enduring spiritual quality, and nurses are constantly put to test on this for they deal with patients of different temperaments, some physically challenged others mentally challenged, while some may just be ill

tempered. A true nurse would effectively handle any scenario with strength and wisdom. Thus, the terms spirituality and nursing complement each other from a philosophical perspective, as an individual who practices nursing inevitably experiences or comes in close contact with his spiritual dimension when reaching out to others in need of spiritual care. Nurses can help to spiritually uplift patients with terminal illness so they can be prepared to leave the bodily kingdom into a higher state of consciousness without any elements of fear, uncertainty or anxiety. Qualities that enable nurses to provide holistic nursing care to complex and diverse populations need to be developed in nursing students. It is important that nurse educators have an understanding of the spiritual perspectives of their students in order to establish a connection between spiritual care in education and in practice. The concept of spirituality in nursing is deeply rooted in the history of our profession, yet its often overlooked in nursing practice. Meeting the spiritual needs of patients is now cited as a desirable goal for nursing care. However, little is known regarding how nurses own beliefs and experiences affect spiritual care giving. So, the purpose of this descriptive non-experimental study is to describe spiritual perceptions of nursing students and their relation to the degree of spiritual care rendered to patients.

THEORETICAL FRAMEWORK This study is anchored to the theory of Martha E. Rogers(1990), which is The Science of Unitary Human Beings. Nursing in the Science of Unitary Human Beings contains two dimensions: the science of nursing, which is the knowledge specific to the field of nursing that comes from scientific research; and the art of nursing, which involves using the science of nursing creatively to help better the life of the patient. Rogers defined health as an expression of the life process. To that end, illness and health are part of the same continuum, and the events occurring throughout the patient's life show how the patient is achieving his or her health potential. Roger views the person as an irreducible whole, the whole being greater than the sum of its parts. Whole is differentiated from holistic, the latter often being used to mean only the sum of all parts. She states that humans are dynamic energy fields in continuous exchange with environmental fields, both of which are infinite. The human field image perspective surpasses that of the physical body. Both human and environmental fields are characterized by pattern, a universe of open systems, and four dimensionality. In this model, the role of the nurse is to serve people. Rogers also proposes noninvasive modalities for nursing, such as therapeutic touch, humor, music, meditation and guided imagery, and even the use of color. The interventions of nurses are meant to coordinate the rhythm between the human and environmental fields, help the patient in the process of change, and to help patients move toward better health.

The practice of nursing, according to Rogers, should be focused on pain management, and supportive psychotherapy for rehabilitation. It is often important to look at both the patient as a whole person, and the patient's environment when treating the patient for an injury or illness. Martha E. Rogers's Science of Unitary Human Beings addresses the importance of the environment as an integral part of the patient, and uses that knowledge to help nurses blend the science and art of nursing to ensure patients have a smooth recovery and can get back to the best health possible.

CONCEPTUAL FRAMEWORK This study is based on the AACN Synergy Model in spiritual care. The AACN Synergy Model emerging as the accepted standard conceptual framework for acute care and critical care nursing. The first of the 5 assumptions underlying the model is that each patient is a whole person: body, mind, and spirit. This assumption means that each patient is more than the pressing physiological needs that caused hospitalization for the critical illness. Nursing care of the whole person, guided by the Synergy Model, addresses not only physiological care but also care in the psychosocial (care of the mind) and spiritual (care of the spirit) domains. The inclusion of spirit as a central aspect of the AACN Synergy Model makes this nursing model a particularly useful guideline for providing spiritual care in ICUs. Indeed, use of the Synergy Model may help nurses overcome some of the constraints to spiritual care in hospitals identified by Van Dover and Bacon priority placed on physical health needs,

multiple demands on nurses time, and varying expectations of nurses and healthcare institutions concerning the nurses role in giving spiritual care. The Synergy Model identifies 8 characteristics of nurses and 8 characteristics of patients within the hospital environment. The key to care is the relationship between nurses and patients, so that nurses competencies coincide with patients needs. The model is termed the Synergy Model because it posits that by matching nurses competencies to complement patients characteristics, something more than the sum of the parts ensues and synergy occurs. Four areas of the model can be related to spiritual care: 2 characteristics of patientsresiliency and resource availability and 2 characteristics of nursescaring practices and response to diversity.

SCHEMATIC DIAGRAM

BSN 3RD YEAR STUDENTS

Perceptions in Elective Nursing

Degree of care rendered to patients

Statement of the Problem The purpose of this study is to look into the perceptions on elective or spiritual nursing and the degree of care rendered to patients by 3rd year nursing students of Misamis University. Specifically, this sought to answer the following: 1. 2. 3. What are the students perceptions on elective or spiritual nursing? What is the degree of Spiritual Nursing Care rendered to patients? Is there a significant relationship between students perceptions on

spiritual nursing and the degree of spiritual nursing care rendered to patients?

NULL HYPOTHESES Ho: There is no significant relationship between students perceptions is spiritual nursing with the degree of care rendered to patients.

SIGNIFICANCE OF THE STUDY

With the findings of the study, the clinical instructors who have the load of imparting knowledge to nursing students may have the guidance on how to enhance the degree of spiritual nursing care among students. Here the clinical instructors may start with understanding individual perceptions in Elective nursing subject among students before going into the essence of teaching students on how to provide spiritual nursing care. The nursing students who are the center of this research may acquire an in depth understanding of an individuals perceptions in spirituality and how these perceptions affect the degree of their spiritual nursing care. The patients who are the recipients of care will be properly assessed by nurses in terms of their spiritual needs. And proper interventions to a certain spiritual diagnoses will be identified. The future researchers may use this study as basis in updating or validating a new research with regards to this topic.

Scope and Limitations of the Study This study will explore perceptions on elective nursing and the degree of care rendered to patients by selected 3rd year nursing students in Misamis University. There were 134 3RD year nursing students enrolled in elective nursing subject for the school year 2011-2012 second semester as the respondents of the study. They were selected through purposive sampling. It was conducted in Misamis

University College of Nursing.

DEFINITION OF TERMS

Elective Nursing. This refers to a subject in the new nursing curriculum that pertains to developing students skills in providing spiritual nursing care. Spiritual Nursing Care. This refers to an aspect on the nursing practice which responds to the spiritual needs of clients. This is concerned with assisting patients in finding meanings of their experiences and identifying spiritual interventions related to a formulated spiritual diagnosis. Perceptions. This refers to an individuals own outlook or understanding of something. Perceptions in Elective Nursing subject refers to students own understanding of spirituality and how to provide spiritual care.

Spirituality. This refers to a persons inner self in relation to finding meaning and purpose of life with ones faith to a creator of all things. This encompasses ones personal faith, spiritual beliefs and religious practices.

PART 2 REVIEW OF RELATED LITERATURE Spirituality has become a theme we do not discuss easily in our culture. Some authors deal with this fact when finding that through the history the Western society changed from incorporating spirituality in everyday language and lifestyle to the scientifically based, positivistic attitude which rejects spiritual matters for its incapability of scientific objectification and treatment. Linguistically, spirituality is derived from the Latin word spiritus, meaning, essential part of the person (Baldacchino & Draper, 2001), breath, make alive, which suggests a broad concept of the essence of life (Strang et al. 2002). Spirit in Dictionary of Philosophy is according to Goddard (2000): breath, life, soul, mind; an animating end energizing principle of Cosmos; a disembodied or incorporeal conscious being; a super sensuous, ideal order of being or realm of mind; the intellectual, rational, poetic, aesthetic, moral, holy, divine. Nursing is linked to spirituality when the word nurse, comes from a Greek word meaning: nurturing of the human spirit (Siedl et al. in Shih et al., 2001). According to McSherry, Draper, and Kendrick (2002) spirituality was not only a concept associated with religion, systems of faith, and worship but also a universal concept, unique to all people, such as creativity, art, and self-expression. Spirituality is a much broader phenomenon than simply a formal religious expression. Murray and Zentner (2000) defined spirituality as, A quality that goes beyond religious affiliation, that strives for inspirations, reverence, awe, meaning and purpose,

even in those who do not believe in any uprightness. The spiritual dimension tries to be in harmony with the universe, and strives for answers about the infinite, and comes into focus when the person faces emotional stress, physical illness or death. Mansfield, Mitchell, and King (2002) also proposed that spirituality provides a personal sense of meaning and life purpose, which is not confined to the beliefs and practices of a particular religion. Goodard (2000) said that Spirituality is an energizing force that propels

individuals to reach their optimal potential. It is an approach to life. Spirituality may be elusive, inexplicable, or merely philosophical, but because it creates order out of chaos, sense out of madness, or harmony out of disharmony, it is indispensable in nursing care Tanyi, 2002 stated Spirituality is a personal search for meaning and purpose in life , which may or may not be related to religion . It entails connection to self-chosen and or religious beliefs , values and practices that give meaning to life , thereby

inspiring and motivating individuals to achieve their optimal being. This connection brings faith, hope, peace, and empowerment. The results are joy, forgiveness of oneself and others, awareness and acceptance of hardship and mortality, a heightened sense of physical and emotional well-being, and the ability to transcend beyond the infirmities of existence. Tanyi (2002) cited authors who claimed that other benefits of spirituality

indicated by research include a restored sense of well-being and a recovery from psychological conditions, such as sexual abuse, substance abuse, and homelessness (LaNae & Feinauer, Shuler et al., Kennedy et al., Brome et al.). He wrote that Walton studied 13 individuals' perceptions of spirituality's influence on their recovery from acute

myocardial infarction. Spirituality provided the participants with peace, hope, strength, and a sense of well-being, which facilitated their recovery. Kendrick (2000), on the other hand, argues against formulation of spirituality as a dimension, saying that semantics of this kind clearly suggest that spirituality is just a part, rather than the whole, of the human condition. He presents spirituality as an orientation that is inclusive of all those elements, which constitute the state of being human. He claims that spirituality is what gives focus to the sum of all the parts that form the human condition and therefore, because of this entirety, cannot be reduced to the status of a single dimensional quality . Another dilemma pointed by Bradshaw arises from spiritual care. She is wondering whether nursing process is not too intruding for spiritual care, whether it is appropriate to process patients most intimate feelings at the time of his highest vulnerability and if (all) nurses have enough knowledge and time to do that (Bradshaw in Skoberne, 2002). Skoberne presents another interesting viewpoint when she claims that spiritual care is not exclusively a relationship among individuals and that we should consider spirituality of the institution as well. Spirituality of the institution is showing itself in general atmosphere rules and even in equipment and we should ask ourselves what the influence of such environment on the severely ill patient is (Skoberne, 2002).

Sodarberg (2000) discusses this issue when she describes atmosphere in ICU (that is influenced by hurriedness, advanced technology, seriousness, anxiety and difficult decisions) which shows as a distant threat of technocracy perceived in

employers reflections. Sodarberg cites Marcel saying that the impact of technocracy involves a massive transformation of values and a change of a humanity spiritual horizon, which means a reduction and impoverishment of reality itself. This can lead to a spirit of abstraction, a certain lack of love, which renders one unable to treat people as humanbeings. Fawcett (2002) explores categories of knowledge and categorises them as developmental, system, interaction and other categories of knowledge. Other categories of knowledge are, according to Fawcett: needs, outcomes, client focused, person environment focused, nursing therapeutics, energy fields, intervention, conservation, substitution, support and enhancement. Fawcett also cited Meleis saying that category of knowledge about needs focuses on nurses functions and consideration of the patients in terms of hierarchy of needs. A human being is reduced to a set of needs, while nursing is reduced to a set of functions. Nurses are portrayed as final decision makers for nursing practice (Meleis in Fawcett, 2000).

Based on an article written by Ann Long (2007) in titled Nursing: A spiritual perspective, it is a fundamental need for nurses to include the promotion of the spiritual dimension of the health of human beings as well as the physical, mental and social facets if they truly wish to engage in holistic care. The author attempts to define the phenomenon of spirituality, aware of the dilemma that many individuals face when thinking and reflecting on this very personal and intangible issue. In addition to her to be spiritual is to become fully human, the article argues, and the reverse is also true. Spirituality in health inextricable in each persons search for the discovery of the truth

about self and the meaning and purpose of life. Healthy communities are the product of healthy individuals who sow spiritual seeds such as unconditional positive regard, acceptance, respect and dignity for the benefit and advancements of individuals and humankind as a whole. The literature providing instances associating spiritual care with the quality of interpersonal care includes assisting an individual to find meaning and purpose in their illness (Simsen, 1985), listening attentively to a patient (Burnard, 1988), enabling an individual to maintain their religious practices while in the hospital (Narayanasamy, 1993), maintaining privacy and dignity (McSherry, 2000), validating clients feelings and thoughts, facilitation, instilling hope (Tuck, Wallace, & Pullen, 2001), expressing love and compassion toward patients, conveying a benevolent attitude (Tanyi, 2002), listening, being present, prayer, use of religious objects, and talking with clergy (Grant, 2004). In Taiwan, spirituality is considered a part of religious culture. In much of the literature, spirituality is used to indicate religion, and spiritual care is mostly practiced in hospice care centers by religious people (Shaw, Joseph, & Linley, 2005). Attention to the spiritual element of human functioning within nursing has been emphasized and demonstrated in different nursing studies, but the lack of it has also been observed (McSherry, 2006; Ross, 2006). Narayanasamy (2001) stated that the spiritual aspect of human beings receives little attention in nursing and that spirituality is an under-utilized aspect of care. In his opinion, carers must become more aware of the impact of spirituality on a patients life and become more skilled in providing that care.

Acknowledging the connection between spirituality and health implies that health care professionals should attend to spirituality in the care they provide to patients. Waaijman (2002) notes that interest in spiritual issues in todays health care sector is growing from two perspectives. Firstly, from the perspective of the patient: the patients must not be identified with their illness, people should not be medicalized, isolated, eliminated from or exploited by the treatment of their illness, their personal integrity should be respected. This is also stressed in recent Dutch studies on charitable care (Van Heijst, 2006) and presence in care (Baart, 2005) which provides a person-centred approach to health care. Secondly, from the perspective of care: the spiritual life of the patient must be an explicit part of health care; nurses must be competently trained to address a patients spiritual needs. Waaijman (2005) argues that health care professionals should focus on a socalled primordial kind of spirituality which is related to ordinary processes of human life such as birth, corporality, primary relationships and the course of life. The first notion refers strongly to a holistic view of nursing that was referred to at the beginning of this introduction. The second notion implies also taking care of the patients spirituality.

RELATED STUDIES

Florence Nightingale emphasized the need for nurses to honor the psychological and spiritual aspects of patients to promote patients health. Whereas Chans (2010) study of a public hospital in Singapore presented similar findings, few studies have explored clinical nurses perceptions of spirituality. The purpose of this study was to investigate the role of specific nurse demographic characteristics in predicting perception differences with regard to spirituality and spiritual care. : The Chinese version of the Spirituality and Spiritual Care Rating Scale was developed using a translate and back-translate process, achieving a content validity index of .98. This study used a cross-sectional descriptive survey with 350 clinical nurses as the study sample. Three hundred forty-nine valid questionnaires were returned (response rate, 99.71%). The institutional review board of the hospital approved this study. Most participants were women, ranging in age from 23 to 64 years. Participants clinical experience ranged from less than 1 year to 40 years, with a mean experience value of 13.42 years. Participants were distributed among all clinical specialties. Slightly less than half (41.83%) professed no religious belief, and most were not involved in religious activities (55.01%, n = 192). A little over half (53.58%, n = 187) had received spiritual care lessons during nurse training, and more than half (58.74%, n = 205) had received spiritual care continuous education after graduation. This survey found perception of spirituality positively related to holding a masters degree, 11 to 19 years of clinical experience, specialty in palliative nursing, and having received spiritual care lessons during nursing training or continuing education. Clinical nurses who held a

masters degree or received spiritual care lessons during continuing education had higher levels of spiritual care perception. This study found education to have a positive impact on participants perception of spirituality and spiritual care. A higher education level and more spiritual care lessons or training courses were found to increase perception level. Study findings provide preliminary insights into nurses perceptions of spirituality and spiritual care in Taiwan. Findings demonstrate an urgent need for additional education programs or training in spiritual care to improve the ability of nurses in catering to the spiritual needs of patients and guide clinical nurses when conducting spiritual care. Nurse educationalists have a poor record in preparing nurses adequately for providing spiritual care. Contemporary nursing philosophy embracing holism demands that nurses learn the appropriate skills to enable them to provide care in all domains, including the spiritual. Three questions are explored within this review: what is spirituality?; what should pre-registration nursing students be taught concerning spirituality?; and how can spirituality in nursing be taught? Although sources of literature stemmed from the West, a predominantly JudeoChristian culture, this is balanced by reference to a synopsis of world religions provided by a number of texts. Research studies included in the review consider nurses concepts of spirituality, nurses awareness of spiritual aspects of care, assessment of patients spiritual needs, and caring and coping strategies for nurses and patients. Some have demonstrated the need for educational input to better prepare nurses for spiritual care but none identify how this might be effectively achieved.

A new study explored the popularity of spirituality in nursing and health-related literature by Sessanna L, Finnell D and Jezewski MA in December 25, 2007.

Researchers from the State University of New York, School of Nursing, University at Buffalo, conducted a concept analysis, guided by Walker and Avant's methodology, to (a) examine how spirituality has been used within the current body of nursing and health-related literature, (b) clarify the meaning of spirituality by discovering what this concept's current critical attributes/characteristics are and (c) propose a definition of spirituality based on the concept analysis findings. They reviewed a total of 90 references, including 73 nursing and health-related references. Concept analysis findings revealed that spirituality was defined within four main themes in the nursing and health-related literature: (a) spirituality as religious systems of beliefs and values (spirituality = religion); (b) spirituality as life meaning, purpose, and connection with others; (c) spirituality as nonreligious systems of beliefs and values; and (d) spirituality as metaphysical or transcendental phenomena. The use of spiritual healing can be traced as far back as the New Testament of the Bible. In modern times, a number of therapeutic techniques involve spiritual aspects, and there is overlap between these different approaches. Individuals and organizations involved with spiritual healing may use many different approaches and styles. Several studies suggest the healing effects of prayer; there are several theories as to how prayer might be beneficial during illness, including both scientific and metaphysical explanations. It has been suggested that patients who pray for themselves

or are aware that others are praying for them may develop stronger coping skills and decreased anxiety, thereby potentially improving health outcomes. Other theories include beneficial effects of prayer or "positive thinking" on the immune system, central nervous system (brain) or endocrine (hormonal) system. The meditative, relaxing effects of prayer have been suggested to have beneficial effects such as lowering blood pressure. There are no plausible scientific explanations for the possible effects of intercessory prayers said without the knowledge of patients. Metaphysical explanations and beliefs often underlie the practice of prayer. Prayers may be rooted in a belief in the power of a superior being or God that can influence health. Studies of the effects of intercessory prayer on health outcomes report variable results, with some research finding benefits, and other trials noting no effects. Most research in this area is not well designed or reported.

Another study was about on the attitudes to spiritual care among nursing staff in a Swedish oncology clinic by Lundmark M. published on July 15, 2006. Knowledge of attitudes towards spiritual care among nursing staff and factors influencing these attitudes will improve the possibilities of meeting the spiritual needs of patients. To identify factors which may influence attitudes to spiritual care, test the relevance of these identified influencing factors in a Swedish nursing context, and replicate a part of a previous study by Strang et al. (Journal of Clinical Nursing 2002;11:48-57) dealing with attitudes to spiritual care in a holistic perspective. A questionnaire was handed out to all nursing staff at a Swedish oncology clinic (n=93) excluding the radiation therapy ward. Data were obtained from 68 nurses or nursing auxiliaries.

To identify factors which may influence attitudes to spiritual care, test the relevance of these identified influencing factors in a Swedish nursing context, and replicate a part of a previous study by Strang et al. (Journal of Clinical Nursing 2002;11:48-57) dealing with attitudes to spiritual care in a holistic perspective. A questionnaire was handed out to all nursing staff at a Swedish oncology clinic (n=93) excluding the radiation therapy ward. Data were obtained from 68 nurses or nursing auxiliaries. A research in titled a critical incident study of nurses' responses to the spiritual needs of their patients by Narayanasamy A. and Owens, J. ( February 2001) aimed to carry out a critical incident study to: (1) Describe what nurses consider to be spiritual needs; (2) Explore how nurses respond to the spiritual needs of their patients; (3) Typify nurses' involvement in spiritual dimensions of care; (4) Describe the effect of nurses' intervention related to spiritual care. Critical incidents were obtained from 115 nurses. The data from these incidents were subjected to content analysis and categories were developed and described. The emerging categories were subjected to peer reviews to ensure reliability and validity of findings. The findings suggest that there is confusion over the notion of spirituality and the nurse's role related to spiritual care. A variety of approaches to spiritual care emerged in this study from the critical incidents derived from nurse respondents. These were categorized as 'personal', 'procedural', 'culturalisit' or 'evangelical'. There was an overwhelming consensus that patients' faith and trust in nurses produces a positive effect on patients and families, and nurses themselves derived satisfaction from the experience of giving spiritual care. In this respect, spiritual care interventions promote a

sense of well-being in nurses as well as being a valuable part of total patient care. The study concluded that there is scope for developing an ideal model of spiritual care using the critical incident data from this study.

CHAPTER 3 RESEARCH METHODOLOGY The chapter presents the research design, setting, respondents of the study, research instruments, data gathering procedure and statistical treatment. Research Design The study used qualitative design. It employed the descriptive-survey method. A structured researcher-made questionnaire was designed to collect the needed data. Research Setting The study was conducted in the College of Nursing of Misamis University. This university is situated in the city of Ozamiz and is one of the leading universities of the city. Ozamiz is a 2nd class city in the province of Misamis Occidental, Philippines. It has a population of 123,137 according to the 2007 census, and is politically subdivided into 51 barangays, this city is notable for its Birhen sa Cotta or the Nuestra Senyora y del Triunfo. Misamis University (MU) is a privately owned, non-sectarian, non-profit educational institution. MU is a university in northwestern Mindanao that caters to more than 7,000 students every year in its 7.5 hectares campus in Ozamiz City and also in Oroquieta City. The university began as a school in Lanao del Norte in the name of Kulambugan Academy and by now is an institution that advocates a progressive and dynamic education that upholds the principle that God is the center of its existence and

that education as its service offering to God and country. The university is found in front of H.T. Feliciano Street, named after the founder of the university and contains several colleges like the following: Arts and Sciences, Engineering and Technology, Business and Management, Education, Agriculture and Forestry, Criminology, Computer Studies, Maritime Education, Dentistry, Medical Technology, Graduate Education, and Nursing and School of Midwifery. Its College of Nursing is situated in perpendicular to the Ladies Dormitory and in parallel with the old gymnasium. It has 6 classrooms, 3 nursing arts room, a faculty and consultation room, and the office of the dean. Its student population as of school year 2011-2012 was approximately 700. The College of Nursing has produced graduates that have been molded to meet global demands, topped the board exams, and is continuing to nurture young minds in the pursuit of providing holistic nursing care.

Research Respondents The respondents of the study were 140 third year nursing students selected through purposive sampling. It is purposive because only those 3rd year nursing students enrolled in elective nursing 1 subject were chosen to be the respondents. The following 3rd year blocks contain the number of students officially enrolled in elective nursing 1 subject. BLOCK A B C D No. of Students 33 38 36 33

Research Instrument To gather the necessary data and information, a researcher made questionnaire was used. The research-made questionnaire was tried out to the non- respondents who were not selected as the respondents of the study before this questionnaires were utilized during the interview to the target respondents. Items were seemed vague and ambiguous to the non-respondents were improved and modified. The aim of this is to ascertain the validity of data-gathering tool. The reproduction of the final draft of the questionnaire was made after it was presented to the adviser for her corrections and

suggestions. The corrections and suggestions of the adviser and the panel remembers were incorporated in the questionnaire. Data Gathering Procedure Before the actual distribution of the research instrument, the researcher secured permission from the research adviser that he be allowed to conduct his study. The researcher approached the advisers of each of the block to allow the researcher to conduct the study in their respective rooms. Upon the approval of the letter request, the researcher administered the questionnaires to the respondents. The respondents were given time to answer the questionnaire and on the agreed schedule, the researcher retrieved the questionnaire. When the questionnaires were collected the data were tallied and presented to the statistician for statistical treatment. Then the researcher analyzed and interpreted the data gathered. Statistical Techniques To derive a comprehensive, valid and reliable result, the following statistical method and techniques were utilized. Frequency and Percentage. Frequency was used to determine the distribution of the responses in each respondent, while percentage was employed to determine the position of the respondents responses out of the total number of responses utilized in the study. Average Weighted Value. This tool was used to describe the respondents attitude and self-efficacy.

The Chi-Square. This technique was used to determine the significant relationship between the students perceptions in spiritual nursing and their degree of care rendered to patients.

RESEARCH QUESTIONNAIRE
Name: Year level and block: Part I. Instruction: Please SHADE the response category of which best describes your personal

perceptions about Spiritual Nursing or Elective Nursing. RESPONSE CATEGORIES: SA- Strongly Agree A- Agree U- Uncertain D- Disagree SD- Strongly Disagree

Perceptions on Elective Nursing

SA

SD

1. My nursing is my service to God.

2. For me, nursing and spirituality are intertwined.

3. Spirituality is an area of nursing that would provide a really wonderful expanded role.

4. In Spiritual Nursing, we are oriented to look at patients holistically, as having a biological, psychological, and spiritual dimension.

5. The concept of spiritual care should be included in Nursing Fundamentals Textbooks. 6. Nurses have a duty to facilitate the meeting of patients spiritual and or religious needs.

7. Spirituality for me is to allow both nurses and patients to selfactualize; to love, that is what brings about healing.

Part II. Instruction: Please SHADE

the response category of which best describes your own

experiences in providing Spiritual Care to patients in various hospital setting. RESPONSE CATEGORIES: A- ALWAYS F- FREQUENTLY S- SOMETIMES N- NEVER

Spiritual Care rendered to patients

1. I experienced difficulties in dealing patients with various spiritual concerns.

2. My own spiritual beliefs affect my performance in providing spiritual care.

3. I try to look and see if there is a way that patients are signaling me that they need spiritual support. 4. I look to see if maybe they have a Bible laying out and if theyre not in pain or not sleeping, and I say, I see you have your Bible here; is there a favorite passage youd like me to read?

5. I pray together with my patient.

6. I spend more time with my patient with a listening heart.

7. I make referrals to a chaplain as my patient would request.