A Content Analysis of Nurses Clinical Judgment and Practice of Spiritual Care in Palliative Care Unit

Abstract

Aim: This study aimed to clarify the content and rationale of clinical judgments regarding spiritual care made by palliative care nurses, and how they are reflected in care practice.

Method: Semi-structured interviews were conducted with nine nurses who had worked in palliative care units for more than two years, and Krippendorff’s content analysis was employed. The Consolidated criteria for reporting qualitative research (COREQ) checklist were applied as the reporting guideline for this study.

Results: Three categories were generated for the content of judgments, such as [Holistic interpretation of existential distress—death anxiety, meaning in life, and sense of worth]. Three categories were generated for the rationale for judgments, such as [Verbal and nonverbal behaviors reflecting patients’ values and attributes in everyday conversations and daily life]. Three categories were generated for reflection and evaluation of spiritual care practice, such as [Utilizing the nurse’s expertise to provide spiritual care].

Conclusion: In spiritual care, nurses based their judgments on cues derived from patients’ values, personal characteristics, and changes in internal state; they inferred concerns related to fear of death and meaning in life and, mindful of time constraints, determined care directions aligned with patients’ current condition and values.