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16 "Spirituality"
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Research Papers
The Effects of Stress Vulnerability and Parental Burnout on Mental Health in Women with Early School-Age Children during the COVID-19 Pandemic: Mediating Effect of Spirituality
Yeom, Mijung , Kwon, Min
J Korean Acad Nurs 2024;54(1):106-117.   Published online February 29, 2024
DOI: https://doi.org/10.4040/jkan.23150
AbstractAbstract PDF
Purpose
This study examined the effects of stress vulnerability and parental burnout on the mental health of women with early schoolaged children, with a focus on the mediating role of spirituality.
Methods
A survey was conducted among 171 women with early schoolaged children in Gyeonggi Province, Gangwon Province, and Seoul. Data were collected from September to December 2022 using the Korean-Symptom Check List 95, the Parental Burnout Assessment, and the Spirituality Assessment Scale. The data were analyzed using structural equation modeling with SPSS/WIN 22.0 and AMOS 20.0.
Results
The study model demonstrated a good fit, explaining 40.5% of the variance in mental health through stress vulnerability, parental burnout, and spirituality. Spirituality had a significant direct impact on mental health. Additionally, participants’ spirituality directly influenced their mental health, while stress vulnerability and parental burnout indirectly affected their mental health and were mediated through spirituality.
Conclusion
Stress vulnerability and parental burnout are negatively associated with mental health, while spirituality partially mediates these effects. Implementing a program to promote spirituality is suggested to assist mothers in recognizing the value and meaning of parenting activities during nursing interventions for mental health.
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The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients
Kim, Jin Sook , Ko, Il-Sun , Koh, Su Jin
J Korean Acad Nurs 2022;52(1):52-65.   Published online February 28, 2022
DOI: https://doi.org/10.4040/jkan.21120
AbstractAbstract PDF
Purpose
This study was conducted to develop a scale to measure spiritual distress in cancer patients.
Methods
A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash’s α coefficient.
Results
The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach’s α was .91, and the coefficients of each subscale ranged from .78~.83.
Conclusion
The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.
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Original Articles
Development and Validation of the New Version of Spirituality Assessment Scale
Il-Sun Ko, Soyoung Choi, Jin Sook Kim
J Korean Acad Nurs 2020;50(1):132-146.   Published online January 31, 2020
DOI: https://doi.org/10.4040/jkan.2020.50.1.132
AbstractAbstract PDF
Abstract Purpose:

The purpose of this study was to develop a new version of Spirituality Assessment Scale (N-SAS) and verify its reliability and validity.

Methods:

The total of 59 preliminary items for the N-SAS were selected through a literature review, two rounds of experts’ content validation, cognitive interviews, and pre-tests. Verification of its reliability and validity was divided into two phases. In Phase I, questionnaires were collected from 219 adults. Reliability was tested using Cronbach’s alpha, validity with item analysis, and exploratory factor analysis. In Phase II, questionnaires developed based on the results of Phase I were collected from 225 adults. Reliability was tested using Cronbach’s alpha, validity with confirmatory factor analysis, and criterion validity.

Results:

The final version of the N-SAS comprised two dimensions (vertical and horizontal), four domains (relationship with God; meaning of life and self-integration; self-transcendence; and relationship with others, neighborhoods, and nature), and 44 items were identified. Total Cronbach’s α was .97; those of each subscale ranged from .79 to .98. N-SAS scores were positively correlated with the scores of Howden’s Spiritual Assessment Scale (r=.81, p<.001).

Conclusion

Findings suggest that the N-SAS can be used to measure spirituality in adults. The use of N-SAS is expected to facilitate perceiving patient’s spiritual needs and providing spiritual care.

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Evolutionary Concept Analysis of Spirituality
Il Sun Ko, So Young Choi, Jin Sook Kim
J Korean Acad Nurs 2017;47(2):242-256.   Published online April 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.2.242
AbstractAbstract PDF
Purpose

This study was done to clarify attributes, antecedents, and consequences of spirituality.

Methods

Rodgers's evolutionary concept analysis was used to analyze fifty seven studies from the literature related to spirituality as it appears in systematic literature reviews of theology, medicine, counseling & psychology, social welfare, and nursing.

Results

Spirituality was found to consist of two dimensions and eight attributes: 1) vertical dimension: ‘intimacy and connectedness with God’ and ‘holy life and belief’, 2) horizontal dimension: ‘self-transcendence’, ‘meaning and purpose in life’, ‘self-integration’, and ‘self-creativity’ in relationship with self, ‘connectedness’ and ‘trust’ in relationship with others·neighbors·nature. Antecedents of spirituality were socio-demographic, religious, psychological, and health related characteristics. Consequences of spirituality were positive and negative. Being positive included ‘life centered on God’ in vertical dimension, and among horizontal dimension ‘joy’, ‘hope’, ‘wellness’, ‘inner peace’, and ‘self-actualization’ in relationship with self, ‘doing in love’ and ‘extended life toward neighbors and the world’ in relationship with others·neighbors·nature. Being negative was defined as having ‘guilt’, ‘inner conflict’, ‘loneliness’, and ‘spiritual distress’. Facilitators of spirituality were stressful life events and experiences.

Conclusion

Spirituality is a multidimensional concept. Unchangeable attributes of spirituality are ‘connectedness with God’, ‘self-transcendence’, ‘meaning of life’ and ‘connectedness with others·nature’. Unchangeable consequences of spirituality are ‘joy’ and ‘hope’. The findings suggest that the dimensional framework of spirituality can be used to assess the current spiritual state of patients. Based on these results, the development of a Korean version of the scale measuring spirituality is recommended.

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The Experience of Spirituality
Pok Ja Oh, Kyung Ah Kang
Journal of Korean Academy of Nursing 2001;31(6):967-977.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.6.967
AbstractAbstract PDF

PURPOSE: This study explored and described the living spiritual experience and was attempted to gain an understanding of spirituality. This was done by eliciting participants' verbal descriptions of their experiences.
METHOD
Data was obtained from in-depth interviews with one cancer patient, one pastor, and three missionaries after obtaining informed consent from each. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed using Colaizzi's phenomenological method. Sandelowski's evaluation criteria for qualitative research, such as reliability, suitability and auditability, were also used to establish reliability and validity of this study.
RESULT
The five major theme clusters that designated the essence of the spiritual experience, "spiritual awareness," "interconnectedness," "love," "transcendent energy," "purpose and meaning in life," emerged from the analysis.
CONCLUSION
This study revealed that spirituality was activated by awareness through introspection and interconnectedness with a Supreme Being. The interconnectedness with a Supreme Being played an important role in harmonious relationships with others and self. It also resulted in revealing the other beneticial attributes of spirituality. Love, the core concept of the interconnectedness, worked as a transcendent energy. Also, the ability to see beyond reality and resulted in finding meaning in life and accomplishing well being.

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Spirituality: Concept Analysis
Pok Ja Oh, Kyoung Ah Kang
Journal of Korean Academy of Nursing 2000;30(5):1145-1155.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.5.1145
AbstractAbstract PDF

The purpose of this study is to explore the concept spirituality and to gain understanding of nursing intervention that may improve spiritual well-being. The concept analysis framework developed by Walker and Avant (1995) was used to clarify the concept. In the study, 'Harmonious Interconnectedness', 'Transcendence', 'Integrative Energy' and 'Purpose and Meaning in Life' emerged as the critical attributes of spirituality. The first attribute, 'harmonious Inter- connectedness', has three categories including intrapersonal, (self), interpersonal (others/ nature) and transpersonal (the Supreme Being). The second attribute, 'Transcendence', is defined as the ability to extend one's own self beyond the limits of usual experiences and to achieve new perspectives. This attribute is demonstrated by 'coping with situations', to 'self-healing', and 'transformation'. The third attribute of spirituality is 'Integrative Energy', which integrates all dimensions and acts as a creative and dynamic force that keeps a person growing and changing. 'Integrative Energy is also defined as an inner resource that gives a sense of empowerment. Therefore the highly spiritual person demonstrate 'inner peace', 'growing', 'inner strength,' and 'well-being'. The fourth attribute 'Purpose and Meaning in Life' represents a sense of connectedness with one's inner values and with a greater purpose in life. It is demonstrated by 'hope' and 'a powerful life'. In this study, the antecedents of the spirituality represented as 'spirit' and its potential enablers were 'Introspection/reflection', 'Interconnectedness with all living things', and an 'Awareness of a Higher-Power'. The consequences of this concept may be described as 'physical, psychosocial, and spiritual well-being'. Empirical referents of this are 'purposeful life' 'self-worth' 'hope' 'love' 'service' 'forgiveness' 'trust/belief' 'inner peace' 'self-actualization' 'religious practices' 'transformation' 'inner strength' and 'coping'. In conclusion, spirituality can be defined based on these critical attributes. Spirituality is a dynamic, integrative energy based on a feeling of harmonious interconnection with self, others and a higher power. Through it, one is enabled to transcend and to live with meaning and purpose in life.

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A Paradigm Analysis Related to Spiritual Experiences Focused on Christian of Patients with Terminal Cancer
Hiun Ju Lee
Journal of Korean Academy of Nursing 2006;36(2):299-309.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.299
AbstractAbstract PDF
Purpose

The main purpose of this study was to develop a substantive theory on the process of the spiritual experience in Christian terminal cancer patients in the context of Korean society and culture. The question for the study was ‘ What is the spiritual process in Christian terminal cancer patients?’.

Method

The research method used was the Grounded Theory Method developed by Strauss and Corbin (1998). Participants for this study in total were 9 Christian terminal cancer patients. Data was collected using in-depth interviews during April 2003 to March. 2004. Data collection and analysis were carried out at the same time.

Result

From the analysis 58 concepts and 20 categories emerged. The categories were presented into a paradigm, which consisted of condition-actions/ interactions-consequences. The theoretical scheme was described by organizing categories. In total, 4 stages were developed from the condition-actions/ interactions-consequences. Throughout these stages, the ‘ overcoming process of unbalanced interconnectedness’ was the core category discovered.

Conclusion

This study provides a framework for the development of individualized care interventions in the ‘ overcoming process of unbalanced interconnectedness’ for Christian terminal cancer patients.

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Spirituality: Concept Analysis Based on Hybrid Model
Pok Ja Oh, Kyung Ah Kang
Journal of Korean Academy of Nursing 2005;35(4):709-720.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.4.709
AbstractAbstract
Purpose

The purpose of this study was to obtain a clearer understanding of spirituality and examine the process of spirituality through defining the meaning and attributes of spirituality.

Method

Concept analysis was done in the three phases, theoretical phase, fieldwork phase, and analytical phase suggested in the Hybrid Model. Five people participated in the fieldwork phase.

Results

Spirituality is activated through self-awareness which occurs as spirit being activated through self-introspection, and through restoration of the relationship with Supreme Being. This interconnectedness with Supreme Being has an absolute impact on one's harmonious interconnectedness with self and neighbors, thus leads all the critical attributes of spirituality to be revealed. The core energy of this harmonious interconnectedness is love. When activated, it has a great impact on an individual as integrative energy, leads one to go beyond everyday experience as well as to have new perspectives, and to live a satisfactory life in every aspect.

Conclusion

The results of this study suggest that promotion of connectedness is the most important element in spiritual nursing interventions. The results can also be used effectively in developing spirituality assessment scales and theory.

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Validity and Reliability of Korean Version of the Spiritual Care Competence Scale
Mi Ja Chung, Youngrye Park, Young Eun
J Korean Acad Nurs 2016;46(6):871-880.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.871
AbstractAbstract PDF
Purpose

The aim of this study was to examine the validity and reliability of the Korean Version of the Spiritual Care Competence Scale (K-SCCS).

Methods

A cross-sectional study design was used. The K-SCCS consisted of 26 questions to measure spiritual care competence of nurses. Participants, 228 nurses who had more than 3 years'experience as a nurse, completed the survey. Confirmatory factor analysis was used to examine the construct validity and correlations of K-SCCS and spiritual well-being (SWB) were used to examine the criterion validity of K-SCCS. Cronbach's alpha was used to test internal consistency.

Results

The construct and the criterion-related validity of K-SCCS were supported as measures of spiritual care competence. Cronbach's alpha was .95. Factor loadings of the 26 questions ranged from .60 to .96. Construct validity of K-SCCS was verified by confirmatory factor analysis (RMSEA=.08, CFI=.90, NFI=.85). Criterion validity compared to the SWB showed significant correlation (r=.44, p<.001).

Conclusion

The findings suggest that K-SCCS serves as an appropriate measure of spiritual care competence with validity and reliability. However, further study is needed to retest the verification of the factor analysis related to factor 2 (professionalisation and improving the quality of spiritual care) and factor 3 (personal support and patient counseling). Therefore, we recommend using the total score without distinguishing subscales.

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Spiritual and Psychosocial Effects of the Spirituality Promotion Program on Clinical Nurses
Imsun Seo, Jinsun Yong, Junyang Park, Juhu Kim
J Korean Acad Nurs 2014;44(6):726-734.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.726
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effects of the Spirituality Promotion Program(SPP) for young nurses working in the stressful university hospital environment.

Methods

The study included 41 nurses in the experimental group, nurses who had worked less than 5 years and completed 8 weeks of SPP between June and July in 2011. The control group, 44 nurses, also received the same program after the study was completed. For the study, a survey was conducted of all participants concerning spirituality, perceived stress, positive and negative affect, empathy, job satisfaction, and leadership practice.

Results

No significant difference was found between the two groups on study variables. Perceived stress decreased significantly in the experimental group (p=.012). Spirituality (p=.019), positive affect (p=.014), empathy (p=.004), job satisfaction (p=.016), and leadership practice (p=.021) increased significantly in the experimental group.

Conclusion

The results show that the Spirituality Promotion Program has positive effects on the spiritual and psychosocial aspect of young nurses. Continuation of this program for nurses is recommended in order to help them develop their selfcare ability and improve nursing competency.

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Effectiveness of Forgiveness Therapy on Resilience, Self-esteem, and Spirituality of Wives of Alcoholics
Hee Kyung Kim, Mihyoung Lee
J Korean Acad Nurs 2014;44(3):237-247.   Published online June 30, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.3.237
AbstractAbstract PDF
Purpose

In this study the effects of forgiveness therapy on the resilience, self-esteem, and spirituality of wives of men suffering from alcohol abuse was examined.

Methods

The study design was a quasi-experimental design. Forgiveness therapy was conducted once a week for 12 weeks. Data were obtained from March 2012 to December 2013. Participants were chosen from women in two Alcohol Counseling Centers. Of the 29 participants, 16 were assigned to the experimental group and 13 to the control group. Data were analyzed using descriptive statistics, t-test, χ2-test, and repeated measure ANOVA.

Results

There were statistically significantly differences for resilience, self-esteem, and spirituality between the experimental and control groups. Forgiveness therapy improved the resilience, self-esteem, and spirituality in the experimental group compared to the control group (p<.05). In follow-up tests, the experimental group had a statistically significantly increase only in self-esteem.

Conclusion

This study results show that forgiveness therapy is effective in improving resilience, self-esteem, and spirituality in wives of men suffering from alcohol abuse. Therefore, forgiveness therapy can be considered a useful nursing intervention to promote improvements in emotional stability and provide pain relief for these wives.

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Translation and Psychometric Testing of the Korean Versions of the Spiritual Perspective Scale and the Self-transcendence Scale in Korean Elders
Suk-Sun Kim, Pamela G. Reed, Youngmi Kang, Jina Oh
J Korean Acad Nurs 2012;42(7):974-983.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.7.974
AbstractAbstract PDF
Purpose

The purpose of this study was to translate the Spiritual Perspective Scale (SPS) and Self-transcendence Scale (STS) into Korean and test the psychometric properties of the instruments with Korean elders.

Methods

A cross-sectional survey design was used to implement the three stages of the study. Stage I consisted of translating and reviewing the scales by six experts. In Stage II, equivalence was tested by comparing the responses between the Korean and English versions among 71 bilingual adults. Stage III established the psychometric properties of the Korean versions SPS-K and STS-K among 154 Korean elders.

Results

Cronbach's alpha of the SPS-K and the STS-K .97, and .85 respectively with Korean elders. Factor analysis showed that the SPS-K had one factor; the STS-K had four factors with one factor clearly representing self-transcendence as theorized. Both scales showed good reliability and validity for the translated Korean versions. However, continued study of the construct validity of the STS-K is needed.

Conclusion

Study findings indicate that the SPS-K and the STS-K could be useful for nurses and geriatric researchers to assess a broadly defined spirituality, and to conduct research on spirituality and health among Korean elders. Use of these scales within a theory-based study may contribute to further knowledge about the role of spirituality in the health and well-being of Korean people facing health crises.

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Meta-Analysis of Spiritual Intervention Studies on Biological, Psychological, and Spiritual Outcomes
Pok-Ja Oh, Young-Hyun Kim
J Korean Acad Nurs 2012;42(6):833-842.   Published online December 31, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.6.833
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the effectiveness of spiritual intervention studies by examining biological, psychological, and spiritual outcomes.

Methods

From electronic databases 2522 studies were retrieved, of which 21 studies met the inclusion criteria. These studies had 1411 participants. Two authors independently extracted data from the selected studies and assessed the methodological quality. The data were analyzed using the RevMan 5.1 program of the Cochrane library.

Results

Overall effect size of spiritual intervention on spiritual and psychological (depression and anxiety) outcomes were moderate (d=-0.65 to d=-0.76, p<.001). The effects on biological outcomes (pain and functional status) ranged from -0.51 to -0.39, respectively. No publication bias was detected as evaluated by a funnel plot. Spiritual intervention had a moderate effect on psychological and spiritual outcomes and a smaller effect on biological outcomes.

Conclusion

The results of this study suggest that spiritual intervention can relieve depression and anxiety. Further randomized controlled trials studies are needed to evaluate the effects of spiritual intervention on biological outcomes.

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Effects of a Short-term Life Review on Spiritual Well-being, Depression, and Anxiety in Terminally Ill Cancer Patients
Sung Hee Ahn, Young Lan An, Yang Sook Yoo, Michiyo Ando, Soo Jin Yoon
J Korean Acad Nurs 2012;42(1):28-35.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.28
AbstractAbstract PDF
Purpose

This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer.

Methods

The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group.

Results

There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group.

Conclusion

The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.

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The Protective Factors of Suicide Probability in Religious Male High School Students
Hee Sook Kim, Young Sun Chae, Young Joo Bae
J Korean Acad Nurs 2012;42(1):1-8.   Published online February 29, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.1.1
AbstractAbstract PDF
Purpose

This study was conducted to identify the protective factors that influence suicide probability in religious male high school students.

Methods

The data was collected from Nov. 5 to Dec. 10, 2009. Data were collected by self-report questionnaire from 255 students selected from 2 religious male high schools in B city. The instruments for this study were the Suicide Probability Scale for Adolescence (SPS-A), Inventory Parents Peer Attachment-Revision (IPPA-R), Spiritual Well-being Scale (SWBS), and Ego-identity Scale. The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and stepwise multiple regression with the SPSS 14.0 program.

Results

The protective factors of suicide probability in religious male high school students were identified as existential spiritual well-being (β= -.46, p<.001), self-identity (β= -.30, p<.001), and mother attachment (β= -.21, p<.001). These three factors explained 61.5% of the variance in suicide probability.

Conclusions

The results suggest that improvement in spirituality, ego-identity, and mother attachment for religious male high school students is important to reduce the probability of suicide.

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Development and Effectiveness of a Spiritual Care Education Program for Nursing Students - Based on the ASSET Model
Mi Ja Chung, Young Eun
J Korean Acad Nurs 2011;41(5):673-683.   Published online October 31, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.673
AbstractAbstract PDF
Purpose

This study was done to develop a spiritual care education program (SCEP) for nursing students to help increase their awareness of the essence of spirituality in care so as to enable them to promote spiritual well-being and spiritual care competence.

Methods

The participants were assigned to an experimental group (n=42) or a control group (n=39). From August to October 2009, the experimental group participated in the SCEP, which were held 2 hours a week for 6 weeks. The data were analyzed using χ2-test, Fisher's exact probability test, paired t-test, t-test with the SPSS WIN 17.0 statistics program.

Results

The experimental group had a higher mean score for spirituality, spiritual well-being and spiritual care competence than the control group. Significant differences were found between the experimental group and the control group.

Conclusion

The results of this study indicate that the SCEP was effective in improving spirituality, spiritual well-being and spiritual care competence for nursing students.

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