Table 2 Themes covered in the SC training curriculum

Target group: Psychiatric nurses in the intervention group (Group 1 = 25 and Group 2 = 25)

Expected duration: Four two-hour sessions in four weeks

Training methods: Lectures and tutorials, PowerPoint presentations, case reports sharing, Video clips and short movies, audio-visual materials, group discussion, role playing, Web-based learning, oral reports and storytelling, contributions of work-based experiences, questions and answers, assignments, book reading about SC

Evaluation method: Pre-test and post-test scores obtained from SCCS and RSIPAS were compared.

Sessions

Main topic

Content

1

Introduction and attitudes towards SC and integration clients’ R/S into clinical practice

- Introduction and explanation of the goals and expectations related to the SC training

- Definition of R/S concepts; similarities and differences

- Spiritual health and R/S needs of clients in mental healthcare, and R/S diversity in clients

-Effects of the spiritual health on other dimensions of health

- The importance of spiritually and SC in mental healthcare

- Definition and outcomes of SC and integration of client’s R/S in to mental healthcare

- History and condition of SC in mental healthcare and national policies on providing SC care

- Definition of concepts like forgiveness, thankfulness, mindfulness, presence, hope, meaning, connection to transcendent power, spiritual change, and ultimate reality.

-Orientation toward the role of chaplains and R/S leaders, as members of the multidisciplinary team in providing SC

- Barriers and challenges of SC and integration of client’s R/S in mental healthcare settings

- Definition of competencies for SC and integration of clients’ R/S into clinical practice

- Assignment: Writing examples and case reports based on the psychiatric nurses’ clinical experiences to assess R/S in clients in mental healthcare settings (as the first step in nursing process to discuss about it in next sessions)

2

Integration of SC in the nursing process

(Assessing spirituality in mental healthcare)

- Assessment of spiritual needs of clients in mental healthcare settings

-Self-consciousness and self-assessment, identification of limitations of the nurses’ skills with regard to assessing clients’ mental healthcare

- Identification of the methods for assessing clients’ R/S and collection of the clients’ spiritual history (standardized assessment tools, manualized interventions, empirically supported practical behaviors related to clients’ characteristics and preferences)

- Assessment of the clients’ reactions to the feelings of loneliness, weakness, disease, and death

-Introduction of some question examples to assess and take history from the clients’ spiritual and religious beliefs/values

- Recognition of the clients’ R/S sources and mental healthcare settings

-Distinguishing between spiritual experiences and psychopathology

- Assignment: Discuss about the case reports and experiences of nurses, R/S assessment in the cases suggested by nurses, administration of the questionnaires and model suggested by instructors.

3

Integration of SC in the nursing process (nursing diagnosis and problems and interventions)

- Nursing diagnosis/problems and implementation of SC interventions:

- Recognition of the nursing diagnosis and R/S problems of the clients in the diagnostic and statistical manual of mental disorders

- Use of verbal/non-verbal skills related to the clients’ culture

- Use of communication skills with respect to SC

- Recognition of positive and negative R/S coping strategies

- Spiritual distress indicators and verbal statements of the clients with regard to spiritual distress

- Planning for the implementation of R/S care and applying the principles of R/S services

- Nurses’ application of the necessary skills to provide R/S interventions, such as active and compassionate communication, humor, touch, music therapy, and self-awareness

- Interventions to reduce spiritual distress, decrease R/S problems, and promote spiritual growth of the clients by cooperation other R/S care professionals, such as chaplains/pastors

- Recognition of R/S conflicts, personal needs of patients in relation to R/S

- Reffering the clients/their families to members of the multidisciplinary team (e.g., chaplains and R/S leaders) timely in the case of requiring help in their theological beliefs and rise of conflicts

-Having awarrness about personal limitations in providing SC and consulting with other members of the multidisciplinary team (e.g., psychologists, chaplains, R/S leaders, and counsellors) as deemed necessary

- Introducing R/S resources, supporting systems/agencies to clients and their families (e.g., place for worship and support groups)

- Application of the clinical guidelines localized for SC and clients’ R/S in to nursing in Iran

- Assignment: determining problems in spiritual diagnoses in case reports as well as designing appropriate interventions for such problems

4

Integration of SC in the nursing process (Evaluation and documentation)

- Evaluation of the SC outcomes for the clients in mental healthcare

- Application of the evaluation methods for the R/S interventions

- Evaluation of variables related to clients, nurses, and treatment process that affect the appropriateness and effectiveness of spiritual interventions in mental healthcare

- Documentation of the SC integration in the nursing process and composition of comprehensive nursing notes based on the holistic care

- Limitations / barriers and ethical challenges in the SC at mental healthcare settings

- Reflection on the personal experiences related to the aspects of SC and integration of the clients’ R/S in mental healthcare settings

- Planning for clients’ discharge and follow-up on their R/S problems in home care

- Ensuring about the follow-up by providing SC feedback to clients and other stakeholders

- Summary and conclusion of the training program

- Assignment: A review of the case reports designed in previous sessions, nursing process, and evaluation of the SC.