Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Spiritual care refers to a purposeful process of helping another find meaning and purpose

in life through a mutual connection. Providing spiritual care is a professional nursing mandate, yet nurses report barriers in education and practice. Veterans want spiritual care to promote quality of life, and to cope with military experiences and chronic conditions. Patients report receiving less than desired spiritual care and nurses report infrequent provision of spiritual care. It is also unclear how congruent patients and nurses are in their perceptions of spiritual care. A spiritual care simulation and performance checklist was developed using a review of the literature, content validity expert review, and pilot testing. Forty registered nurses (RNs) who provide care for veterans engaged in a 10-minute simulation and 10-minute debriefing with a standardized patient (SP). To assess congruence in perceived performance of spiritual care, the RN, SP, and independent observer (IO) completed the checklist independently before debriefing. RN participants completed the Spiritual Care Inventory before and after the simulation to determine whether the simulation/debriefing experience affected their perceived ability to provide spiritual care. Interrater congruence supports construct validity for three checklist items (anxiety, physical suffering, and chaplain). Lack of congruence could be due to different raters, need for checklist revision, and nursing education. Findings support simulation and debriefing as an effective strategy for improving RN perceived ability to provide spiritual care (p < .001).

Keywords: content validity index, education, kappa statistic, nursing, simulation, spirituality, spiritual care, standardized patient, veteran.

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Nursing Commons