Enhancing Spiritually Based Care Through Gratitude Practices: A Health-Care Improvement Project

Addressing spirituality in health care is important as it improves health outcomes; however, several provider barriers exist to providing spiritually based care. Local problem: A chart audit at a multidisciplinary wellness center serving a population with chronic mental health problems identified a need to improve the number of spiritually based interventions provided to clients by the nurse practitioner.

A quasi-experimental design and pre- and post-test questionnaire were used to measure outcomes including the number of spiritually based interventions and provider attitudes.

Providers, including a nutritionist, exercise physiologist, pharmacist, acupuncturist, and nurse practitioner, participated in two, 1-hour interactive educational sessions on providing spiritually based care, emphasizing the use of gratitude practices.

The mean number of spiritually based interventions charted per visit by the nurse practitioner increased from 0.4 pre-implementation to 1.1 post-implementation (rate ratio = 2.57, with 95% CI [1.75, 3.87]; p < .001). Descriptive statistics from all providers show improvements in attitudes and comfort level in addressing spiritually based care. Several intervention areas documented by the nurse practitioner decreased significantly, including mind/body, which may be related to the study, as many spiritually based interventions are also mind/body interventions.

Interactive educational sessions on spirituality can improve a health-care team's attitudes, comfort level, and practice of providing spiritually based care. Generalizability is limited to the project site, but the process could be implemented in other facilities to determine if similar results can be achieved.