An Existential and Spiritual Care Curriculum in Nursing Homes: Development and Evaluation

Diakonhjemmet Care, a Norwegian non-profit organisation rooted in diaconal values, operates five nursing homes in Oslo. To strengthen healthcare professionals' competence in addressing the existential and spiritual (ES) needs of nursing home residents and their families, the organisation initiated the development of the Existential and Spiritual Care Curriculum (ESCC). The ESCC is a pilot training course structured around four modules: (1) intrapsychic factors, (2) interpersonal factors, (3) procedures and action plans and (4) providing existential and spiritual care (ESC) in practice.

The study had two aims: (1) to describe the development of the ESCC and (2) to evaluate healthcare professionals' feedback on their experiences and assess changes in self-efficacy and perceived importance of ESC competence before and after participation.

This pilot study included 12 healthcare professionals working in nursing homes. Data were collected using two quantitative pre- and post-intervention questionnaires (self-efficacy and perceived importance scales), as well as a qualitative evaluation form to gather feedback on participants' experiences with the course. Quantitative data were analysed descriptively, while qualitative responses were thematically analysed.

The development phase resulted in four monthly training sessions of 3 h per session. Overall, mean scores for self-efficacy and perceived importance increased after course participation. The greatest positive change was reported in Module 3 (procedures and action plans), followed by Module 4 ('ability to communicate about R/S concerns') and Module 2 ('ability to recognise one's own professional limits'). A slight negative change was observed in Module 1 for competencies related to active listening and addressing one's own communication barriers, though qualitative data suggested that this module fostered greater self-reflection, self-awareness and conceptual clarity about ESC. All participants found the training useful, although their perceptions of the most valuable learning dimension varied.

The ESCC's broad theoretical and practical approach functioned as a flexible framework, allowing participants to engage with elements most relevant to their clinical context. Module 1 appeared to be the most challenging. While participants acknowledged the importance of being able to 'endure in situations without solutions', they may have lacked confidence in practicing this skill. The course may have served as a turning point in participants' understanding of how others' religious beliefs and worldviews contribute to existential well-being and health.