Spirituality in undergraduate nursing curricula: An integrative review of students' perspectives, attitudes, and...

Spirituality, a key dimension to human functioning, is increasingly recognised as a crucial component of holistic nursing care, yet its integration into undergraduate nursing education remains inconsistent across university settings.

This integrative review provides a synthesis of empirical evidence from international studies published between 2015 and 2025, exploring university nursing academics' and undergraduate nursing students' perspectives, attitudes, and experiences of spirituality education and learning.

Guided by Whittemore and Knafl's (2005) five step framework, the review included qualitative, quantitative, and mixed-method studies that examined spirituality and preparedness for spiritual care in clinical practice. Five databases: Medline, CINAHL Plus, Scopus, ProQuest Full Text, and PsycINFO databases were used. CASP checklists (CASP, 2024) were used to assess quality of 18 included articles. Data were analysed using thematic analysis.

Four major themes emerged: (1) Determinants Shaping Spirituality Perspectives, including gender, religious beliefs and practices, educational exposure, and clinical nursing experience, which significantly influenced students' perceived competence in spiritual care; (2) Interpretive Understandings of Spirituality, where students reported holistic and relational understandings of spirituality following spiritual education; (3) Readiness for Spiritual Care: Confidence, Competence, and Capability, with many students feeling inadequately prepared due to limited knowledge and training despite recognising the importance of spiritual care; and (4) Pedagogical approaches for integrating spirituality into practice, highlighting the effectiveness of simulation, curriculum integration, and spiritual assessment tools in improving students' understanding and preparedness.

Students recognise the importance of holistic care including spirituality in nursing. However, challenges exist in curriculum design and students' preparedness. Students express a need for structured, experiential learning to develop competence in spiritual care.

There is a need for culturally responsive and evidence-informed educational strategies to support the integration of spirituality into nursing education, which can enhance compassionate, person-centred care across diverse clinical settings.