Title, Author, and Date
Spirituality and spiritual care provided by parish nurses
Tuck, I., Pullen L., & Wallace D., 2001.
Purpose
Measured spiritual perspective and spiritual well being in a national sample
of parish nurses and described variables related to their practice. It also
qualitatively examined the provision of spiritual care to clients in this
parish nurse sample.
Population/sample
305 RNs as practicing parish nurses in 34 states were asked to complete
surveys with 119 completed surveys used for data analysis. 24.6 % with
Nursing Diplomas, 15.3% had ADN, 33.9% had BSN, 25.4% had MSN,
and one doctoral degree. Previously had been employed in adult health,
nursing education, community health, nursing administration, mental
health, women’s health, geriatric nursing, pediatrics, and rehabilitation. 47
had attended a parish nurse program less than 1 week, 42 had attended a
program of more than two weeks, 23 had attended a theological or pastoral
program, 12 had attended a spiritual conference, 13 had attended a
religious conference, and 3 had attended a 2-year spiritual conference. 59%
had a parish nurse certificate.
Quantitative and Qualitative = Integrative. Descriptive using surveys and
open-ended questions in interviews.
Design/Method
Quality
Key Findings
Significance
Limitations with descriptive survey as to limited information with out
elaboration or clarification. Nurses defined spiritual intervention from their
own perspectives and perceptions of their practices, rather than defined
criteria.
The three most listed primary foci of PN were holistic care, health
promotion, and education. The most frequent PN activities were screening
52, education 48, visiting 35, providing spiritual care 23, counseling 21,
promoting 20, supporting 18, and coordinating 14. PN scored high on
spiritual perspectives and spiritual well being. Types of spiritual
intervention fell into one of four categories: religious (praying is primary
intervention, offering communion, spiritual service, discussing
spirituality,…), interactional are interventions that foster the nurse client
relationship (being with, caring, instilling hope, supporting,…), relational
(listening, visiting, encouraging, talking…), and professional (accessing,
referring, teaching, assisting, problem solving, …).
Results – p 447.
The spiritual interventions reported are consistent with those reported in
other studies and confirm that the practice of PN is holistic, with an
emphasis on health promotion, health screening, and education. Parish
nurses place great emphasis on spiritual care, but like other nurses, tasks or
physical concerns often have a priority in practice. Spiritual interventions
are added to the domain of practice for all nurses. National sampling.
Title, Author, and Date
Purpose
Perceived health needs of urban African church congregants
Armmer, A., Baldwin, A., Cramer M., & Humbles, L., 2001.
Describe perceived health needs and expectations prior to the
development of a parish nurse program.
Population/sample
117 African American congregants from five urban churches.
Design/Method
Descriptive. Questionnaire (with some open-ended questions)
using a conceptual framework to guide the study.
Quality/Limitations
There was a lack of cultural sensitivity in the terminology
used in the questionnaire. Sample selection was based on
convenience.
Key Findings
Symptom of illness causing the most concern was high blood
pressure. Other symptoms of illness causing concern were:
dental problem, back pain, and health risk (weight, exercise
and diet). Respondents were more concerned about children’s
health risk behavior than own and more concerned with their
own health risk behavior than symptoms of illness. BP
screening was the most requested service. No difficulty in
accessing health care was identified.
Provides PN program development guidance, especially preassessment of setting. Confirms current data of screenings as
important intervention. Adds new information to the new
practice re: symptoms of illness causing concern were:
hypertension, dental problem, back pain, and health risk
(weight, exercise and diet). Respondents were more
concerned about children’s health risk behavior than own
behavior and more concerned with their health risk behavior
than symptoms of illness.
Significance
Title, Author, and Date
Purpose
Key elements for church-based health promotion programs:
outcome-based literature review.
Atwood, R., Peterson J., & Yates, B., 2002.
Non research
Literature that proposes seven key elements found in
literature review to be beneficial in establishing church-based
community health promotion programs that demonstrated
desired health promotion outcomes in decreasing CVD in
women. The seven key elements are: partnerships, positive
health values, availability to health care services, and access
to church facilities, community-focused interventions, health
behavior change, and supportive social relationships p 403.
Population/sample
Design/Method
Quality/Limitations
Key Findings
Significance
This is literature and not research… small sample of two
programs that specially focused on CVD risk reduction
programs for women performed in church settings. Literature
reviews are limited in that they are only current at a point of
time and reflect on current knowledge.
There was evidence in the literature reviews to support the
use of key elements in church-based health programs.
“Effectively promoted health behaviors within certain
communities” p 409. Found to have these key elements:
partnerships, positive health values, availability of services,
access to facilities, community-focused interventions, health
behavior change, and supportive social relationships.
Useful data further define parish nurse role in working with a
specific population to increase activity in midlife women to
reduce the risk of cardiovascular disease.
Title, Author, and Date
Purpose
Developing and implementing a healthy heart program for
women in a parish setting.
Ruesch, C., & Gilmore, D., 1999.
Non research
Develop a heart manual
Population/sample
Midlife-aged women in a parish setting
Design/Method
Primary prevention and health promotional study with class
participation and evaluation.
Quality
Key Findings
Positive feedback from participants about program content
with increased knowledge of improved health behavioral.
Significance
Limited but useful tool to promote CVD health in middleaged women.
Title, Author, and Date
Purpose
Measuring the domain completeness of the nursing
interventions classification in parish nurse documentation.
Androwich, I. & Burchart L., 2004.
To measure the domain completeness and uses of one such
terminology, the Nursing Intervention Classification (NIC),
within the specialty of parish nursing, a spiritual focused
community-based practice.
Population/sample
Parish nursing documentation samples.
Design/Method
Correlation and descriptive study with coupling
documentation mapping to narrative documentation, with a
follow up validation survey from experts in the field.
Quality
Large sample and validity enforced with the use of experts.
Key Findings
3059 interventions were identified with 93% mapping into
NIC. NIC was found to be a superior form of documenting
spiritual care. This study evaluated the extent to which NIC
can capture parish nursing and found that further NICs were
needed. Further research suggested.
New nursing knowledge that NANDA, NIC, and NOC are
very useful in documenting but suggested need for further
study.
Significance
Title, Author, and Date
Purpose
Spiritual nursing interventions.
Sellers, C. & Haag, A., 1998.
Explore what nursing interventions nurses implement to
enhance the spirituality of clients and their families, which
were frequently used, and how did the nurses learn these
spiritual interventions.
Population/sample
Oncology, hospice, and parish nurses in Iowa, Minnesota, and
North Dakota.
Design/Method
Descriptive using a mailed 750 questionnaires
Quality
Not a national survey, author suggested to replicate study to
the general nursing community or to complete a comparative
analysis of interventions nationally. Poor response rate of
29.86% with nice sample of 224 questionnaires used.
Key Findings
95 spiritual interventions were identified. Most frequently
identified interventions were referral, prayer, active listening,
facilitation and validation of client’s feelings and thoughts,
conveying acceptances, and instilling hope. Nurses learned
about spirituality through continuing ed., clinical experience,
basic nursing education, reviewing the nursing literature,
nursing colleagues, and advanced nursing education.
Confirms earlier studies with new knowledge addition. The
findings show an opportunity for increased spirituality
education in general nursing education.
Significance
Title, Author, and Date
How are we doing? Measuring the effectiveness of parish
nursing.
Purpose
Population
Rethemeyer A. & Wehling B., 2003.
Non- research
Share the development of a measurement tool to measure the
practice of parish nursing.
Survey to answer these questions:
Do parish nurses affect change in the health behaviors of those
served?
Are parish nurse easily acceptable to members of the
congregation/
What are the benefits of using the parish nursing for health
needs?
What are the disadvantages, if any, of using the parish nurse
for health needs?
Do parish nurses provide services that are commensurate with
their roles?
17 parish nurses in 19 congregations distributed the surveys to
760 participants.
Design/Method
Descriptive survey tool development tested with focus groups
Quality
Pilots used to validate survey. Limited to Christian faith
denominations.
Key Findings
Results showed that the congregations benefited from the
services that the parish nurse offered. Participants had no
trouble with contacting the parish nurse. Participants indicated
that parish nurses encouraged self-development and selfreflection and had a positive impact on their health. The most
frequent health practices that were impacted by the parish
nurse were: regular blood pressure screenings (49.3%),
participating in worship (41.1%), eating healthier foods
(38.7%), learning of the warnings of heart attack (39.6%), or
stroke (35.4%), attending (health) programs sponsored by the
church (35.1%), and getting regular exercises (31.8%). Tool is
useful for PN programs.
Survey results will be used to define parish nursing and to
articulate the contribution of parish nursing in health care
delivery.
Significance
Title, Author, and Date
Parish nursing: Moving beyond the seven functions.
Purpose
Solari-Twadell, A., 2003.
To identify those nursing interventions that PN use most
(domain).
Population/sample
Parish nurses, nationally
Design/Method
Descriptive, cross sectional study using a mailed survey.
Quality
National survey with good response.
Key Findings
PN were able to select from 486 interventions the most
frequently used interventions from the Nursing Intervention
Classification (NIC) System. Behavioral domain nursing
interventions were selected the most, p 7.
Significance
The NIC classification system can be used effectively to
describe PN, which provides a language for the nursing
practice. The results provide a picture of what PN is.
Title, Author, and Date
The performance of blood pressure and other cardiovascular
Purpose
Population/sample
Design/Method
risk factors as screening tests for ischemic heart disease and
stroke.
Law, R., Morris, K. & Wald, J., 2004.
Non research
To summarize the main evidence and conclusions related to
using BP measurement as a screening test to identify people
who will develop IHD or stroke, as recently published in a
Health Technology Assessment report.
Men (35-64yr) who attended the BUPA Medical center in
London between 1975 and1982. Compared the BP of men
who died of IHD and the men who did not.
Non- research article summarizing information on a topic.
Quality
Key Findings
Lowering BP from any pre-treatment level reduces the risk of
ischemic heart disease (IHD) events and stroke. Blood
pressure is a poor screening test in distinguishing people who
will and will not have cardiovascular events.
Significance
Blood pressure screenings are effective in reducing the risk of
ischemic heart disease (IHD) events and stroke and are
performed in a variety of community-based settings.
Title, Author, and Date
Exploring parish nursing from an ethnographic perspective.
Purpose
Population/sample
Design/Method
Quality
Key Findings
Tuck, I. & Wallace, D., 2000
Describe a parish nurse program from an ethnographic perspective.
3 interviews with; the hospital chief executive officer, director of pastoral
care program, and the coordinator of the parish nurse program. Interviews
were conducted with 7 parish nurses who had served in that capacity for at
least one year. The parish nurses reported an average of 20.6 hr to their
employer, but actually worked 25-40 hr per week as a parish nurse
Ethnographic with semi-structured interviews with key informants
The ethnographic approach allowed for sharing of perceptions of
individuals from different levels of the program and offered a unique
perspective of the culture of parish nursing.
Parish nursing is an established method for health care delivery that is well
received by the community. Parish nursing was seen as an alternative
delivery for providing care in the community to a variety of clients and
“often provided continuity of in a disjointed health delivery system”.
Taxonomies for three domains (attributes 45, nursing action 120, and
offerings includes: education, skill building, health screening, and focused
meetings) are reported from key informants; and two other taxonomies
were derived from data analysis (parish nurse roles and parish nurse
concepts). Cultural themes identified were 1) Administrators: Discovery,
fit with mission, value to organization, and organizations commitment to
parish nursing. 2) Spiritual leaders: Discovery, values of individuals as
participants, fit with mission, and congregation’s commitment to parish
nursing. 3) Parish Nurses: Discovery, values as individuals as participants,
fit with own mission, commitment to actions to meet the needs of
congregation. 4) Discovery, values as attributes of parish nurse, fit with
requested parish nurse actions, commitment to relationship. Parish nursing
offers nurses the opportunity to bridge physical, emotional, and spiritual
lives into one care-giving experience.
Significance
Further study: The taxonomies that emerged from the data (attributes,
nursing actions, and offerings) can be useful in constructing future studies
that measure intervention and outcomes. New knowledge from the
perspective of administrator and spiritual leadership. Results further
defines role.
Title, Author, and Date
Faithful patients: The effect of long-term physician – patient
Purpose
relationships on the cost and use of health care by older adults
Weiss, J & Blustein, J., 1996.
To quantify the benefits of long- standing doctor patient
relationships under present Medicare fee-for-service
arrangements (p 1743). The four hypothesis were:
A longer duration of tie is associated with use of preventive
care services, more healthy behaviors, more effective use of
health care services, and a decreased in the cost of care
services.
Population/sample
Cluster sample of 8,068 Medicare patients that participated in
the Medicaid Current Beneficiary Survey of 1991 and had a
usual source of care.
Design/Method
A descriptive quantitative design using a survey/questionnaire
and post hoc analysis.
Quality
Strengths and weaknesses: Strength was a large sample of
8,068 individuals. The descriptive process has the limitation
of one entry point of collection and only limited objective data
collected. Other limitations were that subjects were not
limited to one source of care and “presumably relatively free
to switch providers” (p1744). A major limitation was noted to
be “the study’s reliance on previous collected data” (p1744).
Key Findings
Long-standing ties between patient and health provider foster
less expensive and less intensive medical care.
Significance
Significant findings of the study: Long-standing ties between
patient and health provider foster less expensive and less
intensive medical care. There is no association between
duration of tie and “healthy behaviors, and the probability of
emergency use…” (p1745).
Title, Author, and Date
Purpose
Parish nurse practice with client aggregates
Weis, D., Schank, M., Coenen, M., & Matheus, R., 2002.
To describe parish nurse practices with client aggregates to
determine if existing nursing classification systems could be
used with aggregates or groups” and to determine if these
systems could be used to describe and document parish nurse
practice (p 105).
Population
19 Parish Nurses, in a regional network group, who were
practicing in 22 Christian faith communities in the Midwest.
Design/Method
Both qualitative and quantitative methods were used that
included descriptive and focus group inquiries. Specific data
was collected on a daily data collection sheet. Demographics
and NANDA and NIC taxonomy was used to describe client
encounters. In addition 10 nurses out of the original 19 were
asked to participate in a focus group. The researchers used a
semi-structured interview to direct the discussion towards
review of the quantitative data. The Focus group was audio
taped.
Quality
Nice sample size and the focus group were used to validate the
quantitative results.
Key Findings
The most frequent NANDA diagnosis were health-seeking
behaviors (28.7%), potential for enhanced spiritual well-being
(14.9%), knowledge deficit (11.5%), and anxiety (4.9%). The
most frequent NIC was active listening, followed by health
screening, support system enhancement, presence, self-esteem
enhancement, learning facilitation, and health education” (p
106). Aggregates receiving care were across the life span.
Significance
NANDA and NIC can be used with aggregates and is useful
in parish nursing. Confirms previous knowledge that the main
focus of parish nursing is health promotion and illness
prevention.
Title, Author, and
Date
Purpose
Nurses’ perspectives on the distinctive aspects of providing nursing care in a
congregational setting.
Chase-Ziolek & Iris, M., 2002.
Identify unique contributions of providing nursing care in a congregation
setting
Population/sample 17 parish nurses participating in a hospital-sponsored, volunteer health
ministry program.
Design/Method
Qualitative:
Focus group and interviews
Quality
The combination of focus groups and interviews is strength. Limited
generalizability.
Key Findings
Key topics were: 1) How the nurses felt they were making a difference, 2) The
unique opportunities of providing care with in a congregation, and 3) The
unique challenges. Four categories emerged in 1): health promotion &
prevention, advocacy, health education, and health counseling, including
psychosocial and spiritual care. Four categories emerged in 2): integration of
health and faith, psychosocial environment, long-term relationships, and nurse
autonomy. The nurses appreciated the relaxed environment, opportunity for
long-term relationships, and the level of professional autonomy. Four
categories emerged in 3): Client autonomy, Impact of religious beliefs,
worship experience, and parish nurse time commitment (volunteers). The
nurse described having less control contrast to (hospital) work settings.
Significance
Identified need to develop adequate practice support, especially for new
parish nurses. Further study to explore how parish nursing fits into the
wider health care system. If there is a need to help people interpret
physician recommendation and decide whether or not to see a physician,
how can parish nurse best work with physicians individually and
collectively to meet client needs?
Title, Author, and Date
Purpose
Population/sample
Design/Method
Parish nurses influencing determinants of health
Buijs, R. & Olson, J., 2001.
Article. How are the concepts of health, health promotion,
faith community, and health determinates connected?
How does the nurse draw on the unique features of the church
to promote health?
“We describe how a parish nurse can influence 2 determinates
of health: social support and healthy child development” p13.
Parish nurses working in a congregational setting (article)
Non research
Literature review looking at related concepts.
Quality
Key Findings
Significance
Title, Author, and Date
Faith communities represent existing, consistent supportive
environments and provide an ideal setting for social marketing
of positive health messages. Parish nurses can advocate for
policies and programs that are supportive of children and
families. A parish nurse can use interventions that offer
parents informational, tangible, or emotional social support.
Healthy child development is one determinant of health that
can be addressed well by a parish nurse in a faith community.
Confirms previous knowledge… parish nursing can have an
effective impact on health within the faith community.
Further research is suggested to compare the effectiveness of
specific interventions in a faith community setting.
Parish nursing: Nurturing body, mind, spirit, and community
Brudenell, I., 2002
Purpose
Describe the development and effectiveness of Parish Nursing
Programs in a specific geographical area of the intermountain
West. Research questions included: 1) “How do faith
communities form parish nurse programs and 2) What is the
effect of parish nursing programs on health outcomes” (p 86).
Population/sample
13 Parish nurses and 8 pastors, 2 hospital chaplains, 2 parish
nurse coordinators from regional medical center representing
13 congregations of 8 different Christian denominations in
southwest Idaho. All but two congregations have an unpaid
model.
Design/Method
A qualitative design, using grounded theory method was used
to answer the research questions. Interviews were held in a
naturalistic environment.
Quality
Strength was the use of the focus group to validate the results.
Homogeneity was a limitation, as all the parish nurses
practiced in Christian faith denominations. Was able to
clarify and ask additional questions. Naturalistic approach
captured a process as it occurred.
Faith communities form parish nurse programs in a
“developmental process” (p 87). The developmental process
includes these four phases are: preliminary stage of
exploration, alliance and informing the faith community,
acceptance, and the establishment of the parish nurse
program.
“Strategies are used to move forward, dealing with transitions
and limitations over time. The process involves knowing the
congregation and the community” (p 87).
All sites were active in health promotion and risk assessment
and transition. “Transitions within a volunteer-based religious
community are fluid and continuous, requiring efforts to
recruit and support volunteers working in health ministry” (pg
92).
In the interviews, clients stated that nursing intervention
yielded effective health outcomes, which impacted the client’s
quality of life.
Key Findings
Significance
New knowledge about the adaptation process of a parish
nurse program with four distinct stages. Defined transition as
a parish nurse role metaparadigm. Impact on QOL identified.
Title, Author, and Date
Client perspective of parish nursing
Tuck, I., Wallace, D., Bowland, C., & Witucki, J., 2002
Purpose
Examine parish nursing from a client’s perspective
Population/sample
Convenience sampling from two congregations that had paid
models in place for 4 years. Parish nurses asked for volunteer
informants and gave the names to the researchers. 12 women
and five men were interviewed.
Ethnographic, with face-to-face open-ended interviews (17)
lasting 20-60 minutes each.
Design/Method
Quality
Convenience sampling has limited generalization of results to
other populations.
Key Findings
Multiple categories, six domains emerged: first contact, parish
nurse action, relationship, access/contact to parish nurse,
dimensions of parish nurse, and contrast, and five themes of
client perception emerged from analysis of interviews: being
available, integrating spirituality and health, helping us help
ourselves, exploring parish nursing, and evaluating parish
nursing.
“ Specific situations were also discussed where the parish
nurse directly impacted the health of individuals” (p 132).
Quotes included personal relationship with parish nurse,
readily available, personally approachable, part of the
ministry of the church, health of the body, mind and soul can
take place in a church setting, parish nurses themselves
matured spiritually, and effective and meaningful health
providers.
New knowledge and validation of current literature.
Further study to explore the effectiveness of this new nursing
delivery model. The author suggests that parish nursing is an
approach to meet Healthy People 2010 goals.
Significance
Title, Author, and Date
Client perceptions of distinctive aspects in nursing care
received within a congregational setting
Purpose
Chase-Ziolek, M. & Gruca, J., 2000
To understand the client’s experience of receiving nursing
care in the context of a congregation.
Population/sample
11 individuals; convenience sampling from 2 urban Catholic
churches with at lease five contacts with the parish nurse.
Design/Method
Qualitative using interviews and coding in a naturalistic
inquiry
Quality
Small sample with in a single denomination limits
generalizability…The services provided were well defined.
Key Findings
Categories were: qualities of the nurse and qualities of the
church environment as a site of care. Attributes of the nurseclient interaction were: manner of care, focus of care,
outcomes achieved. Characteristic of the congregational
setting were: the ambiance, convenience, time for interaction,
and reflection on the connection between faith and health.
Rather than replacing other health care services, the nursing
services increased the use of traditional care through advocacy
and increase access. The author states that the parish nurse
services to increase access is consistent with Healthy People
2010 goals. The nurse-physician relationship was described as
indirect through empowering the client to communicate more
effectively with his or her physician.
This addresses the nurse-physician relationship and makes the
connection between parish nursing and healthy people 2010
goal. The parish nurse is defined by the perceptions of clients
and the site is defined for facilitation of parish nursing.
Significance
Title, Author, and Date
Describing parish nursing using the nursing minimum data set
Purpose
Population/sample
Design/Method
Quality
Key Findings
Coenen, A., Weis, D., Schank, M., and Matheus, R., 1999.
Describe parish nurse practice using the framework of the Nursing
Minimum Data Set (NMDS).
19 Parish Nurses, in a regional network group, who were practicing in 22
Christian faith communities in the Midwest and ten were asked to
participate in a focus group.
A descriptive quantitative and qualitative method was used. Specific data
was collected on a daily data collection sheet. The research questions
were: What was the nursing diagnosis used by the nurse? What nursing
interventions used by the nurse. What nursing interventions used by parish
nurses for select nursing diagnosis? And what were the parish nurses’
perceptions of how the study findings reflected their practice?
Demographics and NANDA and NIC taxonomy was used to describe
client encounters. In addition 10 nurses out of the original 19 were asked
to participate in a focus group. The researchers used a semi-structured
interview to direct the discussion towards review of the quantitative data.
The Focus group was audio taped.
The focus group was used to validate the quantitative results
The nurses identified 1,730 nursing diagnosis. The most frequently
occurring nursing diagnosis were health-seeking behaviors (27.5), grieving
(7.6%), Management of therapeutic regimen (6.4%), Knowledge deficient
6.1%), social isolation (5.8%), anxiety (5.6%), potential for enhanced
spiritual well-being (5.4%), and pain (5.1%). The most frequently
occurring nursing interventions were active listening (16.2%), spiritual
support (9.6%), health screening (9.4%), emotional support (7.9%), and
Individual teaching (5.5%). The focus group validated the results.
Nursing interventions by diagnosis: Health seeking behavior – health
screenings, active listening, individual teaching, and emotional support.
Grieving – grief work facilitation, spiritual support, active listening, and
emotional support. Management of therapeutic regime – health care
information, support system enhancement, individual teaching, active
listening, spiritual support, and emotional support. Social isolations –
spiritual support, active listening, socialization enhancement, and touch.
Pain – active listening, individual teaching, pain management, emotional
support, and spiritual support. Potential for enhanced spiritual well-being –
spiritual support, active listening, emotional support, and touch.
Aggregates receiving care were across the life span. The NMDS did prove
a useful framework for the collection and organization of clinical nursing
data for this study.
Significance
Confirms previous knowledge that the main focus of parish nursing is
health promotion and illness prevention. Nursing interventions per nursing
diagnosis provided new knowledge. The NMDS did prove a useful
framework for the collection and organization of clinical nursing data for
this study.
Title, Author, and Date
The meaning and experience of health ministry within the
cultural of a congregation with a parish nurse
Purpose
Population/sample
Chase-Ziolek, M., 1999.
Understand the meaning and experience of health ministry
(HM) within the culture of a congregation with a parish nurse
examining both emic and etic perspectives.
Research questions:
How does HM reflect the worldview and cultural care values
of a congregation with a parish nurse?
What are the patterns, meanings and expressions of HM in a
congregation with a parish nurse?
What is the emic (insider) understanding of HM?
How is the emic understanding of HM similar or different
from the etic (outsider) understanding of HM?
Urban United Methodist congregation with a volunteer parish
nurse.
Design/Method
Ethnographic with observation, interviews, and reviews of
written documents
Quality
Described setting and culture well
Key Findings
Domains emerged were individual context (definition of
health), historical context (history of denomination and
church, community context (shared values), organization
(leadership of church), and ministry (ministry and mission of
church). Two forms of health ministry were found. Extrinsic
HM included activities aimed to promote health. Intrinsic HM
included activities was other than promoting health such as
congregational life, yet perceived as promoting health.
Knowledge of congregational cultural is essential to facilitate
culturally congruent health ministry. Important to be mindful
of parish nurses role in promoting culturally congruent care
and not to impose it. Respectful of congregational culture and
recognize how health can and does already fit within a given
congregation. Churches have naturally occurring healthpromoting qualities. Be careful to not weaken the already
health-promoting qualities by making health strictly the
territory of the nurse. Facilitating health promoters to support
naturally occurring care.
New knowledge about the culture of a congregation. More
research to new and creative ways to understand the dynamics
of congregational culture.
Significance
Title, Author, and Date
Patient-focused care in parish nursing
Rydholm, L., 1997
Purpose
Non research
Grant’s purpose was to encourage more attention about helping elderly
parishioners cope effectively with their health related concerns.
Goal of data collection was to collect nursing interventions/outcomes to
demonstrate the potential impact of parish nurse outcomes on averting
Medi-care expenses and promoting quality of life.
What are the health concerns of elderly rural clients being bought to the
attention of parish nurses?
In what ways are parish nurse responding to elder health concerns?
What is the nature of client outcomes, with respect to resolution of specific
concerns?
Population/sample
Forty parish nurses participated
Design/Method
Descriptive field notes of 40 nurses collected and formatted into three
categories; diagnosis, interventions, and outcomes.
Quality
Large participation in program
Key Findings
Omaha classification system did not adequately address psychosocialspiritual concerns and interventions. Used the North American Nursing
Diagnosis classification system (p 51). Psychosocial-spiritual concerns
accounted for 53% and physical and functional concerns accounted for the
other 47% of the addressed concerns. Where safety was a concern, care
access was facilitated. In situations that went beyond the training of the
nurse referrals were facilitated with diplomacy and supportive advocacy.
Parish nurses were highly successful with respect to resolutions of physical
symptoms. In each situation where a caregiver was sustained for a 6-month
norm, health care savings was projected at $20,000 x 10 clients =$200,000
savings. Cost savings related to potentially averted hospitalizations by
virtue of referral persuasion or advocacy related to concerns cited above
exceeded $200,000. Parish nurses are needed in remote settings, where
access to health care services is limited and hindered by system mistrust.
Volunteer parish nurse worth is highly underestimated. Community-based
nursing has an invaluable contribution to make to the health care system of
the future.
This article describes nursing diagnosis, interventions, and outcomes of the
parish nurse caring for an elder population and starts to equate cost savings
for the federal government. It is new nursing knowledge and shows
financial impact of volunteer parish nursing in caring for the elder.
population. Additional research looking at other age groups.
Significance
Title, Author, and Date
Body, mind, and soul: The parish nurse offers physical,
Purpose
emotional, and spiritual care
Solari-Twadell, A. & Westberg, G. 1991
Non- research
Population/sample
Design/Method
Quality
Key Findings
Significance
Role identified in regards to helping people to: be better
partners in the management of their health, understand disease
and treatment options, understand the relationship between
health and faith, become aware of community health
resources, and receive support from others in the parish.
Church as best health place: Interacts with people from birth
to death, provides structure in place for adult education,
mission is one of health and salvation, church is seen as
resource for services, and in rural areas, may be the only
health place. The role of Parish Nurse is: Health educator,
health counselor, volunteer coordinator, community liaison,
and role model. Nurses must be skilled in communication and
assessment; be familiar with referral process; be spiritually
matured and able to set priorities and limits. Hospitals see the
parish nurse program as part of mission work and a way to
collaborate with churches.
This work is classic as Granger Westberg is noted to be the
founder of parish nursing.
Title, Author, and Date
Purpose
Healthier communities through parish nursing
De Schepper, C., 1999.
Non research
Avera Health System’s effort to develop parish nurse
programs in a five-state region in the Midwest.
Population/sample
Design/Method
Quality
Key Findings
Significance
Title, Author, and Date
Parish nursing meets system’s mission. Goal to have a
minimum of one parish nurse program in each regional
community within one year. Saw development in four areas:
system support, support at community level, partnership with
educational facilities (colleges provided core curriculum,
cont. education, network activities, and student experience
with working parish nurses as preceptors), and parish nursing
in non-system communities (support for others in developing
programs).
Spiritual support for the parish nurse by sponsoring retreat
(the demands of the church always exceeds the nurses’
resources of time and emotional energy). “ Parish nursing
raises the awareness of church staff, giving them a redefined
sense of calling and ministry to the whole person” (p 58).
More research to measure ways effective outcomes.
Educating parish nurses
Purpose
Key Findings
Significance
Title, Author, and Date
Olson, J., Symington, J., & Clark, M., 1997
Non research
Discussed how the facility from Alberta University developed
the first training for parish nurses in Canada.
In preparation, facility performed a literature review to broaden
their knowledge of parish nursing, attended a parish nurse
training program, hired a parish nurse consultant, and
networked with working parish nurses. Parish nursing is
viewed as a subspecialty in community nursing. The McGill
nursing model was introduced to promote health by engaging
others in collaborative learning. Integral to this model is that
the client has the ability to move towards higher levels of
health. The nurse’s role is one of coach (p 42). Facility
modeled this mode of inquiry as a method of empowerment in
course development efforts. Parish nursing is offered in two
courses that are six credits each. Course one, Promoting the
wellbeing within faith communities, is offered to fourth year
undergraduate nurses and opened to registered nurses. Course
one contains four units. Unit one focuses on the basics of health
healing and wholeness. Unit two explores strategies for
promoting physical, emotional, and spiritual health. Key roles
of the parish nurse are also discussed in unit two. Unit three
explores the parish nurse as facilitator of healing. Unit four
highlights professional issues, legal and ethical, future
educational opportunities, and self-care strategies.
Course II is described as a clinical course in parish nursing
with a nine month supervised 234-hour practicum in a faith
community. This clinical course uses a representative from the
faith community to act as a preceptor that works closely with
facility. Student evaluations have been positive for both the
course and practicum. Students have responded that they would
like increased time for integration and personal reflection.
Recommendations included more small group work for
supportive feedback, more assistance in learning to combine
spiritual care with physical and emotional care. Students who
have taken the practicum report that it prepared them well for
practice within faith communities and that the theory resource
materials were often consulted (p 43). The students reported an
increase in confidence in their nursing role and ability as they
performed the roles as a result.
Since there is no research that looks at parish nurse training,
this article is significant. It describes the theoretical course and
practicum and discusses course evaluation.
Church programs as a first clinical experience
Purpose
Moll, R., Hopper Cook, L., & Saul, J., 2001
Non research
Context-based curriculum focuses on health promotion in the
community starting with the first semester in nursing school.
This article looks at two students that completed their first 4week practicum in a church setting. Edmonton, Canada
(2001).
Population/sample
Design/Method
Quality
Key Findings
Significance
Title, Author, and Date
The first student worked with a parish nurse (PN) in a
congregation. The student was most impressed by the fact that
the PN “worked with people that would otherwise fall through
the cracks the health care system and society (the elderly,
lonely, and discouraged; those with chronic or rehabilitative
health needs; those who merely needed devices) to help them
to help themselves” (2001, p 122). The student states “
nursing is all about healing” (p 122).
The second student worked in a soup kitchen that was
operated by a church. Her main goal was to meet health
department requirements. Her role included cleaning and
rearranging items, making a manual and poster to educate,
remind, and motivate workers to improve the health of the
soup kitchen guest.
This knowledge is significant as it looks at the church and the
church’s outreach as a practicum experience as a student
nurse. It also highlights a mentoring role of the PN for nursing
students.
Four keys to success in parish nursing
Purpose
Sr. Bowman, 1999
Non research
St. Francis, which is part of Healthcare West, started a parish
nurse program as the centerpiece of their community benefit’s
program. After three years the program has grown to 14
nurses in 26 churches and one nurse in catholic charity, where
the nurse ministers to the agency’s clients.
Population/sample
Design/Method
Quality
Key Findings
Significance
Title, Author, and Date
The four keys include choose a proven model, develop
adequate funding sources, appoint leaders committed to
wellness, and seek support from local faith communities.
The program is primarily funded by the foundation and the
funds are used for parish nurse salaries and benefits,
equipment, and supplies. Each PN works with a cabinet,
which consists of 6-12 members of the church congregation.
The role of the health cabinet is to assess the congregation to
determine a care plan. The PN trains volunteers who serve as
lay visitors to make home and hospital visits. They also help
with screenings, fairs, classes, and other events. In their
efforts to reach the underserved population, have partnered
with low-income churches, and have developed goals specific
to this targeted population. The article estimates 6000 parish
nurses in the United States.
The article is significant as it addresses the hospital role as the
activator in starting this program. The role of the cabinet and
volunteers are also considered.
Parish nurse ministry improves health outcomes of low-income
Purpose
Key Findings
Significance
community
Dixon, S., 1996
Lorain Community and St. Joseph’s Regional Center conducted
a community needs assessment. This was a qualitative study of
the process of health care delivery. Based on the results, a
parish nurse program began. In 18 months 75 parish nurses
were recruited and the health center formed partnerships with
56 congregations.
The study revealed that several obstacles blocked provision of
quality and affordable health care to low-and moderate income.
Inadequacy of linking needy patients with doctors and services,
language barriers existed, shortage of primary health
practitioners willing to take Medicaid/Medicare patients,
insufficient effort to inform the public of services, lack of
knowledge to access health care system, and misuse, abuse, and
non-use of services, primarily through lack of knowledge of
general health principles and how services should be used. The
major issue of access was divided into five areas: availability,
accessibility, accommodation, affordability, and acceptability.
The Parish nurse program was developed in response to the
study results and program goals are: promotes health education
to encourage appropriate use of services, inform the community
of health care services and how to access them, remove
language barriers through Spanish literature and bilingual staff,
provide leadership in coordinating services of local providers
and referral services, provide services in a place of trust and
comfort. In evaluation the parish nurse program has had an
immersed impact on the health status of our community. The
PN program has provided a service that is cost effective and
measurable.
The significance is that the article discusses parish nursing as
an intervention for the underserved population based on a needs
assessment through a qualitative study.