Assessment of spiritual care competencies of critical care health professionals: An integrative review.

Objective: The primary aim of the present study was to assess the competencies related to the spiritual care by nurses and health professionals who work in intensive care units, and how these competencies influence clinical practice. As a secondary objective, we have discussed the strengths, weaknesses and threats of incorporating and teaching these competencies among the included studies.

Method: An integrative review of studies published in English, Spanish and Portuguese was performed in the following databases: Embase, Web of Science, Medline/PubMed, PsycInfo, LILACS and Cochrane.

Results: Eleven out of a total of 2,239 articles were included. Most were cross-sectional studies with nurses and the main competencies included were "spiritual care attitude" and "knowledge-related spirituality". The studies were separated into three themes: "Strengths", "Weakness" and "Opportunities". The results showed there are several challenges for professionals working in ICUs, including lack of time, high workload and the influence of the cultural context. Furthermore, few professionals are actually trained to provide spiritual care in the ICU and this care is often provided only at the end of life. Despite this evidence, only one quasi-experimental study on training on the subject in the ICU was identified and no trials, reinforcing the need for more educational studies.

Conclusion: There is still a large gap regarding spiritual care in the intensive care environment, often related to the lack of training and knowledge of the team. Exploring the competencies involved in spiritual care provided by health professionals is a way to deepen the debate within the healthcare-related scientific scenario.

Implications for clinical practice: Our findings allow a better understanding of outcomes related to healthcare, based on the assessment of these competencies and aspects related to critical patients, expanding the possibility of building scientific knowledge in the health area and allowing thoughts about multiple forms of research, including randomized clinical studies.