• Suh-Ing Hsieh, Li-Ling Hsu, Chen-Yi Kao, Sara Breckenridge-Sproat, Hui-Ling Lin, Hsiu-Chen Tai, Tzu-Hsin Huang, and Tsung-Lan Chu.
• Department of Nursing, Chang Gung University of Science and Technology and Associate Researcher of the Nursing Department at Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
• J Clin Nurs. 2020 May 1; 29 (9-10): 1599-1613.

Aims And ObjectivesTo determine factors associated with nurses' spiritual care competencies.BackgroundHolistic nursing care includes biopsychosocial and spiritual care. However, nurses are limited by a lack of knowledge, time constraints and apprehension of assessing spiritual issues, which leaves them unable to assess and meet patients' spiritual needs. Thus, when patients experience spiritual distress, clinical nurses lose the opportunity to support spiritual growth and self-actualisation. In Taiwan, spiritual care, religion and culture are unique compared to those in other countries. Overall, factors associated with Taiwanese nurses' spiritual care competencies lack comprehensive exploration.MethodsThis study adopted a descriptive correlational design using cross-sectional survey (see Appendix S1). Cluster sampling was used to select clinical nurses from fourteen units of a medical centre and a regional hospital. Data were collected from January-June 2018 with a 97.03% response rate. Clinical nurses completed a background questionnaire, spiritual care practice questionnaire, spirituality and spiritual care-related scales. Data were analysed using descriptive and linear regression. This report followed the STROBE checklist.ResultsSpiritual care competence ranged from 44-123 (mean 84.67 ± 12.88; range 27-135). The majority of clinical nurses rated their spiritual care competence as moderate (64-98). The significant factors associated with nurses' spiritual care competence were education, religion, interest in spiritual care, having role models, past life events, barriers to providing spiritual care of the spiritual care practice score, and spiritual attitude and involvement score. The overall model was significant (p < .001) and accounted for 55.0% of variance (adjusted R2  = .488).ConclusionsMost clinical nurses have moderate spiritual care competence. Objective factors identified affect clinical nurses' spiritual care competencies.Relevance To Clinical PracticeTo improve nurses' spiritual care competencies, objective factors that affect clinical nurses' spiritual care competencies must be emphasised. Multiple strategies for enhancing nurses' own spiritual well-being can be provided via employee health promotion projects and activities, and promoting nurses' spirituality and spiritual care competencies can be explored in clinical settings through bedside teaching, situational simulation, objective structured clinical examinations and self-reflection.© 2019 John Wiley & Sons Ltd.

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