1. Dutch nursing students, the Neuman Systems Model in education and spiritual care competence Dr. AE Schep – Akkerman 5 febr 2015 Antwerp Belgium

2. Introduction NSM The intent of the NSM is to set forth a structure that depicts the parts and subparts and their relationship for the whole of the client as a complete system According to the Neuman Systems Model (NSM), nurses have to learn to think about patients in an integral way during their years of study

3. NSM The client is a dynamic composite of 5 variables The expectation is that nurses ‘keep the client system stable’ and therefore will be competent in delivering care for all these dimensions by finishing their study Phycho- logical Physio- logical Spiritual Socio- cultural Develop- mental

4. Aim To identify the development of Dutch bachelor student nurse’ competences in spiritual care during their study, at schools with curricula based or based not on the Neuman Systems Model

5. Method Nursing students at five schools (two schools with curricula based on the NSM) are asked to complete a questionnaire at the beginning of each year of their study Parts of the questionnaire: -Demographic characteristics -Self-assessment with the Spiritual Care Competence Scale (SCCS) -Evaluation own spirituality with the Spiritual Attitude and Involvement List (SAIL) SCCS: van Leeuwen R, Tiesinga LJ, Middel B, Post D, Jochemsen H. The validity and reliability of an instrument to assess nursing competencies in spiritual care. J Clin Nurs. 2009 Oct;18(20):2857-69 SAIL: Meezenbroek Ede J, Garssen B, Van den Berg M, Tuytel G, Van Dierendonck D, Visser A, Schaufeli WB.Measuring spirituality as a universal human experience: development of the Spiritual Attitude and Involvement List (SAIL). J Psychosoc Oncol. 2012;30(2):141-67.

6. Method - analyses SCCS- and SAIL- summary scores will be compared between years of study and between schools with curricula based or not based on the NSM To see if there are any differences between or development in years and / or schools

7. Results After 3 years of study 286 students from a school with a curriculum based on the NSM and 347 students from a school with a curriculum based on another or more nursing models did fill in the questionnaire

8. Results Characteristics respondents Curriculum based on NSM (286 students) Curriculum not-based on NSM (347 students) Female students87%86% Younger than 25 yrs 94% 80% High school (prior to study) 87%81% Health care experience (prior to study) 41%30% Religious lifeview83%47% Daily or weekly pract. spiritual activities* 98%52% *prayer, meditation, read religious book, visit religious places, practice some kind of art, seek rest in nature, voluntary work for the community.

9. Results – summary score per year Spiritual Care Competence Scale

10. Results – summary scores Spiritual competence – subscales 1-3

11. Results – summary scores Spiritual competence – subscales 4-6

12. Results Factors - next to school, also student characteristics: -Personal spirituality (role spirituality in life) -Age -Education (prior to study) -Health care experience (in year prior to questionnaire) -Life view (religious yes/no)

13. Results – summary scores per year Personal spirituality

14. Results – summary scores Personal spirituality - subscales

15. Results – student characteristics

17. Conclusion NSM SCCS score at start study is the same for students at nsm and non-nsm schools > With a curriculum based on the NSM, nursing students do have a stronger learning curve in spiritual care competences

18. Conclusion NSM Nursing students at a school with a curriculum based on the NSM, do have a higher score on personal spirituality (especially the connectedness to the transcendent – religious students) However, religious students at non-nsm schools do have a lower score on personal spirituality than religious students at nsm schools

19. Discussion NSM Differences in spiritual care competence because of difference in curriculum and also because of difference in students? – is there a ‘special’ group of students going to schools with a curriculum based on the NSM?

20. Thanks for listening! Any questions?

21. Results – summary scores

22. Spiritual competence – subscales 1-3

23. Results – summary scores Spiritual competence – subscales 4-6

24. Results – summary scores

29. Personal spirituality - subscales

30. Results – student characteristics

32. Results – summary scores

36. Significant difference NSM – non NSM (+) Year 1Year 2Year 3Year 4 SCCS -Assessment++++ -Improving++++ -Pers. Support++++ -Referral++ -Attitude++ -Communication+ SAIL - Conn. to oneself++ - Conn. to others+++ - Conn. to transc.++++