Objectives: A paucity of research has examined the relationship between addressing the spiritual needs of hospitalized Asians and their overall satisfaction with service provision. This study examined this relationship, in tandem with the effects of eight potential mediators, to develop a model of spiritual care for older hospitalized Asians. Method: Structural equation modeling was used with a national sample of Asians (N = 805), age 50 and above, who were consecutively discharged from hospitals over a 12-month period. Results: The relationship between spiritual needs and satisfaction was fully mediated by five variables: nurses, physicians, the discharge process, visitors, and the admissions process. Discussion: As the first study to develop and test a model of spiritual care for older hospitalized Asians, the findings provide practitioners with the information to target their efforts on the most important organizational areas that facilitate more effective, culturally relevant service delivery to members of this population.
AndersenR. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter?Journal of Health and Social Science Behavior, 36, 1-10.
2.
AndersonJ. M.AndersonL. J.FelsenthalG. (1993). Pastoral needs and support within an inpatient rehabilitation unit. Archives of Physical Medicine and Rehabilitation, 74, 574-578.
3.
AstrowA. B.WexlerA.TexeiraK.HeM. K.SulmasyD. P. (2007). Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care?Journal of Clinical Oncology, 25, 5753-5757.
4.
BalboniT. A.PaulkM. E.BalboniM. J.PhelpsA. C.LoggersE. T.WrightA. A.. . .PrigersonH. G. (2010). Provision of spiritual care to patients with advanced cancer: Associations with medical care and quality of life near death. Journal of Clinical Oncology, 28, 445-452.
5.
BalboniT. A.VanderwerkerL. C.BlockS. D.PaulkM. E.LathanC. S.PeteetJ. R.PrigersonH. G. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25, 555-560.
6.
BalboniT.BalboniM.PaulkM. E.PhelpsA.WrightA.PeteetJ.. . .PrigersonH. (2011). Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer, 117, 5383-5391.
7.
BaronR. M.KennyD. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
8.
BlunchN. J. (2008). Introduction to structural equation modeling using SPSS and AMOS. Thousand Oaks, CA: SAGE.
9.
ByrneB. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications and programming (2nd ed.). New York, NY: Taylor & Francis.
10.
CandaE. R.FurmanL. D. (2010). Spiritual diversity in social work practice: The heart of helping (2nd ed.). New York, NY: Oxford University Press.
11.
ChandraA.SieckS.HockerM.GerardoC. J.VillaniJ.HarrisonD.. . .LimkakenqA. (2011). An observation unit may help improve an institution’s Press Ganey satisfaction score. Critical Pathways in Cardiology, 10, 104-106.
12.
ClarkP. A.DrainM.MaloneM. P. (2003). Addressing patients’ emotional and spiritual needs. Joint Commission Journal on Quality and Safety, 29, 659-670.
13.
ConnerN. E.EllerL. S. (2004). Spiritual perspectives, needs and nursing interventions of Christian African Americans. Journal of Advanced Nursing, 46, 624-632.
14.
CrispB. R. (2010). Spirituality and social work. Surrey, UK: Ashgate Publishing.
15.
DavidsonJ. E.BoyerM. L.CaseyD.MatzelS. C.WaldenC. D. (2008). Gap analysis of cultural and religious needs of hospitalized patients. Critical Care Nursing Quarterly, 31, 119-126.
EllisM. R.CampbellJ. D. (2004). Patients’ views about discussing spiritual issues with primary care physicians. Southern Medical Journal, 97, 1158-1164.
18.
FinneyS. J.DiStefanoC. (2006). Non-normal and categorical data in structural equation modeling. In HancockG. R.MuellerR. O. (Eds.), Structural equation modeling: A second course (pp. 269-314). Greenwich, CT: Information Age Publishing.
19.
GalanterM.DermatisH.TalbotN.McMahonC.AlexanderM. J. (2011). Introducing spirituality into psychiatric care. Journal of Religion & Health, 50, 81-91.
20.
GanatraH. A.ZafarS. N.QidwaiW.RoziS. (2008). Prevalence and predictors of depression among an elderly population of Pakistan. Aging & Mental Health, 12, 349-356.
GribbleR. K.HauptC. (2005). Quantitative and qualitative differences between handout and mailed patient satisfaction surveys. Medical Care, 43, 276-281.
23.
HermannC. P. (2001). Spiritual needs of dying patients: A qualitative study. Ontology Nursing Forum, 28(1), 67-72.
24.
HodgeD. R.HorvathV. E. (2011). Spiritual needs in health care settings: A qualitative meta-synthesis of clients’ perspectives. Social Work, 56, 306-316.
25.
JacksonJ. L.ChamberlinJ.KroenkeK. (2001). Predictors of patient satisfaction. Social Science & Medicine, 52, 609-620.
26.
JangT.KryderG. D.CharD.HowellR.PrimroseJ.TanD. (2004). Prehospital spirituality: How well do we know ambulance patients?Prehospital and Disaster Medicine, 19, 356-361.
JoreskogK. G.SorbomD. (1993). Lisrel 8: Structural equation modeling with the simplis command language. Chicago, IL: Scientific Software International.
29.
KaldenbergD. O. (2001). Patient satisfaction and health status. Health Marketing Quarterly, 18, (3-4), 81-101.
30.
KangJ.ShinD. W.ChoiJ. Y.ParkC. H.BaekY. J.MoH. N.. . .SonK. Y. (2012). Addressing the religious and spiritual needs of dying patients by health care staff in Korea: Patient perspectives in a multi-religious Asian country. Psycho-Oncology, 21, 274-381.
31.
KlatskyA.TekawaI. (2005). Health problems and hospitalizations among Asian-American ethnic groups. Ethnicity & Disease, 15(4), 753-760.
32.
KlineR. B. (2011). Principles and practices of structural equation modeling (3rd ed.). New York, NY: Guilford Press.
33.
KoenigH. G. (2007). Spirituality in patient care (2nd ed.). Philadelphia, PA: Templeton Foundation Press.
34.
KoenigH. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, Article ID 278730.
35.
KoenigH. G. (2013). Spirituality in patient care: Why, how, when, and what (3rd ed.). West Conshohocken. PA: Templeton Press.
36.
KoenigH. G.KingD.CarsonV. B. (2012). Handbook of religion and health (2nd ed.). New York, NY: Oxford University Press.
37.
KorenM. E.PapamiditriouC. (2013). Spirituality and staff nurses: Application of modeling and role modeling theory. Holistic Nursing Practice, 27, 37-44.
38.
LeeU.-K.U.O.ChanK. (2009). Religious/spiritual and other adaptive coping strategies among Chinese American older immigrants. Journal of Gerontological Social Work, 52, 517-533.
39.
LeiP.-W.WuQ. (2012). Estimation in structural equation modeling. In HoyleR. H. (Ed.), Handbook of structural equation modeling (pp. 164-180). New York, NY: Guilford Press.
40.
LeungP. P. Y.ChanC. L. (2010). Utilizing Eastern spirituality in clinical practice: A qualitative study of Chinese women with breast cancer. Smith College of Studies in Social Work, 80, 159-183.
41.
LevinJ. (2010). Religion and mental health: Theory and research. International Journal of Applied Psychoanalytic Studies, 7, 102-115.
42.
McBrienB. (2010). Emergency nurses’ provision of spiritual care: A literature review. British Journal of Nursing, 19(12), 768-773.
43.
MeertK. L.ThurstonC. S.BrillerS. H. (2005). The spiritual needs of parents at the time of their child’s death in the pediatric intensive care unit and during bereavement: A qualitative study. Pediatric Critical Care Medicine, 6, 420-427.
44.
MuellerR. O.HancockG. R. (2008). Best practices in structural equation modeling. In OsborneJ. (Ed.), Best practices in quantitative methods (pp. 488-508). Thousand Oaks, CA: SAGE.
45.
MuellerR. O.HancockG. R. (2010). Structural equation modeling. In HancockG. R.MuellerR. O. (Eds.), The reviewer’s guide to quantitative methods (pp. 371-383). New York, NY: Taylor & Francis.
46.
MuiA. C.ShibusawaT. (2008). Asian American elders in the twenty-first century: Key indicators of well-being. New York, NY: Columbia University Press.
47.
MurrayS. A.KendallM.BoydK.WorthA.BentonT. F. (2004). Exploring the spiritual needs of people dying of lung cancer of heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39-45.
48.
NagaiC. (2008). Clinicians’ self-assessment of cultural and spiritual competency: Working with Asians and Asian Americans. Community Mental Health Journal, 44, 303-309.
49.
NandanM. (2005). Adaptation to American culture: Voices of Asian Indian immigrants. Journal of Gerontological Social Work, 44, 175-203.
50.
NarayanasamyA. (2010). Recognising spiritual needs. In McSherryW.RossL. (Eds.), Spiritual assessment in healthcare practice (pp. 37-55). Cumbria, CA: M&K Publishing.
NeuhausenK.KatzM. H. (2012). Patient satisfaction and safety-net hospitals: Carrots, not sticks, are a better approach. Archives of Internal Medicine, 172, 1202-1203.
53.
NixonA.NarayanasamyA. (2010). The spiritual needs of neuro-oncology patients from patients’ perspective. Journal of Clinical Nursing, 19, 2259-2270.
54.
PargamentK. I. (2007). Spiritually integrated psychotherapy: Understanding and addressing the sacred. New York, NY: Guilford Press.
55.
PearceM. J.CoanA. D.HerndonJ. E.KoenigH. G.AbernethyA. P. (2012). Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Supportive Care in Cancer, 20, 2269-2276.
56.
PengC.-Y.C.J.HarwellM.LiouS.-M.EhamanL. H. (2007). Advances in missing data methods and implications for educational research. In SawilowskyS. S. (Ed.), Real data analysis (pp. 31-78). Information Age Publishing.
57.
PreacherK. J.LeonardelliG. J. (2013). Calculation for the Sobel test: An interactive calculation tool for mediation tests. Retrieved from http://quantpsy.org/sobel/sobel.htm
58.
PressI. (2002). Patient satisfaction: Defining, measuring, and improving the experience of care. Chicago, IL: Health Administration Press.
59.
Press Ganey Associates. (2011). Hospital pulse report: Patient perspectives on American health care. South Bend, IN: Author.
SchumackerR. E.LomaxR. G. (2010). A beginner’s guide to structural equation modeling (3rd ed.). New York, NY: Taylor & Francis.
62.
SheaJ. A.GuerraC. E.WeinerJ.Aguirre AbigailC.RavenellK. L.AschD. A. (2008). Adapting a patient satisfaction instrument for low literate and Spanish-speaking populations: Comparison of three formats. Patient Education and Counseling, 73, 132-140.
63.
SoenkeM.LandauM. J.GreenbergJ. (2013). Sacred armor: Religion’s role as a buffer against the anxieties of life and the fear of death. In PargamentK. I. (Ed.), APA handbook of psychology, religion, and spirituality: Vol. 1. Context, theory, and research (pp. 105-122). Washington, DC: American Psychological Association.
64.
TaitE. M.LaditkaS. B.LaditkaJ. N.NiesM. A.RacineE. F. (2011). Praying for health by older adults in the United States: Differences by ethnicity, gender, and income. Journal of Religion, Spirituality & Aging, 23, 338-362.
65.
TanyiR. A.RecineA. C. G.WernerJ. S.SperstadR. A. (2006). Perceptions of incorporating spirituality into their care: A phenomenological study of female patients on hemodialysis. Nephrology Nursing Journal, 33(5), 532-538.
66.
TaylorE. J. (2003). Nurses caring for the spirit: Patients with cancer and family caregiver expectations. Oncology Nursing Forum, 30, 585-590.
67.
TorschV. L.MaG. X. (2000). Cross-cultural comparison of health perceptions, concerns, and coping strategies among Asian and Pacific Islander American elders. Qualitative Health Research, 10, 471-489.
WestS. G.TaylorA. B.WuW. (2012). Model fit and model selection in structural equation modeling. In HoyleR. H. (Ed.), Handbook of structural equation modeling (pp. 209-231). New York, NY: Guilford Press.
71.
WilliamsJ. A.MeltzerD.AroraV.ChungG.CurlinF. A. (2011). Attention to inpatients’ religious and spiritual concerns: Predictors of association with patient satisfaction. Journal of General Internal Medicine, 26, 1265-1271.
72.
World Health Organization. (1990). World Health Organization expert committee: Cancer pain relief and palliative care. Retrieved from http://whqlibdoc.who.int/trs/WHO_TRS_804.pdf
