Spirituality

The interest in the Mediterranean diet has grown considerably due to its potential health benefits on the prevention of diverse age-related chronic diseases and its association with longevity. This dietary pattern, considered among the healthiest in the world, is not simply a combination of healthy foods but goes further in its historical and cultural roots. Mediterranean diet is not intrinsically tied to any specific religion or spiritual system, but its cultural and geographical context has influenced the dietary practices of its inhabitants, encompassing the history of Western civilization and of the three Monotheistic religions Christianity, Judaism, and Islam. These religions may have some impact on dietary choices due to religious customs and practices. In 2010 the Mediterranean diet was inscribed on the UNESCO's Representative List of Intangible Cultural Heritage of Humanity, highlighting it as a social and cultural expression of the different food cultures of the Mediterranean region and indicating that the importance of this dietary and lifestyle pattern lies not only in its specific foods and nutrients, but in the way in which its characteristic foods are produced, cooked, and eaten. In this narrative review we will discuss the possible connections between the main religions originated in the Mediterranean basin and their influence on the composition of the Mediterranean diet, and the links between spirituality/religion and this dietary pattern. This traditional model can represent a form of conscious healthy eating and lifestyle in contrast to the unhealthy Western lifestyle and ultra-processed food consumption widespread throughout the world.

Care is a multidimensional concept that includes spirituality as a dynamic and integrative aspect of human experience. Integrating spirituality into clinical practice enables a more comprehensive response to the full spectrum of human needs, which is why spiritual care competence emerges as an aptitude that fits the profile and skills to be developed by those working on care provision. Regrettably, not enough attention has been paid to spiritual care competence largely due to the lack of knowledge of professionals and what this entails. Therefore, this study aims to define the main attributes of the concept of Spiritual Care Competence in Palliative Care, identify its antecedents and consequences, examine its empirical referents, and clarify the conceptual boundaries. The concept analysis method of Walker and Avant was used. Main attributes were organized into three main domains: (1) intrapersonal resources, such as spiritual awareness, humility, sensitivity, confidence, wisdom, and intuition; (2) interpersonal resources, such as presence, active listening, compassion, and empathy; and (3) transpersonal resources, such as the ability to establish meaningful connections, assist in finding meaning, and explore hope. These domains can be nurtured over time but ultimately require professional maturity and experience. Antecedents of spiritual care competence include active engagement in care, formal training in spiritual care, and recognition of the individual's spiritual dimension. Consequences were identified for the person being cared for, the professional and the care environment and include suffering relief, reduced stress and anxiety, enhanced spiritual well-being, and lower healthcare costs. When spiritual care competence is intentionally cultivated and continuously developed, professionals advance toward the ideal of person-centered humanistic care, fostering better at the End-of-Life patient/family outcomes and contributing to professional satisfaction and personal fulfillment.

ImportanceSacred moments-meaningful, memorable, and sometimes spiritual moments of connection-occur in health care and may enhance clinician well-being.ObjectiveTo assess the prevalence, associated factors, and potential benefits of sacred moments among physicians.Design, setting, and participantsThis cross-sectional national survey of randomly selected US internal medicine physicians with no subspecialties was conducted from June 23, 2023, to May 8, 2024. Participants were identified from a national physician database. Surveys assessed physician characteristics, burnout (defined as an occupational phenomenon of emotional exhaustion, cynicism, depersonalization, and a sense of low personal accomplishment), and factors hypothesized to be protective against burnout, including the occurrence and frequency of experiencing sacred moments with patients. Religious or spiritual beliefs, interpersonal connections, and sense of purpose in life and work were also assessed.ExposureThe Internist Wellness Survey.Main outcomes and measuresThree domains of burnout, including emotional exhaustion, depersonalization, and reduced personal accomplishment, were assessed using the Maslach Burnout Inventory-Human Services Survey. Multivariable logistic regression models assessed associations between physician characteristics and sacred moments and the association between sacred moments and burnout.ResultsOf 1421 randomly selected internal medicine physicians, 629 completed a survey (44.3% response rate). Physicians spent a median of 23 (IQR, 15-29) years practicing; 376 of 617 (60.9%) were male. A total of 299 of 617 respondents (48.5 %) were hospitalists while 307 of 618 (49.7%) were primary care providers. A total of 424 of 626 respondents (67.7%) reported experiencing a sacred moment with a patient. Of the 421 respondents supplying additional responses, 19 (4.5%) often or always discussed these experiences with colleagues. Factors associated with the greatest increased odds of experiencing a sacred moment included considering oneself a very spiritual person (odds ratio [OR], 2.23; 95% CI, 1.44-3.44; P Conclusions and relevanceIn this national survey of internal medicine physicians, experiencing sacred moments is common; discussing them with colleagues is not. These findings suggest that frequently experiencing sacred moments and discussing them with colleagues could bolster physician well-being.

AimThis paper outlines key developments, innovations, and milestones in the field of spirituality and spiritual care in nursing.DesignA discursive paper.ResultsNursing scholars have significantly influenced the profession and contributed to the development of nursing knowledge, particularly in the field of spirituality and spiritual care. Key research has focused on nurses' perceptions and attitudes toward spirituality, clarifying foundational spiritual concepts, and establishing a framework of core spiritual care competencies for the profession.ConclusionDespite these advancements, significant gaps remain in nurses' knowledge, understanding, and experience in providing spiritual care. The development of agreed-upon spiritual care competencies at the European level offers important guidance for the profession, and educational initiatives are underway to support their integration. However, the field remains in an early stage of development, and further research is needed to embed spiritual care competencies into national and international nursing policy and practice. Moreover, continued research is also essential to inform and evaluate current educational programmes and nursing interventions, and to support the translation of evidence-based knowledge into effective spiritual care delivery.Implications for the profession and/or patient careSpiritual support is proven to be an important consideration for many patients and families globally. Imbedding spiritual care education into both undergraduate and postgraduate nursing curricula is essential to prepare nurses to address the spiritual needs of patients in healthcare settings. Structured curricula that provide clear instructions on how to recognise, assess, and respond to spiritual concerns in clinical practice can enhance nurses' competence and confidence. Embedding spiritual care into education and training helps normalise spiritual care as a component of holistic nursing, supporting its inclusion in everyday care rather than treating it as an optional or marginal practice. Such educational integration has the potential to improve the consistency and quality of spiritual care across healthcare settings.ImpactInternationally there are evident gaps in the consistent provision of spiritual care to patients and their families. These are being addressed through conceptual clarity, the agreed-upon competencies, and enhanced educational initiatives. It is essential to continue to increase awareness among the nursing profession on the necessity of addressing spiritual care needs, within the context of cultural perspectives to ensure that value is placed on the significance of these issues on a global scale.Patient or public contributionThere was no patient or publication contribution in this specific commentary.