Analysis of influencing factors of orthopedic nurses' spiritual care competencies based on structural equation model

Purpose To comprehensively understand the spiritual care competencies of orthopedic nurses and analyze the factors that affect them. Methods This study employed convenience sampling to conduct a cross-sectional survey among orthopedic nurses at Hefei First People's Hospital. Data was collected utilizing a general information questionnaire, alongside the Chinese versions of the Spiritual Care Competence Scale, the Spiritual Care Perspective Scale, the Professional Identity Assessment Scale, and the Hospital Ethical Climate Scale. Guided by the Person-Environment Fit theory and the Triadic Reciprocal Determinism theory, a structural equation model was utilized to analyze the influencing factors and pathways related to the spiritual care competence of orthopedic nurses. Results A total of 112 valid questionnaires were obtained, yielding an overall score of 68.92 +/- 11.03 for orthopedic nurses' spiritual care competencies, with an average score of 3.14 +/- 0.50 per item. The results of the Pearson correlation analysis revealed a significant positive correlation (all P < 0.01) between spiritual care competence and the scores for spiritual care perspective, professional identity assessment, and hospital ethical climate. The spiritual care perspective, professional identity, and hospital ethical climate emerged as the influencing factors of orthopedic nurses' spiritual care competence, exhibiting total effects of 0.30, 0.53, and 0.85, respectively. Notably, the hospital ethical climate exerts an indirect influence on spiritual care competence through the mediation of spiritual care perspective and professional identity, with the indirect effect accounting for 61.18% of the total effect. Conclusion There remains significant potential for enhancing the spiritual care competencies of orthopedic nurses. The hospital's ethical climate not only has a direct and positive impact on spiritual care competence but also indirectly influences it through the lens of nurses' spiritual care perspectives and professional identity assessments. Hospital administrators may wish to consider strategies for bolstering the hospital's ethical climate, fostering a deeper spiritual care perspective and heightened professional identity among nurses, and ultimately improving their spiritual care competence.