American indians and spiritual needs during hospitalization: developing a model of spiritual care.

PURPOSE Although spirituality is typically intertwined with health in Native cultures, little research has examined the relationship between American Indians' spiritual needs and overall satisfaction with service provision during hospitalization. This study examined this relationship, in tandem with the effects of 8 potential mediators, to develop a model of spiritual care for older hospitalized American Indians. DESIGN AND METHODS Structural equation modeling was used with a sample of American Indians (N = 860), aged 50 and older, who were consecutively discharged from hospitals across the United States over a 12-month period. RESULTS As posited, addressing spiritual needs was positively associated with overall satisfaction with service provision. The relationship between spiritual needs and satisfaction was fully mediated by 4 variables: nursing staff, the discharge process, physicians, and visitors. IMPLICATIONS As the first study to develop and test a model of spiritual care for older hospitalized American Indians, this study provides practitioners with the information to provide more effective, culturally relevant services to older American Indians.