The principal components model: a model for advancing spirituality and spiritual care within nursing and health care practice


  • McSherry Wilfred BSc, MPhil, PhD, RGN

    1. Senior Lecturer, Department of Nursing and Midwifery, Faculty of Health and Social Care, University of Hull, Hull, UK
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Wilfred McSherry Department of Health and Social Care Foss Building West Campus University of Hull Cottingham Road Hull HU6 7RX E-mail:


Aim.  The aim of this study was to generate a deeper understanding of the factors and forces that may inhibit or advance the concepts of spirituality and spiritual care within both nursing and health care.

Background.  This manuscript presents a model that emerged from a qualitative study using grounded theory. Implementation and use of this model may assist all health care practitioners and organizations to advance the concepts of spirituality and spiritual care within their own sphere of practice. The model has been termed the principal components model because participants identified six components as being crucial to the advancement of spiritual health care.

Design.  Grounded theory was used meaning that there was concurrent data collection and analysis. Theoretical sampling was used to develop the emerging theory. These processes, along with data analysis, open, axial and theoretical coding led to the identification of a core category and the construction of the principal components model.

Methods.  Fifty-three participants (24 men and 29 women) were recruited and all consented to be interviewed. The sample included nurses (n = 24), chaplains (n = 7), a social worker (n = 1), an occupational therapist (n = 1), physiotherapists (n = 2), patients (n = 14) and the public (n = 4). The investigation was conducted in three phases to substantiate the emerging theory and the development of the model.

Results.  The principal components model contained six components: individuality, inclusivity, integrated, inter/intra-disciplinary, innate and institution.

Conclusion.  A great deal has been written on the concepts of spirituality and spiritual care. However, rhetoric alone will not remove some of the intrinsic and extrinsic barriers that are inhibiting the advancement of the spiritual dimension in terms of theory and practice.

Relevance to clinical practice.  An awareness of and adherence to the principal components model may assist nurses and health care professionals to engage with and overcome some of the structural, organizational, political and social variables that are impacting upon spiritual care.