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A paradigm is presented as a perspective for the investigation of spirituality in nursing. Elements in the paradigm include assumptions about the self-transcendent nature of human beings as derived from the developmental-contextual worldview, a description of spirituality in terms of various forms of connectedness integral to human development and health, and assumptions about the empirical and multidimensional nature of spirituality. Extant sources of conceptual, empirical, and clinical knowledge are utilized to support the ideas put forth in the emerging paradigm. It is concluded that the study of spirituality from the perspective of the paradigm would entail examination of the multiple expressions of connectedness intrapersonally, interpersonally, and transpersonally as related to human health and well-being.

Initial research into the significance of spirituality among terminally ill adults was extended. Two hypotheses were examined using three groups of 100 adults matched on age, gender, education, and religious background: a) Terminally ill hospitalized adults indicate a greater spiritual perspective than nonterminally ill hospitalized adults and healthy nonhospitalized adults. b) Spiritual perspective is positively related to well-being among terminally ill hospitalized adults. All 300 participants completed the Spiritual Perspective Scale, Index of Well-Being, and other information. Planned comparisons analysis results supported the first hypothesis; low but significant correlation lent support to the second hypothesis. Differences among groups on recent change in spiritual views also were examined; a significantly larger number of terminally ill adults indicated a change toward increased spirituality than did nonterminally ill or healthy adults.

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The purpose of this study was to compare terminally ill with healthy adults for differences in religiousness; sense of well-being also was explored. This study was based upon a conceptualization of dying as a developmental phase of life. It was hypothesized that terminally ill adults report greater religiousness than healthy adults. A terminally ill and a healthy group with 57 adults each were matched on four key variables: age, gender, education, and religious affiliation. All 114 participants completed two questionnaires: the Religious Perspective Scale and the Index of Well-Being. A t-test of differences between the group means supported the hypothesis (t (112) = 3.11, p less than .001). There was no difference between the groups on sense of well-being; both indicated moderately high levels of well-being. A positive relationship between religiousness and well-being was found in the healthy group (r = .43, p less than .001), but not in the terminally ill group.