Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

First Advisor

Toms, Forrest


This ethnographic study documented the outcomes of the congregational nursing program in clinical settings where leaders and caregivers included consideration of patient spiritual needs to improve health outcomes and reduce care disparities. Spiritual leadership (SL) was my guiding theoretical orientation. Compared to motivation-based theories of leadership, SL is the most inclusive of leadership theories that encompass ethics, values and religion. My study addressed the following questions in congregational nursing health care programs: In what ways can the level of spiritual leadership be described and documented? How is spiritual leadership characterized and practiced? How can patient spiritual well-being be described and documented? How is patient spirituality characterized? Do patients perceive their spiritual well-being is influenced by the spiritual leadership of health care providers? Drawing on the interpretivist/constructivist paradigm (Guba & Lincoln, 2005), my study employed case study methods (Flyvbjerg, 2011) to capture patterns involving spiritual leadership and patient perceptions regarding outcomes of including spirituality in their health care treatment plan. Healthcare organizations are becoming aware that the autocratic style of leadership is no longer effective, and institutions might be better served by employing spiritual leadership principles. My study has documented the strong connection between spiritual leadership, patient care and spiritual well-being. This study holds the potential to contribute to the body of knowledge surrounding the effectiveness of spiritual leadership in health care settings. It also has the potential to inform the way community health is delivered in the future to maximize effectiveness and improve overall health outcomes of target populations.