Chapter 46 - Spirituality Flashcards
3 Spiritual Needs (Shelly & Fish)
- Need for meaning and purpose
- Need for love and relatedness
- Need for forgiveness
Meeting spiritual needs
- Offering a compassionate presence
- Assisting in the struggle to find meaning and purpose in face of suffering, illness, & death
- Fostering relationships that nurture the spirit
- Facilitating patient’s express of religious or spiritual beliefs and practices
Concepts Related to Spirituality
- spirituality
- faith
- hope
- love
- spiritual health or well-being
- religion
Spirituality
Anything that pertains to the person’s relationship with nonmaterial life force or higher power
Faith
A confident belief in something for which there is no proof or material evidence
Hope
Ingredient in life responsible for a positive outlook. Enables individuals to consider a future and find ways to move towards it
Love
Develops from basic human need (Maslow’s)
Spiritual health or well-being
State of meaning, purpose, love and belonging and forgiveness are met
Religion
An organized system of beliefs about a higher power
Elements of Spirituality (Berghardt & Nagai-Jacobson)
- Experienced as a unifying force, life principle, and an essence of being
- Expressed and experienced in and through connectedness with nature, the earth, the environment, and the cosmos
- Expressed and experienced in and through connectedness with other people
- Shapes the self-becoming and is reflected in one’s being, knowing, and doing
- Permeates life, provides purpose, meaning, strength, and guidance and shaping the journey
Faith
- A confident belief in something for which there is no proof or material evidence
- Term used to describe a cultural or institutional religion
Agnostic
One who holds that nothing can be known about the existence of a God
Atheist
Person who denies the existence of a God
Life affirming religious influences
enhance life, give meaning and purpose to existence, strengthen self, health giving and life sustaining
Life denying/affirming religious influences
on life patterns, experiences and associations, burdens of guilt on individuals, health and life
Factors affecting spirituality
The most important are:
- Developmental considerations
- Family - teachings and beliefs
- Ethnic background - Native Americans vs. Western
- Formal religion - Religious classes (next, next, slide)
- Life events - “I’ve found a faith”
- Both positive and negative
Spirituality, Health and Illness
Spiritual beliefs are of special importance to nurses because of the many ways they can influence a patient’s level of health and self-care behaviors
Spiritual well-being in illness
- Personal faith: belief in God;s existence, peace in spiritual beliefs, confidence in God’s power, strength from faith beliefs, trust in God’s providence
- Spiritual Contentment: satisfaction with faith, feelings of closeness to God, lack of fear, reconciliation, security in God’s love, faithfulness
- Religious Practice: support of faith community, affirmation in worship, encouragement of spiritual companions, consolation from prayer, communication with God through religious practices
- Severity of Illness: degree of functional impairment
- Stressful Life Events: emotional, sociocultural, financial
- Social Support: family, friends, caregivers
Seven Principles of Theosomatic Medicine (Levin)
- religious affiliation and membership benefit health by promoting healthy behavior and lifestyles
- regular religious fellowship benefits health by offering support that buffers the effects of stress and isolation
- participation in worship and prayer benefits health through the physiologic effect of positive emotions
- religious beliefs benefit health by their similarity to health-promoting beliefs and personality style
- simple faith benefits health by leading to thoughts of hope, optimism, and positive expectations
- mystical experiences benefit health by activating a healing bioenergy or life force or altered state of consciousness
- absent prayer for others is capable of healing by paranormal means or divine intervention
Assessment
- Spiritual belief system (formal dimensions, often overtly religious)
- Personal spirituality (informal dimensions, often very personal and individualized)
- Integration and involvement in a community (supportive environment)
- Ritualized practices and restrictions (personally meaningful activities, including dietary/treatment restrictions)
- Implications for medical care
- Terminal events planning (advance directives, funeral arrangements, etc.)
Nursing Diagnoses
- Readiness for enhances spiritual well-being
- Spiritual distress
- Spiritual Guilt
- Impaired Religiosity
- Fear
- Hopelessness
- Self-Esteem Disturbance
- Ineffective Individual Coping
Expected Goals / Outcomes
- Identify spiritual beliefs that meet needs for meaning and purpose, love and relatedness, and forgiveness
- Derive from these beliefs, strength, hope, and comfort when facing life crisis
- Develop spiritual practices that nurture communion with inner self, God, and the world
- Express satisfaction with compatibility of spiritual beliefs and everyday living
- Explore the origin of spiritual beliefs and practices
- Identify factors in life that challenge spiritual beliefs
- Explore alternatives to these challenges
- Identify spiritual supports
- Report or demonstrate decreased spiritual distress after intervention
Implementing Spiritual Care
- Offering supportive presence
- Facilitating patient’s practice of religion
- Nurturing spirituality
- Praying with a patient
- Praying for a patient
- Counseling the patient spiritually
- Contacting a spiritual counselor
- Resolving conflicts between spiritual beliefs and treatments
Facilitating the Practice of Religion
- Familiarize patient with religious services within institution
- Respect patient’s need for privacy during prayer, unless safety is an issue
- Assist patient to obtain devotional objects and protect them from loss or damage
- Arrange for patient to receive sacraments if desired, but assess for other warning signs (I.e. suicidal cues)
- Attempt to meet dietary restrictions
- Arrange for priest, minister, or rabbi to visit if patient wishes
Counseling Patients Spiritually
- Articulate spiritual beliefs
- Explore origin of patient’s spiritual beliefs and practices
- Identify life factors that challenge patient’s spiritual beliefs
- Explore alternatives when given these challenges
- Develop spiritual beliefs that meet the need for meaning and purpose, care and relatedness, and forgiveness
Room Preparation for Spiritual Visit
- Make sure room is orderly and free of unnecessary equipment
- Provide a seat for the counselor near patient’s bed
- Clear the top of bedside table and cover with clean white cloth for sacraments
- Draw bed curtains if patient cannot be moved to private setting
Evaluating Expected Outcomes
-Sources of Conflict \+Attempt to understand and assess their degree of “religiousness” \+Religious and health practices \+Jehovah’s Witnesses \+Blood donations/transfusions \+Religion and money \+Donations of portions/ratios of your salaries \+Religion and life living \+Extravagances
-Sources of Support, Strength, & Healing
+Support - Praying, reading, and “speaking” to “God” may assist in times of stress
+Strength - People have been known to undergo tremendous physical stress due to faith
+Healing - Emotional healing and stress relief for health considerations. These can come from ill patients, their families, or through the people in contact with them
