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Chapter 35 Cheryl Smythe-Padgham DNP, RN, WHNP-BC
Often defined as an awareness of one’s inner self and a sense of connection to a higher being, nature or to some purpose greater than oneself (Mauk and Schmidt, 2004)
An important factor that helps individuals achieve the balance needed to maintain health and well being and to cope with illness
Florence Nightingale believed that spirituality was a force that provided energy needed to promote a healthy hospital environment and that caring for a person’s spiritual needs was just as essential as caring for a person’s physical needs
The concepts of spirituality and religion are often interchanged, but spirituality is a much broader and more unifying concept than religion (Hollins, 2005)
Many nurses and other healthcare providers fail to recognize the spiritual dimension of their clients
Nurses need an awareness of their own spirituality in order to provide appropriate and relevant spiritual care to others
Accept their client’s beliefs and experiences
Spirituality has different meanings for different people
Try out this quick quiz “what’s your spiritual type” at:http://www.beliefnet.com/section/quiz/index.asp?surveyID=27
A relationship between spirituality and healing
Healing often takes place because of believing
A link exists between mind, body and spirit
A person’s inner beliefs and convictions are powerful resources for healing
http://www.youtube.com/watch?v=WCgY8tIg2dA
Spirituality Spirituality exists in all people regardless of
their religious beliefs Spiritual care helps people identify meaning
and purpose in life, look beyond the present, and maintain personal relationships
Spiritual well-being Vertical dimension-the relationship between a
person and God or some other higher power
Spiritual well being (continued) Horizontal dimension- positive relationships
and connections people have with others
Those who are spiritually healthy experience joy, are able to forgive themselves, accept hardship, report enhanced quality of life and have positive sense of physical and
emotional well-being
Faith Is a relationship with a higher power that
incorporates a reasoning faith (belief) and a trusting faith (action)
Religion Specific system of beliefs and practices
associated with a particular denomination, sect, or form of worship
People from different religions view spirituality differently
Religious care is helping clients maintain their faithfulness to their belief systems and worship practices
Hope Spirituality and faith bring hope A concept that provides comfort while
people endure hardships or personal challenges
Hope is energizing, giving people a motivation
Throughout a lifetime, people grow more spiritual
Spiritual beliefs change as clients grow and develop
Beliefs among older people vary based on many factors like past experience, gender, religion, economic status, and ethnic background
Acute illness Sudden, unexpected illness
that poses a threat to a client’s life, health and or well-being creates spiritual distress
Chronic illness Threatens the person’s independence,
causing fear, anxiety, and spiritual distress
Terminal illness Commonly causes fears of physical pain,
isolation, the unknown, and dying Uncertainty about what death means and
thus makes clients susceptible to spiritual distress
Near-death experience Clients who have had a near death
experience are often reluctant to discuss it
Taking a faith history reveals clients’ beliefs about life, health and a supreme being
Each personality has a unique spirituality, respect each client’s personal beliefs
The Joint Commission requires health organizations to provide for pastoral care
Love, trust, hope, forgiveness, meaning and community are universal spiritual needs
Spiritual assessment is an ongoing process over the course of the client’s stay in the hospital
Establish trust and rapport, make the opportunity to conduct meaningful discussions
Many spiritual assessment tools B-E-L-I-E-F assessment tool, spiritual well-
being scale, spiritual perspective scale
Faith/belief Life and self-responsibility Connectedness Life satisfaction Culture, fellowship and community Ritual and practice Vocation
Readiness for enhanced spiritual well being
Spiritual distress related to terminal illness
Risk for spiritual distress Ineffective coping
Goals/outcomes Goal:Client will maintain feeling of control
while approaching the end of his life Outcome: client will share feelings about
death in 3 days Outcome: client will identify and participate in
spiritual activities in 2 weeks Setting priorities Collaborative care- members of clergy,
family
Health promotionEstablishing presence- spend time
with client, involves offering a closeness with the client, physically, psychologically and spiritually. Demonstrate caring presence by listening, health instruction, support
Supporting a healing relationship- holistic view
Acute careSupport systemsDiet therapies or religious practicesSupporting rituals
Restorative and Continuing CarePrayer/meditationSupporting grief work
Data is usually subjective Must evaluate any ethical concerns
that arose in the course of the client’s spiritual care and support