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