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- Is an awareness of one's inner self and a sense of connection to a higher being, nature, or to some purpose greater than oneself. A complex concept that is unique to each individual and exists in everyone. It is multideminsional, personal, and subjecive
System of beliefs and practices that a person can use to express their spirituality
Day set aside for special religious observance. All world religions observe certain holy days. Often special observances such as fasting, meditation, and prayer may be associated with these days.
High holy days
Solemn religious observances throughout the year
Helping patients maintain faithfulness to their belief system and worship practices
Helping people identify meaning and purpose in life, look beyond the present, and maintain personal relations as well as a relationship with a higher being or life force.
Holistic view of health
A balance of physical, psychological, sociological, cultural, emotional, development, and spiritual variables. takes the broadest possible view of illness and disease.
Views the client as an active participant and the health process not just a passive resident
Holistic view of health
Three parts of spiritual care
Physical. Psychological. Spiritual.
Spiritual care: physical examples
Saving. Massage. Touch. Procedures.
Spiritual care: psychological examples
Therapeutic communication. Understanding. Listening.
Spiritual care: spiritual examples
Presencing, empathy. Prayer . Meditating with the patient.
The art of nursing, being with a patient: gift of self
4 features of "presence"
- Getting of self in the present moment
- Available with all of the self
- Listening, with full awareness of the privilege of doing so
- Being there in a way that is meaningful to another person
what presence can accomplish in nursing
prevents emotional and environmental isolation
5 overlapping concept of spirituality
Connectedness, transcendence and self transcendence, meaning and purpose in life, inner strength and peace, faith and hope. These all circle around the patient
Helps the patient feel well and guides choices
A source of energy that instills hope, provides motivation, and promotes a positive outlook on life
Fosters calm, positive, and peaceful feeling despite life experiences of chaos, fear, uncertainty. Helps people feel comfortable even at times of great dispense.
Awareness of that which cannot be seen or known in ordinary physical ways. Allows people to have new perspectives and new expierences.
Enables a person to Love, seek meaning and hope, have meaning in life, and nurture relationships with others.
Allows patients to move beyond the stressors of everyday life and find comfort, faith, hope, peace, and empowerment
Connected within oneself
Connected with others and the environment
Connected with the unseen, God, or a higher power
Connectedness can be catagorized 3 ways
Intrapersonal, interpersonally, tran-personally
Do not believe in the existence of any God
Believes that it is impossible to know if there is a God
Manifested by a feeling of being generally alive, purposeful, and fullfilled
Agnostics discover the meaning in spirituality through:
In what they do or how they live. Believe people bring meaning to what they do
Atheist find the meaning of spirituality in:
Work and relationships with others
Allows a person to hold a belief about something without physical evidence. Gives purpose and meaning to a person's life allowing for action.
Multidimensional and gives comfort while people endure life-threatening situations, hardships, and other personal changes
Spiritual growth theories
Erickson's and Fowlers
Erickson's: Trust vs. Mistrust on spirituality
- (Birth to 18 months)
- Spiritual well being provided by parents
- Trust provides basis for hope
- Love, affection, security, and a stimulating environment promotes spirituality
Spiritual beliefs at Erickson's: Autonomy vs. Shame and Doubt stage
- (20-36 months)
- fascination with magic and mystery
- often believes illness is related to bad behavior
- begins to learn the difference between right and in
- imitates parents spiritual or religious actions, recites prayers, and sings simple religious songs but does not understand their meaning
- interprets meanings literally
Spiritual beliefs at Erikson's initiative verses guilt stage
- (3 to 6 years)
- Feels guilty when not acting responsibly
- influenced by spiritual and religious stories, examples, moods, and actions
- models moral behaviors of parents
- begins to ask about God or supreme beings
Spiritual beliefs at Erickson industry vs inferiority stage
- (6 to 12 years)
- wants to learn about spirituality
- has a clear picture of God or supreme being, morality, and difference between right and wrong
- sorts fantasy from fact
- demands proof of reality and believes literal meanings of spiritual stories
Spiritual beliefs at Erikson's identity vs identity confusion stage
- Reflects on inconsistencies in stories
- Begins to question spiritual practices, forms own opinions, and occasionally discards parents beliefs
- Abstract reasoning leads to exploration of moral issues
- Spirituality comes from connectedness with family nature in God or Supreme Being
Spiritual beliefs at intimacy verses isolation and loneliness
- (young adulthood)
- Establishes self-identity and world view
- Forms independent beliefs, attitudes, and lifestyles
- Uses principles to solve problems when individual's and a society's rules conflict
Spiritual Beliefs at Erickson's Generativity versus Stagnation
- (Middle age adulthood)
- Develops appreciation of past spiritual experiences
- Embraces people from different faiths and religions
- Reviews value system during crisis
- Values others
Spiritual Beliefs at Erikson's: Despair vs. Disgust
- (Older adulthood)
- Values love and interactions
- Focuses on overcoming oppression and violence
Fowler's Stages of Spiritual Development says spirituality exist in religious and nonreligious people. True or False
In this theory of development there are six stages that must follow in sequence. Each stage adding new thoughts to already held beliefs.
Stage 0: undifferentiated
- 1 to 3 years
- Learning knowledge and emotional reactions rather than establishing spiritual beliefs
- Repeat short prayers for praise and affection
- Enhances toddler's sense of security
Transition from stage 0-1 occurs when:
Language and thought allow the child to use symbolism
Stage 1: intuitive-projective
- 4 to 6 years
- Fantasy filled, imitative phase when child influenced by examples
- Faith is result of parent/teacher teaching
- Enjoy socialization of sunday school classes
- Imitate behavior even if they don't understand it
Stage 2 mythic- literal stage 7 to 12 years
- learn to distinguish fact from Fantasy
- accepts stories and beliefs
- parents and religious leaders still influence more than peers do
- Has the ability 2 learn the beliefs and practices of a religion or culture
Stage 3: Synthetic-Conventional
- Religions more similar than different. Can't decide if they are wrong, compartmentalize differences, or ask advice
- Conform to beliefs of those around them
Stage 4: Individuating-Reflexive
- Young adult
- Focus on Reality
- Self-Identity and Worldview established
- Religious teachings may be accepted
- Searches for new connectedness
Stage 5: Paradoxical-Consolidative
- Mid-Adulthood(only some individuals over 30 achieve)
- views truth from a number of viewpoints
- Newfound appreciation for past
- increased respect for inner voice
- Religion offers more comfort
- Mid to late adulthood or maybe never
- work to resolve problems in society
- may derive sense of worth from Sharing
- May take religious practices seriously
- have a high level of spirituality
Types of problems in mid adulthood that fowler says a person may try to solve
Social, potitical, economic, or ideological
Spiritual Distress is....
Refers to a challenge to the spiritual well-being or to the belief system but usually provide strength, hope, and meaning to the life of the patient. Causes the person to feel lonely even abandoned
Characteristics of spiritual well-being
- Sense of inner peace
- compassion for others
- reverence for life
- appreciation of both unity and diversity
- humor in wisdom generosity and ability to transcend self
- capacity for unconditional love
examples of spiritual needs
Need: for love, hope, trust, for forgiveness, to be respected and valued, dignity, values, creativity, to belong to a community, for the meeting 2 the fullness of life, and to connect with a higher power
Reasons for spiritual distress
- A life-threatening diagnosis
- severe pain and related factors
- dietary restrictions
- amputation of body parts or isolation
- death or illness of a significant other
- inability to practice spiritual rituals in feeling embarrassed while practicing them
Indications of spiritual distress in a patient
- Express lack of hope, lack of meaning and purpose in life, lack of forgiveness of self
- expresses feelings of being abandoned by a higher power
- refuses interaction with family and friends
- sudden change in religious practice
- request to see religious leader
Factors influencing spirituality
- Acute illness( sudden or expected)
- chronic illness( threatened a person independence)
- terminal illness( uncertainty about death)
- near death experience(NDE)
Psychological phenomenon close to clinical death or recovered after declared death. These people are often reluctant to talk about it. But are no longer afraid of death.
Near death experience ( NDE)
Interventions for spiritual distress
- Provide presents and active listening
- support practices, diets, rituals
- assist with prayer or meditation
- refer for spiritual counseling
Examples of religious rituals that provide comfort
private worship, prayer, singing, fasting, meditation, scripture reading, communion, offerings
Express a level of caring and support, establishes a trusting relationship, and learn patients view point. These are all examples of which level of the nursing process?
what two things to do to learn a patient's viewpoint?
Ask direct questions and utilize spiritual assessment
The HOPE tool
- sources of hope, meaning, comfort, and connection
- organized religion
- personal spirituality and practice
- Effects on medical care and end of life issues
the BELIEF tool
- Belief system
- ethics or values
- involvement in spiritual community
- future events
Potential diagnoses for spiritual health
anxiety, ineffective coping, fear, complicated grieving, hopelessness, and powerlessness
NANDA accepted diagnoses for spiritual health
- readiness for enhanced spiritual well-being
- Spiritual distress
- risk for spiritual distress
Supporting patience to practice religious activities, helping patients in corporate spiritual beliefs into healthcare decision making, promoting a sense of peace and hope, providing resources when requested. these are all examples of which stage in the nursing process
2 ways to implement spiritual health in general.
Health promotion by establishing presence
Supportive healing relationships bye mobilising hope, providing interpretation of sufferig that is acceptable to the patient, and by helping patients use resources
nursing process: types of implementation in acute care setting?
Support systems, diet therapies, and supporting rituals
Nursing process: types of restorative and continuing care?
Prayer, meditation, and supportive grief work.
What are the two dimensions of spiritual well-being?
Vertical-supports the transcendent relationship between person and God or higher power
Horizontal-positive relationships and connections that people have with others