CH 35 Spiritual Health Fundamentals PDF

SPIRITUAL HEALTH 170B Fundamentals CH 35 Spiritual Health  Intended Student Learning Discuss the influence of spirituality on pt’s health practices. Describe the relationship among faith, hope, & spiritual well-being. Compare & contrast the concepts of religion & spirituality. Assess...

SPIRITUAL HEALTH 170B Fundamentals CH 35 Spiritual Health  Intended Student Learning Discuss the influence of spirituality on pt’s health practices. Describe the relationship among faith, hope, & spiritual well-being. Compare & contrast the concepts of religion & spirituality. Assess a pt’s spirituality & spiritual health. Explain the importance of establishing caring relationships with patients to provide spiritual care. Discuss nursing interventions designed to promote a patient’s spiritual health. Identify approaches for establishing presence with patients. Evaluate pt outcomes related to spiritual health. FIG 35.1 The concept of spirituality has 5 distinct but overlapping constructs. Spiritual Health TABLE 35.1 Relationship Between Developmental Stage and Spirituality Erikson’s Developmental Stage Spiritual Belief Birth to 18 months Spiritual well-being provided by parents. Trust vs. Mistrust Trust provides basis for hope. Love, affection, security, & a stimulating environment promote spirituality. 20-36 months Fascination with magic & mystery. Autonomy vs. Shame & Doubt Often believes that illness is related to bad behavior. Begins to learn the difference between right & wrong. Imitates parents’ spiritual or religious actions; recites prayers & sings simple religious songs, but does not understand their meanings. Interprets meanings literally. 3-6 years Feels guilty when not acting responsibly. Initiative vs. Guilt Influenced by spiritual & religious stories, examples, moods, & actions. Models moral behaviors of parents. Begins to ask about God or supreme beings. 6-12 years Wants to learn about spirituality. Industry vs. Inferiority Has a clear picture of God or supreme being, morality, & the difference between right & wrong. Sorts fantasy from fact. Demands proof of reality & believes literal meanings of spiritual stories. Spiritual Health TABLE 35.1 Relationship Between Developmental Stage and Spirituality Erikson’s Developmental Stage Spiritual Belief Adolescence Reflects on inconsistencies in stories. Identity vs. Identity Confusion Begins to question spiritual practices, forms own opinions, & occasionally discards parents’ beliefs. Abstract reasoning leads to exploration of moral issues. Spirituality comes from connectedness with family, nature, & God or supreme being. Young Adulthood Establishes self-identity & world view. Intimacy vs. Isolation & Forms independent beliefs, attitudes, & lifestyles. Loneliness Uses principles to solve problems when individual’s & society’s rules conflict. Middle-age adulthood Develops appreciation of past spiritual experiences. Generativity vs. Stagnation Embraces people from different faiths and religions. Reviews value system during crisis. Values others. Older Adulthood Values love & interactions with others. Ego identity vs. Despair & Focuses on overcoming oppression & violence. Disgust Beliefs vary based on many factors such as gender, past experiences, religion, economic status, and ethnic background.  Factors Influencing Spirituality When illness, loss, grief, or a major life change occurs  people either use spiritual resources to help them cope & search for meaning OR spiritual needs & concerns develop. Spiritual distress is a disruption in the life principle that pervades a person’s entire being & transcends the person’s biologic & psychosocial nature.”1 People question their identity & feel doubt, loss of faith, & a sense of being alone or abandoned. People question their spiritual values or the meaning of life, raising questions about their way of life, purpose for living, & source of meaning.2 A conflict exists between a person’s beliefs & prescribed health regimens or the inability to practice usual rituals.  Factors Influencing Spirituality Acute Sudden, unexpected illness often creates spiritual distress. The sudden illness or Illness injury creates an unanticipated scramble to integrate & cope with new realities, e.g., disability. Many chronic illnesses threaten a person’s independence  causing anxiety, Chronic fear, & spiritual distress. Dependence on others for routine self-care needs often Illness creates feelings of powerlessness. Dying is a holistic process encompassing a pt’s physical, social psychological, & Terminal spiritual health.3 Terminal illness causes fears of physical pain, loss of Illness independence, isolation, the unknown, & dying. It creates an uncertainty about what death means, making pts susceptible to spiritual distress. Near Death NDE are often transformational & can be either positive or negative Experience experiences. Individuals experiencing a NDE who discuss it openly with family 4 or caregivers find acceptance & meaning from this powerful experience. 5 They (NDE) are often no longer afraid of death & have a ↓ desire for material wealth.  Assessment Convey caring in manner and communication style. Know your pts cultural values & beliefs. Respect privacy, diversity & individual needs. Interact & listen to the pt & family 6 Promote an honest discussion about each patient’s spiritual beliefs. Assessment reveals patient’s beliefs about life, health, & a Supreme Being or power. Through the Pt’s Eyes Assessment Tools Faith/Belief Life & Self-Responsibility Connectedness Life Satisfaction Culture Fellowship & Community Ritual & Practice Vocation BOX 35.2 Nursing Assessment Questions Spirituality & Spiritual Health Which experiences in the past have been most difficult for you? What gives you hope during those difficult times? Which aspects of your spirituality have been most helpful to you? Which aspects of your spirituality would you like to discuss? Faith, Belief, Fellowship & Community To what or whom do you look as a source of strength, hope, or faith in times of difficulty? How does your faith help you cope? What can I do to support your religious beliefs or faith commitment? Would you like me to pray with you? What gives your life meaning? Life & Self-Responsibility How do you feel about the changes this illness has caused? How do these changes affect what you now need to do? BOX 35.2 Nursing Assessment Questions Life Satisfaction How happy or satisfied are you with your life? Which accomplishments help you feel satisfied with your life? What is it that makes you feel dissatisfied? Connectedness What feelings do you have after you pray or meditate? Who do you feel is the most important person in your life? Vocation How has your illness affected the way you live your life spiritually at home or where you work? In what way has your illness affected your ability to express what is important in life to you? Assessment Tools  Nursing Diagnosis Risk for Spiritual Status Decreased Spiritual Distress Hopelessness Powerlessness Spiritual Distress Decreased Spiritual Distress Spiritual Distress Assessment findings that show a Assessment findings reveal person’s ability to experience & patterns that reflect Meditatioa person’s integrate meaning & purpose in life actual or potential Jupiterdispiritedness n is the through connectedness with self & (e.g., expressing a lack biggest of hope, planet others. meaning, or purpose in life; Person has potential resources in expressing anger toward God; or reserve when faced with illness or verbalizing conflicts about personal a threat to well-being. beliefs.  Knowledge Experience Individualize caring practices Previous pt responses to nursing FIG. 35.6 Critical thinking model for spiritual health Services offered by health care interventions designed to support the providers & community agencies pt’s spiritual well-being Nursing interventions that instill hope & provide spiritual support Planning Collaborate with patient/family on choice of interventions Consult with pastoral care/clergy/spiritual leaders as appropriate Incorporate spiritual rituals & observances Attitudes Standards Develop a trusting relationship with Support pt’sThis autonomy to make planning.. patient/family by exhibiting CREDITS: presentation template was created by choices Slidesgo, including icons by Flaticon, and infographics & images by Freepik Promote self-determination confidence in your knowledge & skills Implementation: Health Promotion Establish presence by sitting with a patient to attentively listen to his/her feelings & situation, talking with the patient, accepting or supporting the patient’s need to cry, & simply offering time are powerful spiritual care approaches Support a healing relationship. Learn to look beyond isolated patient problems & recognize the broader picture of a patient’s holistic needs. A holistic view enables the nurse to establish a helping role & a healing relationship AEB these 3 factors.. 1. Realistically mobilizing hope for the patient & nurse 2. Finding an interpretation or understanding of the illness, pain, anxiety, or other stressful emotion that is acceptable to the patient 3. Helping the patient use social, emotional, & spiritual resources. Implementation: Acute Care Pts experience multiple stressors that threaten their sense of control. Perform ongoing assessment of spiritual needs because pt’s needs change rapidly. Support & enhance the pt’s spiritual well-being are challenges when focus is toward treatment & cure vs care. Barriers to spiritual care in acute care settings: Lack of time, education or training, family involvement, patient privacy; language barriers; confusion over one’s own spirituality Display a soothing presence & supportive touch when providing care. The artful use of hands, encouraging words of support, promotion of connectedness, & a calm & decisive approach establish a nurse presence that builds trust. Implementation: Acute Care Support Systems provide pts with the greatest sense of well-being during hospitalization. Serve as a human link connecting the pt, family & interprofessional team. Caregiving environment includes presence of family & friends. Provide privacy & promote interpersonal bonding that is needed for recovery. Spiritual advisers & members of the clergy are important resources for the pt.  fosters interprofessional approach to pt care. Keep clergy informed of pt’s status/condition. A spiritual care provider is helpful for decisions regarding end-of-life care. Support rituals & activities (readings, spiritual visitations, religious services, receiving sacraments, taped meditations, classical or religious music, tv religious services, etc. Respect religious icons, medals, crosses, etc. Restorative & Continuing Care Prayer gives the individual the opportunity to renew personal faith & belief in a higher being in a specific, focused way that is either highly ritualized & formal or quite spontaneous & informal. Meditation creates a relaxation response that reduces daily stress. Pts state “increased awareness of their spirituality & presence of God or supreme being. Supporting grief work in pts experiencing terminal illness or who suffered permanent loss of body function require a nurse’s support in grieving & coping with their loss. TABLE 35.2 Religious Dietary Regulations Affecting Health Care Buddhism Jehovah’s Witness Catholics Judaism Fast Ash Wednesday & Good Friday; no meat on Fridays @ Lent Baptists, Mormonism Evangelicals, Pentecostals Hinduism Native Americans Individual tribal beliefs influence food practices. Islam Russian Orthodox Church FIG. 35.6 Critical thinking model for spiritual health Knowledge Experience Coping theory Previous patient responses to Behaviors reflecting spiritual health spiritual care interventions Evaluation Review the pt’s self-perceptions regarding spiritual health Review the pt’s view of his/her purpose in life Discuss w/ family & close associated the pt’s connectedness Ask if the pt’s expectations are being met Standards Attitudes Use established expected outcomes Demonstrate integrity; be open to to evaluate the patient’s response to any possible conflict between the evaluation. CREDITS: This presentation template was created by careSlidesgo, including icons by Flaticon, and infographics & patient’s opinion & yours; decide how Demonstrate ethics of care images by Freepik to proceed to reach mutually beneficial outcomes