This document discusses guidelines for assessing and providing spiritual care to families as a unit in nursing practice. It proposes assessing families' spirituality through categories like meaning, strengths, relationships, beliefs and individual members' spirituality. A guideline is presented to help nurses elicit spiritual information from families in these categories. The document emphasizes the importance of attending to both individual and family spirituality to provide holistic family care. It also introduces spiritual interpretation to represent diagnosis and interventions to support families' spiritual well-being and address any spiritual distress.
The document discusses the relationship between psychology and spirituality. It notes that both fields focus on human interiority and development. While spirituality has a long history, psychology emerged more recently in the late 19th century. The document explores different perspectives on how the fields relate, from being partners to rivals, and how they can have mutually critical correlations to better understand human experience. It also summarizes some key theories in psychology like Freudian, Jungian, and object relations theories and how they have informed understandings of spirituality.
The document provides biographical details about William Barry and William Connolly and their involvement in spiritual direction. It then discusses 10 key aspects of spiritual direction: 1) the importance of religious experience and contemplation, 2) fostering the relationship between God and individuals, 3) helping directees notice interior facts, 4) development and resistance in relationships, 5) evaluating religious experiences, 6) becoming a spiritual director, 7) the basis of the director-directee relationship, 8) criteria for spiritual direction, 9) disturbances in the relationship, and 10) the history of spiritual direction dating back to desert fathers and mothers. The overall document serves as an introduction to the practice of spiritual direction.
Muhammad Saud KharalPhD in Social Science, Department of Sociology Faculty of Social and Political Sciences, Universitas Airlangga, Surabaya Indonesia.
Email: muhhammad.saud@gmail.com
Definitions and Measurement of ReligionDevon Berry
This document discusses definitions, measurement issues, and commonly used measures related to assessing religion and spirituality in health outcomes research. It provides definitions for spirituality, religiosity, and the distinction between the two. Measurement issues discussed include the multidimensional nature of religion and spirituality as well as the lack of gold standard measures. Commonly assessed domains include religious attendance, religious coping, spirituality/meaning, and spiritual well-being. Several validated multidimensional measures are described that assess constructs such as daily spiritual experiences, meaning, and forgiveness.
This document provides an overview of spiritual development in children and youth. It discusses definitions of spirituality, perspectives on spiritual development, and Fowler's stages of faith development. Spirituality deals with how people approach life's unknowns and relate to what is sacred. While difficult to define, it involves finding meaning and connecting to oneself, others, nature, or a higher power. Spiritual development is influenced by factors like relationships, critical thinking, and independence from authority.
The Daily Spiritual Experience Scale (DSES) is a 16-item self-report measure designed to assess ordinary spiritual experiences in daily life, including constructs like awe, gratitude, compassion, and inner peace. It was developed using qualitative testing with diverse groups. Psychometric analyses show it has high reliability and validity. The scale captures a single factor of daily spiritual experience. It has been widely used in over 70 published studies and translated into many languages for use in diverse cultures.
RELIGION, RELIGIOSITY AND SPIRITUALITY IN THE BIOPSYCHOSOCIAL MODEL OF HEALTH...Masa Nakata
This document summarizes research on the relationship between religiosity, spirituality, and health outcomes in older adults. It finds that religiosity and religious coping increase with age, and are linked to better mental health outcomes like well-being and lower depression. Studies also associate religiosity with better physical health and lower mortality. However, the exact nature of the relationship is complex, with open questions around causality and possible psychological or social factors that may mediate the effects.
The document discusses the relationship between psychology and spirituality. It notes that both fields focus on human interiority and development. While spirituality has a long history, psychology emerged more recently in the late 19th century. The document explores different perspectives on how the fields relate, from being partners to rivals, and how they can have mutually critical correlations to better understand human experience. It also summarizes some key theories in psychology like Freudian, Jungian, and object relations theories and how they have informed understandings of spirituality.
The document provides biographical details about William Barry and William Connolly and their involvement in spiritual direction. It then discusses 10 key aspects of spiritual direction: 1) the importance of religious experience and contemplation, 2) fostering the relationship between God and individuals, 3) helping directees notice interior facts, 4) development and resistance in relationships, 5) evaluating religious experiences, 6) becoming a spiritual director, 7) the basis of the director-directee relationship, 8) criteria for spiritual direction, 9) disturbances in the relationship, and 10) the history of spiritual direction dating back to desert fathers and mothers. The overall document serves as an introduction to the practice of spiritual direction.
Muhammad Saud KharalPhD in Social Science, Department of Sociology Faculty of Social and Political Sciences, Universitas Airlangga, Surabaya Indonesia.
Email: muhhammad.saud@gmail.com
Definitions and Measurement of ReligionDevon Berry
This document discusses definitions, measurement issues, and commonly used measures related to assessing religion and spirituality in health outcomes research. It provides definitions for spirituality, religiosity, and the distinction between the two. Measurement issues discussed include the multidimensional nature of religion and spirituality as well as the lack of gold standard measures. Commonly assessed domains include religious attendance, religious coping, spirituality/meaning, and spiritual well-being. Several validated multidimensional measures are described that assess constructs such as daily spiritual experiences, meaning, and forgiveness.
This document provides an overview of spiritual development in children and youth. It discusses definitions of spirituality, perspectives on spiritual development, and Fowler's stages of faith development. Spirituality deals with how people approach life's unknowns and relate to what is sacred. While difficult to define, it involves finding meaning and connecting to oneself, others, nature, or a higher power. Spiritual development is influenced by factors like relationships, critical thinking, and independence from authority.
The Daily Spiritual Experience Scale (DSES) is a 16-item self-report measure designed to assess ordinary spiritual experiences in daily life, including constructs like awe, gratitude, compassion, and inner peace. It was developed using qualitative testing with diverse groups. Psychometric analyses show it has high reliability and validity. The scale captures a single factor of daily spiritual experience. It has been widely used in over 70 published studies and translated into many languages for use in diverse cultures.
RELIGION, RELIGIOSITY AND SPIRITUALITY IN THE BIOPSYCHOSOCIAL MODEL OF HEALTH...Masa Nakata
This document summarizes research on the relationship between religiosity, spirituality, and health outcomes in older adults. It finds that religiosity and religious coping increase with age, and are linked to better mental health outcomes like well-being and lower depression. Studies also associate religiosity with better physical health and lower mortality. However, the exact nature of the relationship is complex, with open questions around causality and possible psychological or social factors that may mediate the effects.
The document provides information about a 2-week intensive training program called the Divine Intervention. The training focuses on powerful prayer and energy techniques for healing at the spiritual, energetic, emotional, and physical levels. Participants will learn how to direct electrical and magnetic energy for healing, receive sacred teachings to support themselves and others, and potentially experience spontaneous remission of diseases. The intensive retreat takes place in a peaceful wooded environment and includes meditation, yoga, healing techniques from different traditions, and guidance from experienced practitioners.
This document provides an overview of an online course on spirituality from the Touro Institute. It discusses how spirituality is a multidimensional concept that is important to health and well-being. The course aims to define spirituality, discuss theories and stages of spiritual development, and explain the connection between spirituality and healing. It also outlines the learning objectives for participants to understand the physical, psychological and spiritual dimensions and how spirituality relates to theories, definitions, elements, development stages and health.
Spiritual health and community well being anjali gupta
WHO defined Health is state of compelete physical, mental,social and spiritual well being and not merely the absence of disease or infirmity. means holistic health is something out of bio-social model. its all about spiritual dimension keeps beople wise, energetic, positive, hopeful and happy. Raj Yoga meditation is a tool where you can learn and get experience in life which never had experience in life this is what Dr Anjli Gupta experienced in her life and sharing you all with her experience
This document discusses the role of spirituality in addiction treatment and recovery. It argues that addiction affects the body, mind and soul, so treatment must address spiritual well-being. Twelve-step programs incorporate spiritual principles like honesty, hope and forgiveness. Studies show better recovery outcomes for those engaged in daily spiritual practices like prayer. While some therapists avoid spirituality due to concerns over imposing values, clients find spiritual discussions and references helpful when facilitated properly. True recovery involves profound personal changes attributed to a higher power by many recovering addicts.
This document discusses the role of spirituality in social work practice. It provides an overview of research highlighting the importance of clients' spiritual beliefs and how a lack of training in addressing spiritual issues can impact social workers' ability to effectively help clients. Common spiritual interventions discussed include cognitive behavioral interventions, meditation, 12-step programs, forgiveness interventions, prayer, and using art or music in a therapeutic way. The document emphasizes that social workers need cultural and spiritual competence to properly address the holistic needs of clients.
The document summarizes research showing that when personal or external sources of control are threatened, religious belief can serve as a compensatory source of control. Specifically:
1) Manipulations that lower personal control increase beliefs in an external controlling God or supernatural force as a way to regain a sense of order.
2) This effect is mediated by increased feelings of anxiety from a lack of control. Religious belief is heightened most when it emphasizes an external entity's control.
3) Threats to personal, external, or different sources of control can increase alternative sources of personal or external control as substitutable means of regaining a sense of order.
Through a discussion of current research, the article highlights the psychological and physical benefits of spiritual/religious practices. Such practices are shown to positively influence lifestyle habits like diet and alcohol use from a young age. They also provide a strong support system through religious communities. Overall, spiritual/religious practices throughout life are found to positively impact health and well-being.
DrRic Spirituality in Health Presentation at The Lightheart Center (slide sha...DrRic Saguil
The document discusses spirituality and its relationship to health. It defines spirituality as a sense of connection beyond the physical world, including practices like meditation and prayer. It discusses how spirituality can play an anchoring role in disease by improving stress response, controlling inflammation, and affecting gene expression. Regular spiritual practices like meditation have been shown to change the structure of the brain and expression of hundreds of genes involved in processes like inflammation. The approach is to use spiritual grounding, nutrition, movement and helping others to cultivate inner peace and positively impact health.
Spirituality and its application in nursing practiceSafad R. Isam
SpiritualityIt is the life force that gives meaning to a how a person understands, views, and lives life.
Spirituality can be
. . . determined by culture
. . . determined by life experiences unrelated to culture
. . . Influenced by both culture and personal experiences that are opposite to the cultural norm.
Jean Watson was a nurse scholar known for developing the Theory of Human Caring. She received several academic degrees including a PhD in nursing. Watson authored numerous books that outlined her theory, which focuses on caring as central to nursing. The theory proposes 10 carative factors that guide nurses to address patient's psychosocial needs through compassionate care. A core concept is the transpersonal caring relationship between nurse and patient. Critics note the theory may be difficult to apply in modern hospital settings with short patient stays. However, Watson's work emphasizes the humanistic aspects of nursing care.
The document summarizes Jean Watson's work developing her Theory of Human Caring and Transpersonal Caring. It outlines the evolution of her 10 Carative Factors into Caritas Processes, moving from a focus on human needs to a deeper emphasis on spiritual caring, love and healing. The Caritas Processes reframed caring as a loving relationship and a way of "being" centered around compassion and human dignity.
Dr. Jean Watson is a renowned nursing theorist known for developing the Theory of Human Caring. She received her PhD in Educational Psychology and Counseling from the University of Colorado. Her theory emphasizes caring as the central focus of nursing and identifies 10 Carative Factors that help nurses establish caring relationships with patients. These factors include developing a helping-trust relationship, being present and supportive of expressions of positive and negative feelings, and creatively problem-solving. Watson's theory views humans holistically and aims to help patients find meaning and inner harmony through nursing care.
This document provides an introduction to spirituality from a Christian perspective. It discusses definitions of spirituality, focusing on the idea that spirituality involves life guided by the Holy Spirit. It explores the origins and history of the term "spirituality" and describes spirituality from ontological, experiential, classical, scientific, and artistic understandings. Finally, it outlines 12 guiding principles for Christian spiritual life, including indwelling of the Holy Trinity, finding God in daily life, and living contemplative and apostolic lives.
The document discusses various perspectives from psychology that relate to spirituality, including object relations theory, self psychology, Jungian analysis, cognitive developmental theories, transpersonal psychology, and empirical studies. It notes both insights and limitations of these perspectives for understanding Christian spirituality, emphasizing that psychological approaches are human means whereas spiritual transformation involves a relationship with God that cannot be fully explained by human models.
The document summarizes the development and testing of the Spiritual Health And Life-Orientation Measure (SHALOM), a 20-item questionnaire for assessing spiritual well-being. SHALOM is based on a Four Domains Model of spiritual health that includes personal, communal, environmental, and transcendental domains. It was developed through extensive statistical testing and has been used with diverse populations. Research has shown SHALOM to be a valid and reliable tool for measuring spiritual well-being in a short amount of time across different cultures and religions.
Jean Watson's theory of caring science focuses on caring as the essence of nursing. She describes 10 carative factors that constitute caring in nursing, including forming humanistic values, cultivating sensitivity, developing trusting relationships, and meeting human needs from basic to self-actualization. Watson views caring as health promoting and sees the nurse-patient relationship as transpersonal, with caring occurring through an intersubjective connection between persons. Her theory emphasizes the holistic care of mind, body, and spirit to support health as unity and harmony within the individual.
This document provides an overview of a course on pastoral care and counseling. The course aims to equip students for effective pastoral ministry by developing their understanding of helping relationships and reflecting on pastoral care from a Christian perspective. It covers topics like theological and psychological foundations, counseling ethics, stress management, family counseling and conflict resolution. The document outlines the course objectives, content, required textbooks and resource sites. It also provides definitions and discussions of key concepts like pastoral care, counseling, and the roles and functions of a pastoral counselor.
Spirituality in Family....Dr. catherine... dyutirajagiri
Spirituality is important for healthy family functioning. It provides love, respect, communication and a sense of shared purpose. Studies show families with strong spirituality have less crime, better health, and less mental illness. Spirituality teaches values like love, forgiveness and social responsibility. It helps families cope with challenges by offering hope, meaning and a sense of belonging to something greater. Developing spirituality can strengthen families.
Meeting People Where They Are: Taking Spiritual Assessment - Tessie Mandevill...wwuextendeded
Meeting People Where They Are: Taking Spiritual Assessment – Tessie Mandeville, Reverend & Bobbi Virta, Reverend
Presented at the 2015 Palliative Care Summer Institute conference at Bellingham Technical College
The document provides information about a 2-week intensive training program called the Divine Intervention. The training focuses on powerful prayer and energy techniques for healing at the spiritual, energetic, emotional, and physical levels. Participants will learn how to direct electrical and magnetic energy for healing, receive sacred teachings to support themselves and others, and potentially experience spontaneous remission of diseases. The intensive retreat takes place in a peaceful wooded environment and includes meditation, yoga, healing techniques from different traditions, and guidance from experienced practitioners.
This document provides an overview of an online course on spirituality from the Touro Institute. It discusses how spirituality is a multidimensional concept that is important to health and well-being. The course aims to define spirituality, discuss theories and stages of spiritual development, and explain the connection between spirituality and healing. It also outlines the learning objectives for participants to understand the physical, psychological and spiritual dimensions and how spirituality relates to theories, definitions, elements, development stages and health.
Spiritual health and community well being anjali gupta
WHO defined Health is state of compelete physical, mental,social and spiritual well being and not merely the absence of disease or infirmity. means holistic health is something out of bio-social model. its all about spiritual dimension keeps beople wise, energetic, positive, hopeful and happy. Raj Yoga meditation is a tool where you can learn and get experience in life which never had experience in life this is what Dr Anjli Gupta experienced in her life and sharing you all with her experience
This document discusses the role of spirituality in addiction treatment and recovery. It argues that addiction affects the body, mind and soul, so treatment must address spiritual well-being. Twelve-step programs incorporate spiritual principles like honesty, hope and forgiveness. Studies show better recovery outcomes for those engaged in daily spiritual practices like prayer. While some therapists avoid spirituality due to concerns over imposing values, clients find spiritual discussions and references helpful when facilitated properly. True recovery involves profound personal changes attributed to a higher power by many recovering addicts.
This document discusses the role of spirituality in social work practice. It provides an overview of research highlighting the importance of clients' spiritual beliefs and how a lack of training in addressing spiritual issues can impact social workers' ability to effectively help clients. Common spiritual interventions discussed include cognitive behavioral interventions, meditation, 12-step programs, forgiveness interventions, prayer, and using art or music in a therapeutic way. The document emphasizes that social workers need cultural and spiritual competence to properly address the holistic needs of clients.
The document summarizes research showing that when personal or external sources of control are threatened, religious belief can serve as a compensatory source of control. Specifically:
1) Manipulations that lower personal control increase beliefs in an external controlling God or supernatural force as a way to regain a sense of order.
2) This effect is mediated by increased feelings of anxiety from a lack of control. Religious belief is heightened most when it emphasizes an external entity's control.
3) Threats to personal, external, or different sources of control can increase alternative sources of personal or external control as substitutable means of regaining a sense of order.
Through a discussion of current research, the article highlights the psychological and physical benefits of spiritual/religious practices. Such practices are shown to positively influence lifestyle habits like diet and alcohol use from a young age. They also provide a strong support system through religious communities. Overall, spiritual/religious practices throughout life are found to positively impact health and well-being.
DrRic Spirituality in Health Presentation at The Lightheart Center (slide sha...DrRic Saguil
The document discusses spirituality and its relationship to health. It defines spirituality as a sense of connection beyond the physical world, including practices like meditation and prayer. It discusses how spirituality can play an anchoring role in disease by improving stress response, controlling inflammation, and affecting gene expression. Regular spiritual practices like meditation have been shown to change the structure of the brain and expression of hundreds of genes involved in processes like inflammation. The approach is to use spiritual grounding, nutrition, movement and helping others to cultivate inner peace and positively impact health.
Spirituality and its application in nursing practiceSafad R. Isam
SpiritualityIt is the life force that gives meaning to a how a person understands, views, and lives life.
Spirituality can be
. . . determined by culture
. . . determined by life experiences unrelated to culture
. . . Influenced by both culture and personal experiences that are opposite to the cultural norm.
Jean Watson was a nurse scholar known for developing the Theory of Human Caring. She received several academic degrees including a PhD in nursing. Watson authored numerous books that outlined her theory, which focuses on caring as central to nursing. The theory proposes 10 carative factors that guide nurses to address patient's psychosocial needs through compassionate care. A core concept is the transpersonal caring relationship between nurse and patient. Critics note the theory may be difficult to apply in modern hospital settings with short patient stays. However, Watson's work emphasizes the humanistic aspects of nursing care.
The document summarizes Jean Watson's work developing her Theory of Human Caring and Transpersonal Caring. It outlines the evolution of her 10 Carative Factors into Caritas Processes, moving from a focus on human needs to a deeper emphasis on spiritual caring, love and healing. The Caritas Processes reframed caring as a loving relationship and a way of "being" centered around compassion and human dignity.
Dr. Jean Watson is a renowned nursing theorist known for developing the Theory of Human Caring. She received her PhD in Educational Psychology and Counseling from the University of Colorado. Her theory emphasizes caring as the central focus of nursing and identifies 10 Carative Factors that help nurses establish caring relationships with patients. These factors include developing a helping-trust relationship, being present and supportive of expressions of positive and negative feelings, and creatively problem-solving. Watson's theory views humans holistically and aims to help patients find meaning and inner harmony through nursing care.
This document provides an introduction to spirituality from a Christian perspective. It discusses definitions of spirituality, focusing on the idea that spirituality involves life guided by the Holy Spirit. It explores the origins and history of the term "spirituality" and describes spirituality from ontological, experiential, classical, scientific, and artistic understandings. Finally, it outlines 12 guiding principles for Christian spiritual life, including indwelling of the Holy Trinity, finding God in daily life, and living contemplative and apostolic lives.
The document discusses various perspectives from psychology that relate to spirituality, including object relations theory, self psychology, Jungian analysis, cognitive developmental theories, transpersonal psychology, and empirical studies. It notes both insights and limitations of these perspectives for understanding Christian spirituality, emphasizing that psychological approaches are human means whereas spiritual transformation involves a relationship with God that cannot be fully explained by human models.
The document summarizes the development and testing of the Spiritual Health And Life-Orientation Measure (SHALOM), a 20-item questionnaire for assessing spiritual well-being. SHALOM is based on a Four Domains Model of spiritual health that includes personal, communal, environmental, and transcendental domains. It was developed through extensive statistical testing and has been used with diverse populations. Research has shown SHALOM to be a valid and reliable tool for measuring spiritual well-being in a short amount of time across different cultures and religions.
Jean Watson's theory of caring science focuses on caring as the essence of nursing. She describes 10 carative factors that constitute caring in nursing, including forming humanistic values, cultivating sensitivity, developing trusting relationships, and meeting human needs from basic to self-actualization. Watson views caring as health promoting and sees the nurse-patient relationship as transpersonal, with caring occurring through an intersubjective connection between persons. Her theory emphasizes the holistic care of mind, body, and spirit to support health as unity and harmony within the individual.
This document provides an overview of a course on pastoral care and counseling. The course aims to equip students for effective pastoral ministry by developing their understanding of helping relationships and reflecting on pastoral care from a Christian perspective. It covers topics like theological and psychological foundations, counseling ethics, stress management, family counseling and conflict resolution. The document outlines the course objectives, content, required textbooks and resource sites. It also provides definitions and discussions of key concepts like pastoral care, counseling, and the roles and functions of a pastoral counselor.
Spirituality in Family....Dr. catherine... dyutirajagiri
Spirituality is important for healthy family functioning. It provides love, respect, communication and a sense of shared purpose. Studies show families with strong spirituality have less crime, better health, and less mental illness. Spirituality teaches values like love, forgiveness and social responsibility. It helps families cope with challenges by offering hope, meaning and a sense of belonging to something greater. Developing spirituality can strengthen families.
Meeting People Where They Are: Taking Spiritual Assessment - Tessie Mandevill...wwuextendeded
Meeting People Where They Are: Taking Spiritual Assessment – Tessie Mandeville, Reverend & Bobbi Virta, Reverend
Presented at the 2015 Palliative Care Summer Institute conference at Bellingham Technical College
Family therapy aims to treat psychiatric symptoms as related to dysfunctional family dynamics. The document outlines the history, goals, types and assessment of family therapy. It discusses pioneers like Ackerman and Satir, and models including psycho-dynamic, Bowen, structural and general systems. Types of family therapy described are individual, conjoint, couples, multiple family and network therapy. Assessment involves evaluating communication, self-concept, expectations, differences, interactions and climate. Nurses play a role in education, medication management, listening to families and providing support.
APPLICATIONS OF SPIRITUALITY IN THERAPYKevin J. Drab
This document provides an overview of spirituality and its applications in therapy. It discusses how spirituality plays an important role in many people's lives and how failing to consider a client's spiritual beliefs can be detrimental in treatment. Some key points made include that up to 90% of patients rely on religion or spirituality during illness, spiritual interventions can help those struggling to find meaning, and competently addressing spirituality requires counselors to understand different beliefs and practices without imposing their own views. The document aims to help therapists appropriately incorporate spirituality when relevant to a client's goals and wellbeing.
This module aims to provide spiritual care training to participants. It discusses the relationship between religion, spirituality, and pastoral care. Spiritual care involves engaging with others as fellow humans, attending to how people receive care, and supporting what nurtures a person's spirit. When facing death, some common spiritual concerns include relationships/belonging, meaning/self-worth, and coping/control. Effective spiritual care involves listening to a person's story without judgment and building trust.
Family therapy involves multiple sessions with a therapist and all members of a nuclear or step family to address issues interfering with family functioning. The goals are to improve communication, change roles and rules, strengthen the family system, and solve problems. Bowenian family therapy focuses on reducing anxiety by increasing differentiation and decreasing reactivity. Structural family therapy aims to adjust boundaries and strengthen the parental subsystem. Therapists observe family dynamics and enact changes to make the system more adaptive in the present.
This document discusses the relationship between spirituality and health. It defines spirituality as a search for meaning, purpose and connection that is deeper than physical or material things. The document explores how spirituality affects different age groups and can positively impact health by decreasing stress, blood pressure and depression. It also examines the role of spirituality in complementary healthcare practices and insurance coverage of such services. Overall, the document argues that spirituality is an important but often overlooked aspect of complete well-being.
This document discusses the relationship between religion and various psychiatric disorders based on studies. It finds that religion can influence disorders both positively and negatively. Religiosity is generally associated with lower rates of depression, anxiety, and substance abuse, likely due to social support and coping resources. However, religious beliefs can also contribute to guilt, distress, and obsessions in some individuals with conditions like depression and OCD. The direction of causality between religion and mental health is complex and not fully understood.
This document discusses spirituality in nursing. It defines spirituality as encompassing values, meaning, purpose, and a connection to something greater. Holistic nursing supports the intimate connection of body, mind, and spirit. Spirituality has 3 key characteristics - unfolding mystery, interconnectedness, and inner strength. The document also outlines Kohlberg's 3 phases of moral development and Fowler's 7 stages of faith development. It provides a spiritual assessment scale and discusses the importance of spiritual care through being present, listening, and compassionate touch for patients.
1) The article discusses the appropriate role of spirituality in medical care, arguing that spirituality is an important part of the human experience that should not be ignored when patients are facing serious illness.
2) It recommends that physicians discuss spiritual issues with patients sensitively and refer patients to spiritual counselors when appropriate, while not imposing their own beliefs or taking on spiritual counseling roles themselves.
3) Addressing patients' spiritual needs can help improve care and reduce suffering without compromising scientific medical practice.
Spirituality Training For Palliative Care FellowsMasa Nakata
This document summarizes a survey of palliative care fellowship directors in the United States regarding how they teach spirituality to their fellows. The survey aimed to understand how programs define and teach spirituality, who provides the education, and how fellows are evaluated. 14 fellowship directors responded to the survey, representing 29% of programs. The survey found that while all programs agreed on teaching definitions of spirituality and religion and the role of chaplains, they have not incorporated robust educational and evaluation methods to fully train fellows.
This study examined the relationship between family functioning and religiosity/spirituality. A survey was completed by 144 participants recruited through Penn State students. The study found no correlation between family functioning and religiosity/spirituality, contradicting the hypothesis. Additionally, the study found no difference in religiosity between males and females or difference in family functioning between genders, consistent with hypotheses. Contrary to hypotheses, marital status was also not correlated with higher family functioning. Several limitations of the small, biased sample were noted.
Religion, Culture, and Nursing Chapter 13 Patricia A. Hanson a.docxaudeleypearl
Religion, Culture, and Nursing Chapter 13
Patricia A. Hanson and Margaret M. Andrews
Dimensions of Religion
Religion is complex and multifaceted in both form and function. Religious faith and the institutions derived from that faith become a central focus in meeting the human needs of those who believe. The majority of faith traditions address the issues of illness and wellness, of disease and healing, of caring and curing (Ebersole, Hess, & Luggan, 2008; Fogel & Rivera, 2010; Leonard & Carlson, 2010).
Religious Factors
Influencing Human Behavior First, it is necessary to identify specific religious factors that may influence human behavior. No single religious factor operates in isolation, but rather exists in combination with other religious factors and the person’s ethnic, racial, and cultural background. When religion and ethnicity combine to influence a person, the term ethnoreligion is sometimes used. Examples of ethnoreligious groups include the Amish, Russian Jews, Lebanese Muslims, Italian, Irish, or Polish Catholics, Tibetan Buddhists, American Samoan Mormons, and so forth. Faulkner and DeJong (1966) have proposed five major dimensions of religion in their classic work on the subject: experiential, ritualistic, ideologic, intellectual, and consequential.
Experiential Dimension The experiential dimension recognizes that all religions have expectations of members and that the religious person will at some point in life achieve direct knowledge of ultimate reality or will experience religious emotion. Every religion recognizes this subjective religious experience as a sign of religiosity.
Ritualistic Dimension The ritualistic dimension pertains to religious practices expected of the followers and may include worship, prayer, participation in sacraments, and fasting
Ideologic Dimension The ideologic dimension refers to the set of beliefs to which its followers must adhere in order to call themselves members. Commitment to the group or movement as a social process results, and members experience a sense of belonging or affiliation.
Intellectual Dimension The intellectual dimension refers to specific sets of beliefs or explanations or to the cognitive structuring of meaning. Members are expected to be informed about the basic tenets of the religion and to be familiar with sacred writings or scriptures. The intellectual and the ideologic are closely related because acceptance of a dimension presupposes knowledge of it.
Consequential Dimension The consequential dimension refers to religiously defined standards of conduct and to prescriptions that specify what followers’ attitudes and behaviors should be as a consequence of their religion. The consequential dimension governs people’s relationships with others.
Religious Dimensions in Relation to Health and Illness Obviously, each religious dimension has a different significance when related to matters of health and illness. Different religious cultures may emphasize one of the five ...
Henrietta Ayinor Topic 1 DQ 1Spirituality in my worldview has SusanaFurman449
Henrietta Ayinor : Topic 1 DQ 1
Spirituality in my worldview has a great connection with faith, and a search for meaning and purpose in life, connection with others and surpassing Oneself. This results in s sense of inner peace and wellbeing. A strong spiritual connection may improve can improve an individual's sense of satisfaction with life or enable accommodation to disability (Delgado 2005)
Phenwan et al. (2019) Spirituality is the essence of a human being The meaning of life, feeling of connectedness to the transcendental phenomena such as the universe or God. This connectedness may or may not be part of any religions. It is also part of comprehensive palliative care, defined by the World Health Organization. An individual's spiritual well-being is a feeling of one's contentment that stems from their inner self and is related to their quality of life
SSorajjakool (2017) Religious beliefs and customs can significantly shape a nurse- patients relationship this can also influence the expectations of the nurse and patient as well as their wishes and personal boundaries regarding daily routines such as dressing, diet, prayer and touch. Undoubtedly, the sensitivity with which clinicians communicate with patients and make decisions regarding appropriate medical intervention can be greatly increased by an understanding of religious as well as other forms of cultural diversity. As a nurse caring for a patient will be deliberate in making effort to understand a patient's religious preferences this way, I will not impose my religious believes on the patient while helping them to access and receive preternatural care as a provide my nursing care this is beacuse different patienst have their spiritual prereferences and health and illness means dieferent things to dieferent people spiritually.
Delgado C. (2005). A discussion of the concept of spirituality. Nursing science quarterly, 18(2), 157–162. https://doi.org/10.1177/0894318405274828
https://pubmed.ncbi.nlm.nih.gov/15802748/
Phenwan, T., Peerawong, T., & Tulathamkij, K. (2019). The Meaning of Spirituality and Well- Being among Thai Breast Cancer Patients: A Qualitative Study. Indian journal of palliative care, 25(1), 119–123.
https://doi.org/10.4103/IJPC.IJPC_101_18
SSorajjakool, S., Carr, M. F., Nam, J. J., Sorajjakool, S., & Bursey, E. (Eds.). (2017). World religions for healthcare professionals. Taylor & Francis ISBN 1317281020, 9 781317281023
Retrievedfromhttps://www.routledge.com/World-Religions-for-Healthcare-Professionals/SSorajjakool-Carr-Nam-Sorajjakool-Carr-Bursey/p/book/9781138189140
Yenly Fernandez Rodriguez
1 posts
Re: Topic 1 DQ 1
Topic 1 DQ 1
Individuals hold different worldviews about spirituality. The spiritual worldview of an individual depends on various factors, such as family beliefs, origin, and culture. In the world, multiple religions exist to influence an individual's connection with a supreme being (SSorajjakool, Carr, Nam, Sorajjakool & Bursey, 2017). Fo ...
This document summarizes a proposed study on the impact of spirituality on counseling for families experiencing cancer in the Kentucky-Tennessee region. The study would use a mixed methods approach, beginning with a standardized spirituality assessment and then conducting semi-structured interviews to describe participants' perceptions of spirituality in their own words. Previous research has found that spirituality plays an important role in coping and quality of life for cancer patients and their families, but definitions and understandings of spirituality vary widely. The goal of this study is to better understand how spirituality impacts counseling needs for families dealing with cancer in this region. Participants would include cancer patients and their immediate family members from several treatment centers in Kentucky and Tennessee.
Spiritualty in Management / Workplace SpiritualityP.K. AGARWAL
Spirituality, thus, deals with understanding the nature of the Soul and one’s journey back to identifying with the Soul and experiencing it as one’s true nature.
Spirituality is the science about how to be blissful..
The Milan Model was developed by Luigi Boscolo, Gianfranco Cecchin, and Maria Palazzoli in Italy in the 1980s. It was influenced by Gregory Bateson's ideas and moved family therapy toward a "second order" approach. The original Milan Model involved brief, strategic therapy with families seen once a month for 10 sessions by a male-female therapist team. They used interventions like positive connotation, rituals, and circular questioning to challenge family beliefs while maintaining neutrality and low resistance. The model has since evolved as the original therapists parted ways and new approaches incorporated cultural diversity and systems theory.
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
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Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Spirituality And Family Nursing Spiritual Assessment And Interventions For Families
1. I S S U E S A N D IN N O V A T I O N S I N N U R S I N G P R A C T I C E
Spirituality and family nursing: spiritual assessment and interventions
for families
Ruth A. Tanyi MSN RN FNP-C APRN-BC
Doctoral Student in Public Health: Preventive Care, Loma Linda, California, USA
Accepted for publication 5 April 2005
Correspondence: TANYI R.A. (2006) Journal of Advanced Nursing 53(3), 287–294
Ruth A. Tanyi, Spirituality and family nursing: spiritual assessment and interventions for families
Family Nurse Practitioner, Aim. The aim of this paper is to propose a guideline for spiritual assessment and
Prevention, Lifestyle and
interventions explicitly for families, while considering each family member’s unique
Wellness Services,
spirituality.
PO Box 1185,
Loma Linda, Background. Spirituality’s positive effect is pervasive in health care and in the lives
CA 92354, of many families; therefore, there is a need to integrate spiritual assessment and
USA. interventions in total family care.
E-mail: rtanyi@yahoo.com Discussion. The majority of published guidelines on spiritual assessment and
interventions are designed predominantly for individuals. They fail to differentiate
between individual and family spirituality or offer only brief discussions on family
spirituality. Such guidelines are potentially problematic. They may lead nurses to
focus only on individual spirituality and neglect to discern family unit spirituality or
recognize the presence of conflicts in spiritual perspectives within the family. While
other disciplines such as social work and family therapy have several guidelines/
strategies to assess family spirituality, there is a dearth of such guidelines in the
family health nursing and spirituality literature, in spite of the rhetoric about
incorporating spirituality as part of total family assessment. As a beginning solution,
guidelines are proposed for spiritual assessment and interventions for the family as a
unit, and the category of spiritual interpretation to represent diagnosis is introduced.
Case studies exemplify how to integrate the guideline, and illustrate elements that
may favour specific interpretations which would guide the interventions.
Conclusion. As nurses continually strive to assist families with their health needs,
they must also attend to their spiritual needs, as one cannot truly assess a family
without assessing its spirituality.
Keywords: family health, nursing, spiritual assessment, spirituality
description is consistent with the multi-dimensional and
Introduction
ambiguous nature of spirituality.
In this paper, family spirituality is described as the search for The family is defined here as two or more individuals who
meaning and purpose in life, meaningful relationships, call themselves a family and are bonded together emotionally.
individual family member spirituality, family values, beliefs, They may or may not be biologically related or share physical
and practices, which may or may not be religiously based, space. Family is further defined as a single unit with intercon-
and the ability to be transcendent (Sperry & Giblin 1996, nected parts (Friedman 1998, Wegner & Alexander 1999).
Tanyi 2002). Family spirituality can be much broader than Given the complex nature of spirituality, the intention in
individual spirituality, as it encompasses individuals’ distinct this paper is not to serve as a conclusive and definitive guide
spirituality and that of the family unit. The broadness of this to spiritual assessment and interventions for families. Rather,
Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd 287
2. R.A. Tanyi
a beginning guideline is proposed in order to better equip strategies to assess family spirituality (e.g. Boyd-Franklin &
nurses to provide and improve spiritual care. In accordance Lockwood 1999, Frame 2000, Hodge 2000), there is a
with this era of modern nursing and increased discourse on dearth of such guidelines in the family nursing and
spirituality, this paper introduces the category of spiritual spirituality literature, in spite of the rhetoric to incorporate
interpretation to represent diagnosis. Finally, the paper spirituality as part of total family assessment.
contributes to the literature on family health nursing and The majority of published guidelines in the nursing
spirituality. literature (e.g. Stoll 1979, Murray & Zentner 1989, Labun
1997) are predominately geared for assessing individual
clients rather than families. They fail to distinguish
Background
between individual and family unit spirituality, or offer
Despite the lack of consensual definition of spirituality only brief discussions on family spirituality. Guidelines to
(MacLaren 2004), its positive effect pervades health care assist the family health nurse with the spiritual dimension
and is evident in the nursing literature. Therefore, providing of care are timely and necessary in order to meet families’
spiritual care will remain an invaluable part of nursing, as holistic needs.
nurses work with humans who are spiritual beings. Spiritu- It could be argued that family health nurses may still
ality and religion are sometimes used interchangeably, but the employ the same guidelines as nurses working with individual
two concepts are different, thus warranting a distinction. clients. To an extent this approach is appropriate, but may
Religion involves an organized entity with established rules, pave the way for potential problems, as nurses may focus on
practices, beliefs, values, and boundaries about a Higher only the individual’s spirituality, neglecting to discern the
Power or God to which individuals should adhere (Thoresen family’s spirituality as a unit. Guidelines exclusively for the
1999). On the contrary, spirituality has been described as a family would better equip nurses to consciously approach the
personal journey and defined as: spiritual dimension from both the individual and family
perspectives. It would alleviate the frustration of sorting
the personal search for meaning and purpose in life, which may or
through volumes of literature not specifically germane to
may not be related to religion. It entails connection to self-chosen
assessing family spirituality. It would help nurses recognize
and/or religious beliefs, values, and practices that give meaning to
conflicts between individual and family spirituality, and the
life, thereby inspiring and motivating individuals to achieve their
impact on the individual’s health and family unit. Lastly, it
optimal being. This connection brings faith, hope, peace, and
would assist nurses to better organize spiritual data.
empowerment. The results are joy, forgiveness of oneself and others,
awareness and acceptance of hardship and mortality, a heightened
sense of physical and emotional well-being, and the ability to Spirituality: a powerful family resource
transcend beyond the infirmities of existence (Tanyi 2002, p. 506).
A few published studies have examined spirituality as a
From the above definition, family spirituality may or may not family phenomenon. Electronic database searches of CI-
be religiously based. While some families’ spiritual orienta- NAHL, Psyc-INFO, MEDLINE/PubMed, and ProQuest, in
tion may involve religion, others may view spirituality as addition to manual searches of family journals such as
related to the universe, environment, or significant relation- Marital and Family Therapy, Family Relations, Marriage
ships. Families with an atheist or agnostic orientation may and Family Counselling, and Family Process over the last
also be spiritual. Whatever the spiritual orientation, families’ three decades yielded few studies in this area. The scant
values, practices, beliefs are all part of their distinct spiritu- published studies reviewed for this paper were conducted in
ality, which may influence their functioning and help them various countries; however, two from the United Kingdom
manage crises (Walsh 1998). (UK), three from Canada, and the remainder from the
The need to address family spirituality has been espoused United States of America (USA) were pertinent to the
by family health nursing writers (e.g. Friedman 1998, paper’s focus. The ensuing section summarizes the studies
Wright & Leahey 2000). It is also clearly evident in the that underscore the powerful effects of spirituality as an
literature of various health professions, such as medicine invaluable resource.
(Maugans 1996, Walsh et al. 2002), clinical psychology Spirituality can be expressed vertically via a relationship
(Frame 2000, Wolf & Stevens 2001), social work (Hodge with God/Higher Power and/or horizontally via significant
2000, 2001), and family therapy (Anderson & Worthen relationships with others or self (Stoll 1989). The families in
1997, Rivett & Street 2001). While other disciplines such the following studies expressed their spirituality both vertic-
as social work and family therapy have several guidelines/ ally, as they reported a relationship with God/Higher Power,
288 Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd
3. Issues and innovations in nursing practice Spirituality and family nursing
and horizontally, because of significant relationships with Table 1 Guideline to spiritual assessment for families
family members and others. Meaning and purpose
Spirituality is an important factor in facilitating healthy Who or what does the family consider the most meaningful?
marital and family functioning (Giblin 1996). Research What gives the family meaning in their daily routines?
shows that spouses’ spiritual views and beliefs can decrease What gives the family peace, joy, and satisfaction?
psychological stress and increase their sense of coherence Strengths
What gives the family strength?
(Mullen et al. 1993). A family’s spirituality can assist in
What helps the family to deal with crises?
maintaining normalcy, cohesion, and resilience in the midst What does the family do in order to rebuild their strength?
of crises (Beavers & Hampson 1990, Leis et al. 1997, Boyd- Relationships
Franklin & Lockwood 1999). It can expedite positive What do family members like about their family?
adjustment to the loss of a family member (Richards & Does the family have a relationship with God/Higher Power,
universe, or other? If yes, how do they describe it?
Folkman 1997, Handsley 2001, Walsh et al. 2002), ameli-
Is the family involved in community-based spiritual activities?
orate difficulties associated with disabilities (Treloar 2002), If yes, which ones?
help foster a deeper meaning and purpose in positive family Beliefs
events such as childbirth (Callister et al. 1999, Semenic et al. What are the family’s beliefs? And what do these beliefs
2004), and contributes to satisfying, lasting marriages (Ka- mean to their health?
slow & Robison 1996). Does the family practise rituals such as prayer, worship,
or meditation?
Other findings show that families with strong spiritual
Individual family member spirituality
orientations can effectively attenuate family caregivers’ bur- How do family members express/describe their spirituality?
dens (Pierce 2001, Theis et al. 2003). In single-parent And what does this mean to their health?
families, spiritual rituals such as prayers have been shown Are there conflicts between family members because of their
to provide solace and unity (Moriarty & Wagner 2004). spiritual views?
If yes, what is the impact, if any, on the individual and family’s
Kloosterhouse and Ames’ (2002) study further highlights that
health?
families’ spiritual beliefs and practices can strengthen them Family’s preference for spiritual care
and provide hope, meaning and purpose in their lives when How does the family describe/express their spiritual views?
dealing with stressors. Can the family give examples of how nurses can integrate
their spiritual views when working with them?
Does the family consider anyone their spiritual leader?
Spiritual assessment And if necessary, can the spiritual leader be contacted
to assist with providing care to the family?
The major goals of spiritual assessment are (1) to support and
enhance families’ spiritual well-being and development; (2) to Sources: Fitchett (1993), Maugans (1996), Hodge (2000), McEvoy
(2000), Wilkinson (2000), Tanyi (2002).
discern spiritual distress and its effect on overall family
These questions serve only as a guide to help nurses elicit spiritual
health; and (3) to ascertain ways to incorporate family
information for each category. Nurses can, therefore, rephrase these
spirituality when providing care. To capture the essential questions according to the family’s understanding and expressions of
elements of spirituality and organize the assessment, nurses their spirituality.
can utilize the guideline in Table 1 to categorize the data
according to: meaning and purpose, strengths, relationships,
beliefs, individual member’s spirituality, and family’s prefer- remain open to families’ spiritual beliefs and perspectives,
ence for spiritual care. never imposing their personal beliefs or values on families.
The initial step of a thorough spiritual assessment and They also must explain the purpose of the assessment, how
intervention requires that nurses be comfortable with the the information is used, and obtain families’ consent before
topic and develop a trusting relationship with the family consulting with spiritual leaders (Richards & Bergin 1997).
(Maugans 1996). One cannot precisely gauge when a nurse Before beginning the assessment, nurses must first attain
should establish a trusting relationship with a family as this family consent. Thereafter, the significance of spirituality in
depends on their interactions over a period of time. However, the family’s lives must be ascertained (Table 1). Answers to
nurses’ actions, such as displaying genuine caring and the example questions in Table 1 would provide insight about
concern, respecting families’ circumstances, and remaining the family’s beliefs and strengths, and the influences of
non-judgemental can foster a healthy environment and spirituality on their health. It would reveal the role of
expedite the development of a trusting relationship. In order spirituality in family’s abilities to seek meaning and purpose
to maintain the ethical aspects of spiritual care, nurses must in their lives, and shed light on the family’s sense of
Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd 289
4. R.A. Tanyi
connectedness/disconnectedness, alerting nurses to potential Table 2 Guideline to spiritual interventions for families
sources of spiritual distress. Spiritual support
Although nurses should approach the family as a single Be present and available to the family in a non-hurried manner
unit, it is advantageous to collect data on each family Respect the family’s spiritual orientation and
member, as these data may reveal conflicts in spiritual views support their practices
among family members, and the impact, if any, on the family Encourage and support comments that reflect the family’s need
for spiritual growth
unit and individuals’ health. Family responses on how to
Spiritual well-being
incorporate spirituality in their care would also add under- Support and encourage the family’s use of spiritual resources
standing to their unique spiritual needs. as desired
Additionally, genograms and ecomaps are visual dia- Assist the family in locating spiritual groups and resources in
grammatic tools that can be used to assess family spiritu- their community
Support, acknowledge, and applaud verbalized comments of
ality. A genogram is a three-generation family tree, which
peace, harmony, and satisfaction with family circumstances
depicts a family’s history (Bowen 1980). Likewise, the and relationships
spiritual genogram can be used to depict a three-generation Encourage continual spiritual growth
picture of the family’s spiritual journey. Any event the Spiritual distress
family describes as spiritual should be outlined in the Attempt to determine the reason(s) for the distress, and support the
genogram. The process of completing the genogram can family’s efforts to examine their beliefs and values
Acknowledge the family’s position, but if necessary, obtain their
serve as a reflective tool for family members to evaluate
consent to consult with a spiritual leader of their preference
their spirituality, as they understand and perceive it. It can Provide research-based evidence to the family about the
also help to clarify questions about the family’s spirituality positive impacts of spirituality on family health and functioning
and to affirm their strengths (Massey & Adriana 1999, Continue to display empathy, acceptance, kindness in a
Hodge 2000, 2001). Ecomaps portray a family’s relation- non-judgemental manner
ship with external systems such as health care or govern- Sources: Maugans (1996), Wilkinson (2000), Tanyi (2002).
ment, and the impact of these systems on the family. Due to the multi-dimensional and ambiguous nature of spirituality,
Information from the ecomap would help nurses to the assessment and interventions may overlap into other categories.
organize the family spiritual history and address legitimate Nurses must, therefore, bear in mind each family’s unique situation.
spiritual issues (Frame 2000).
Spiritual needs may be difficult to discern; hence, nurses
should observe family members’ non-verbal behaviours The desired outcome for spiritual assessment and inter-
during the assessment. The home environment, including vention is spiritual well-being. In this state, family members
books or artwork, may also provide clues to family spiritu- express satisfaction with their relationships, beliefs, circum-
ality (Ross 1994). stances, and display a strong sense of connectedness with
Because spiritual distress may impede a family’s ability to each other, their God/Higher Power, universe, environment,
manage conflicts and have a devastating effect on their and others (Wilkinson 2000). Evaluation criteria are verbal-
wellbeing, nurses must be astute in discerning it and ized comments from family members indicating (1) continu-
intervening quickly and appropriately (Table 2). Spiritual ing spiritual growth; (2) feelings of connectedness and peace;
distress should be suspected if the family expresses a sense of (3) satisfaction with family circumstances, and improved
hopelessness, abandonment, inner conflicts about their sense of overall health and well-being.
beliefs, and questions the meaning of their existence (Wil-
kinson 2000).
Case examples
The ensuing fictitious case studies exemplify certain potential
Spiritual interventions
components within a family unit to favour an interpretation
The process of spiritual assessment is an effective intervention. of spiritual support, wellbeing, or distress. While there are
It allows the family to openly discuss their spiritual strengths many other potential spiritual interpretations, these cases
and legitimizes their abilities to manage life’s challenges only underscore the major ones. As families’ circumstances
(Hodge 2000). Nurses can, therefore, encourage families to change over time, spiritual interpretations are not permanent;
draw upon this strength to manage other problems. Following they change to reflect a family’s state at any given time. The
the assessment, nurses would formulate an appropriate inter- cases further illustrate how to integrate spiritual assessment,
pretation to guide the interventions in Table 2. interpret data and implement appropriate interventions.
290 Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd
5. Issues and innovations in nursing practice Spirituality and family nursing
Since Amy’s diagnosis of hepatitis C, the father has become
The Ntuba family
withdrawn and openly verbalizes his anger towards God. He
The Ntuba family consists of husband Henry, aged 50, wife feels he is being punished and asks why God would allow
Maggie aged 48, and Henry’s brother Evan, aged 37. Evan such a thing to happen to their child and family. He no longer
has acute kidney failure. He undergoes haemodialysis 3 days attends church or bible studies and communicates less with
per week and has recently tested positive for tuberculosis his family. His behaviours have a negative impact on the
(TB). He does not have active TB, but takes TB prophylaxis family’s health, creating tension in the household and
treatments. After completing this treatment, he will receive a destabilizing the family unit. The family prefers nurses to
new kidney. support their spirituality by displaying kindness, genuine
The nurse discerns that this family’s spiritual orientation is caring and respect. With the exception of the father, family
religion based, Catholic, thus vertically connected to God. members share similarities in their spiritual views (Augsber-
They report that God helps them deal with difficulties, such ger 1986).
as Evan’s health. They engage in weekly family prayer and In this case, nurses would document the appropriate
attend church regularly. They believe God is in charge of their interpretation of spiritual distress depicted by the father’s
lives and Evan’s health. This family displays a strong vertical disconnectedness with God and horizontal discon-
horizontal connection with one another, and they believe nectedness with family members. The initial nursing inter-
their purpose is to stay connected as a family unit. They deny vention would be to acknowledge the family’s situation in a
any sense of anxiety about Evan’s health, exhibiting a deep non-judgemental manner, while gaining their trust. Thereaf-
sense of strength and peace. Each family member’s unique ter, nurses would attempt to reach the father by reminding
expression of spirituality is similar to other members (Augs- him how the family has effectively managed crises in the past
berger 1986), and no conflicts are apparent. They agree that through spiritual practices.
having a nurse who respects their spiritual views and prays If nurses are unable to diffuse the distress or feels ill-
for and with them is very important. equipped to handle the situation, they should ask the family’s
Upon collecting the information, nurses would organize permission to initiate a spiritual referral from a spiritual
and document the data under the Tables’ headings. As an leader of their choice. If the family rejects the nurse’s
example, the Ntuba family’s meaning and purpose is to stay initiation, the topic could be reintroduced at a later time.
connected; they believe in God; their strength comes from Nonetheless, nurses would continue to acknowledge and
God; they have a strong horizontal relationship with each respect the family, while providing continual support, and
other and their church; no spiritual conflicts are present; and implement the other interventions in Table 2.
they prefer nurses to respect their spiritual views, and pray
for and with them.
The Wong family
Nurses would then formulate the appropriate interpret-
ation of continual spiritual well-being. This interpretation is The Wong family consists of Paul, aged 67, who has Diabetes
appropriate for families that express satisfaction with their Mellitus type 2, his wife Mary, aged 64 and their daughter,
spiritual lives (Wilkinson 2000). In this case, the role of Maggie, aged 21. Paul’s laboratory tests are stable. However,
nurses is to encourage, acknowledge, and support the family nurses visits the family regularly for diabetic education and
in their spiritual journey, and incorporate the other interven- monitors Paul’s blood sugar levels, diet, and exercise. The
tions in Table 2. nurse observes they are a spiritual family although they
openly express their atheism. They have strong horizontal
relationships with the external systems of health care, their
The Ngoh family
neighbours, and extended family members; they show deep
The Ngoh family consists of Martin, aged 48, his wife Anna, love and trust in one another. The vertical aspect of their
aged 46, their son Phil, aged 16, and daughter Amy aged 18. spirituality is evident in their love for the universe; they often
Amy has hepatitis C, which she contracted following a blood spend quiet moments enjoying nature. Faith in and commit-
transfusion. The nurse discovers that this has been a very ment to all their vertical and horizontal relationships give
close Protestant family. They usually resolved conflicts them strength, enabling them to cope with Paul’s diabetes.
through open communication, bible study, church attend- This family’s purpose is to remain supportive, connected,
ance, and prayer. Their spirituality is religion based, and their and loving to one another. They express inner peace and joy
belief and faith in God has given them strength to manage as a family unit. They want nurses to support their spiritu-
crises. ality by showing genuine kindness while respecting their
Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd 291
6. R.A. Tanyi
family appears interested but reluctant, nurses should nurture
What is already known about this topic a trusting relationship with the family during subsequent
• Because humans are spiritual beings, all families are encounters before reintroducing the topic.
spiritual; spirituality is a vital resource that helps fam- If the family agrees, nurses must first explain the purpose of
ilies manage crises and maintain equilibrium. the assessment and how the information would be used. A
• The need to address family spirituality is espoused in the thorough family assessment requires that data be collected
literature. from each family member (Wright & Leahey 2000). If all
• There is a lack of guidelines to assist nurses with spir- family members are not present, data from those not
itual assessment and interventions explicitly for famil- available can be obtained later. If time does not allow nurses
ies. to complete the entire assessment, data from one category
(e.g. beliefs) can be obtained, and the rest completed at
subsequent visits.
What this paper adds While a lack of educational preparation and time
• When considering family spirituality, it is important to constraints are cited as barriers to providing spiritual care
recognize the uniqueness of each family member’s (McSherry 1998), other research suggests that nurses do in
spirituality. fact attend to families’ spiritual needs (Stiles 1990) regardless
• A guideline is proposed for spiritual assessment and of these barriers. Therefore, Swinton’ (2001) argument that
interventions for families as a beginning solution to the the issue of time constraints may represent how nurses
lack of such guidelines. prioritizes care may be operative; especially for nurses who
• A call is issued to family nursing writers, clinicians, and desire to provide spiritual care, and do not perceive it as a
researchers to develop this proposed guideline. burden (Walter 2002). While educational preparation is
beneficial, the initial step in providing spiritual care is being
comfortable with the topic regardless of a formal education
atheism. No conflicts are noted, and family members share (Maugans 1996).
similar spiritual views (Augsberger 1986). The ideal setting for using this guideline is families’ homes,
Although an atheist family, the Wongs clearly display a and so it is especially useful for family health nurses making
strong sense of spiritual well-being. They epitomize the home visits. However, the guideline is useful in almost all
concept that all families are spiritual, because humans are community settings, such as nursing homes and hospices,
spiritual beings. They further exemplify that each family has where nurses have frequent contact with families.
spiritual needs (e g. respect and kindness from nurses) even Patients with chronic illnesses are more likely to make
when no crises are present, although the extent of needs frequent visits to their healthcare providers and develop
would vary for every family and circumstance. In this trusting relationships with them; therefore, the guideline is
situation, nurses would document the data, formulate an also applicable for advanced practice nurses in clinic settings.
accurate interpretation of continual spiritual support, and In clinics, the guideline can be used during annual physicals,
then implement the interventions in Table 2. as more time is typically allotted for these visits. It is unlikely
that nurses will meet the entire family during clinic visits.
Nonetheless, the data can still be obtained and documented
Implications for nursing practice
from one source, then expanded as nurses encounters other
After obtaining other healthcare information, the spiritual family members at different visits. This guideline would
data should be collected next; this may be at the initial, improve nurses’ understanding of families’ dynamics, and
second, or subsequent encounters with the family, provided a could reveal potential conflicts between spiritual beliefs and
trusting relationship is established or beginning to be devel- adherence to healthcare treatments; thus, it can be adapted to
oped, and the family consents to it. The initial process of suit each family’s unique needs.
collecting healthcare data provides an excellent opportunity
for nurses to introduce the spiritual aspect, because most
Conclusion
healthcare history forms ask for religious affiliation. If the
family is willing to discuss their religious affiliation, nurses Use of this guideline would improve nurses’ understanding of
may use this opportunity to broach the topic of spiritual family functioning, thereby enhancing communication and
assessment. The family’s response will tell nurses either to trust in nurses–family relationship. Spiritual care is ongoing
continue or to abandon the topic (McEvoy 2000). If the with each family interaction, and spirituality is an important
292 Ó 2006 The Author. Journal compilation Ó 2006 Blackwell Publishing Ltd
7. Issues and innovations in nursing practice Spirituality and family nursing
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