Spirituality refers to the human search for meaning and purpose through connection to something greater than oneself. It involves belief in a higher power and can provide strength, hope and meaning. Spiritual well-being is a feeling of being alive, purposeful and fulfilled through inner peace, compassion, gratitude and other qualities. Spiritual distress challenges one's beliefs and can result from medical issues, treatments, or situational factors like death or inability to practice spiritual rituals. Nursing care should consider patients' spiritual needs and practices around holy days, symbols, prayer, diet, healing, dress, birth and death.

2. SPIRITUALITY Derived from Latin word SPIRITUS which refers to “breath” or “wind”. SPIRITUALITY FAITH RELIGION

3. Spirituality refers to that part of human being that seeks meaning less through intra, inter and transpersonal connection.

4. spirituality involves a belief in a relationship with some higher power , creative force, divine being or infinite source of energy

5. DESCRIBING SPIRITUALITY Meaning: Having purpose, making sense of life. Value: Having cherished believes and standards. Transcendence: Appreciating a dimension that is beyond the self. Connecting: Relating to others . Becoming: Which involves reflection, allowing life to unfold, and knowing who one is

6. Spiritual Needs Need for LOVE HOPE TRUST FORGIVENESS BEING RESPECTED & VALUED DIGNITY FULLNESS OF LIFE VALUES CREATIVITY CONNECTING WITH HIGHER POWER BELONGING TO A COMMUNITY

7. Spiritual well being A feeling of being “generally alive, purposeful and fulfilled.

8. Characteristics of spiritual wellbeing Sense of inner peace Compassion for others Reverence for life Gratitude Appreciation for unity and diversity Humor Wisdom Generosity Ability to transcend self Capacity for unconditional love

9. Spiritual distress A challenge to the spiritual wellbeing or to the belief system that provides strength, hope and meaning to life.

10. Factors leading to spiritual distress 1.PHYSIOLOGICAL PROBLEMS A medical diagnosis of terminal / debilitating disease. Experiencing pain. Loss of a body part or function. Miscarriage / still birth.

11. 2. TREATMENT RELATED FACTORS Recommendation for blood transfusion. Abortion Surgery Dietary restrictions Amputation of a body part. isolation

12. 3. SITUATIONAL FACTORS Death/ illness of a significant other. Inability to practice one’s spiritual rituals Feeling of embarrassment when practicing them

13. Spiritual practices affecting nursing care ‘ HOLY’ DAYS SACRED WRITING SACRED SYMBOLS PRAYER AND MEDITATION BELIEVES AFFECTING DIET & NUTRITION BELIEVES RELATED TO HEALING BELIEVES RELATED TO DRESS BELIEVES RELATED TO BIRTH BELIEVES RELATED TO DEATH

14. ‘ HOLY’ DAYS A day set aside for religious observance.

15. SACRED WRITING

16. SACRED SYMBOLS

17. PRAYER AND MEDITATION

18. BELIEVES AFFECTING DIET & NUTRITION

19. BELIEVES RELATED TO HEALING

20. BELIEVES RELATED TO DRESS

21. BELIEVES RELATED TO BIRTH

22. BELIEVES RELATED TO DEATH

23. Spiritual counseling & help in the hospital