Nursing A ConceptBased Approach to Learning VOLUME TWO
Nursing: A Concept-Based Approach to Learning VOLUME TWO EDITION VOLUME TWO| | SECOND EDITION MODULE 30 Spirituality Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Module 30 The Concept of Spirituality and, Exemplar 30. 2 Religion and, Exemplar 30. 3 Spiritual Distress Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spirituality Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
The Concept of Spirituality • Religion, Faith, Hope, Transcendence, and Forgiveness • Generally involves belief in higher power Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spiritual Health and Well-Being • Manifested by feelings § Generally alive, purposeful, fulfilled § Connected with self, others, higher power, Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spiritual Distress • Challenge § To one’s spiritual well-being and to the belief system that provides strength, hope, meaning • Contributions to spiritual distress § Psychological problems § Treatment-related concerns § Situational concerns Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Core Aspects of Spirituality • Religion § § Organized system of beliefs, practices Guidance in responding to life challenges Sense of community Traditional practices, rituals, • Related to life events Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Core Aspects of Spirituality, continued • Faith § Belief in, commitment to someone, something § May be used interchangeably with religion, as in faith-based organization • Hope § Concept that incorporates spirituality Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Core Aspects of Spirituality, continued • Transcendence § Often used interchangeably with selftranscendence • Forgiveness § Many clients feel a sense of shame or guilt Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spiritual Development Page 1874 • Children § Sense of wholeness, internal resources, identity § Part of a greater world § Sense of meaning and purpose § Ability to express hope • Elders § Life review § Open discussion about suffering and dying Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved 10
Concepts Related to Spirituality Page 1875 • • • Culture and Diversity Health, Wellness, and Illness Sexuality Ethics Legal Issues Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Nursing Assessment • Nursing history § Joint Commission mandates each client be assessed for spiritual beliefs, practices • General questions, more thorough if in distress Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Nursing Assessment, continued • Nursing history § Ask questions using acronym FICA • • F = Faith or beliefs I = Implications, influence C = Community A = Address Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Nursing Assessment, continued • Culture: ask about faith and belief systems to understand culture and spirituality relationships • Fellowship and community: ask about support networks • Ritual and practice: ask about life practices used to assist in structure and support during difficult times • Vocation: ask whether illness or hospitalization has altered spiritual expression Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Nursing Assessment, continued • Spiritual Health History § What gives you energy during difficulty times? § How does your faith help you cope? § What gives your life meaning? § How has your illness affected the way you live your life spiritually at home or where you work? Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Nursing Assessment, continued • Objective data: § Environment: dress, symbols, religious articles § Behaviors § Verbalization § Affect and Attitude § Visitors Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved 16
Spiritual Practices Affecting Nursing Care • Clients often identify religious practices as important for coping with illness. § Guidelines to avoid imposing personal spiritual beliefs • Seek basic understanding of client’s needs, preferences • Follow client’s expressed wishes • Do not urge clients to adopt certain beliefs, practices • Strive to understand personal spirituality Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Religious Beliefs About Health • Let’s take a few minutes to discuss some specifics… - Judaism Jehovah’s Witness Roman Catholic Protestant Muslim Christian Science • Follow this link to learn more… • Nurses and Their Patients Religious Beliefs Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved 18
Nursing Diagnosis • Potential diagnoses: • Anxiety • Ineffective coping • Fear • Complicated grieving • Hopelessness • Powerlessness • Actual diagnoses: • Readiness for enhanced spiritual well-being • Spiritual distress • Risk for spiritual distress Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spiritual Distress • Defining characteristics § Expresses lack of hope, meaning, purpose § Expresses being abandoned by, angry with God § Refuses interaction with friends, family § Undergoes sudden changes in spiritual practices § Requests to see religious leader § Lacks interest in nature, reading spiritual literature Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Planning • Client will: § Fulfill religious obligations § Draw on, use inner resources more effectively § Maintain or establish personal relationship with a supreme being in the face of unpleasant circumstances Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Implementation § § § § Support systems Diet therapies Supporting rituals Beliefs about illness and healing Prayer Meditation Supportive grief work Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Implementation, continued • Recognize, and validate inner resources § Coping methods, humor, motivation • Assist client to leave a legacy Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Implementation: Provide Presence • Being with client • Four features of presencing § § Giving of self in present moment Being available with all of self Listening, aware of privilege of doing so Being there in way meaningful to other Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Praying with Clients • Client preference • “Would you feel comfortable if I prayed with you? ” • Assess what they would like to pray for • Pray aloud or stay with client in silence Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved 25
Evaluation • Successful outcomes reveal the patient developing an increased or restored sense of connectedness with family; maintaining, renewing, or re-forming a sense of purpose in life; and for some, exhibiting confidence and trust in a Supreme Being or Power. Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved
Spiritual Self-Awareness for the Nurse • Nurses cannot hear or respond to a client’s spiritual need unless they hear and respond to their own need. Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved 27
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