Spiritual Care

Spiritual Care 

Spirituality, the dimension of human life that has been regarded as the central artery that permeates, energizes, and enlivens all other dimensions. (Raholm , 2002)

The word spirituality is derived from the Latin word spiritus, which refers to breath, wind, or air. (O’Neill & Kenny, 1998)

Spirituality is defined as a personal belief in a higher power or being that guides life. This definition is broad enough to cover a multitude of spiritual belief systems yet is specific enough for participants to understand and determine whether they define themselves as spiritual.( Jeffrey A., 2003)

“Spirituality was like a beacon of light that provided illumination and sustained hope while enduring serious illness.” 10(p90)

Spirituality, the dimension of human life that has been regarded as the central artery that permeates, energizes, and enlivens all other dimensions, may serve as buffer for the stressful physical, emotional, and psychological events associated with illness. Spirituality is the manner by which human beings make sense of life events and establish meaning of their existence amid potentially life-threatening illnesses. Spirituality is a universal phenomenon; however, no universal definition exists.( Raholm , 2002)

Spirituality has been found to enhance health.(Coyle , 2002) Research literature shows evidence that studies investigating the influence of spirituality on the recovery and coping of patients with diseases such as cardiac illness are rapidly emerging.

Spirituality as “an individual’s attitudes and beliefs related to transcendence (God) or to the nonmaterial forces of life and of nature” (p. 4).

Spiritual and religious coping may reduce stress and improve optimism in patients facing major life crises.

Spirituality plays an integral role in dealing with life-threatening illness.

Spirituality has been identified in the literature as an important component for finding meaning and coping with illness. Spirituality is a significant part of culture and a phenomenon in which interest is growing. Spirituality may be considered a belief in a higher power or God and may be defined as transcendence or a connection to a higher power

Spiritual care is about helping people whose sense of meaning, purpose and worth is challenged by illness.

Spiritual care recognizes the relationship between illness and the spiritual domain, and acknowledges the possibility of a search for meaning in the big questions of life and death.

Spiritual issues were important and often the source of unmet needs for patients and carers in both illness groups. Fear, distress and uncertainty were commonly displayed and expressed, although not necessarily to people’s own families or to professionals

At diagnosis, patients and carers came face to face with the prospect of suffering and death

Those patients and carers who were religious found comfort from the support of their church and in prayer

Spiritual needs are an essential component of holistic health care assessment. To exclude the spiritual dimension is to fail to acknowledge the totality of human experience.

Spiritual needs were expressed in terms of the need to maintain a sense of self and self-worth, to have a useful role in life, retaining an active role with family and friends.

Spiritual needs were inextricably intertwined with physical, social and emotional needs in these patients, but the prospect of dying led people into a deeper level of questioning and searching for meaning and sometimes forgiveness, with which they often struggled alone form many months.

“Spiritual needs are the need and expectation which humans have to find meaning, purpose and value in their life.”

In this holistic model, every disease entity has a psychosomatic component, and biologic, psychologic, social, and spiritual factors contribute to symptoms.

We have documented the importance of peace of mind and spiritual wellbeing for people with two different life threatening illnesses.

Research studies that related spirituality and illness to variables such as the constructs of hope, optimism, self-efficacy, uncertainty, and health locus of control were also included.

Research literature shows evidence that studies investigating the influence of spirituality on the recovery and coping of patients with diseases. Several studies have shown that persons who score higher on spirituality or religious scales have lower mortality. Findings suggest that the degree of spiritual well being may be an important factor in the progression or regression of sickness.

Knowledge of a patient’s spirituality should help service providers predict aspects of psychosocial needs and to respond sensitively and

appropriately.

The technological advancements of the past century have provided the healthcare industry with sophisticated machinery to save and sustain life, shifting the focus from a caring, service-oriented model to a technological, cure-oriented model.

Key words for spirituality included spirituality, spiritual health, spiritual well-being, spiritual dimension, spiritual care, spiritual distress, spiritual need, spiritual support, spirituality assessment, spirituality measurement,

religion, religiosity, purpose in life, meaning in life, transcendence, and connectedness.

“Suffering invites people to enter their own spiritual domain. . . our spirit searches for the meaning of life and suffering.”

Patients consider spirituality, specifically prayer, as “complementary and alternative” mode of medicine and perceive it as helpful.9

It is evident from the identified theoretical frameworks used in the studies that the domain of spirituality lacks a universal framework that can be used as theoretical basis for ongoing research studies.

“Presence is a sacred intimate connection that occurs between individuals and the divine.”1(p41)Receiving presence was identified to have 4 subcategories namely divine presence; presence of friends, family, and community; presence of healthcare providers; and presence of creation; and it was also identified to permeate through 3 supportive categories namely developing faith, discovering meaning and purpose, and giving the gift of self.

Conceptualized spirituality as a sacred journey from a perspective of suffering and desire and was visible in different stages consisting of explicit suffering; concealed, unrevealed suffering; the inner space; belief; and serving in love. “Suffering invites people to enter their own spiritual domain . . . our spirit searches for the meaning of life and suffering.”12(p14) Conceptualized that spiritual beliefs provided hope for the future.

Viewed prayer as a predictor of optimism. Spiritual and religious coping may reduce stress and improve optimism in patients facing major life crises.

The core category “discovering meaning and purpose” and consisted of 5 phases of discovering meaning and purpose.

These needs were identified as those motivating forces that facilitated recovery namely optimism, faith, acceptance, altruism, self-transcendence, self-fulfillment, and changing life goals.

Signs of spiritual needs included frustration, fear, hurt, doubt, or despair; feeling life is not worthwhile; feeling isolated and unsupported; feeling useless; lacking in confidence; relationship problems; feeling of losing control; asking “Where do I fit in?” and “What have I done to deserve this?”

Signs of spiritual well-being included inner peace and harmony; having hope, goals, and ambitions; social life and place in community retained; feeling of uniqueness and individuality, dignity; feeling valued; coping with and sharing emotions; ability to communicate with truth and honesty; being able to practice religion; and finding meaning.

Patients consider spirituality, specifically prayer, as “complementary and alternative” mode of medicine and perceive it as helpful.9They perceive spirituality as a phenomenon that influences recovery and adaptation to cardiac illness because it gives courage, inner strength, sense of well-being, comfort, positive attitude, love, and enhanced coping.10 Sometimes a person loses focus on one’s spirituality, especially during the advanced stages of terminal illness. This may be due to lack of hope or a shift of focus to one’s physiologic needs as symptomatology worsens.

The authors found that 47% of the study patients with advanced cancer reported unmet spiritual needs by religious communities and 72% reported unmet spiritual needs by the health care system.

F – Faith, Belief, Meaning

I – Importance and Influence

C–Community

A–Address/Action in Care

Recognition of spiritual needs is a vital element of cultural assessment and culturally respectful care.

CITATION

( Raholm , M. (2002). Weaving the fabric of spirituality as experienced by patients who have undergone a coronary bypass surgery. J Holist Nurs, 20(1), 31-47.)

(Jeffrey A., A. (2003). Spirituality and life-threatening illness: a phenomenologic study . Oncology Nursing Forum , 30(4), 594.)

(Coyle , J. (2002). Spiritually and health: towards a framework for exploring the relationship between spirituality and health. J Adv Nurs., 37(6), 589-597.)