1. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning VOLUME TWO | SECOND EDITION Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Nursing: A Concept-Based Approach to Learning MODULE 30 Spirituality VOLUME TWO | SECOND EDITION

2. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Module 30 The Concept of Spirituality and, Exemplar 30.2 Religion and, Exemplar 30.3 Spiritual Distress

3. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Spirituality

4. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition The Concept of Spirituality Religion, Faith, Hope, Transcendence, and Forgiveness Generally involves belief in higher power

5. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Spiritual Health and Well-Being Manifested by feelings  Generally alive, purposeful, fulfilled  Connected with self, others, higher power,

6. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

7. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

8. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

9. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Core Aspects of Spirituality, continued Transcendence  Often used interchangeably with self- transcendence Forgiveness  Many clients feel a sense of shame or guilt

10. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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 10

11. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Concepts Related to Spirituality Page 1875 Culture and Diversity Health, Wellness, and Illness Sexuality Ethics Legal Issues

12. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Nursing Assessment Nursing history  Joint Commission mandates each client be assessed for spiritual beliefs, practices General questions, more thorough if in distress

13. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Nursing Assessment, continued Nursing history  Ask questions using acronym FICA F = Faith or beliefs I = Implications, influence C = Community A = Address

14. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

15. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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?

16. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Nursing Assessment, continued Objective data:  Environment: dress, symbols, religious articles  Behaviors  Verbalization  Affect and Attitude  Visitors 16

17. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

18. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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 18

19. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

20. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

21. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

22. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Implementation  Support systems  Diet therapies  Supporting rituals  Beliefs about illness and healing  Prayer  Meditation  Supportive grief work

23. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition Implementation, continued Recognize, and validate inner resources  Coping methods, humor, motivation Assist client to leave a legacy

24. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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

25. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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 25

26. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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.

27. Copyright © 2015, 2011 by Pearson Education, Inc. All Rights Reserved Nursing: A Concept-Based Approach to Learning Volume Two, Second Edition 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. 27