2. Adriona Taylor Southeastern Louisiana University

3.  Clinical Interest: Spirituality and its’ affects on the development of obesity.  Concept: Spirituality  Spirituality has been defined in numerous ways. These include: a belief in a power operating in the universe that is greater than oneself, a sense of interconnectedness with all living creatures, and an awareness of the purpose and meaning of life and the development of personal, absolute values. It's the way you find meaning, hope, comfort, and inner peace in your life (University of Maryland Medical Center, 2011, “What Is Spirituality, “ para 1).  Obesity is the most common metabolic/nutritional disease in the U.S. (Davis, 2001). Since the 1980s, obesity worldwide has more than doubled. As a result, overweight and obesity are the fifth leading risk for global deaths, with at least 2.8 million adults dying each year as a result of being overweight or obese (WHO, 2012).

4.  How is Katie Eriksson’s Theory of Caritative Care applicable to spirituality and its’ affects on the development of obesity (among adults)?

5. According to Tomey and Alligood 2006, the caritative theory is based on the following axioms and theses, modified and clarified from Eriksson’s basic assumptions with approval:

6.  The human being is fundamentally an entity of body, soul, and spirit.  The human being is fundamentally a religious being, but all human beings have not recognized this dimension.  The human being is fundamentally holy. Human dignity means accepting the human obligation of serving with love, of existing for the sake of others.  Health means a movement in becoming, being and doing, and striving for integrity and holiness which is compatible with bearable suffering.  The basic category of caring is suffering.  The basic motive of caring is the caritas motive.  Caring implies alleviating suffering in charity, love, faith, and hope. Natural basic caring is expressed through tending, playing, and teaching in a sustained caring relationship.  Caring relationship forms the meaningful context of caring and derives its origin from the ethos of love, responsibility, and sacrifice, that is, a caritative ethic.

7.  Since the 1970s, Eriksson’s nursing care process model has been systematically used, tested and developed as a basis of nursing care and documentation at Helsinki University Central Hospital (Tomey and Alligood, 2006).  That Eriksson’s ideas about caring and her nursing process model work in practice has been verified by everything from a multiplicity of essays and tests of learning in clinical practice to master’s theses, licentiates’ theses, and doctoral dissertations produced all over the Nordic countries (Tomey & Alligood, 2006, pp. 191-223).  This art of caring is being embraced by several nursing units in the Nordic countries, for they have based their practice and caring philosophy on Eriksson’s ideas and her caritative theory.  Eriksson’s theory has been studied and used as the theoretical framework for a number of research studies, journal articles and published books, in which she authored or co-authored.

8.  The Nursing Theory Philosophy – Katie Eriksson’s Theory of Caritative Caring is a nursing model that can be applied to spirituality and it’s affects on the development of obesity.  Spirituality has often been influential in defining the value system which shapes the life of individuals, including their past, present and future living existence on Earth. It can be gathered from the above, that spirituality certainly contributes, has a voice and holds a vital position in this world, as a whole.

9.  In many cases, the spiritual foundation of a patient is not readily assessed or even incorporated because those in healthcare lack knowledge about this component of care or because they do not see the value of spirituality in the care of the patient. Patients place a high value on their spiritual and emotional needs and this correlates to patient satisfaction with care (Press Ganey, 2003).  Spiritual assessment is vital and necessary in caring for the entire being of a patient. It just may be the key to discovering the presence of emotional eating, depression, lack of support system, etc. which can lead to obesity.  Obesity has risen to epidemic levels within the United States, (NIH, 2012)

10.  In the U.S. today, more than one-third of the adult population suffers with obesity. This drastic increase in obesity within the United States has occurred over the last 20 years. Two of the greatest issues with obesity is its’ cost and potential cause of other chronic medical conditions.  Spirituality is a concept of significance because it aids the healthcare provider, in being “better” at service to his/her patient population while increasing the potential for more therapeutic outcomes.  Application of Eriksson’s nursing theory philosophy, causes all parties involved both patient and caregiver, to view and adapt a caring system that involves the totality of the individual. This involves the human’s body, soul and spirit.

11.  THEORETICAL DEFINITION  Merriam-Webster Dictionary defines spirituality as: The state, quality, manner, or fact of being spiritual (Merriam-Webster Online Dictionary, 2012). Merriam-Webster Dictionary defines spiritual as: Of, relating to, consisting of, or having the nature of spirit; not tangible or material (Merriam-Webster Online Dictionary, 2012).  “The way forward is to think of spirituality in terms to its relevance and importance to individuals in their everyday lives” (McSherry, 2006).  The theory supports the above definition in that it notes a very key component that Eriksson expresses in her model. This key component is caring for the whole being which includes the spiritual aspect or make- up of the individual. In fact, the model suggests that the only way to care most effectively is by meeting all the needs of the patient because he or she is a religious being in some shape or another.

12.  OPERATIONAL DEFINITION  There are a number of tools available for obtaining spiritual assessment.  Example: Spiritual Needs Index, Herman 2007.  The definition above is supported by the theory in that the tool used is assessing the spiritual needs of those being served. The theory of caritative caring suggests that when providing total care, the spiritual component of the individual must be assessed because it plays a vital part in how well the patient will be cared for, as well as, the overall healing outcome.

13.  It is believed and thought in some cases, that spirituality and obesity are linked. It is assumed that depending on the foundation of one's spirituality, one could possibly suffer or be at risk for becoming obese. With rising obesity levels, it is of great necessity that all that can be done happen, in an effort, to prevent an even greater prevalence from occurring, as well as all of its' detrimental effects. If healthcare providers are intentional above assessing a patient's spirituality, and developing plans of care based on this premise and if obesity and spirituality are linked, it may be possible to halt or decrease the development of obesity. With the incorporation of the Theory of Caritative Caring, it charges the provider to view the patient and care for the patient holistically, which causes the spiritual foundation to be known, thus providing a possible clue to the likelihood of obesity forming based on the patient's spiritual stance and perspective. If this is noted early enough, this devastating phenomenon obesity, can be prevented as healthcare providers, aid it helping individuals define their spirituality as well as help educate them about the importance and role of it in their lives so they do not have to become prey to this life-threatening condition.

14.  Davis, F.A. (2001). Taber’s cyclopedia medical dictionary. Philadelphia, PA. F. A.Davis Company  Herman, C.P. (2007). The degree to which spiritual needs of patients near the end of life are met. Oncology Nursing Forum, 34(1), 70-78. Retrieved from CINAHL with full text.  Merriam-Webster On-Line Dictionary (2012). Retrieved from http://www.merriam-webster.com http://www.merriam-webster.com

15.  McSherry W 2006 Principle Components Model: a Model for Advancing Spirituality and Spiritual Care within Nursing and Health Care Practice. McSherry, W. (2006). The Principle Components Model: a Model for Advancing Spirituality and Spiritual Care within Nursing and Health Care Practice. Journal of Clinical Nursing, 15, 905-917. Retrieved from Medline database.  National Institutes of Health (2012). Obesity. Retrieved November 15, 2012 from http://health.nih.gov/topic/Obesityhttp://health.nih.gov/topic/Obesity

16.  Press Ganey (2003). Press Ganey knowledge summary: Patient satisfaction with emotional and spiritual care. Retrieved September 28, 2012, from http://www.pressganey.comhttp://www.pressganey.com  Tomey, A.M. & Alligood, M.R. (2006). Nursing theorists and their work. St. Louis, Missouri. Mosby Elsevier.  University of Maryland Medical Center (2011). What is spirituality? Retrieved September 25, 2012 from http://www.umm.edu/altmed/articles/spirituality-000360.htm http://www.umm.edu/altmed/articles/spirituality-000360.htm