Ch. 12 Assessing Spirituality and Religious Practices

What questions should be included in a spiritual assessment? Select all that apply.

"Do you need a private place to pray?" "What gives you meaning to your life?" "How does your spiritual practices help you to deal with pain? It is important to ask about spiritual practices and what the client needs to perform those practices such as a private area for prayer. It is also important to understand how the client's spiritual beliefs help them to deal with pain and how the view life. Asking if the client eats pork and if they are a practicing Catholic provides no information that the nurse can use to establish a plan of care.

A client says that illness is a curse brought on by living outside the laws of God and is retribution for personal evil. Which religion is this client most likely practicing?

*Christianity* In Christianity, some people see illness as a curse and retribution for personal evil. In Islam, illness is seen as a trial. In Judaism, there is no particular belief about illness. In Buddhism, terminal illness may be seen as a unique opportunity to reflect on life's ultimate meaning and the meaning of one's relation with the world.

Which tool is appropriate for a nurse to implement to perform a non-formal spiritual assessment on a client?

*FICA inventory* The FICA assessment tool is a non-formal tool for spiritual assessment of a client. Personal interviews, open-ended questions, and casual conversation can also be used to assess the client's spirituality, but they are not tools. These can be included as a part of daily nursing care.

When performing a spiritual assessment, what may help the nurse to identify related nursing diagnoses, needed interventions, and improve client care?

*Gaining relevant information about the client's spirituality.*

A nurse is caring for a terminally ill client. The client's family has requested that at the time of death, the client's arms not be crossed and any clothing or bandages with the client's blood be prepared for burial with the person. The nurse recognizes that this family follows the rituals of which religion?

*Judaism*

The nurse understands that the best plans for referral or intervention will develop from what part of the nurse-client interaction?

*Ongoing dialogue*

A nurse must perform a nonformal spiritual assessment of a client. Which tool would be most appropriate for the nurse to use?

*SPIRIT assessment tool* The SPIRIT assessment tool is a nonformal tool for spiritual assessment of a client. Personal interviews, open-ended questions, and casual conversation can also be used to assess the client's spirituality, but they are not tools. These can be included as a part of daily nursing care.

In the assessment of a client, the nurse is having her complete a daily spiritual experiences self-assessment scale. Which of the following should the nurse mention to the client before giving her this assessment tool?

*She may substitute another word for God in the scale, if she would like.* The daily spiritual experiences scale contains a list that includes items the client may or may not experience. The client should consider if and how often she has these experiences and should try to disregard whether she feels she should or should not have them. In addition, a number of items use the word "God." If this word is not a comfortable one, the client should substitute another idea that calls to mind the divine or holy for her. The client does not need to confirm her answers with a spiritual leader, nor is she barred from completing the scale if she is a member of an organized religion.

Spirituality is a human experience that (Select all that apply.)

*includes a supreme being seeks to transcend self*

After completing a spiritual assessment, a nurse determines that the client has signs and symptoms requiring medical diagnosis and treatment. What should the nurse do?

*make a referral to the PCP* After grouping the data of a spiritual assessment, it may become apparent that the client has signs and symptoms of a medical condition and needs treatment. The nurse should refer the client to a primary care provider. The nurse would never ignore signs of a disease nor attempt to treat the medical condition, which is out of the scope of practice. Talking to the client more about the spiritual issues would not happen until after the medical condition has been addressed

The nurse is asking open-ended questions in order to establish a dialogue with a client when talking about spirituality. This is an example of what type of approach?

*nonformal* Non formal techniques include open-ended questions and allowing the client to disclose pertinent information. They are systematic to the extent that the client's responses guide future choices of questions.

A nurse cares for a client who states that he believes that God can be seen in everything and every action. The nurse recognizes this as what characteristic of spirituality?

*self-reflection* The client refers to self-reflection. Spirituality is based on self-reflection and not group-oriented as a religion. It is unorganized and subjective; it differs from person to person. There are no universal beliefs on spirituality. Rather, spirituality is based on experience and not rituals.

The nurse learns that a client routinely engages in spiritual practices. Which activities should the nurse document as being spiritual in nature? Select all that apply.

*yoga, prayer, attending church*

What are some of the general recommendations when the nurse is taking a spiritual history? (Select all that apply)

-Spirituality is an important component of physical well-being and mental health -Respect a client's privacy and do not impose your beliefs on them. -Make referrals to chaplains, spiritual directors, or community resources as appropriate. General recommendations when taking a spiritual history: Consider spirituality as a potentially important component of every client's physical well-being and mental health. Address spirituality at each complete physical examination and continue addressing it at follow-up visits if appropriate. In client care, spirituality is an ongoing issue. Respect a client's privacy regarding spiritual beliefs; do not impose your beliefs on others. Make referrals to chaplains, spiritual directors, or community resources as appropriate. Be aware that your own spiritual beliefs will help you personally and will overflow in your encounters with those for whom you are to make the encounter a more humanistic one.

sample format spiritual assessment

-spiritual well-being or distress is entirely subjective and the only objective data concern outward signs of anxiety, stress, or depression that accompany spiritual distress -also may observe fasting, meditation, or prayer

FICA Spiritual History Tool

F- faith and belief I- importance C- community A- address in care

formal spiritual assessment

FICA, brief religious scoping questionnaire (RCOPE)- addresses positive and negative religious/spiritual coping

The nurse is using the HOPE tool to assess a client's spirituality. What will the nurse include when conducting this assessment? Select all that apply.

Sources of hope Organized religion Personal spirituality and practices Effects on medical care and end-of-life issues The areas assessed when using the HOPE tool to assess a client's spirituality include sources of hope, organized religion, personal spirituality and practices, and effects on medical care and end-of-life issues. Faith and belief is not a part of this assessment tool.

spirituality

a search for meaning and purpose in life that seeks to understand life's ultimate questions in relation to the sacred; informal, nonorganized, self-reflective, may involve spiritual experiences, subjective

spiritual assessment

active and ongoing conversation that assesses the spiritual needs of the client; formal or informal, respectful, nonbiased

spiritual care

addressing the spiritual needs of the client as they unfold through spiritual assessment; individualistic, client-oriented, collaborative

religion

rituals, beliefs, practices, and experiences involving a search for the sacred that are shared within a group; formal, organized, group-oriented, ritualistic, objective (easily measurable)