Giddens p 35-49 and nursing today chapter 21 spirituality professionalism in nursing

says that holistic nursing is defined as

"all nursing practice that has healing the whole person as its goal"

spiritual nursing care is

"an intuitive, interpersonal, altruistic, and integrative expression that is contingent upon the nurse's awareness of the transcendent dimension of life but that reflects the patient's reality

Atchley's continuity theory of the spiritual self.

(1) deep inner silence, (2) insight, (3) compassion, (4) connection with the ground of being, (5) transcendence of personal self, (6) wonder, and (7) transformation.

barriers may result in the nurse's inability to be totally present and communicate effectively with the patient.

-nurse may be distracted -the nurse may miss the meaning of the patient's message because of failure to clarify the meaning of a word, a phrase, or a facial expression. - the nurse may interject personal feelings and reactions

Hope

......... refers to beliefs, wishes, or actions taken in situations of uncertainty. ............ is linked to faith but tends to have an emphasis on the fear of the unknown.

nursing interventions

.......... .............. are identified that directly relate to spiritual care: Spiritual Support and Spiritual Growth Facilitation

Faith,

.......... as defined by Dyess, refers to an "evolving pattern of believing, that grounds and guides authentic living and gives meaning in the present moment of inter-relating

Prayer

............. is conversation with God or a Higher Power, however that Higher Power is conceived.

older adults

.............. ................ adapt spiritual beliefs and practices through an awareness of their spiritual experiences and that private religiosity is more highly correlated with experiential spirituality than is public religiosity.

Sacraments,

............... recognized by Christian faiths, represent special occasions for experiencing God's saving presence.

Culture

................. refers to a pattern of shared attitudes, beliefs, and values.

Communication

.................... is one of three distinct approaches involved with spiritual care previously discussed. The nurse must be able and willing to actively listen to the patient and notice nonverbal cues as a foundation for understanding the patient's needs, beliefs, and values.

Japanese

Believe physical contact with blood, skin diseases, and corpses will cause illness. Also believe improper care of the body, including poor diet and lack of sleep, cause illness. Believe in healers, herbalists, and physicians for healing, and energy can be restored with acupuncture and acupressure. Their high regard for the status of physicians decreases the likelihood that they will question their care. Use group decision making for health concerns. Disability is a source of family shame. Mental illness is taboo. Pain is not expressed, as it is considered a virtue to bear pain. Addiction is a strong taboo.

Chinese

Chinese patients will not discuss symptoms of mental illness or depression, because they believe this behavior reflects on family; therefore, it may produce shame and guilt. As a result, there may be psychosomatic symptoms. Use herbalists, spiritual healers, and physicians for care

CULTURE—A NURSING APPROACH

Consider your own cultural biases and how these affect your nursing care. Understand the need to recognize cultural implications in planning and implementing nursing care. Learn how to use cultural assessment tools. Treat patients with dignity and respect. Use sensitivity in providing culturally competent care. Recognize opportunities to provide specific culturally based nursing care. Evaluate your own previous encounters with patients from other cultures and backgrounds.

Spirituality

Dr. Kenneth Pargament: "............... represents a search for the sacred or transcendent (God, Jesus, Muhammad, the Buddha, Brahman, Ultimate Truth of Reality).

African-American

Extended family has large influence on patient. Older family members are honored and respected, and their authority is unquestioned. Oldest male is decision maker and spokesman. Strong emphasis on avoiding conflict and direct confrontation. Respect authority and do not disagree with health care recommendations—but, they may not follow recommendations.

Asian/Pacific Islander

Family- and church-oriented. Extensive family bonds. Key family member is consulted for important health-related decisions. Illness is a punishment from God for wrongdoing or is caused by voodoo, spirits, or demons. Illness is prevented through good diet, herbs, rest, cleanliness, and laxatives to clean the system. Wear copper and silver bracelets to prevent illness.

spiritual intervention, that of taking action

Giving verbal support and encouragement of spiritual beliefs • Making a referral to a chaplain or pastoral care professional • Using religious literature that is meaningful to the patient and/or the patient's family • Using prayer with the patient's or family's consent

Hindu and Muslim

Indians and Pakistanis do not acknowledge a diagnosis of severe emotional illness or mental retardation, because it reduces the chance of other family members getting married. Medical beliefs are a blend of modern and traditional practice.

Hispanic/Latino

Older family members are consulted on issues involving health and illness. Patriarchal family—men make decisions for family. Illness is viewed as God's will or divine punishment resulting from sinful behavior. Prefer to use home remedies and consult folk healers known as curanderos or curanderas rather than traditional Western health care providers. Many believe in the hot and cold theory of disease, although they may differ about what constitutes hot or cold.

American Indian

Oriented to the present. Value cooperation, family, and spiritual beliefs. Strong ties to family and tribe. Believe good state of health exists when patient lives in total harmony with nature. Illness is viewed as an imbalance between the person and natural or supernatural forces. May use medicine man or medicine woman instead of or in conjunction with seeking Western health care. Illness is prevented through rituals and prayer. Some distrust health care providers because of historical conflicts in the United States, lack of culturally competent care, and underrepresentation of American Indians as health care providers.

presence,

To fully demonstrate ................. the nurse needs to be an active listener and to be able to demonstrate empathy, humility, vulnerability, and commitment.

Vietnamese

Vietnamese are slow to trust authority figures because of their refugee experiences. They accept mental health counseling and interventions, particularly when they have established trust with the health care worker. Very patriarchal society. Although home remedies are tried first, Vietnamese are compliant with Western health care treatment after they seek such treatment.

Family Dynamics

are also closely aligned with spirituality. A person's belief system is strongly influenced within the family unit from early in life.

define religion

as a set of institutionalized beliefs and rituals

spirituality

can be defined "as an individualized journey characterized by experiential descriptors such as meaning, purpose, transcendence, connectedness and energy.

faith

can refer to a specific religious tradition or belief in something that cannot be touched or seen.

The provision of spiritual care can be thought about in three distinct approaches that include

communication, action, and presence.

O'Brien

concluded that most descriptions of spirituality include not only transcendence but also the connection of mind, body, and spirit, in addition to love, caring, and compassion and a relationship with the Divine

Ruth Stoll

defined spirituality in 1989 when she wrote, It is who I am—unique, and personally connected to God

spirituality

definitions of ............... encompass the following: a principle, an experience, attitudes and belief regarding God, a sense of God, and the inner person

Bachelor of Science in Nursing

graduate needs to be able to conduct comprehensive assessments including the spiritual realm.

The culturally competent nurse

has an enhanced ability to provide quality care, which fosters better patient understanding of the plan of care.

North American Nursing Diagnosis Association International (NANDA-I)

includes three standard nursing diagnoses: "spiritual distress," "spiritual distress, risk for," and "spiritual well-being, readiness for enhanced.

developmental

individual's spirituality is, in part, dependent on the ................. stage of the individual.

Atchley's continuity theory of the spiritual self.

individuals develop preferences as part of their personalities that influence their spiritual self as they age.

religiosity

is defined as "the adherence to religious dogma or creed, the expression of moral beliefs, and/or the participation in organized or individual worship, or sacred practices.

One of the goals of Healthy People 2020

is to eliminate health disparities Health disparities are inequalities in disease morbidity and mortality in segments of the population.

cultural norms

large numbers of individuals share specific spiritual beliefs and/or practices, this can be identified as a religious group with .............. .............

components of spirituality

prayer, presence, scripture reading, peaceful environment, meditation, music, pastoral care, inspiring hope, active listening, validation of patients' thoughts and feelings, values clarification, sensitive responses to patient beliefs, and developing a trusting relationship

American Hospital Association (2012)

recommends that exposure to health careers begin early in the education of minority populations, as well as of males, to reach out to those who are currently underrepresented in nursing and who will account for an increasing share of the labor pool

cognitive

the individual's status impacts thought, awareness, and ability for purposeful actions related to spirituality.

The American Nurses Association (ANA) affirms in the Code of Ethics

the necessity for the nurse to be sensitive to individual needs: "The need for health care is universal, transcending all individual differences. The nurse establishes relationships and delivers nursing services with respect for human needs and values, and without prejudice.

Complementary therapies: Alternative therapies :Integrative therapies:

those that are used in conjunction with mainstream treatments. those that are used instead of mainstream medical therapies. those for which there is some scientific basis for use.

Nursing Outcome Classification,

two spiritual outcomes are identified: Spiritual Health (2001) and Personal Health Status

nurse

when patients express a spiritual need, there is generally immediacy about that need that warrants a response from the ............

FICA Tool for Spiritual Assessment

• Faith or beliefs: What are your spiritual beliefs? Do you consider yourself spiritual? What things do you believe in that give meaning to life? • Importance and influence: Is faith/spirituality important to you? How has your illness and/or hospitalization affected your personal practices/beliefs? • Community: Are you connected with a faith center in the community? Does it provide support/comfort for you during times of stress? Is there a person/group/leader that supports/assists you in your spirituality? • Address: What can I do for you? What support/guidance can health care provide to support your spiritual beliefs/practices?

Attributes of Spirituality

• Spirituality is universal. • Illness impacts spirituality. • Patient and/or family must be willing to share and act on spiritual beliefs. • Spiritual beliefs and practices are impacted by family and culture. • Nurse must be willing to assess and integrate patient beliefs into care. • Nurse must be willing to consult with/refer to appropriate spiritual expert. • Community-based religious organization can provide support/resources.

Office of Minority Health and Disaster Preparedness

• Using interpreters • Using bilingual materials • Managing cultural variation • Implementing culturally based standards