SPIRITUALITY

• Spirituality

  The human tendency to seek meaning and purpose in life, inner peace, acceptance, forgiveness, harmony, hope, beauty, and more
• Religion


  Usually applied to ritualistic practices and organized beliefs
• An agnostic is a person who doubts the existence of God or a Supreme Being or believes the existence of God has not been proved
• An atheist is one without belief in a deity
• A nursing study of atheists’ preferences for nursing care found that respondents wanted to be respected for their nonbelief and not have clinicians refer to God or offer prayer
• Spiritual nursing care


  • Intuitive, interpersonal, altruistic, integrative, contingent on the nurse’s awareness of the transcendent dimension of life, and reflects the client’s reality
• Spiritual nursing care is an expression of self
• Spiritual distress


  A disturbance in the belief or value system that provides strength, hope, and meaning to life
• Defining characteristics of spiritual distress

  • Expresses lack of hope, meaning of life, inadequate acceptance of self
  • Expresses feeling abandoned or anger toward power greater than self
  • Refuse interaction with significant others
  • Exhibits sudden changes in spiritual practices
  • Requests (or refused) to interact with a spiritual leader
  • Has no interest in nature or in reading spiritual literature
• Spiritual health


  Portrayed as the opposite of spiritual distress, thought to not occur by chance, but by choice
• Spiritual or religious coping


  • Refers to the spiritual beliefs or ways of thinking that help people cope with their challenges
• Theories about human development include spiritual development
• A normal part of spiritual development for teens and young adults involves evaluating the beliefs and religiosity of authority figures to form beliefs and practices that are meaningful for them
• It is not unusual to find adults who have failed to complete the developmental task of evaluating beliefs and religiosity
• Religious practices that nurses should know

  • First seek a basic understanding of clients’ spiritual needs, resources, and preferences (i.e., assess)
  • Follow the client’s expressed wishes regarding spiritual care
  • Do not prescribe or urge clients to adopt certain spiritual beliefs or practices, and do not pressure them to relinquish such beliefs or practices
  • Strive to understand personal spirituality and how it influences caregiving
  • Provide spiritual care in a way that is consistent with personal beliefs
• Clients often confuse religiosity with spirituality, contributing to their uncertainty about receiving spiritual care from nurses
• Observing and using the client’s language for spirituality and exhibiting sensitivity and respect helps nurses converse therapeutically with clients to provide spiritual care
• Holy days

  • Solemn religious observances and feast days throughout the year may be referred to as holy days and may include fasting or special foods, reflection, rituals, and prayer
  • Examples include Rosh Hashanah, Yom Kippur (Jewish), Good Friday, Christmas (Christian), Buddha’s birthday (Buddhists), Mahashivarathri (Hindu), and Ramadan (Islam)
• Sacred texts

  • The concept of the Sabbath is common to both Christians and Jews, in response to the biblical commandment “Remember the Sabbath day to keep it holy”
  • Most Christians observe the “Lord’s Day” on Sunday, whereas Jews and Sabbatarian Christians observe Saturday as their Sabbath
  • Muslims traditionally gather on Friday at noon to worship and learn about their faith
  • Sacred symbols include jewelry, medals, amulets, icons, totems, or body ornamentation that carry religious or spiritual significance
  • People may wear religious symbols at all times, and they may wish to wear them during diagnostic studies, medical treatment, or surgery
  • Examples include rosaries for Roman Catholics and malas for Muslims
• Prayer and meditation

  • Prayer involves humans pleading or experiencing the divine
  • Different types of prayer experiences include ritual, petitionary, colloquial, and meditational
  • Meditation is the act of focusing one’s thoughts or engaging in self-reflection or contemplation
• Beliefs affecting diet are important for healthcare providers to consider when prescribing diet plans
• Examples of dietary beliefs

  • Orthodox Jews avoid shellfish or pork
  • Muslims avoid alcoholic beverages or pork
  • Mormons avoid caffeinated or alcoholic beverages
  • Older Catholics may choose not to eat meat on Fridays
  • Buddhists and Hindus are often vegetarian
  • Religious law may also dictate dietary restrictions
• Church of Jesus Christ of Latter-Day Saints (Mormons) are not to drink caffeinated or alcoholic beverages
• Older Catholics may choose not to eat meat on Fridays because this was prescribed in years past
• Buddhists and Hindus are often vegetarian, not wanting to take life to support life
• Religious law may dictate how food is prepared; for example, many Jewish people require kosher food, which is food prepared according to Jewish law
• Clients may have religious beliefs that attribute illness to a spiritual disease or sin
• Some clients may believe disease is a punishment for sin in their past
• Many religions have traditions that dictate dress
• Examples of dress traditions

  • Orthodox and some Conservative Jewish men wear yarmulkes
  • Orthodox Jewish women cover their hair with a wig or scarf
  • Mormons may wear temple undergarments
  • Hasidic Jewish men do not shave certain hair
  • Khalsa do not shave certain hair
• For all religions, the birth of a child is an important event giving cause for celebration
• Examples of birth rituals

  • Muslims recite a prayer during birth
  • Hindus perform religious rituals
  • Most Christian parents christen or baptize their babies
  • Christian parents may want baptism for seriously ill infants
  • Male circumcision is obligatory in Jewish and Islamic traditions
  • Hindus do not practice circumcision
• Roman Catholic priests perform the Sacrament of the Sick when clients are very ill or near death; Orthodox Christians have a similar ritual
• Death rituals

  • Muslims want their body turned toward Mecca when dying
  • Hindus may want to face south when dying
  • Ritual bath and body preparation for burial may be done by family members or a burial society
  • Jews and Muslims bury within 24 hours following death
  • Hindus cremate the body within 24 hours
  • Jews "sit Shiva" for several days after death
  • Buddhists perform prayers and rituals for the deceased
• The Joint Commission mandates spiritual assessment for each client admitted to its accredited institutions
• Nurses should assess client spirituality as it relates to health
• Nurses should not assume all practices of a client's stated religion
• Questions for spiritual assessment may include asking about faith or beliefs
• His Baptist neighbor

  Provides rent
• Questions in the accompanying Assessment Interview


  • F = Faith or beliefs
  • I = Implications or influence
  • C = Community
  • A = Address