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10th Annual Israeli Spiritual Care Confernece for professionals 5 – 6 Nov 2013 Tove Giske Associate Professor Haraldsplass Deaconess.

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Presentation on theme: "10th Annual Israeli Spiritual Care Confernece for professionals 5 – 6 Nov 2013 Tove Giske Associate Professor Haraldsplass Deaconess."— Presentation transcript:

1 10th Annual Israeli Spiritual Care Confernece for professionals 5 – 6 Nov 2013 Tove Giske Associate Professor Haraldsplass Deaconess University College Bergen, Norway

2 2Giske; How to recognize & verbalize spirituality

3 Bergen, Norway 3Giske; How to recognize & verbalize spirituality

4 Overview of presentation 1. Theoretical backdrop 2. How to recognize spiritual concerns & resources 3. Presentation of spiritual care research – how undergraduate nursing students learn 4. Recommendations for universities and clinical practice Giske; How to recognize & verbalize spirituality4

5 1. Theoretical backdrop – help to think professionally 5 Victor Frankl Carl Jaspers Giske; How to recognize & verbalize spirituality

6 Victor Frankl & Logoterapi Austrian & American psychiatrist 1905 – 1997 Imprisoned in Auschwitz 2 nd world war Develop LOGO THERAPY: Humans seek and can find meaning through: Accomplish something By receiving An attitude of living through suffering 6Giske; How to recognize & verbalize spirituality

7 Limit situations - grensesituasjoner Carl Jaspers (1883 – 1969) German philosopher and psychiatrist Some situations in life we cannot change – he calls them ”limit situations” Illness Different kinds of loss Death Threaths of such situations 7Giske; How to recognize & verbalize spirituality

8 - But also make one wonder and reflect… 8Giske; How to recognize & verbalize spirituality Limit situations can cause pain and suffering

9 Limit situations make us stop Realise that life cannot be taken for granted That I am vulnerable That my life esily can be over or someone I love/are connected with can die 9Giske; How to recognize & verbalize spirituality

10 Limit situations can Lead us to become more aware of what is important in life Challenge us to reflect more deply about life Mature us ethically and intelectually 10Giske; How to recognize & verbalize spirituality

11 Have you experienced ”limit situations”?

12 2. How to recognize spiritual concerns Pain Agony Questions Wondering Rest Peace Many expressions – listen to the meaning for the individual person 12Giske; How to recognize & verbalize spirituality

13 13 WE HAVE TO LISTEN WITH 2 EARS Giske; How to recognize & verbalize spirituality

14 What is the person’s concern? And how is it expressed? ? - Who am I? - Who loves me? - Is there a meaning in what happens? - What about guilt – am I guilty? - How can I live with pain and suffering? - How will my future be? 14Giske; How to recognize & verbalize spirituality

15 What frame of reference do the person have?? What about - faith - View of life - tradition - cultur Does this person have? 15Giske; How to recognize & verbalize spirituality

16 Art & Science of Spiritual Care 16 McSherry & Ross (eds.) (2010) Spiritual Assessment in health care Practice. M&K Publishing Giske; How to recognize & verbalize spirituality

17 3. Presentation of spiritual care research amongst undergraduate nursing students AIM: to determine undergraduate nursing students’ perspective on spiritual care and how they learn to practice it Giske, T. & Cone P.H. (2012) Opening up to learning spiritual care of patients: A grounded theory study of nursing students. Journal of Clinical Nursing, 21(13-14), Giske; How to recognize & verbalize spirituality

18 Participants: 8 focus groups with 42 undergraduate students 3 1st year 3 2nd year 2 3rd year Average age 25,6 (20 – 45) Life view 30 Christian, 2 ”religious”, 1 Cathlic 3 Agnostic, 3 Atheist, 2 Gnostic, 1 Naturalist 18Giske; How to recognize & verbalize spirituality

19 Questions to the focus groups: What is spiritual care? How do you learn to practice it? Tell us about your experiences 19Giske; How to recognize & verbalize spirituality

20 Analysis Interviews transcribed and analysed accoding to Grounded Theory: Constant comparison Coding Open coding Selevtive coding Theoretical coding 20Giske; How to recognize & verbalize spirituality

21 Norwegian context 1000 years of Christianity 85 % of 5 million belonging to a Christian demonination 2nd largest group: Muslims (1,9 %) 3rd Norw. Humanistic Association (1,7 %) Most Norwegians believe in God Faith is seen as private. Taboo to talk about 21Giske; How to recognize & verbalize spirituality

22 Spiritual care – the what No clear definition Being concerned with the whole person, the soul and what could not be seen Religious faith; reading holy books, prayer Seen as part of nurses responsibility BUT Poorly defined in litterature, Least focused on professionally What nurses knew least about Seen few role models in clinical studies 22Giske; How to recognize & verbalize spirituality

23 Participants main concern How to create a professional relationship with patients and maintain it when spiritual concerns were recognised 23Giske; How to recognize & verbalize spirituality

24 Students solve this concern by Opening up for learning spiritual care 3 intertwined phases Learning develope as a spiral through out the nursing training 24 Preparing for connection Connecting with and supporting patients Reflecting on experiences Giske; How to recognize & verbalize spirituality

25 25 Categories – Three iterative phases Sub-categories of each phase 1 Preparing for connection Knowing oneself more deeply Preparing in class and on your own 2 Connecting with and supporting patients Connecting in mutual vulnerability Supporting patients respectfully 3 Reflecting on experiences Thinking through what you did Sharing experiences with others Giske; How to recognize & verbalize spirituality

26 4. Recommendations Universities : Separate and clear themes in teaching at university Repeated focus with increasing complexity throughout the study Choose methods that promote self-awareness, understanding own spirituality and values Use interactive methods - Share examples, use role play, reflect in a safe environment with the support of fellow students and teacher Requirements to read literature - theories and research related to spirituality. Be part of exams 26Giske; How to recognize & verbalize spirituality

27 Recommendations for clinical studies Teachers can be key person to help students recognize possibilities for learning related to spiritual care Use the rich possibilities for learning the uniqueness in diverse situations Teachers work together with supervisor in practice to emphasize data collection and interventions including spirituality Facilitate for students to experience role models Support & challenge students to involve themselves with patients in a respectful manner Create time & room for reflection in and after practice 27Giske; How to recognize & verbalize spirituality

28 Baldacchino D (2006) Nursing competences for spiritual care. Journal of Clinical Nursing 36(7), Catanzaro AM & McMullen KA (2001) Increasing nursing students’ spiritual sensitivity. Nurse Educator 26(5), Cone, P.H. & Giske T. (2012) Teaching Spiritual Care – A Grounded Theory Study among Undergraduate Nursing Educators. Journal of Clinical Nursing, doi: /j x Frankl, V. (2006) Man’s search for meaning. An Introduction to Logotherapy. Boston, MA, Beacon Press. Giske, T. (2012) How undergraduate nursing students learn spiritual care in clinical studies – a review of literature. Journal of Nursing Management, 20, 1049– 1057 Giske, T. & Cone P.H. (2012) Opening up to learning spiritual care of patients: A grounded theory study of nursing students. Journal of Clinical Nursing, 21(13- 14), Highfield MEF, Johnston Taylor E & Amenta MO (2000) Preparation to care: The spiritual care education of oncological and hospice nurses. Journal of Hospice and Palliative Nursing 2, Hoffert D, Henshaw C & Mvududu N (2007) Enhancing the ability of nursing students to perform a spiritual assessment. Nurse Educator 32(2), ICN (2000) Code of Ethics. International Council of Nurses [ICN]. Jaspers, K. & Schilpp, P. (1981) The philosophy of Karl Jaspers. La Salle, Open Court. Lemmer C (2002) Teaching the spiritual dimension of nursing care: A survey of U.S. baccalaureate nursing programs. Journal of Nursing Educatio,41(11), ) McSherry W (2006) Making sense of spirituality in nursing and health care practice. An interactive approach (2 nd ed.). Jessica Kingsley Publishers, London. McSherry W, Gretton M, Draper P & Watson R (2008) The ethical basis of teaching spiritual care: A survey of student nurses perception. Nurse education Today, 28, Mitchell DL, Benett MJ & Manfrin-Ledet L (2006) Spiritual development of nursing students: Developing competence to provide spiritual care to patients at the end of life. Journal of Nursing Education 45(9), Narayanasamy A (1999) ASSET: A model for actioning spirituality and spiritual care education and training in nursing. Nurse Education Today 19, Narayanasamy A & Owens J (2001) A critical incident study of nurses’ responses to the spiritual needs of their patients. Journal of Advanced Nursing 33(4), Ross L (2006) Spiritual care in nursing: an overview of the research to date. Journal of Clinical Nursing 15, Salmon B, Bruick-Sorge C, Beckman SJ & Boxley-Harges S (2010) The evolution of student nurses’ concepts of spirituality. Holistic Nursing Practice, 24(2), Tanyi RA (2002) Towards clarification of the meaning of spirituality. Journal of Advanced Nursing, 39(5), Taylor E J (2007) What do I say? Talking with patients about spirituality. Templeton Foundation Press, Philadelphia, PA. Taylor EJ, Mamier I, Bahjri K & Petersen (2009) Efficacy of a self-study program to teach spiritual care. Journal of Clinical Nursing 18(8), van Leeuwen R & Cusveller B (2004) Nursing competences for spiritual care. Journal of Advanced Nursing 48, van Leeuwen R, Tiesinga LJ, Middel B, Post D & Jochemsen H (2008) The effectiveness of an educational programme for nursing students on developing competence in the provision of spiritual care. Journal of Clinical Nursing 17, Wallace M, Campbell S, Grossman SC, Shea JM, Lange JW & Quell TT (2008) Integrating spirituality into undergraduate nursing curricula. International Journal of Nursing Education Scholarship, 5(1), article Giske; How to recognize & verbalize spirituality


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