1. Chapter 21 Spirituality and Health Care
Roberta Mowdy

2. The Nature of Spirituality
Definition
Spirituality: integrative energy, capable of producing internal human harmony or holism.

3. The Nature of Spirituality (cont’d)
Spirituality includes
A sense of transcendent reality
Strength from inner resources
Living fully in the present
Having a sense of inner knowing

4. Religious Perspectives
A religious perspective often entails a set of beliefs that help explain the meaning of life, suffering, health, and illness.
Religion can be an approach to spirituality, and spirituality is often a component of religion, but the two concepts are different.

5. Secular Perspectives
From a secular perspective, spirituality is seen as a set of positive values, such as love, honesty, or truth, chosen by the individual, that ultimately become that person’s supreme focus of life.

6. Manifestation of Spirituality
Four developmental stages for human spirituality
Stage 1
The chaotic (antisocial) stage, with its superficial belief system.

7. Manifestation of Spirituality (cont’d)
Stage 2
The formal (institutional) stage, with its adherence to the law.

8. Manifestation of Spirituality (cont’d)
Stage 3
The skeptic (individual) stage, with its emphasis on rationality, materialism, and humaneness.

9. Manifestation of Spirituality (cont’d)
Stage 4
The mystical (communal) stage, with its “unseen order of things.”

10. A Tradition of Spirituality in Nursing
Modern nursing has a rich legacy of the appreciation of spirituality in health and illness.

11. A Tradition of Spirituality in Nursing (cont’d)
Florence Nightingale’s views of nursing practice were based on a spiritual philosophy that she set forth in Suggestions for Thought.

12. A Tradition of Spirituality in Nursing (cont’d)
Florence Nightingale believed that spirituality entailed the development of courage, inner peace, creative insight, and other “God-like” qualities.
Nightingale’s convictions commanded her to lifelong service in the care of the sick and helpless.
Physical healing was seen as a natural process regulated by natural laws.

13. Spirituality and Religion in Nursing Theory
Twenty-six major nursing theories and conceptual frameworks have been developed since the 1960s.
Fourteen of these theories recognize a spiritual domain of health somewhere in their assumptions, but only two theories mention it directly by name.

14. Spirituality and Religion in Nursing Theory (cont’d)
Betty Neuman and Jean Watson are the only two theorists who clearly acknowledge the impact of spirituality in the development of their theories.

15. Spiritual Crisis
The North American Nursing Diagnosis Association (NANDA) recognized the nursing diagnosis of spiritual distress in 1978.

16. Spiritual Crisis (cont’d)
Characteristics of spiritual distress
Concerns with the meaning of life and death
Anger toward God
Concerns about the meaning of suffering
Seeking spiritual help
Altered mood and behavior

17. Spiritual Crisis (cont’d)
Nurses should be aware that some individuals have been seriously harmed by their religious communities.
Nurses can practice “presencing” to support patients in spiritual distress, along with referral to the hospital chaplain or appropriate support group.
By becoming aware of and comfortable with his or her own spirituality, the nurse can provide comfort and assurance for patients in spiritual distress.

18. Spiritual Practices in Health and Illness
Carl Jung, the Swiss psychoanalytic pioneer, was the first to directly propose that all human and even physical illnesses are the result of maladjustment between the physical and the spiritual being.

19. Spiritual Practices in Health and Illness (cont’d)
Jung is credited with explaining why ancient religious and secular stories survive over the centuries.
These stories survive because they continue to resonate at the core of human nature.

20. Spiritual Practices Two phenomena support spirituality in health care
The managed care environment makes people feel that their health needs are not being addressed.
More than one-third of American adults seek alternative solutions to health and illness problems
Research demonstrates the relationships between spiritual practice and health outcomes.

21. Prayer Surveys reveal that most Americans pray.
Individuals with a spiritual orientation have known for a long time that positive thoughts and affirmations influence events for the better.
Prayer is sometimes defined as “communicating with God” or speaking with some type of divine entity.

22. Prayer (cont’d)
There are many and varying opinions about praying and types of prayer.
A few simple principles can be followed.
Pray with humility, love, and compassion.
Prayers that express love and support or that seek forgiveness of self and others are powerful messages to their recipients.

23. Meditation and Healing
The relaxation response and prayer have been demonstrated to affect illness.

24. Meditation and Healing (cont’d)
Everyone involved in health care is in a position to make use of positive reinforcement to enhance clients’ well-being.
Relaxation response requires minutes twice each day of quiet meditation on a word or image that is spiritually meaningful to the person.

25. Meditation and Healing (cont’d)
Relaxation, meditation, visualization, and hypnosis can help with seriously ill clients, including many with cancer.
Meditation is a technique of listening, which is not a passive process.
Meditation is a way of focusing the mind in a state of relaxed awareness to pay attention to deeper thoughts and feelings and to deeper spiritual awareness.

26. Spiritual Healing
Spiritual modes of healing do not always lead to cure.
Spiritual healing takes a much broader view and includes enhanced comfort and an inner peace with disability or death.

27. Therapeutic Touch
Therapeutic touch (TT) is an active alternative healing modality that involves redirecting the human energy system.
As a healing practice, TT is consistent with the science of unitary human beings developed by Martha Rogers.
Defines persons as energy fields in interaction with the larger environmental energy field.

28. Therapeutic Touch (cont’d)
The practitioner of TT acts with the intent of relaxing the recipient, reducing pain and discomfort, and accelerating healing when appropriate.
The TT practitioner should approach the client with compassion and the intent to heal, and the recipient of care ideally approaches the healing encounter with receptivity and openness to change.

29. Nursing Practice and Spiritual Wellness
Although the nursing profession is deeply rooted in religious traditions, modern nursing has spent considerable energy attempting to distance itself from this aspect of its history.

30. Nursing Practice and Spiritual Wellness (cont’d)
The world’s religions consistently allude to the symbolic and deep meaning of the work that nurses do.
When nursing is practiced with deep consciousness and purpose, it nurtures the nurse as well as the client.

31. Nursing Practice and Spiritual Awareness
A concerted effort at spiritual development, or the nourishment of the soul, is essential to nurses’ overall mental and physical well-being.
Spirituality is a way of life that involves a profound respect for self, others, and creation.