1. Copyright 2002, Delmar, A division of Thomson Learning Chapter 6 Spiritual Assessment

2. Copyright 2002, Delmar, A division of Thomson Learning Competencies Describe how different spiritual beliefs might influence the patient’s view of health. Conduct a spiritual assessment on a patient. Identify signs and symptoms that indicate the patient is experiencing spiritual distress. Formulate nursing interventions that promote the patient’s spiritual well-being.

3. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and Religion Spirituality—the concern for the meaning and purpose of life Religion—an organized system of beliefs usually centered around the worship of a supernatural force or being  Rituals  Faith  Dogma

4. Copyright 2002, Delmar, A division of Thomson Learning Spiritual Theory: Key Terms God Prayer Monotheistic religions Polytheistic religions Sin Heretic Schismatic (continues)

5. Copyright 2002, Delmar, A division of Thomson Learning Spiritual Theory: Key Terms Atheist Agnostic Cult Soul Spirit Reincarnation Heaven Nirvana

6. Copyright 2002, Delmar, A division of Thomson Learning Holistic Health and Spirituality Spiritual well-being Spiritual distress

7. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Judaism Core beliefs  Monotheistic, Yahweh (God)  Jewish people are “chosen” people Religious leaders  Rabbi, cantor, mohel Holy books and artifacts  Bible, Torah, yarmulkes (continues)

8. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Judaism Holy day of the week  Friday from sundown until Saturday sundown Holy holidays, festivals, observances  Rosh Hashana, Yom Kippur, Hanukkah, Passover Dietary restrictions (continues)

9. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Judaism  Kosher foods, meat, and dairy products and not be taken together Period of fasting  Associated with special holidays Medical treatment  Seek care for oneself, prayers and visitation proper for the sick, medicine and physicians held in high esteem (continues)

10. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Judaism Birth control  Sex and birth control permitted within marriage Abortion  High respect for life, fetus not human until birth Observances of birth—Circumcision Rites of initiation  Bar mitzvah, Bat mitzvah (continues)

11. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Judaism Withdrawal of life support Death  Burial within 24–48 hours of death  Shiva: 7-day period of mourning Organ donation permitted

12. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Islam Core beliefs  Monotheistic, Allah (God) Religious leaders  Imam Holy books and artifacts  Koran, Shari’a Holy day of the week  Friday (continues)

13. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Islam Holy holidays, festivals, observances  Pray five times per day from sunup to after sundown  Ramadan Dietary restrictions  No pork, pork products, alcohol  Fasting from dawn to sundown during Ramadan (continues)

14. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Islam Medical treatment  Seeking medical care is encouraged  Female bodies should remain covered Birth control  Sexual relations and use of birth control are permitted within marriage (continues)

15. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Islam Abortion  Forbidden after ensoulment Observances of birth Rites of initiation  Circumcision Withdrawal of life support (continues)

16. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Islam Death  Suicide is forbidden  Family and friends present at death  Ceremonial cleansing of the body  Burial preferably same day Organ donation  May receive organ donations, transplanted organs, and blood transfusions

17. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Roman Catholic Core beliefs  Monotheistic  God (father), Jesus (son), and the Holy Spirit Religious leaders  Priests, bishops, monks, nuns Holy books and artifacts  Bible, crucifixes, rosary beads (continues)

18. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Roman Catholic Holy day of the week  Sunday Holy holidays, festivals, observances  Christmas, Good Friday, Easter, Pentecost, and the Assumption Dietary restrictions  No meat on Fridays during Lent (continues)

19. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Roman Catholic Period of fasting  Ash Wednesday and Good Friday Medical treatment  Encouraged to seek care  Anointing the sick, prayer, visitation Birth control  Sexual relations permitted within marriage  Natural family planning (continues)

20. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Roman Catholic Abortion  Prohibited Observances of birth  Prayers, blessings, baptism Rites of initiation  Baptism Withdrawal of life support  Permitted under certain circumstances (continues)

21. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Roman Catholic Death  Prayers  Burial, cremation, autopsies permitted Organ donation  Permitted

22. Copyright 2002, Delmar, A division of Thomson Learning (continues) Religions and Health Care: Protestant Core beliefs  Monotheistic  God (Father), Jesus (Son), and the Holy Spirit Religious leaders  Priests, ministers, pastors Holy books and artifacts  Bible, cross

23. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Protestant Holy day of the week  Sunday Holy holidays, festivals, observances  Christmas, Easter Dietary restrictions and period of fasting  None (continues)

24. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Protestant Medical treatment  Anointing of the sick, prayer, seek medical attention Birth control  Sexual relations and birth control permitted within marriage Abortion  Usually permitted to preserve health of mother (continues)

25. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Protestant Observances of birth  Prayers and blessings Rites of initiation  Baptism Withdrawal of life support Death  Burial, cremation, and autopsies permitted (continues)

26. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Protestant Organ donation  May/may not be permitted

27. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Jehovah’s Witness Core beliefs  Jesus is God’s son but inferior in status to God Religious leaders  Elders Holy books and artifacts  New World Translation of the Bible Holy day of the week  No one day is holier than any other (continues)

28. Copyright 2002, Delmar, A division of Thomson Learning (continues) Religions and Health Care: Jehovah’s Witness Holy holidays, festivals, observances  Do not celebrate Christmas or Easter Dietary restrictions  Meat should be free of blood Period of fasting  None Medical treatment

29. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Jehovah’s Witness  Seek medical care for illness  Prohibits ingestion of blood—no blood products Birth control  Sex is permitted within marriage  Birth control is permissible Abortion  Permitted if required to save mother’s life (continues)

30. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Jehovah’s Witness Observances of birth  None Rites of initiation  Baptism Withdrawal of life support Death  Burial and cremation permitted Organ donation  Permitted

31. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Native American Core beliefs  Cultural traditions Religious leaders  Medicine man, elder Holy books and artifacts  No books; tradition is passed on verbally  Feathers, gourds, shells, medicine pouch (continues)

32. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Native American Holy day of the week  None Holy holidays, festivals, observances  Associated with changes in season Dietary restrictions  Variable (continues)

33. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Native American Period of fasting  May be related to prayer Medical treatment  Illness may be related to a sin or unhappy spirit or god Birth control and abortion  Usually not practiced Observances of birth (continues)

34. Copyright 2002, Delmar, A division of Thomson Learning Religions and Health Care: Native American Rites of initiation  Possibly at puberty Withdrawal of life support  Viewed as unnatural Death  Spirit of person lives on after death Organ donation  Discouraged

35. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process Spiritual assessment  Establish rapport  Maintain eye contact  Quiet, private environment  Maintain nonjudgmental manner  Respect silence and diversity (continues)

36. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process Conducting the spiritual history  Establish therapeutic relationship  Inquire about the use of advance directives and organ donation  Ask if patient has a specific religious affiliation, or if any spiritual or religious beliefs will affect the health care received (continues)

37. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process  Observe for clues about spirituality (religious jewelry, clothing)  Inquire who should be notified in case of emergency Nursing diagnosis  Spiritual distress  Potential for enhanced spiritual well-being (continues)

38. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process Signs of spiritual distress  Crying, sighing, withdrawn behavior  Questioning spiritual beliefs  Statements of worthlessness, hopelessness, or death  Statements about God or God’s purpose  Requests for spiritual assistance (continues)

39. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process Planning and implementation  Listen actively  Provide an empathetic, warm, interested response to patient’s concerns  Show respect for patient’s spiritual beliefs  Refer to hospital chaplain or patient’s spiritual leader (continues)

40. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process  Provide patient and family with opportunity to practice religion and spirituality Nursing actions to avoid  Do not proselytize your own spiritual beliefs  Do not instruct the patient in religious or spiritual doctrine  Do not serve as a spiritual advisor (continues)

41. Copyright 2002, Delmar, A division of Thomson Learning Spirituality and the Nursing Process Do not use clichés Evaluation  Acceptance of spiritual support  Decrease in signs of spiritual distress (crying, restlessness, statements of worthlessness or hopelessness)  Verbalization of satisfaction with spiritual beliefs