Spiritual Assessment - Essay Example

 ABSTRACT Spiritual assessment is the careful evaluating of the spiritual needs of a patient to be able to provide a care plan suited for the patient's spiritual needs. The proper procedure of spiritual assessment, its meaning and how to apply it with respect to the different kinds of religion and their medical treatments in line with their beliefs will be discussed in this paper. This study will help in analysing the results of spiritual assessment. The provision of the care plan will not only involve the nurses' participation but most importantly, the presence of the chaplain and the patients family will help in filling in the patient's spiritual needs. INTRODUCTION A man's whole being is mostly moulded by spirituality and religion. These signs of well being can be seen by the clothes and accessories that a person wears, ones spiritual practices and rituals, participation in religious community and beliefs and philosophy in life. Some religious practices can even be seen on how a person grow and style their hair. Spirituality speaks of ones personal growth and awareness. It is a recognition of something outside of one’s self that cannot be defined. It is a personal quest for seeking the meaning of life. Religion on the other hand, is a dogma and the existence of a higher power. It is the belief of sacredness, moral codes and values being supported and practised by an organization. Even though spirituality and religion are different, it can or can’t be interrelated. Religion can be practised with spirituality. Spirituality can be practised without being so religious. Spirituality and religion can be addressed in different ways. In the nurses and doctors point of view, the idea of the role of spirituality in a patient’s life will help them understand the patient’s response to an illness. In an article by Cancer.gov (2004) a spiritual assessment may help the doctor understand if a patient will use religious or spiritual beliefs to cope with the cancer diagnosis and treatment. PATIENTS HEALTH CARE AND RELIGION In a world where many different religions exist, it is important that a nurse should know the patients spiritual beliefs before conducting spiritual assessment to the patient. There are many different kinds of medical treatment beliefs applicable to different kinds of religion. Mary Ellen Zator Estes (2002) had differentiated the medical treatments applicable for different religions. In Judaism, medicines and physician were held in high esteem. Patients also seek care for oneself through prayers and proper visitation. For an Islam patient, medical care is encouraged; however, female bodies should remain covered during treatment. Roman Catholic patients are encouraged to seek medical care and once confined in the hospital, visitation, anointing of the sick and prayer is practised. Same with Roman Catholic, Protestant patients also seek medical attention and anointing of the sick as well as prayers are being practised. Jehovah’s Witness patients seek medical care when they are ill, however, during operations or when blood is needed, ingestion of blood nor any other blood products are prohibited. Upon knowing these beliefs, spirituality and nursing processes can now be applied. It is important that spiritual assessment be applied in nursing and giving care for a patient. SPIRITUAL ASSESSMENT George Fitchette (no date) described spiritual assessment as the process of discerning the spiritual needs and resources of the person with whom nurses are working with. Unlike diagnostic models in some medical fields, the assessment model in spiritual care should not simply focus on problems, but also includes the resources that people brings to help them cope with those problems. In short, it is gathering of information with regards to the patient’s spiritual status. Spiritual assessment is important for it gives a comprehensive assessment of a patient’s spiritual needs. With these, care givers will be able to balance the wonders of technology with the spiritual demands of a human nature. In assessing for a spiritual need of a person, open ended questions should be asked in order for the patient to answer it without reluctance. In cases where patients are reticent in revealing how and what they feel in front of a person they are not closely related with, the use of technology may be helpful. This will take away the feeling of being judged. Living water's spiritual assessment program (2006) provided the answer to this dilemma with the use technology to ask patients specific, targeted questions that may elicit defensiveness, and allow chaplains to do the interpreting and the treating. Patients do not seem reluctant to answer questions asked by a machine. And a lot of grounds can be covered in a short period of time. For an electronic questionnaire, several questions are being asked and answered with a click of the mouse. Some questions include “how often do you attend religious services?” choices would vary from “never”, “major holidays only”, “more than four times a year”, “weekly” and “more than once a week”. There will be a follow-up question that asks “Aside from how often you attend regular religious services, do you consider yourself to be:” where the choices include “Against religion”, “Not at all religious”, “Only slightly religious”, “Fairly religious” and “Deeply religious”. On the other hand, for a chaplain who enters the patient’s room with a clipboard, pen and a set of questionnaires, assessing the patient will include weighing the patient’s reaction of his visit as well as the mood of the patient. In the spiritual assessment inspired by Steve S. Ivy, questions include: Name: What is important to you in your life right now? What was important to you in the past? These questions where concluded with: Look over your answers, then write a couple of observations and insights that occur about these questions and your answers. What do you noticed? One example of an actual spiritual assessment was extracted from George Fitchette (no date). The interview is as follows: C 1. (I stood at the end of the bed as I introduced myself) Mrs. Haines? P 1. Yes? C 2. My name is Amy and I'm a Chaplain. 6 West is a part of the hospital where I routinely visit patients. I'm here to say hello and to see how you are doing. P 2. I'm not doing very well. I have emphysema, diabetes, and a heart condition. I can't breathe. I can't even get from here (her bed) to there (the portable toilet that was next to her bed) without help. C 3. It must be very frustrating for you. P 3. Yes it is. I am not able to care for myself. You must see a lot of people who never leave here. Most people who come here die. I'm not going to leave here. I have to use the toilet. Will you wait while I use it? I would really like you to stay for awhile. (She buzzed the nurse.) C 4. I'll be happy to wait. (The nurse came in to help her.) I'll be back when you are finished. (I left for a brief period of time and returned.) P 4. Thank you for coming back. C 5. Would you like to talk about why you feel you are not going to leave here? P 5. I can't breathe. I have so many health problems and they seem to be getting worse. My doctor said that he doesn't know what else to do for me. I need full time care now and my daughter and son-in-law both work. C 6. Do you live with them? P 6. Yes. They can't take care of me. I don't know what I'm going to do. I don't want to give up. C 7. Is it possible to hire someone to help care for you? P 7. I suppose, but I need someone all the time. C 8. Could someone come in during the day and your daughter and son-in-law take over when they get home? P 8. Yes. That would work, but I don't want to spend all of my daughter's inheritance on someone to care for me. I suppose I could do it for a year or so. I doubt if I'll live much longer than that. I need to talk to my daughter. Will you come back after I talk to her and help me decide what to do? C 9. Yes. I will come back. I feel that you need to decide what is best for you but I will be more than happy to listen and help you figure it out. Dorothy became weaker since she was confined in the hospital. She is somehow reluctant to leave the hospital or give up for she realizes that she will require full-time care at home if she leaves the hospital. She now is faced with the prospect that she is neither an invalid person nor a dying person. This change is creating a crisis in her sense of purpose and meaning in life. She wonders what she can hope for and whether it would be alright for her to give up. She appears to need the assistance of her physician, daughter, and chaplain in helping her consider what her next decision will be. Dorothy appears to be a devouted Catholic and her faith should be an important resource in helping her as she reconsiders the object of her hopes. Through these spiritual assessment questions and after thorough reading and evaluating, a plan to meet the patients needs can now be formulated. CARE PLAN IN MEETING A PATIENTS SPIRITUAL NEEDS The thoughts of Dorothy being and invalid or an almost dying person and the fact that she doesn’t want to burden her daughter and son-in-law by taking care of her left her depressed. However, the visit of the chaplain delights her. With this, the comforting presence and support of her daughter and the chaplain is important. The chaplain would be a great help in listening and sharing with her anger, sadness, depression and any expression or feelings for that matter. In order to end her confusion about giving up, visitation, prayer and anointing of the sick should be practised and encourages her to participate. The chaplain can be of great help through reflections and encouragements. The topics discussed by Dorothy and the chaplain should also be opened up to her attending physician and her daughter. Her Roman Catholic beliefs will be important here in slowly explaining and making her understand about God’s forgiveness of sins and her living with God and with eternal life. According to Harold G. Koenig, M.D. (2003), once spiritual needs are uncovered, the health professional must orchestrate the meeting of those spiritual needs. This may involve a referral to chaplain services; providing access to inspirational reading material or directions to the hospital chapel; notifying the patient’s clergy or friends at church; praying with a patient; or simply listening and trying to understand. It almost never means giving spiritual advice or providing solutions to the patient’s spiritual struggles. The end result is usually deeply rewarding for patient and provider. REFERENCES Estes, M. E. Z. (2002). Health Assessment and Physical Examination. The Patient Interview. Retrieved June 6,2006 from http://www.delmarlearning.com/companions/content/ 0766824101/ppts/258,3,Spirituality and Religion Fitchette, George (no date) Wondering If It's Time To Give Up: A Case Example of the 7 by 7 Model for Spiritual Assessment1. Retrieved June 6, 2006 from http://www.rushu.rush.edu/rhhv/docs/search='spiritual%20assessment%20of%20a%20patient Koenig, Harold G., M.D., (2003). Meeting the Spiritual Needs of Patients. Retrieved June 9, 2006 from http://www.pressganey.com/products_services/readings_findings/ satmon/article.php?article_id=94 No author (2006) Handbook for Spiritual Assessment. Living water's spiritual assessment Program. Retrieved June 9, 2006 from http://www.spiritualassessment.com/manual.htm Read More