Spirituality as a nursing concept: definitions and clinical significance

Spirituality

According to the holistic model of care, a lot of nurses should contemplate their patients' spiritual necessities so that they can give them the total patient care that they deserve (Govier, 2000). There is rising consciousness of the influence that spiritual happiness can do for a patient's real and apparent health and excellence of life (Chibnall et al., 2002; Mount, 2003). Spirituality and spiritual care in the past years is gaining a lot of drive in the present nursing field. Draper and McSherry (2002) mention that it has arose out of nowhere to occupy a noticeable part of present health care. Furthermore, inside the nursing occupation, an emphasis on people as bio psychosocial-spiritual beings is expanding acknowledgement. This view is founded on the basis that there should be a balance or stability of mind, body and spirit for the preservation of health in an individual (Stoll, 1989; Stooter, 1995). On the other hand, there is proof that a lot of nurses, as well as nurse educators, have a hard time with the idea of spirituality and therefore, may disregard this feature of care (Greenstreet, 1999; McSherry, 2000). The purpose of this article is to donate towards explaining the idea of spirituality.

Concept Examination

"A concept is an element that is used in the creation of the theory" (Miller-Keane, 1997, p.362). Concepts are nonconcrete which are originated from specific characteristics that involve hope, love, longing (McEwen & Wills, 2007, p.52). Concept study is operated to define and examine a word and how it is used in language and nursing literature, explanation in expressing characteristics, qualifications and provides new devices for theory and research expansion. Concept analysis can be used to express and evaluate the diagnosis of nursing. ( Tanyi,2002). Spirituality in health care and nursing has significantly enlarged. Joint Commission on Accreditation of Health Care Organizations (JACHO) has given a mandate of health care providers to appear and make an address to a patient's spiritual needs (Tanyi, 2002) JACHO (2005) mentioned that "Spiritual evaluation should, at the least, decide the patient's faith, principles, and what spiritual practices are very vital to the patient. This data would help in figuring out the influence of spirituality, if there is any, on the care/services that are being offered and will recognize if any additional evaluation is needed.

The standards need organization's to designate the essence and selection of spiritual and other assessments and the involvements of the people that are occupied in making sure that the assessment is performed." Spirituality is a very significant concept in the health science setting. A lot of people are not happy with medical treatment. During the time of life pressuring illness with diseases such as AIDS, Cancer, and heart conditions, people can sometimes undergo frustration, rage and loss of hope. In order to meet the request of illness a lot of people utilize various coping means such as meditation, prayer and other spiritual activities.

Aims or Reasons

Spirituality is a theoretical perception and has a lot of meanings because of its imperceptible and nature that is subjective. The purpose of concept analysis is to explain the idea of spirituality in health care and nursing and to sway how nurses and patients should mix this notion into use. The conceptual analysis strategy that was proposed by Walker and Avant (2005) has been utilized as the conceptual framework. The phases in the Walker and Avant model are the following: chose a concept, decide the goals or determinations of analysis, recognize all the various uses of the concept conceivable, decide the important characteristics, recognize model case, pinpoint borderline, related, conflicting, created, and unlawful cases, identify forebears and significances and to define empirical referents. This model was chosen is because it has eight steps. It enables an in-depth analysis of the perception. This model can produce detailed working definitions, make available new devices for theory and research development, and clinically progress nursing practice.

Describing Attributes

Attributes are features of the concept that are recurrently exercised. The inherent characteristics of spirituality are: faith, faithfulness, connectedness, inner strength, harmony, and creativeness, love, meaning, holy, and a connection between God/man / eventual reality, soul, religious approaches, heavenly, emotional state, thoughts, contemplation, standards, personal philosophy, imagination and drive. The extrinsic characteristics are religious affiliation, church services, having a good church attendance, prayer, optimistic confirmations, relationship or interaction with God, ranked configurations. Ministers, priests, religious practices and co contribution in experiences that are shared with humans. During the time of disaster, people would turn to a higher power because they believed that their prayers would be answered, along with strength, peace, courage and inspiration. In a lot of people culture, spirituality plays a vital role. Religious spirituality has given people the encouragement and stamina they need to survive on daily basis. Fasting, praying and singing religious songs are widely accomplished in their spirituality. They have a very strong belief in God and their faith is not moved by anything. Worshipping days are usually observed on Sundays. My personal view on Spirituality is that relationship with God. I looked to this Supreme Being for strength, courage and hope. With this concept many people learn how to, forgive, be compassionate and caring, honest and trustworthy. With these attributes nurses can apply them to their patients and override the challenges they face on a daily basis. . I personally practice this concept on a daily basis by meditation, fasting and listening to music that is religious.

Model Case

A model case is a composed story intended from clinical involvements with patients, or actual non-composed examples taken from real life that comprise all the important attributes of the Concept and absolutely demonstrate it. (Tanyi, 2002)

According to Walker and Avant (2005) case examples are utilized to promote further understanding of the concepts. Patsy was a 35-year-old female who had been diagnosed with CVA. She had left sided weakness and she would slur when she talked. Monica was a woman that carried an extremely strong faith in God which gave a lot of meaning to her life but she is furious and in her mind believes that God is out to punish her. Diana told the nurse that she was scared that her boyfriend was going to abandoned her and that she would not be able to get married and create a family. Diana intensely believes in family customs like having a family that will give her purpose and meaning to her life. She appreciated becoming a mother which is an important motive for her being. This significance is endangered by fear and her illness. The nurse provided emotional encouragement by lending an ear and offering to help her by referring her to a psychologist and pastoral care which Diana gladly agreed to do. Diana became very grateful to the nurse for taking time out of to just be a good listener and to give her some spiritual support.

Diana was dismissed from the service. She then went to tell the nurse that she appreciated her for the support and reassurance during her time of desolation. She brings a beautiful box of cookies to show her gratitude. Dian told the nurse that she continued to go to the counseling sessions and support groups. She talked about how she and her boyfriend were now engaged and was excited about settling down and starting a family. Her rejoining with God, her morals and principles have transformed her feeling of faith, determination, hope, determination and meaning in life. This new consciousness has given her a consciousness of thankfulness, love, admiration, joy and satisfaction. With these characteristics she was able to downtrodden her sadness and fears.

This example is a model case as it shows all of the characteristics of spirituality as emphasized in the meanings. It validates believing and having faith in God, important relations, personal standards and beliefs it also proves how a faith system and association with others can endorse inner peace and strength. Diana was spiritually converted which allowed her to surmount her examinations. This model case covers all the rudiments recognized as critical qualities of spirituality.

Borderline Case

A borderline case is an example of a concept that encompasses some a little but to every one of the attributes (Tanyi, 2002). Eric was put into hospital with ETOH abuse and with seizures. Tom articulated how he believed life had not been fair to him. He talked about how he had been serving God and going to church but his life was unhappy. He lost everything including his home, job and wife. Eric expressed his insecurity about God and no longer has the courage to go on with his life. Eric expressed his grief and that he had no one to depend on because of his misfortune. Eric began to question his purpose in life. He was no longer encouraged to go on with life anymore. He stated that life had no meaning for him and that his future was hopeless. I offered emotional support and explained to him that he needed to talk to a counselor and also go to a support group. Eric had also been referred to a psychiatrist. At that point he felt that he would get the strength that he desired to continue. With optimistic assertions and prayers he was relinking with the Supreme Being. He was dismissed. About three months later Eric had come back with the same diagnosis. This is a borderline case as it displays some of the characteristics of spirituality, but not every one of them. Eric suffered an instant of connectedness to me all through our spiritual associations for a little time which had some kind of significance to his life. At that time Eric felt an appreciation of expectation, tranquility and trust. The instant he was cleared from my care, he lost the will power to go on any further with his spiritual customs. He had no kind of faith method to maintain him spiritually.

Precursors and Outcomes

There are conditions that are present before the incidence of a concept and which is named antecedents. The significances are consequences which arose as an outcome of a concept. (Tanyi, 2002)

The precursors of spirituality comprise life and spirit. (Tanyi, 2002). Guaranteed life actions such as illness, deaths, solitude, divorce and, loss of a loved one, can motivate someone to acquire a longing for spiritual consciousness. The hunt for meaning includes the need to appreciate the intimidating event and its influence on life before a spiritual happiness is accomplished. In every person there appears to be a spiritual measurement, a characteristic that goes further than religious association that struggles for creativeness, respect, awe, meaning, and drive even in those that do not have a belief in God. The spiritual measurement tries to be in synchronization with the universe, and struggles to find answers that concern the infinite (Tanyi, 2002). The effects of spirituality are hope, peace, love, happiness, bravery, clemency, strength and trust. The unconstructive results can be remorse and inner disagreement about one's standards and principles (Tanyi, 2002).

Empirical Referents

Dossey et al. (1995) as cited in (Tanyi, 2002) give a 55-item spiritual valuation tool evaluating: purpose and meaning of life, interconnectedness, and inner strength. In the primary care settings, the spirituality graphic diagrams established by McBride et al. (1998b) as alluded to in Tanyi, 2002 deliver a rapid, informal and non-threatening technique of measuring spirituality. The spirituality symbolic diagrams are valuation instruments, which comprise of questions that can be utilized to measure persons' spiritual practices and what they have experienced. The spirituality charts have been discovered to have high dependability and legality. These instruments are valuable to the nurse because it expedites message with the enduring and delivers an augmented arrangement of the patient's spiritual requirements (Tanyi, 2002).

Spirituality in Nursing

Spirituality can or cannot connect to religion which is contingent on the individual belief system. Spiritual practices can endorse happiness, peace and enablement. In nursing custom, understanding the spiritual feature of a patient is significant. This spiritual valuation can give the patient with the superiority maintenance that is wanted. Studies have presented that nurses have come across a lot of obstacles in giving spiritual care, such as inadequate academic groundwork, lack of post academic training, insufficient time and employment, and absence of discretion to guide patients (Tanyi, 2002). Some nurses think that spirituality is best tackled by pastoral care since they do not have the quality time to devote with the patients because of the amplified amount of work. "The North American Nursing Association Diagnosis Association, International (NANDA-I 2005) expressed nursing diagnostic terminology connected to patient care apprehensions and practice, recognizing the importance of being concerned for patient spirituality." (Sessana, Finnell and Jezewski, 2007). Three nursing judgment has been expressed and applied ever since 1978. They are Spiritual pain, Danger for spiritual distress, and willingness for better-quality spiritual happiness. (Sessana, Finnell and Jezewski, 2007) To deliver holistic care, it is vital that a spiritual valuation is accomplished.

Conclusion

My spiritual beliefs have assisted me to better measure the patient spiritual requirements. Upon evaluation, I will ask the patient to tell me their foundation of hope and strength, or what it is that they find most expressive. This data will contribute in bringing the suitable help I studied to acquire a trusting, caring relation with my patients and for the reason of this my patients are not scared to talk about their social practices, what they believe in or standards. Paying attention and watching the patients can deliver perceptions about their spirituality. Also being non- hypercritical and unprejudiced to patient's condition can improve interaction and can introduce suitable spiritual counseling.