Walker and Avant, (2011) define concept analysis as a process of simplifying the inexplicit ideas that are most common in the health care discipline. This method has been beneficial in exploring the developments and current issues in science. It provides information that enhances deeper understanding, structure and attributes on the concepts being analysed. The paper utilised the method and framework given by Walker and Avant (2011).
This paper seeks to explore and expound on the concept of spiritual care in the nursing practice. The concept has been derived from Jean Watsons theory of human caring/caring science. She defines caring as a science that comprises human science orientation, human caring processes, sciences and experience. The eight steps of Walker and Avant (2011) have been followed. Clarification of the aim of this analysis is given, followed by a review scholarly literature on the concept to establish the relevance in the nursing discipline. The uses, attributes and model case are also outline in that order. The final section of the paper tackles the antecedents and consequences followed by the empirical referents.
Aim of the Analysis
Spiritual nursing care is a core concept in the nursing profession that has been evolving in the past two decades, (Cetinkaya, Azak and Dundar, 2013). However, it remains vague and researchers are left to explore on what keeps unfolding on this concept overtime. According to Foster, Bell and Gilmer (2012) this concept is important for nurses because they are expected to offer all-rounded care to patients. The aim of this analysis is to explore this concept in depth and its application in the nursing discipline. It will provide critical information on how nurses should provide professional spiritual care to patients.
Understanding spirituality is vital in being in a position to offer spiritual care (Centikaya et al., 2013). This has catalysed the publication of related literature by scientific researchers. Foster et al.(2012) states that in earlier research nurses had little knowledge on the spiritual needs of the patients. Currently, nurses have identified the spiritual needs in both verbal and non-verbal cues. However, with nurses acknowledging that spiritual care is their role there has been poor response and application of the same in their work. This can be related to technological advancements being utilised to ensure effectiveness in medical care and overshadowing the critical role of spiritual care. Other studies attribute this to nurses feeling inadequate and less prepared to provide spiritual care.
Inclusion of spiritual care in normal care plan happens rarely among nurses. (Monareng, 2013) suggests that the few who do so attest that they have to make prior arrangements as it does not happen naturally. However, Foster et al. (2012) states that even after prior arrangements they feel uncomfortable doing so. This indicates that there are factors hindering the ability of nursing personnel to offer spiritual care. According to Monareng, (2013) nurses ought to be aware of their own spirituality so as to be in a position to offer spiritual care. Spiritual nursing care involves undertakings that promote a healthy balance between the spiritual and the bio-psychosocial aspects of the person, which promotes a sense of happiness and completeness.
There are a variety of world views and variety of opinions from people with regard to spiritual care. Purow, Alisanski, Putnam and Ruderman (2011) state that the human spirit unifies a person and promotes health by ensuring inner harmony, which is a feeling of peace caused by God in man. Literature in spiritual nursing care ranges from general conceptions of a caring presence to religious acts such as prayer or reading religious texts. As human beings have spiritual needs spiritual care entails keeping hope alive to those that are giving up and help the understand there is a reason for their pain (Centikaya et al., 2013).
With regard to the literature and in depth study, spiritual care solely entails how the nursing personnel interact with the patients (Purow et al.,2011).They should have a positive attitude and offer health care services to Gods glory. Going an extra mile and making sacrifices for the patients sake as Foster et al. (2012) puts it, is part of what demonstrates compassionate care. This is regardless of training on spiritual care. Offering this aspect of care is an art that requires one to make a deliberate decision to do so for the good of the patient (Monareng, 2013). Nurse-patient care is embedded on spirituality and is critical.
Spiritual care is used and considered as a part of a comprehensive nursing assessment as suggested by Purows et al. (2011). Nurses are responsible for attending to and being aware of the patients spiritual needs as a dimension of quality health care. Neglect of this aspect of care has severe implications on the illness adaptation. The nurses must therefore consider the importance of providing spiritual care as it contributes to the patient being well. To individual nurses who may feel inadequate and comfortable doing so, they should refer to nurses who are comfortable in that. Appropriate action should also be taken for those feeling inadequate. They should be trained on how to incorporate spiritual care in their nursing practise.
Uses of the Concept
Monareng (2013) defines spiritual care as a personal pursuit for acquiring answers to life questions and about the meaning of relationships that are transcendent. Other important components of spirituality are inner strength, connectedness, self-transcendence and belief (Centikaya et al., 2013). Spirituality is an inherent component of humans that is exhibited by non-religious people in search for meaning to life (Foster et al., 2012). Offering spiritual care is thus based on understanding spirituality. Spiritual care concept is used as an element of holistic practice. Purows et al. (2011) states that spiritual caring revolves around the ability to keep close relationships, offer caring presence and compassionate care to the patients. It is viewed as a central aspect in providing quality care. In its definition its depicted as holistic care that facilitates the recipients search for meaning and purpose.
In the business world spiritual care is considered as therapy and spirituality as the expression of the resources to which people turn to for authoritative an intuition guide (Roy, C., and Roy Adaptation Association, 2014). The rapid social changing structures of the workplace put individuals with the responsibility for ones own well-being. There are more explicitly religious therapeutic models providing knowledge and healing power.
According to Walker and Avant (2011), defining attributes are the characteristics and descriptors that appear frequently in uses. According to Monareng (2013), attributes of spiritual nursing care are search for meaning and purpose, spiritual caring presence and spiritual dialogue. Caring presence encompasses showing unconditional love and acceptance to the patient (Purows et al., 2011). Nurses have to actually be with the patient and meet them at the point of their deepest needs. Centikaya et al.(2013) suggests that availability to listen and touch is critical as the nurses offer spiritual support to individuals. Through their presence the values of concern, respect, compassion and empathy are made visible to the patient.
Search for meaning and purpose is another frequent attribute (Monareng, 2013). It emerges in the nurses awareness of the transcendent scope of life that is mirrored on a patients reality. The nurses should seek to answer the questions on the meaning of the pain that the patients go through based on their religious belief (Purows et al., 2011). They should seek to answer them from a religious perspective concerning the meaning and purpose of their illness and suffering. Meaning and purpose is also identified through connectedness to self and others as stated by Centikaya et al. (2013). Connection to a high power also shape the way patients perceive their diseases and suffering. Nurses should therefore be aware of the high power so as to assist patients in understanding the supreme purpose of their lives.
To promote further understanding of the concept examples are used, Walker and Avant (2011). Florence a young lady in her early twenties is taken to the hospital for medical attention due to her leg injury. After consultations and medical check-up she is diagnosed with a bacterium named cellulitis. The stage of infection is worse such that Florence will have to lose her leg. The doctor in-charge of her gets time and talks to her about it without much consideration on the effect of such news. Florence receives the information in great shock as it had never occurred to her mind that such could happen. The nurse assigned to her comes and seemingly not so concerned just to give her medication as part of the nurses normal routine. The nurse is busy and has no time to spare for conversation with the patient.
During the next shift the nurse assigned to her comes to check if all is well. Florence just nods her head in a hopeless manner. The nurse straightaway realises that something is troubling the young girl. Florence shies away from sharing her cause of anxiety but the nurse is kind and genuinely concerned. Florence recognises the sincere concern and soon a good rapport is established. She opens up to share her fears and anxieties. The nurse talked to her in a good way and made her confident that things will go on well regardless of her situation. This reassurance enabled Florence to cope with her situation.
James is admitted to the hospital after a fatal accident. He is in such a bad state that he has no hope to live. He recalls that prior to the accident was a call from the wife who was seeking divorce and this makes him bitter that he wishes to die. Eva the nurse assigned to him recognises his restlessness and anxiety. She seeks to express love, hope and compassionate care to him. She makes him comfortable and James shares his feelings of hopelessness and fear of the divorce. He wishes to die now that God allows such to happen. She reassures him that there is a purpose of his life. That such circumstance teaches one to fully depend on supreme authority beyond us. James appreciates for the conversation and says that he feels better and hopes to be well soon. Eva continues to keep encouraging James.
The above two cases include the attributes identified of caring presence and meaning and purpose of life. They clearly illustrate the concept of spiritual care. Thus meeting the spiritual needs of the patient is essential for their well-being (Centikaya et al., 2013)
A Borderline Case
Anne goes to clinic for medical attention. She complains of general body weakness, frequent headache and dizziness. All her tests indicate no problem and Terry the nurse detects emotional problems. Terry talks to her in a more relating than treating manner and Anne opens up. She explains to Terry her disappointment following failure to be accepted by her fiancees parents. It has happened with three fiances and they all end up listening to their parents and leaving her. She expresses her lack of meaning to life and wonders why it had to be her. Terry listens to her and empathises with her.
Terry counsels her and reassures her that God has a good plan for her. Anne goes home happy but comes back a month later having taken rat poison for suicide. This case only exhibits some attributes of spiritual caring. The caring presence Terry offers is short term and in the long-run its not of help to Anne. Anne remains hopeless no wonder her suicide attempts.
A Contrary Case
A contrary ca...
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