Spiritual distress

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Spiritual distress is a disturbance in a person's belief system. As an approved nursing diagnosis, Spiritual Distress is defined as "a disruption in the life principle that pervades a person's entire being and that integrates and transcends one's biological and psychological nature."[1]
Contents
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1 Nursing Diagnoses 2 Sample Care Plan 3 See also 4 Notes 5 Further reading

[edit]Nursing

Diagnoses

Authors in the field of nursing who contributed to the definition of the characteristics of Spiritual Distress used indicators to validate diagnoses. The following manifestations of Spiritual Distress are a part of an abstract data gathered by LearnWell Resources, Inc from the studies of Mary Elizabeth O'Brien and is used as a Spiritual Assessment Guide to present alterations in spiritual integrity. The diagnosis of Spiritual Distress is defined by indicators that are present: spiritual pain, spiritual alienation, spiritual anxiety, spiritual guilt, spiritual loss, and spiritual despair. Seven Manifestations of Spiritual Distress: [2][3]

"Nursing diagnoses: spiritual pain, as evidenced by expressions of discomfort of suffering

relative to one's relationship with God, verbalization of feelings of having a void or lack of spiritual

fulfillment, and/or a lack of peace in terms of one's relationship to one's creator. Nursing- diagnoses: spiritual alienation, as evidenced by expressions of loneliness or the

feeling that God seems very far away and remote from one's everyday life, verbalization that one has to depend upon one's self in times of trial or need, and/or a negative attitude toward receiving any comfort or help from God.

Nursing diagnoses: spiritual anxiety , as evidenced by expression of fear of God's wrath and

punishment; fear that God might not take care of one, either immediately or in the future; and/or worry that God is displeased with one's behavior.

Nursing diagnoses: spiritual guilt, as evidenced by expressions suggesting that one has failed

to do the things which he should have done in life and/or done things which were not pleasing to God; articulation of concerns about the "kind" of life one has lived.

Nursing diagnoses: spiritual anger, as evidenced by expression of frustration or outrage at

God for having allowed illness or other trials, comments about the "unfairness" of God, and/or negative remarks about institutionalized religion and/or its ministers or spiritual care givers.

Nursing diagnoses: spiritual loss, as evidenced by expression of feelings of having temporarily

lost or terminated the love of God, fear that one's relationship with God has been threatened, and/or a feeling of emptiness with regard to spiritual things.

Nursing- diagnoses: spiritual despair, as evidenced by expressions suggesting that there is no

hope of ever having a relationship with God or of pleasing Him and/or a feeling that God no longer can or does care for one." The indicators (pain, alienation, anxiety, guilt, loss, and despair) must or may be present in defining the characteristics of spiritual distress. The use of indicators in diagnosing alterations in spiritual health is controversial because indicators may appear related to both spiritual and psychosocial problems. Wilfred McSherry, a senior lecturer in the School of Care Sciences at the University of Glamorgan, published an article on the Journal of Advanced Nursing about potential dilemmas in conducting a spiritual assessment. The article argued that "the area of spiritual assessment needs careful consideration, both nationally and internationally, by those professionals involved in the provision of spiritual care so that potential dilemmas can be identified and reviewed. Such consideration may prevent the construction and subsequent use of inappropriate assessment tools within practice." [4]

ASSESSMENT DATA NURSING DIAGNOSIS DESIRED OUTCOMES* * Nursing Assessment Mrs. Sally Horton is a 60-year-old hospitalized homemaker who is recovering from a right radical mastectomy. Her primary care provider told her yesterday that due to metastases of the cancer, her prognosis is poor. This morning her nurse finds her tearful, stating she slept poorly and has no appetite. She asks the nurse, Why has God done this to me? Perhaps its because I have sinned in my life. Ive not gone to church or spoken to a minister in several years. Is there a chapel in the hospital where I could go and pray? Im terribly afraid of dying and what awaits me.

Nursing diagnosis Spiritual Distress related to feelings of guilt and alienation from God as evidenced by questioning why God has done this; inquiries about praying in a chapel; insomnia; no appetite

Spiritual Health [2001] as evidenced by Interacts with spiritual leader of her religion Uses a type of spiritual experience that provides her comfort Connects with others to share thoughts, feelings, and beliefs

NURSING INTERVENTIONS*/SELECTED ACTIVITIES RATIONALE Spiritual Support [5420] Be open to Mrs. Hortons feelings about illness and death. Assist her to properly express and relieve anger in appropriate ways. Observe and listen empathetically to her communication. Encourage the use of spiritual resources, if desired. Coping Enhancement [5230] Create an accepting, nonjudgmental atmosphere. Encourage verbalization of feelings, perceptions, and fears. Allow time for grieving. Encourage her to list values that guide behavior in times of tragedy. Encourages expression of inner fears and concerns and teaches the client the value of confronting issues.

Anger can be a source of energy and its release a source of freedom when expressed in a constructive manner. The nature of spiritual care may directly affect the speed and quality of recovery and/or redefining hope and finding meaning in death. Spiritual needs may sometimes be overlooked or ignored. Recognizing and respecting the individuals spiritual needs is an important advocacy role for nurses. Establishes rapport and the therapeutic relationship, which promotes communication and open expression. Being with the person who is suffering gives meaning to his or her experience. Helps the client clarify values and beliefs by reflecting on past behaviors. Experience is a major source for values development. *The NOC # for desired outcomes and the NIC # for nursing interventions are listed in brackets following the appropriate outcome or intervention. Outcomes, indicators, interventions, and activities selected are only a sample of those suggested by NOC and NIC and should be further individualized for each client.. Physical Examination Height: 165.1 cm (5 5) Weight: 54.0 kg (199 lb) Temperature: 36.6C (98F) Pulse: 88 BPM Respirations: 22/minute Blood Pressure: 146/86 mm Hg Large surgical dressing right chest wall and axillary region, dry and intact. Slight edema right hand and arm.

Diagnostic Data RBC: 3.5 10 6 /mL Hgb: 10.5 g/L Hct: 35% EVALUATION Outcome met. Mrs. Horton has been visited on several occasions by her minister. She reads scripture each day and has found consolation in reading the Book of Psalms. She states God is merciful and will help me bear my suffering.

Rationale Encourages expression of inner fears and concerns and teaches the client the value of confronting issues. Anger can be a source of energy and its release a source of freedom when expressed in a constructive manner. The nature of spiritual care may directly affect the speed and quality of recovery and/or redefining hope and finding meaning in death. Spiritual needs may sometimes be overlooked or ignored. Recognizing and respecting the individuals spiritual needs is an important advocacy role for nurses. Establishes rapport and the therapeutic relationship, which promotes communication and open expression. Being with the person who is suffering gives meaning to his or her experience. Helps the client clarify values and beliefs by reflecting on past behaviors. Experience is a major source for values development.