Theological foundations for spiritual care

Five theological tenets are described which may undergird the integration of religious awareness and spiritual care into nursing curricula. The five all emphasize addressing the articulated needs of the patient within the context of the nursing process. These tenets, while Wesleyan in emphasis, suggest ways in which any nurse may engage in the common ministry of all Christians without usurping the role of clergy or chaplains.This article is a revision of a chapter of Dr. Brittain's doctoral dissertation from St. Mary's Seminary and University.     

Pastoral care for the head-injured: A biopsychosocial/spiritual perspective

This article discusses the pastoral role in the individual and family crisis of a head injury. A case study illustrates the nature and consequences of this widespread but little-understood injury. Physical, emotional, and spiritual consequences of this injury are discussed. Finally, this article describes four pastoral responses to head-injured victims and their families: helping the victim to speak the unspeakable, facilitating prayerful imagination, connecting therapeutic efforts among professionals, and advocating for the family with national and community head injury resources.Private Practice, 1542D Honey Grove Dr., Richmond, VA 23229.     

The sound of spiritual care: music interventions in a palliative care setting

The article describes how music has been integrated into spiritual and supportive care for palliative care patients at Brantford General Hospital (Ontario). Numerous case examples illustrate how a song or piece of music can play a vital role in the spiritual dimension of end of life care. The article expands the concept of the "living human document" by positing that a life story has an accompanying soundtrack: a musical memory and sensorial attunement that can be energized when music is offered at the bedside. The writers suggest that music provides an alternate spiritual language for patients whether or not they have a religious affiliation.     

Layers of engagement: Staff perceptions of spiritual care in residential aged care

ABSTRACT

Addressing the spiritual care needs of residents living in aged-care facilities should be an important dimension of quality care. We conducted semi-structured interviews with residential aged-care staff (including caregivers, nurses, managers, and chaplains) in New Zealand to explore how spiritual care is understood and operationalized. Many participants appeared to equate spiritual care with holistic care that respects the whole person. Participants discussed five types of spiritual care engagement requiring different skills, knowledge, and personal commitment, including information gathering, facilitation, companionship, end-of-life care, and counseling. Our findings suggest that the spiritual care that was offered by our participants, clergy and non-clergy alike, was predominantly informal and unplanned.     

Spiritual needs: Gender differences among professional spiritual care providers

The current study explored gender differences regarding spirituality by comparing the relative frequency with which male (n = 85) and female (n = 103) professional chaplains experience various facets of the spiritual experience. The women in the sample reported experiencing five of the seven spiritual constructs examined significantly more often than men, including the need for (1) belonging, (2) meaning, (3) hope, (4) beauty, and (5) acceptance of death. No significant gender differences were found for spiritual needs related to morality concerns or religious practices.     

Criteria for a comprehensive model of spiritual development in secular educative care

This paper argues that to fulfil what is required of a model of children's spiritual development in the context of secular educative care, six criteria must be met: the meaning of the terms and nature of the phenomenon must both be specified; the relationship to an underlying ontology must be clarified and the status of alternatives characterized; the sense in which spirituality is developmental and open to change through intervention must be identified and which specific developmental changes are 'spiritual' designated; there must be consistency with an accepted paradigm for the understanding and study of human development; the role and status of spiritual development within a secular system of educative care needs explanation; consequential practical implications must be specified. In suggesting this is an unfulfilled requirement, the challenges posed by each of these criteria are identified.     

The spiritual care of sick children: reflections from a pilot participation project

The authors are a multi-disciplinary team of chaplains, one with a counselling qualification, and an academic with a research background in spirituality and youth work. A pilot participation project undertaken at Birmingham Children’s Hospital (UK) focused on increasing the understanding of the spiritual needs of sick children and young people and involving children and young people in improving the service and provision of spiritual and religious care to them. Views from children, young people and parents were sought with the intention of developing resources and training that help facilitate the meeting of spiritual and religious needs of children and young people in hospital. Within the wider chaplaincy team are chaplains from the six major world faiths and this project considers spiritual needs of children and young people who perceive themselves as belonging to a faith group or not. Reflections from the pilot include identifying ten principles and practices to inform the spiritual care of sick children and proposing the concept of interpretive spiritual encounters as a tool for spiritual care. The pilot study indicated that being more proactive in offering spiritual care enhanced the quality of service offered by Chaplaincy.     

The difficulties assessing spiritual distress in palliative care patients: a qualitative study

This paper reports on a focus group study aimed at exploring the difficulties that palliative care healthcare professionals encounter while assessing the spiritual distress of their patients. Three focus groups were conducted in a hospice (n = 15). Participants were all healthcare professionals working in the hospice in-patient unit. Interviews were taped and later transcribed. The data was analysed through content analysis. Emergent themes included: lack of vocabulary around spiritual issues, personal issues surrounding death and dying, training issues, fear of being unable to resolve spiritual problems, time constraints and difficulty separating spiritual and religious needs. Participants provided a number of recommendations for improving care. This pilot study has generated useful data in relation to how spiritual care of patients might be improved. Despite the abundance of academic publications and policies on spirituality, this area is not integrated well into palliative care.     

The spiritual experience index: A measure of spiritual maturity

The Spiritual Experience Index was developed to measure spiritual maturity in persons of diverse religious and spiritual beliefs. The scale was constructed from a developmental rather than a multidimensional conceptualization of faith. Initial findings from a religiously heterogeneous college sample indicated good reliability for the SEI and supported its use as a unidimensional measure. Higher scores on the SEI were significantly related to lower dogmatism and intolerance of ambiguity. The SEI was also moderately related to higher religious participation and positively correlated with intrinsicness and quest. However, compared with the intrinsic and quest scales, the SEI emerged as the strongest indicator of adaptive spiritual functioning. Directions for future research are suggested.     

Clinical pastoral education: a physician's experience and reflection on the meaning of spiritual care in palliative care

In this article a physician reflects on her experience as a chaplain intern and how this Clinical Pastoral Education experience led to a deeper understanding of spiritual care in the palliative setting.     

Retrospective spiritual narratives: exploring recalled childhood and adolescent spiritual experiences

This paper draws on a collection of retrospective narratives of childhood and adolescent spiritual experiences to explore the qualities and characteristics of the spirituality of the young. They recall a range of spiritual experiences that touch on death, mortality, visions, and perceptions and connections beyond the self. Their experiences include varying intensities of emotion and invoke a range of responses in them and others. The paper considers the social, emotional and familial context of these early life experiences and their impact on spiritual experience and the possibility/impossibility and freedom/lack of freedom to express, and integrate spirituality.     

Self-mutilation: a spiritual endeavor

This article explores the phenomenon of self-mutilatory behaviors among practitioners both today and throughout history with the intent of exposing what the author finds to be a radical correlation between mental illness and spirituality. It is the author's belief that today's strong focus on the biology of mental illness, though essential, will extend us only so far in our comprehension of mental pathology; and that an investigation into the spiritual needs of humankind may serve to round out our understanding.     

临床共情与护理技术结合:人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

"Elicitation hooks": a discourse analysis of chaplain-patient interaction in pastoral and spiritual care

The article considers the communicative role of the hospital chaplain and maps some of the language strategies deployed to facilitate disclosure of the patients' concerns and achieve enhanced spiritual care. These include: i) involvement, ii) politeness and iii) encouraging disclosure or exploring emotion.     

Power,empowerment and surrender in the context of paediatric spiritual care

The dynamics of ‘surrender’ is here put in dialectic with the dynamics of ‘power’ observed in situation involving children and their caregivers in a paediatric hospital setting. Following a qualitative research method used in practical theology, three case studies are presented and then interpreted in the light of both social sciences and Christian theology/spirituality. In the power/surrender paradox, there will always be a need for discernment for each situation and each encounter if the caregiver wants to better care for the children and continue to acknowledge their contribution to the life experience and wisdom of adults. Power and surrender both need to be embraced in order to grow in a fruitful spiritual life.     

An object relations paradigm for spiritual development with highlights from Merton's spiritual journey

This essay reviews personality development from an object relations perspective. The major principles of this personality theory are then applied to spiritual development. The validity of this application is revealed in a consideration of autobiographical text from Thomas Merton. Merton's seemingly divergent experiences of contemplation and action are placed within an object relations paradigm of spiritual development thus highlighting the applicability of bridging object relations theory to spiritual development.