Spiritual and emotional determinants of health

Within our present health care system, there is a growing movement that argues that our perceptions of health and illness are in need of change. This change includes redefining what we mean by health in terms of the whole person—the emotional, social, and spiritual dimensions of our being, as well as the physical. An increasing number of health professionals and social scientists believe our concepts of health and illness must consider all these aspects of life. It is believed that the quality of life may be enhanced by such perceptions of health, which include social and spiritual factors. Using data from the 1985 Akron Area Survey—The Subjective Quality of Life in the Akron Area—this study explores the effects of spiritual well-being and emotional well-being on health satisfaction. Results indicate that emotional and spiritual factors do significantly contribute to the subjective evaluation of health, especially for individuals who are physically limited.An earlier draft of this paper was presented at the joint session of the Association for the Sociology of Religion and the American Sociological Association, August 20, 1986. The author would like to thank Margaret Poloma, Ph.D., The University of Akron, and Mark Tausig, Ph.D., The University of Akron, for their helpful comments.     

Spiritual well-being in older adults: Harmonious interconnectedness

The current study was designed to identify indicators of spiritual well-being in persons 65 years of age and over, using a grounded theory approach through the constant comparative method of data analysis. The basic social process of harmonious interconnectedness was discovered. This process was the unifying force between categories and within each identified category. The study has implications for health care personnel in that it provides a basis for assessing spiritual well-being in patients.This study was partially funded by a special project grant from Marquette University.     

Spiritual issues in mental health care

Religious and spiritual issues in mental health are explored in the context of four conceptual models: the medical, the nursing, the humanistic, and the pastoral. This is done by looking at each model in terms of content, diagnostic focus, language and treatment goals, and primary qualities in the health provider.The models are illustrated by case studies gathered from a multidisciplinary setting. The discovery that each model can incorporate the religious and spiritual dimension in mental health care, but that each model does this in distinctive ways, is a key point.     

Spiritual Disposition and Understanding Illness

Although Dull and Skokan (1995) proposed a cognitive model of the effect of religion on health, they neglected to clearly identify the multi-dimensional nature of religion as a cognitive schema. The present paper identifies various aspects of spiritual disposition (defined as personality and beliefs) that can play a role in an individual’s adaptation to illness. Specifically, this paper reviews the factors of religious doctrine and affiliation, spiritual beliefs, religious orientation, God locus of control, faith and hope as aspects of a spiritual disposition and explores how they can function as resources and/or negative factors in the process of adjustment to illness. Implications for clinical health care (e.g., pastoral counsellors) are drawn from this review.     

Helps to Fostering Students' Spiritual Health [1]

Interviews with 98 teachers from a variety of schools were used to develop a definition of spiritual health, and to establish how these teachers thought spiritual health might best be fostered and what hindered its development in the school curriculum. A recurring theme, which seemed to be coming through the comments from teachers in this study, was the very important role that teachers play in helping students develop relationships. This was of vital importance as spiritual health was seen as being reflected in the quality of relationships that students develop with themselves, others, the environment, and with a Transcendent Other. The characteristics of teachers most frequently mentioned as desirable for the promotion of spiritual health were classified as follows:

? caring, sensitive, personal approach;

? concern for individuals;

? committed to personal beliefs and values.

Investigation of these teacher characteristics showed variation by gender, personal view of spiritual health, major curriculum concern, teacher and school type. Implications of these variations are discussed in this paper, together with the role of Spiritual Facilitator, to help nurture students' spiritual health.     

Taxonomy of Spiritual Experiences

Spiritual experiences are often associated with health crises, with little information about the structure of the experience. A taxonomic analysis was conducted on data from a group of healers, unveiling a structural model of spiritual experience comprised of three domains: circumstances, manifestation and interpretation. Circumstances included the aspects of setting, situation, and timing. Manifestation incorporated the modes of awareness and the phenomena of the experience. Components of interpretation included personal meaning and congruence with social norms. The examples reflected the orientation of the study population. Further research could examine the applicability of the taxonomy to other religious or spiritual orientations and may assist in clinical assessment of spiritual experiences.Diane Wind Wardell, Ph.D., R.N.C., H.N.C., C.H.T.P./I., and Joan C. Engebretson, Dr.P.H., R.N., H.N.C., are Associate Professors in the School of Nursing at the University of Texas Health Science Center at Houston. Correspondence to Diane Wind Wardell, Diane.Wardell@uth.tmc.edu.     

Integrating Spiritual Experiences in Counseling

Although the spiritual dimension is an integral part of psychotherapy, most mental health professionals lack the necessary training for working with spiritual experiences therapeutically. The experiential focusing method developed by Eugene Gendlin (eg., 1969, 1981) offers a key tool for counselors to help clients integrate their spiritual experiences in counseling. In this article, the author offers a definition of the spiritual experience, outlines the focusing method, presents examples of its application, and discusses the implications of using focusing to help clients integrate spirituality in counseling.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

Religious Resources,Spiritual Struggles,and Mental Health in a Nationwide Sample of PCUSA Clergy

A growing body of research explores patterns and correlates of mental health among clergy and other religious professionals. Our study augments this work by distinguishing between religious resources (i.e., support from church members, positive religious coping practices), and spiritual struggles (i.e., troubled relations with God, negative interactions with members, chronic religious doubts). We also explore several conceptual models of the interplay between these positive and negative religious domains and stressful life events. After reviewing theory and research on religious resources, spiritual struggles, and mental health, we test relevant hypotheses using data on a nationwide sample of ordained clergy members in the Presbyterian Church (USA). At least some support is found for all main effects hypotheses. Religious resources predict well-being more strongly, while spiritual struggles are more closely linked with psychological distress. There is some evidence that stressful life events erode mental health by fostering an elevated sense of spiritual disarray and struggle. We find limited support for the stress-buffering role of religious resources, and limited evidence for a stress-exacerbating effect of spiritual struggle. Study limitations are identified, along with a number of implications and promising directions for future research.     

Ageing Health Care and the Spiritual Imperative: A View from Scotland

SUMMARY

This paper, given as a keynote presentation at the third international conference on Ageing and Spirituality 2004 in Adelaide, Australia, offers a perspective on ageing that makes central and fundamental the spiritual journey. Ageing is not confined to the old. We are all ageing all the time and whilst the imperative of ego integration (Erikson, 1986, 1982) is more pressing in old age, the march of time makes no exceptions. The paper starts with a consideration of the Scottish context and the current interest in Scotland in spirituality and health. Borrowing from the human developmental ideas of Frankl, Jung, Erikson, and Klein, the paper takes the view that we are all spiritual beings, and we are all trying to be successful, integrated reconciled and mature individuals. Ageing and spirituality is relevant to every individual. Successful ageing is fundamentally concerned with the successful self. The spiritual journey is bound up with the search for meaning. Ageing is part of the task of being human and it involves decline and loss. The spiritual journey–search for meaning–is unique to each one of us. The spiritual journey is made evident in the search for the ultimate destination of giving up self, transcending self. Remembrance and routine are methods by which the ageing and the spiritual journey can be facilitated. A successful ageing, according to this perspective, is therefore one that embraces and self-consciously embarks upon a spiritual journey. To take it further–the spiritual journey is bound up with ageing–and further still–ageing is a spiritual journey (Bianchi, 1984). The primary task of ageing is spiritual development. Spiritual development is helped by an appropriate societal context in which ageing as spiritual journey can flourish. This has implications for health and social care services.     

Spiritual advisors and old age psychiatry in the United Kingdom

This survey investigates the role and views of NHS spiritual advisors across the United Kingdom on the provision of pastoral care for elderly people with mental health needs. The College of Health Care Chaplains provided a database, and questionnaires were sent to 405 registered NHS chaplains/spiritual advisors. The response rate was 59%. Quantitative and qualitative analyses were carried out. Spiritual advisors describe their working patterns and understanding of their roles within the modern NHS, and their observations of the level of NHS staff awareness of the importance of spiritual issues in the mental health care of older adults. They provide insights into possible negative and positive perceptions of their roles at a service level, and contribute suggestions of topics relevant to shared education between pastoral care and clinical services. This survey further highlights ethical and operational dimensions at the point of integration of the work of spiritual advisors and multidisciplinary teams.     

Spiritual Struggles and Health: Assessing the Influence of Socioeconomic Status

Growing evidence suggests that spiritual struggles may play a major role in explaining the relationship between religion and health. Even so, there are significant gaps in the literature. More specifically, researchers do not know enough about how spiritual struggles arise in the first place. This study has two major goals. The first is to see whether socioeconomic status is associated with spiritual struggles. The second is to see whether spiritual struggles are associated with physical health. A conceptual model is tested that contains the following core hypotheses: (1) individuals with lower levels of educational attainment are more likely to encounter chronic economic difficulties; (2) people who experience ongoing financial strain are more likely to live in rundown neighborhoods; (3) people who live in dilapidated neighborhoods will be more angry than their well‐to‐do counterparts; (4) people who are more angry will, in turn, be more likely to experience spiritual struggles; and (5) greater spiritual struggles will be associated with more symptoms of physical illness. Data from a recent nationwide survey (N = 2,146) provide empirical support for each hypothesis.     

The Mediating Role of Emotional Intelligence between Spiritual Intelligence and Mental Health Problems among Iranian Adolescents

This study examined the mediating role of emotional intelligence between spiritual intelligence and mental health. The participants in the study were 247 high school Iranian students, (124 male and 123 female, in the age range between 15 and 17 years old). The results showed that spiritual and emotional intelligences explained mental health problems differently. Structural equation modelling revealed that spiritual intelligence had indirect effect on mental health problems, via emotional intelligence. These findings have implications for prevention of mental health problems among adolescent.     

Spiritual Care: Recognizing Spiritual Needs of Older Adults

SUMMARY

This paper explores aspects of spiritual needs and assessment, while emphasizing the importance of aged care providers being spiritually self-aware. The context of this exploration is meaning in life, spirituality and quality of life as experienced by older adults. Depression and dementia are frequently seen among older adults in residential aged care with resultant lowered quality of life. Pastoral and spiritual care may be used effectively to help alleviate depression and support older people who have dementia. However, to be able to provide appropriate spiritual care, spiritual needs should be assessed. Ways of assessing spiritual needs are suggested.     

Bridging Science and Religion: How Health‐Care Workers as Storytellers Construct Spiritual Meanings

Contrary to the notion that medical science has supplanted religious understandings of human suffering, recent research suggests that health‐care workers like nurses can still portray their confrontations with illness and death in spiritual terms through storytelling. However, scholars have yet to systematically analyze the rhetorical devices used to construct spiritual meanings. Drawing on a symbolic interactionist perspective, we theorize that front‐line health professionals can deploy various rhetorical devices to infuse their workplace interactions with a spiritual significance. We also propose novel fuzzy set analysis techniques for determining which configurations of devices are most important in developing spiritual meanings. This approach was illustrated by examining 173 stories elicited from nurses at a nonsectarian, teaching hospital about encounters at work that significantly impacted their understanding of spirituality. Consistent with our expectations, the way in which nurses tell stories about their experiences not only shapes whether they attach spiritual significance to them, but whether they perceive spirituality and medicine to be compatible. We discuss the implications of our findings for future research on lived religion, conflicting identities, and institutional boundaries.     

肿瘤科护士灵性照护认知与灵性照顾能力的相关性研究

采用量性调查和质性访谈结合的方法,对肿瘤科护士灵性照护认知和灵性照顾能力现状,以及他们之间的相关性进行研究和探讨,结果显示肿瘤科护士的灵性照顾能力总分为(69.74±15.31)分,灵性照护认知得分为(174.99±24.95)分,灵性照顾能力和灵性照护认知得分之间呈正相关(r=0.307,P<0.001),说明肿瘤科灵性照顾能力和灵性照护认知有待进一步提升,可通过干预或培训提升肿瘤科护士的灵性照护认知,从而提高其灵性照顾能力。     

Counseling for Spiritual Wellness: Theory and Practice

Spiritual wellness is an emerging area of interest in counseling. It still lacks clarity, however, in definition and application. To increase familiarity with and encourage counselor intervention regarding the spiritual dimension, the authors of this article attempt to define more clearly the concept of spiritual health and to describe ways to use techniques for the enhancement of spiritual wellness and the advancement of spiritual development.