spiritual care


spiritual care

 that aspect of health care that attends to spiritual and religious needs brought on by an illness or injury. Health care professionals profess a commitment to holistic care, in which the whole person is ministered to, yet they often leave spiritual problems to persons whom they consider better qualified than they to deal with problems of this kind. Thus patients often have deep concerns that are unspoken and suffering that is not shared.

Assessment of spiritual needs should go beyond a perfunctory question about religious affiliation at the time of admission. Questions about values and beliefs should be asked, preferably at the end of the assessment interview, when the patient shows trust and confidence in the nurse. It may be that patients will provide little information at first, but later on, when there is a more trusting relationship with the nurse, or when a frightening medical diagnosis has been made, assessment and interventions may be indicated. However, if patients remain reluctant to discuss personal beliefs and values, their right to privacy is respected.
Stoll has suggested that there are four general areas of concern to be addressed during spiritual assessment. These include (1) the person's concept of God or deity and how this concept is significant in his or her life; (2) sources of help and strength in times of spiritual crises; (3) religious practices; and (4) the relation between spiritual beliefs and health, sickness, and death.
Profound questions of the meaning of suffering and death may surface when a person is experiencing a serious illness or similar crisis of physical health. In the face of impending death or a radical change imposed by the loss of a body part or function, patients may experience panic, anxiety, depression, and feelings of guilt or abandonment. They need opportunities to express spiritual concerns to an attentive listener, to bring into focus and work through their questions and doubts, and to experience hope and support for the beliefs that give them strength and consolation.
While health care providers are not typically the primary source of spiritual counsel, they can contribute to the overall welfare of their patients by being alert for expressions of spiritual distress, listening to the patients when they want to talk about spiritual concerns, and reading and praying with them when appropriate. Referral to the hospital chaplain or the patient's minister, priest, or other spiritual guide is an important part of meeting a patient's spiritual needs, but it does not relieve health care professionals of their responsibility for continued spiritual support.