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The Faith Connection
More RNs integrate spirituality into their practices to accommodate a growing patient demand and to address needs beyond the physical

 
 
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About 72 percent of Americans who responded to a Newsweek poll said they would welcome a conversation with their physician about their faith, according to the Nov. 10, 2003, issue.

loria Williams, MPA, RN, knows the power of having spiritual beliefs.

Medical professionals had diagnosed Williams’ grandfather, a Baptist minister, with brain cancer when he was about 50 and scheduled a date for surgery. He prayed a lot, and people prayed for him. During his next appointment, when medical professionals took X-rays of his brain, his cancer was gone.

Whether the act of praying eradicated this man’s cancer is up for theological debate, but several studies have documented the medical benefits of holding spiritual beliefs. Researchers have found that people who regularly attend religious services or who draw strength and comfort from spiritual beliefs have healthier immune systems and lower death rates.

Studies also suggest that patients want medical professionals to address their spiritual needs. About 72 percent of Americans who responded to a Newsweek poll said they would welcome a conversation with their physician about their faith, according to the Nov. 10, 2003, issue.

With data showing not only the health benefits of spiritual beliefs but also increased patient demand for spiritual care, nurses across the country are going beyond their medical skills to integrate spirituality into their practices.

“Spirituality in the context of health is re-emerging in public and professional arenas as an essential and vital component of health care,” said Elizabeth Johnston Taylor, Ph.D., RN, in her book Spiritual Care: Nursing Theory, Research and Practice (Prentice Hall: 2001). Taylor, an associate professor of nursing at Loma Linda University School of Nursing, wrote the book as a practical guide for nurses on how to provide spiritual care.

In the book, she describes how nurses are increasingly expected to incorporate the spiritual dimension within their care. She believes spirituality represents an innate, integral dimension of a person, and nurses who want to care for the whole client must also nurse the spirit.

Easing the passage

Goals for medical professionals when discussing spiritual issues with patients and families near the end of life:

  • Clarify the patient’s or family’s concerns, beliefs and needs. Follow hints they give you about spiritual issues.
  • Make a connection with patients or families by listening carefully, acknowledging their concerns, exploring emotions, using empathetic statements and using “wish” statements, such as, “I also hope she can go home.”
  • Identify common goals for care and reach agreement on clinical decisions.
  • Mobilize sources of support for the patient.

    Rebecca Ray

SOURCE: Lo, Bernard, et al. (2002). “Discussing Religious and Spiritual Issues at the End of Life: A Practical Guide for Physicians.” The Journal of the American Medical Association, 287(6), 749-754.

Satisfying the spirit

Harold Koenig, MD, an associate professor of psychiatry and internal medicine at Duke University Medical Center, suggests patients are dissatisfied because medical professionals don’t meet their spiritual needs. In his article “Meeting the Spiritual Needs of Patients,” which appears in the July/August 2003 Press Ganey Satisfaction Monitor, Koenig said this “widespread patient dissatisfaction” may interfere with their recovery.

About 76 percent of medical/surgical patients and 88 percent of psychiatric patients at a Chicago hospital reported three or more spiritual needs during hospitalization, according to Koenig; however, 80 percent of patients said their physicians had never or rarely addressed their spiritual needs.

Health care professionals, though, have made the mistake of trying to impose their spiritual beliefs on patients.

When the Rev. Scott Kuepfer, chaplain at Sioux Valley Children’s Hospital in Sioux Falls, S.D., observes this, he intervenes by helping staff members listen more attentively to patients and their family members. In the past, he’s seen staff members who are overly eager to offer spiritual care, and he coaches them about how to redirect their enthusiasm to better help the patient.

When health professionals don’t address patients’ spiritual needs, spiritual struggles may result, Koenig said. In a study of almost 450 patients who were followed for two years after hospital discharge, Koenig and his colleagues found that spiritual struggles could lead to a higher risk of death, poor mental health, low quality of life, longer hospital stays and a greater need for long-term care services after discharge.

Meeting patients’ spiritual needs, however, reduced the likelihood of patients developing depression and sped recovery for those who did develop depression. Attending to spiritual needs also may influence patients’ speed of response to medical treatment, Koenig said.

Williams, workforce manager in the department of strategy and planning at Kaiser Permanente-Northern California Region, believes spirituality may have played a role in prolonging the life of her late cousin Mildred, who died of lung cancer in 2003. Mildred, who would attend prayer meetings and church every Sunday, lived several years longer than most people with her illness. She never lost faith or got depressed, even after the cancer spread to her brain, Williams said.

Pauli Marr, MSN, RN, chief nursing officer for patient care services at St. Mark’s Hospital in Salt Lake City, said that patients “absolutely” recover faster when their spiritual needs are met.

Spirituality isn’t limited to organized religion, Marr said. Patients who don’t believe in a deity or who haven’t figured out their theological beliefs can benefit spiritually by doing seemingly nonreligious activities, such as looking at nature, loving animals or watching a humorous television show, she added.

Williams has seen music minister to patients, too. When her church choir visited a nursing home and sang “Amazing Grace,” a 90-year-old female patient sang with them, and the nursing home staff members began to cry. Williams later found out they were crying because the patient hadn’t spoken in about 10 years.

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