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SPIRITUAL INTERVENTION AND THE SCIENCE OF UNITARY HUMAN BEINGS

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Describe the context for spiritual interventions from a Rogerian paradigm ... Describe two successful interventions delivered with minimal organizational backing ... – PowerPoint PPT presentation

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Title: SPIRITUAL INTERVENTION AND THE SCIENCE OF UNITARY HUMAN BEINGS


1
SPIRITUAL INTERVENTION AND THE SCIENCE OF UNITARY
HUMAN BEINGS
  • Australian College of Holistic Nurses
  • 5th INTERNATIONAL CONFERENCE 2002
  • Touching the Spirit
  • Ancient Wisdom in the Art and Science of Future
    Nursing
  • Hahndorf, SA Australia
  • Thomas Cox RN, MS, MSW, MS (Nursing)
  • Doctoral Candidate
  • Virginia Commonwealth University
  • School of Nursing
  • November, 2002

2
Objectives
  • Describe the context for spiritual interventions
    from a Rogerian paradigm
  • Review literature on spirituality relevant to
    spiritual interventions
  • Describe two successful interventions delivered
    with minimal organizational backing
  • Suggest paths to spiritual intervention in
    practice

3
Premises
  • Opportunities for spiritual interventions arise
    naturally when we attend to the integrality of
    the human-environment fields, can be provided
    with minimal cost, time, and help if the
    caregiver is attentive, responsive and creative.
  • Barriers to spiritual expression impair the
    ability of clients to address their own
    spirituality - whether the clients and staff
    perceive them as internal or external to the
    client, or do not see them at all.
  • Removing obstacles to spiritual expression are
    likely to be more effective than efforts to
    compensate for such obstacles, allowing people to
    engage naturally in spiritually meaningful
    activities is easier than mobilizing resources

4
Science of Unitary Human Beings
  • Humans are energy fields - integral with and in
    continuous mutual process with environmental
    energy fields
  • Though Rogers does not specifically address
    spirituality, integrality is similar to other
    spiritual conceptions such as oneness, prime
    mover, Freuds oceanic feeling, flow,
    presence, nature, being
  • Malinski - integrality is what is experienced
    when people have spiritual experiences.
  • SUHB nurses often center and meditate before
    nursing activities, as do other nurses

5
Dimensions of Spirituality
  • Meaning-making
  • Meaning, purpose, or significance of human life
  • Values clarification
  • beliefs and standards about what we hold to be
    true, beautiful, sacred, profane
  • Transcendental or integral relationship to the
    infinite
  • experience and appreciation of pandimensionality
    oceanic feeling, synchronicity, archetypes,
    unboundedness
  • Connecting with self and others
  • including relationship with God(dess), higher
    power, Gaia
  • Unfolding/Becoming
  • Beliefs regarding an evolutionary course to
    life, that we evolve consciously, and to a higher
    state of being

6
Defining Characteristics of Spiritual Distress
  • Necessary Experiencing a disturbance ones
    belief system.
  • Possible
  • Questioning of ones own belief system.
  • Experiences discouragement, despair, spiritual
    emptiness
  • Unable to practice usual religious rituals.
  • Has ambivalent feelings (doubts) about beliefs.
  • Believe (s)he has no reason to live.
  • Emotionally detached from oneself and significant
    others.
  • Is concerned, angry, resentful, afraid
    regarding life, anguish, death.
  • Asks for help dealing with spiritual issues/doubts

7
S 1
  • Impaired Coping
  • Humor
  • to facilitate appreciation of that which is
    funny, to relieve tensions
  • Hopelessness
  • Hope instillation
  • to promote a positive sense of the future
  • Spiritual Distress
  • Spiritual support
  • to facilitate a sense of inner peace
  • Spiritual Well-Being
  • Spiritual growth facilitation
  • to support growth/reflection reexamination of
    values

8
Institutional Support for Spiritual Work
  • Joint Commission for Accreditation of Healthcare
    Organizations (JCAHO)
  • Address the spiritual needs of diverse clients
  • World Health Organization
  • The definition of health includes four domains of
    well-being physical, mental, social and
    spiritual.
  • The North American Nursing Diagnosis Association
  • spiritual distress is a nursing diagnosis
  • International Council of Nurses Code for Nurses
  • Requires that nurses address patients spiritual
    needs
  • Nursing Interventions Classification System
  • "hope instillation", "spiritual growth
    facilitation" and "spiritual support" are
    appropriate nursing interventions

9
Examples of Spiritual Interventions
10
Impediments to Spiritual Intervention
  • Lack of specific resources
  • Differing definitions of spirituality and
    religion
  • Uncertainty of the appropriateness of spiritual
    intervention
  • Lack of peer support and limited continuity for
    spiritual interventions
  • Inadequate resources for specific spiritual
    interventions.

11
The Clients
  • J - A short term, though considered to be a
    potentially long-term referral for chronic care,
    voluntary, acute admission to a university
    affiliated in-patient, mental health facility
  • S a long-term (15 years) patient at a state
    run psychiatric hospital on a ward for aggressive
    male clients

12
J 1
  • Young, White/American-Indian male, severe
    depression, suicidal ideation deemed long-term.
  • Had not spoken since admission and refused
    medications
  • Approached casually, sat side by side for 20
    minutes, and eventually asked how he felt about
    being here.
  • He stated distaste for being unable to be
    outside.

13
J 2
  • Upon further gentle probing around Native
    American issues explains that he spent most of
    his time hunting, fishing and scavenging on
    family land.
  • Intervention - pharmaceuticals are a method of
    healing, blended by powerful, shamanic figures,
    based on natural healing remedies found in nature
  • J accepts meds, works on several healing issues,
    and leaves in a matter of days.

14
S 1
  • Older, African-American male.
  • Hospitalized in a public psychiatric hospital for
    20 years.
  • Refuses to sleep in a bed
  • Frequently heard mumbling Come to Jesus
  • Behavioral intervention team tries traditional
    behavior modification approach with edible
    re-inforcers.

15
S 2
  • S eats treats and refuses to stay in room
  • Intervention secure a tape player from
    behavioral team and play Gospel music in clients
    room.
  • Client eats snack, listens to music, unfolds
    unused bed, climbs in and sleeps for several
    hours first use of a bed in 8 years
  • Over several days, when nursing staff took the
    time to set the environment in his new room up,
    and sit with him for a few minutes, S would
    quietly eat his snacks and spend some time
    sleeping in his room

16
Recommendations 1
  • Spiritual interventions are as much a matter of
    recognizing the need as of developing the
    intervention.
  • Often, all that is needed is permissions
    frequently denied in the setting, to be
    themselves.
  • Resources for spiritual interventions are low
    cost, flexible, and need not present conflicts
    for staff.
  • Attend to the expressed needs, the impediments to
    immediate gratification, and use a little
    creativity.

17
Recommendations 2
  • Js behavior and ideation could have been
    interpreted as delusional or a symptom of
    substance abuse rather than spirituality
    accepting his frame of reference for his behavior
    as spiritual was a key to working with him.

18
Recommendations 2
  • S was a frequently violent and nearly impossible
    to understand when agitated. Nobody ever thought
    about why he was singing or how it might be used
    to help him.
  • In fact, it was conventional wisdom on the unit
    that when S started singing he was soon likely to
    get violent.
  • In fact, an entire team of psychologists, nurses,
    behavior therapists, and social workers designed
    a behavioral intervention that was nowhere near
    as effective as a cassette tape with hyms.

19
S 1
  • Older,

20
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21
S 1
  • Older,
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