Nursing promotes a holistic view of care, one that incorporates the patient’s mind, body, and spirit. Many studies have found that patients consider physical and spiritual health equally important, and that patient outcomes are positively correlated with spirituality (Oakley, Katz, Sauer, Dent, & Millar, 2010). While the Joint Commission on Accreditation of Healthcare Organizations (JACHO) requires an initial spiritual screening for patients, it does not provide process specifics (Joint Commission on Accreditation of Healthcare Organizations [JACHO], 2005). This paper uses an assessment questionnaire to conduct a spiritual-needs assessment and provides summary analysis of the assessment’s strengths as well as addressing barriers or challenges to real-life application. Spiritual Assessment Process
This author developed a questionnaire of six questions to be used as a spiritual assessment tool. A neighbor, B.G., a married fifty-year old women with two children in college consented to the assessment but preferred to be orally interviewed for the assessment. Below are the list the questions read to her and responses are represented in her own words. Questionnaire/Interview
1. Do you consider yourself religious or spiritual? What things provide meaning for you? Answer: Oh yes, I put God at the center of my life. I consider it my job to get up everyday and try to be a better person, doing whatever God calls me to do. I try to be kind and not have judgments. 2. Do you belong to a certain faith of denomination?
Answer: I am Catholic. I go to St. Mary Magdalene up on the hill every Sunday. Sometimes I go on Friday for Adoration and I go to my women’s bible study every Wednesday. 3. Would you like support from your church and/or the hospital chaplain if you were hospitalized? Answer: Yes, I would hope for prayers and visits from my church family and would love to have a chaplain come to visit me. 4. How do you express your faith?
Answer: I pray everyday, sometimes several times a day. It really helps me.
It gives me strength and peace. I also read devotional books every morning and before I go to bed. I get a lot of joy and peace from that. 5. How does your faith help you cope with illness?
Of course, I don’t want to be sick or have bad things happen but I know that everything is God’s will and that some things I don’t understand but he does. I am not afraid of death or suffering because I know it is part of his plan and in the end will be heaven. 6. How would you like your health care provide to support to you spiritually? Would you want them to pray with you? Answer: I think it would be nice to know that my doctor or nurse believes in God but I don’t ask because I think it is too personal. I would like to be sure that my church was contacted if I was in the hospital. I would like to have a bible and my books. I would want to pray but I think I would rather pray by myself than with my doctor or nurse. I was in the hospital once and they had morning and evening prayers over the loudspeaker everyday. I really enjoyed that. It was really comforting. I hope they still do it. (B. G, personal communication, July 3rd, 2014). Assessment Summary
The interview and conversation was a very pleasant experience. B.G. appeared comfortable with the topic and relaxed. The conversation ran about 30 minutes and some of B.G’s responses were rather lengthy and extrapolated to other topics. For the purpose of this paper, B. G’s comments were edited down to her specific responses to the questions presented. Strengths/Discoveries
Griffen and Yancy (2009) state that, “caregivers often envision intense, time-consuming interventions as necessary for provided spiritual care” (Griffen & Yancy, 2009, p. 879). A great strength of this assessment tool is that it provides a short, targeted questionnaire that can be filled out by the patient and then reviewed with the patient by the nurse. The tool can help determine patient strengths in coping, avenues of support, and guide spiritual supportive care. In this case it allowed for the discovery of prayer, devotional readings, church and chaplain support as very meaningful coping supports for B.G. This tool also allows for a conversation that is less clinical in nature between the patient and practitioner, which may enhance the interpersonal relationship. Griffen and Yancy (2009) maintain “small, even subtle exchanges provide powerful spiritual benefits for patients” (Griffen & Yancy, 2009, p. 879). In this case, small acts such as providing the patient with a bible or her books, contacting her church, arranging a chaplain visit, and giving privacy for prayer could provide tremendous spiritual care.
The amount of time it took to complete the assessment would be a great challenge in a health care setting where time is very limited. The length could have been influenced by the informality of the out of hospital setting, the oral setting, and the subject’s comfort with the subject area. I believe a better process would be to have the patient fill out the questionnaire and then review it with the patient. This may allow for a more targeted conversation. This challenge alludes to another barrier, which is the skill and comfort level of the practitioner in preforming this kind of assessment. Health care professionals have had years of training in physical assessment but very little education in how to preform spiritual assessments. Health care workers may feel uncomfortable talking about spirituality with patients due to lack of experience and education (Oakley et al., 2010). Conclusion
Performing a spiritual needs assessment provides health care workers with information that can help to better meet the needs of their patients and can enhance the patient-professional relationship. Using an assessment tool provides the nurse with the means to broach a difficult subject as well as an opportunity to investigate resources that may enhance patient comfort and healing. Use of a targeted assessment tool, providing education and training for staff would improve the assessment process and help to guide more holistic patient care.
Griffen, A. T., & Yancy, V. (2009, May). Spiritual dimensions of the
perioperative experience. Association of Operating Room Nurses. AORN Journal, 89(5), 875-882. http://dx.doi.org/doi:http://dx.doi.org/10.1016/j.aorn.2009.01.024 Joint Commission on Accreditation of Healthcare Organizations. (2005). Evaluating your spiritual assessment process. Retrieved from http://www.pastoralreport.com/archives/spiritual.pdf Oakley, E. T., Katz, G., Sauer, K., Dent, B., & Millar, A. L. (2010). Physical therapists’ perception of spirituality and patient care: Beliefs, practices and perceived barriers. Journal of Physical Therapy Education, 24(2), 45-52. Retrieved from http://search.proquest.com/docview/854339040?accountid=7374