Abstract
Throughout its history, the nursing profession has claimed to provide holistic patient care, which is defined as bio-psycho-socio-spiritual care. Today, however, many nurses do not feel comfortable with the “spiritual” element of care and are uncertain about their professional role in the assessment and delivery of spiritual care. Discomfort and avoidance of attending to the spiritual needs of human beings creates “a hole” in holistic patient care. Contributing factors to the “hole in holistic patient care” include: 1) blurring of boundaries in the language and definitions of “spirituality” and “religion”, 2) insufficient attention to definitions of spirituality and spiritual distress; 3) confusion and role conflict with professional identity among disciplines related to responsibility for spiritual care; 4) insufficient education and skill development for nurses and other healthcare professionals in the assessment, intervention and appropriate referral of patients experiencing spiritual distress. The purpose of this article is to explore the history of holistic nursing as it pertains to the human dimension of spirituality and conclude with practice models for spiritual assessment and spiritual care that can “fill” the hole in holistic nursing care.
Highlights
Life threatening illness and related suffering are arguably situations in which holistic care is the most important
The following sections will explore the history of holistic nursing as it pertains to the dimension of spirituality, barriers and misconceptions related to spiritual care, and end with a review of existing practice models for spiritual care and spiritual assessment tools that could promote the filling of the “hole” in holistic care
The various societal shifts and health care responses are reflected in newer models for spiritual care, some which are interdisciplinary. Such societal influences have included the development of clinical pastoral education (CPE) that integrated psychology and theology, Medicare reimbursement based on diagnosis related groups (DRGs), the history of holistic care reflected in nursing, the hospice and palliative care movement, Joint Commission standards for health care organizations, and ongoing chaplaincy debates between approaches of unstructured spiritual presence versus a more structured approach to spiritual diagnosis and care planning
Summary
Life threatening illness and related suffering are arguably situations in which holistic care is the most important. Provision of spiritual care is significant, as research has shown that spiritual health is related to better overall health outcomes and that healthcare consumers believe that spiritual needs should be addressed by healthcare providers [3]. Better health outcomes that can be promoted with spiritual care include disease prevention and recovery, sense of overall wellbeing, and enhanced ability to cope with illness and adjust to stress-related life events [4]-[7]. As a profession, has historically claimed to provide holistic care, yet, research indicates that many nurses do not feel comfortable or are not adequately trained to address the “spiritual care” dimension of their patients [11]-[14]. The following sections will explore the history of holistic nursing as it pertains to the dimension of spirituality, barriers and misconceptions related to spiritual care, and end with a review of existing practice models for spiritual care and spiritual assessment tools that could promote the filling of the “hole” in holistic care
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