What tool can the the nurse use to conduct a spiritual assessment?

Spiritual Assessment and Counsel in Healthcare

Introduction to Spiritual Assessments

The holistic view of healthcare encompasses the “whole person”: the mind, body, and spirit of a human being. Psychotherapy helps heal the mind and keep it healthy. Proper nutrition, exercise, and medical support help to keep the body healthy and improve it. But what of the spiritual aspect as it relates to health and well-being? Let’s take a closer look at spirituality, what a spiritual assessment is, and how it can help improve health.

Is the Spiritual Aspect Important?

Most people consider themselves spiritual.

A survey conducted in the year 2000 revealed that of all North Americans:1

91% said they believed in God or a Universal Spirit

83% reported that God is highly important in their lives

79% of Americans said they believed spiritual faith can help people recover from disease

63% felt that doctors should ask their patients about spiritual beliefs

What is a Spiritual Assessment?

A spiritual assessment is necessary to find out if any beliefs could impact health. There are formal spiritual assessment tools, a few of which we will discuss later on, that help healthcare professionals in identifying patients’ spiritual needs. Assessment tools can also be used to see whether patients are experiencing spiritual distress. However, informally assessing patients’ spirituality by asking open questions about their spiritual beliefs and needs are also effective ways to determine patients’ spirituality. Let’s first take a look at the nature of spirituality and the areas that need to be addressed during a spiritual assessment.

What is Spirituality?

Spirituality means different things to different people, and it is an intensely personal issue for many. In general, spirituality is the ways in which individuals fulfill what they believe to be the purpose of their lives. It’s a way of life that comes from a person’s inner realm that can be from a secular or religious point of view.

Spirituality is important to our psychological wellbeing because it can provide direction and energy. Therefore, spiritual awareness can provide these vital points:

It helps an individual discover a sense of meaning and purpose in life
It provides a healthy sense of belonging
It points us in the right direction when we're seeking to define and stick to our values

Studies support that spirituality helps prevent and heal disease. It also helps those who are enduring distress and disability.2
So, a spiritual assessment can help pinpoint areas in life that may help a person recover.

Spiritual Beliefs

Spiritual beliefs can involve God, prayer, or meditation. Beliefs frequently include the relationship people have in relation to God (or a superior being) which influences their perspectives on life, death, and reality.

Faith

Faith usually has to do with God. People with faith in God perceive God as essential in providing strength to deal with daily challenges. God is called upon for help in healing physical or mental illnesses.

Religion

Religion includes practices and rituals, such as prayer or meditation and engaging with people in the religious community, such as fellow church members and clergy.

Spiritual and religious beliefs do overlap in many important areas – both can have a heavy influence when it comes to coping with illness. Also, it’s essential to look at both of these concepts, because some individuals see themselves as spiritual but not necessarily religious.

Spiritual Needs

Spiritual needs in healthcare can be separate and distinct from religious ones. Spiritual beliefs may or may not be religious, but most religious individuals are spiritual. Most people, especially when they’re faced with illness and the questions of life and death, will have spiritual needs and concerns that should be viewed as essential to high-quality patient care.

To address spiritual needs, healthcare professionals must understand how each individual fulfills their purpose in life. For some patients, it’s in non-religious ways, and for others, it is highly religious. Therefore, performing a spiritual assessment helps a healthcare professional learn how spirituality can help the healing process.

In a hospital setting, religious needs could translate into special diets, not being in a mixed-gender ward, the availability of places to pray (non-secular or secular chapels), the availability of chaplains in patients’ faiths, and how people with fatal illnesses are allowed to die.

Spiritual Gifts

The spiritual gift and its expression are concepts that innate talents, such as artistry, allows a person better self-expression. When spiritual gifts are used, it increases the potential for individual success and happiness. As part of a formula for healing, if a person is using their spiritual gifts to bring joy to themselves or others, it can provide peace and pleasure.

Spiritual Tools

Spiritual tools are the ways patients can help to change their mindsets from fear to a more confident, positive approach to the world. Some examples of spiritual tools include meditation, practicing surrendering to a higher power daily, taking a personal inventory, prayer, saying affirmations and reading devotionals.

Who Performs a Spiritual Assessment?

Family Physicians

Family doctors are the frontline of medical care and become familiar to their patients with repeat visits. This initial contact with a variety of patients gives GPs vast opportunities to determine the spiritual needs and care of many people.

Nurses

Nurses are one of the main providers of spiritual care to patients. Hands on nursing care in hospitals and other medical settings permits close relationships between nurses and their patients, giving nurses ample opportunities to provide spiritual care to patients.

Other Healthcare Professionals

Other healthcare professions, most notably psychiatrists, psychologists, and addiction treatment specialists, also offer opportunities for spirituality to figure into more effective and successful treatments. For example, people see someone in these fields when they are feeling stressed or depressed. Research shows that a lack of spiritual beliefs can be linked to depression.3

Imbalance in a person’s spiritual needs is often seen in addiction treatment. It’s important for psychiatrists, psychologists, and addiction treatment professionals to address the spiritual issues because of their influence on mental health and recovery.

Spiritual Gifts Assessment Tool

It’s important for healthcare professionals to understand patients’ spiritual gifts. This way, doctors, nurses, and other healthcare staff can learn where a person’s joy comes from, which can then be used in the healing process. The HOPE Assessment Tool for Spiritual Assessment can help identify personal sources of hope and meaning, as well as spirituality and practices.4

HOPE is an acronym used in the following ways:4

H: Hope, strength, comfort, and how patients deal with difficult times
O: Organized religion - learning if patients are part of a religious community and how it helps them
P: Personal spiritual beliefs and what practices patients find most helpful
E: Effects on medical or end of life issues as they relate to the patients' spiritual resources, and if there are any specific spiritual practices that patients want included in their medical care

Spiritual Distress Assessment Tool

Spiritual distress develops when there are unmet spiritual needs which leads to a disturbance in the person’s spiritual state. The Spiritual Distress Assessment Tool (SDAT) aims to uncover any unmet spiritual needs and determine the presence of spiritual distress. The higher degree in which a spiritual need stays unmet, the greater the level of disturbance in the spiritual state and the higher degree of spiritual distress is experienced by the patient.

Healthcare professionals need to discover if spiritual distress is playing a role in a patient’s health. Just as research has shown that strong spirituality can help heal sickness and improve health, spiritual distress, such as low spiritual well-being or struggles with religion, may be associated with worse health outcomes.5

During this spiritual assessment, a standardized set of questions are asked and then evaluated for any unmet spiritual needs and their resulting disturbances. If the SDAT discovers spiritual distress, it provides a healthcare professional with a deeper understanding of their patient.

FICA Spiritual History Tool

The FICA Spiritual History Tool gets its name from the four categories it assesses:4

Faith and belief: finding out the patients' spiritual beliefs and what gives their life meaning
Importance: discovering how spiritual beliefs are used in dealing with illness
Community: learning how patients are involved in a spiritual or religious community
Address in Care: asking how they would like their healthcare professionals to address these spiritual issues in the healthcare process

Using the FICA spiritual assessment is an important tool for healthcare professionals to provide the best care to the patient. The information learned in the assessment may direct treatment and recovery.

How Does a Spiritual Assessment Improve Healthcare?

What are the 5 types of instruments used for spiritual assessment?

These six qualitative instruments consist of a brief assessment instrument and five comprehensive Page 3 SPIRITUAL ASSESSMENT 3 instruments: one completely verbal approach—spiritual histories—and four penandpaper, diagrammatic approaches—spiritual lifemaps, spiritual genograms, spiritual ecomaps, and spiritual ecograms ...

What is a spiritual assessment in nursing?

A formal spiritual assessment involves asking specific questions during a medical interview to determine whether spiritual factors may play a role in the patient's illness or recovery and whether these factors affect the medical treatment plan.

What is spiritual distress assessment Tool?

The Spiritual Distress Assessment Tool (SDAT) is a 5-item instrument developed to assess unmet spiritual needs in hospitalized elderly patients and to determine the presence of spiritual distress. The objective of this study was to investigate the SDAT psychometric properties.

What are some nursing assessment questions for spirituality?

Some questions to be included in a spiritual assessment include: “Who or what provides the patient with strength and hope?”; “Does the patient use prayer in (his/her) life?”; “What type of spiritual/religious support does the patient desire?”; “What does dying mean to the patient?”; “Is there a role of church/synagogue ...