Showing papers on "Spiritual care published in 1999"

Spirituality in nursing : standing on holy ground

Abstract: Spirituality in Nursing: Standing on Holy Ground, Fourth Edition explores the relationship between spirituality and the practice of nursing, providing students and professionals with invaluable insights from a variety of perspectives. Topics include nursing assessment of patients' spiritual needs, the nurse's role in the provision of spiritual care, the spiritual nature of the nurse-patient relationship, the spiritual history of the nursing profession, and contemporary interest in spirituality within the nursing profession. Completely updated and revised, this Fourth Edition now includes a chapter on servant leadership.

Evidence based palliative care: There is some evidence—and there needs to be more

Abstract: In the first decades of the 21st century much healthcare spending will be concentrated on the end of life. Predictions for the year 2025 show an ageing population, with more people worldwide dying from chronic or progressive illnesses rather than acute conditions.1 Indeed, this revolution is already upon us. In the United States end of life expenditure through Medicare consumes 10-12% of the total health budget and 27% of the Medicare budget.2 Among older people healthcare expenditure for those in the last year of life was 276% higher than for people of similar age.3 Cartwright and Seale estimated that in England about 22% of hospital bed days were taken up by people in the last year of life.4 Although discussion of death is still taboo in our society, all health and social professionals must now be assessing the best way of caring for a person with a progressive illness and their family. This underlines the importance of palliative care. Palliative care is a person centred approach concerned with physical, psychosocial, and spiritual care in progressive disease. It focuses on both the quality of life remaining to patients and supporting their families and those close to them. Throughout the world specialist palliative care services have grown, though their distribution is uneven. In 1999 there were over 6560 hospice or palliative care services in 84 countries, with 933 services in …

The impact of hospice inpatient care on the quality of life of patients terminally ill with cancer.

Abstract: This study explored the expectations and experiences of patients with terminal cancer in a hospice inpatient environment in an attempt to evaluate their quality of life and the impact of the care and services provided. A total of 52 patients terminally ill with cancer from 11 hospice units in Hong Kong participated in the study. Data were collected from patients by devising a Hospice Care Performance Inventory (HCPI), which was an interview schedule consisting of 25 items. The HCPI was developed after a review of the literature on the quality of life experienced by patients with advanced cancer and the aims of hospice units in Hong Kong. Each item was rated by the patient on a Likert scale in terms of its importance and the perceived effectiveness of the care provided. The study identified six issues in which expectations did not seem to match effectiveness. These issues indicated areas in which improvement could be attempted to enhance the quality of life for the patients. The most important was maximizing self-care and mobility. Two issues were identified in which effectiveness was high and importance to the patient relatively low. One of these issues was pain management, and the other was spiritual care.

Spiritual Care Matters

Abstract: Helping theories are applied in the context of faith and its relationship to healing and rehabilitation. Spirituality is presented as a potential resource for persons who experience disability. Spiritual care is particularly helpful if nurtured (in appropriate ways) by the rehabilitation professional.

Lung cancer: the role of the nurse in treatment and prevention.

Abstract: The aim of this article is to develop nurses’ knowledge and understanding of their role in caring for patients with lung cancer, both in the acute and palliative setting. It also explores the nursing role in prevention through helping patients to stop smoking. After reading this article you should be able to: Discuss the underlying pathophysiology of lung cancer. Describe the investigations and treatments for lung cancer. Account for the symptoms associated with lung cancer and highlight measures used to control them. Consider the role of the nurse in providing psychological and spiritual care. Reflect on the role of the nurse in the prevention of lung cancer.

Holistic care and spirituality: potential for increasing spiritual dimensions of nursing.

Abstract: Holistic care addresses the physical, psychological, social and spiritual dimensions of the client. Health care providers, however, frequently overlook the spiritual dimension. Spiritual care is inseparable from physical, social and psychological care because together they form the whole. Promoting spiritual well-being supports clients in their journey to find meaning and hope in life and peace in death. The preparation of nurses for the spiritual aspects of care deserves much more attention.

Handbook on Ethical Issues in Aging

Abstract: Preface Ethical Issues--In Whose Best Interest by Tanya Fusco Johnson Ethical Issues in a Sub-culturally Diverse Society by Anthony Cortese Ethical Issues in a Religiously Diverse Society by Cromwell Crawford Ethical Issues in Spiritual Care by Patricia Suggs Ethical Issues in Medical Care by Anthony Back and Robert Pearlman Ethical Issues in the Quality of Care by Kathy Marquis and Bette A. Ide Ethical Issues in Terminal Care by Dallas M. High Ethical Issues in the Care of the Judgment Impaired by Lawrence Heintz Ethical Issues in Mental Health Care by Martha Holstein and David McCurdy Ethical Issues in Personal Safety by Georgia J. Anetzberger Ethical Issues in Nonfamily Care by Phyllis B. Mitzen and Arlene Gruber Ethical Issues in Family Care by Jennifer Crew Solomon Ethical Issues in Legal Care by Marshall Kapp Ethical Issues in a High-Tech Society by Gari Lesnoff-Caravaglia Ethical Issues in Research on Aging by Beth Vernig, Robert O. Morgan, and Carolee A. Devito Ethical Issues in Long-Term Care by Lawrence McCullough, et al. Ethical Issues in Decision Making: A Balanced Perspective by Tanya Fusco Johnson Ethical Issues in Aging: Synthesis and Prospects for the Twenty-first Century by W. Andrew Achenbaum References Index

Working in the Dark: The State of Palliative Care for Patients with Severe Dementia

Abstract: We fail to recognize such common symptoms as pain, and the current standard of care often does not achieve the ends we expect. We work in the dark-we do what we can-we give what we have. Our doubt is our passion and our passion is our task. -Henry James, The Middle Years Over the past thirty years, dedicated workers in palliative care have developed a unique philosophy that focuses on comfort and have worked to translate that philosophy into superb end-of-life care. Palliative care encourages patients to come to terms-at their own pace-with their disease and their prognosis (Doyle, Hanks, and MacDonald, I998). Patients are encouraged to participate in medical decisions and in their own psychological and spiritual care. They can do so because up to the final weeks and days of their lives most retain the ability to give family and caregivers directions about their preferences (Breitbart et al., I995; Pereira, Hanson, and Bruera, 1997; Weinrich and Sarna, I994). Unfortunately, patients with dementia face an entirely different situation, presenting a particular challenge to those who provide palliative care. Our failure to adequately address this challenge has been the cause of unnecessary pain and suffering (Bernabei et al., I998). Palliative care for patients with dementia is different and difficult because clinical science in this area is even more limited than it is in the palliative care of other common and chronic diseases. We know very little about the symptom experience in the terminal stage of dementia and the best ways to manage that experience. Data suggest that we fail to recognize such common symptoms as pain, and the current standard of care often does not achieve the ends we expect (Parmelee, I996; Parmelee, Smith, and Katz, I993). Palliative care for this population is also difficult because patients with dementia progressively lose cognitive function. Their relationships with others and their ability to participate in their care declines as their need for palliative care increases. They are often denied the opportunity to negotiate their status as "terminal" and to direct the development of a plan of care. Moreover, the ambiguity of advance directives and the difficulty of defining the "end stage" of dementia make it difficult for caregivers to look to the patient's wishes for guidance. Caregivers may find that this uncertainty also isolates them from the dominant bioethic that requires that they respect a patient's autonomy by means of substituted judgments, that is, by doing what they believe the patient would want. The problems in providing palliative care for patients with severe dementia are fundamental. The solution lies in adopting a bioethic called narrative consensus and promoting research that fosters an evidence-based practice. THE CURRENT STATE OF THE ART: THE CASE OF MRS. L Mrs. L is an 8$ year-old woman with Alzheimer's disease who has been admitted to the hospital with the diagnosis of a fever caused by a urinary tract infection. She is receiving intravenous antibiotics and fluids. This is the patient's third hospital admission in the past five months. Two previous admissions were for urinary tract infections and the other was an episode of aspiration pneumonia. She lives at home with her daughter and her dementia leaves her dependent in all basic activities of daily living. The daughter is not sure if her mother still recognizes her Mrs. L has no advance directive. . While in the hospital, a disagreement has arisen. Mrs L's daughter is concerned that she has been eating very lite. She is co as well that her mother's gestures and vocalizations indicate that she is hungry. The staff believe that Mrs. L is agitated and requires treatment with antipsychotics. The daughter appeals to the staff: "I know my mother This is not her agitation. When she's agitated, she doesnt do this; she yells and even will hit me. …

Behavior Patterns of Health Care Utilization in Terminal Cancer Patients

Abstract: Background: In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods: We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results: Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions: Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

A holistic nursing model for spiritual care of the terminally ill.

Abstract: Terms such as religion and spirituality usually imply a mature understanding of philosophical values of life principles and existence. In a holistic paradigm, nurses are ethically obligated to support spiritual aspects of care just as they do the biophysical elements. But how often is this all important step overlooked in our assessments and interventions? This essay contains a discussion of basic spiritual and religious principles, the moral obligations to alleviate spiritual suffering and the principles of altruism, beneficence, goodness, individuality, and the need for continuing spiritual education as a component of a holistically competent practice.

The Four Worlds of Spiritual Assessment and Care

Abstract: From the dawn of human consciousness, religious and spiritual expressions have been inexorably intertwined with some degree of assessment toward more effective care— whether such care is offered by shaman, imam, rabbi, shirpa, prophet, priest, pastor, physician, nurse, or lay minister. Currently, two major forces have brought spiritual assessment and care into sharp focus regarding the delivery of health care in the U.S. The first is the advent of managed care. The shift in emphasis from sickness-based to wellness-based reimbursement, spurred by spiraling costs, has brought close scrutiny to provider effects on patient outcomes. The second major force, related to the first, has been increased attention to alternative medicine and to previously unacknowledged adjuncts to traditional health-care delivery, most often understood by the terms “holistic health” or “wellness.” One of the sub-areas within holistic health is spiritual care. A measure of the increasing importance of spiritual care within the delivery of U.S. health care is the fact that the Joint Commission on Accreditation of Health Organizations (JCAHO) is gradually upgrading the place of chaplaincy services in the Standards. Thus, a clear, simple, user-friendly, inclusive, valid, reliable, useful diagnostic, care-anticipating, and outcomes-measurable spiritual-care model is becoming more a necessity in the increasingly demanding discipline of clinical chaplaincy.

The Influences of Spiritual Care Nursing Education Towards Death and Dying

Abstract: In order to care the persons who are dying a nurse should first solve her / his own conflicts about death and be aware of their own concepts of death and dying In order to find out patient's spiritual needs and to give better spiritual nursing care a nurse should know her / his own spiritual needs and be aware of their own concepts of spiritual nursing problems To improve nurse's understanding towards death and dying and nurse's knowledge towards spiritual needs and spiritual nursing care 14 weeks(two hours a week) spiritual nursing care education was given to 3th grade baccalaureate nursing college student Before and after spiritual nursing care education 30 items of prepared questionare focused on the attitudes toward death and dying was asked Pre and post results are as follow ; 1 The dying patient's emotional and physical needs There was no significant difference between pre and post educated groups Both of the situations they agreed upon that the dying patients have high emotional and physical needs to solve 2 Telling the truth of dying process There was no significant difference between pre educated group and post educated group 3 Attitudes of medical personnels There was no significant difference between pre and post educated groups These responses indicate that nursing college student didn't have enough experiences on dying patients care 4 General attitudes on death and dying Number of nursing students who were thinking positively toward death and dying were Increased (pre post ) and who were thinking negatively toward death and dying were also decreased (pre post ) 5 Attitudes toward mechanical assistance for life-expanding of helpless patient There was a significant difference between pre and post educated groups About of them approved upon mechanical assistance for life and about of them disapproved 6 Attitudes of family members of dying patient There was no significant difference between pre and post educated groups About of both groups, agreed upon that the family members feel annoyed with dying patients and about of both groups disagreed Whether they received the spiritual nursing education or not, they were aware of that the family members feel annoyed with dying patients 7 Special facility and educational preparation for dying patient There was a significant difference between pre and post educated groups These responses indicated that after they received the education, they felt more about the necessity of special facility and educational preparation for the death and dying patients 8 Special facility and welfare system for the old There was a significant difference between pre and post educated groups There responses indicated that after they received the education, they felt more about the necessity of special facility and welfare systems for the old

The Expanded Care for Healthy Outcomes (ECHO) Project: addressing the spiritual care needs of homeless men in recovery.

Abstract: As the nation's homeless population continues to rise, new practice models will need to address the specific health care needs of the homeless while providing cost-effective wellness-oriented quality care. This article describes the early development of one such model. The Expanded Care for Healthy Outcomes (ECHO) Project is an interdisciplinary curriculum/practice model that explores the vital intersection of spiritual and primary care in promoting health among homeless guests at the Pine Street Inn Nurses Clinics in Boston, Massachusetts. The authors describe the incorporation of spiritual assessment and care in clinical practice with homeless men to maximize patients' physical, psychosocial, and spiritual wellness.

Informing the debate: chaplaincy and spiritual care in Scotland

Abstract: This article is based on research into how healthcare chaplains understand and practice spiritual care in Scotland. Scotland, with its own department of health and national church, is distinct within the United Kingdom. While a great deal has been written regarding spiritual care in the 1990s little has been contributed by chaplains, who seem unaware of the debate. The research demonstrates that Scottish chaplains are less religious in understanding and practice than might generally be expected, and also how they naturally embrace palliative care, with its approach to the individual and his/her family/carers. The findings show that chaplains are experienced in providing spiritual care in its widest sense. However, chaplains need to take the initiative to engage in the spiritual care debate, and increases their input in education and training. Those directing the spiritual care debate need not be afraid of being led down a religious road by consulting chaplains.

Spiritual Care for Persons with Dementia: Fundamentals for Pastoral Practice

Abstract: Contents * Preface * Momma, Oh Momma, I Can't Remember * Pastoral Care for the Person with Dementia * "To See Things as God Sees Them": Theological Reflections on Pastoral Care to Persons with Dementia * Spirituality, Religion, and Alzheimer Disease * Pastoral Care of Problematic Alzheimer's Disease and Dementia Affected Residents in a Long-Term Care Setting * Forget Me Not: The Spritual Care of People with Alzheimer's Disease * Assuring Professional Pastoral Care for Every Nursing Home Resident * In Memory of Loved Ones Who Have Enriched Our Lives: Helping Staff Create and Hold Memorial Services in Nursing Homes * Selected Books of Interest * Index * Reference Notes Included

Better care for the dying. Hawaii healthcare system develops a manual for end-of-life care.

Abstract: In early 1996, as it became clear that Americans were becoming increasingly concerned about end-of-life care, the leaders of St. Francis Healthcare System (SFHS), Honolulu, convened a meeting at which local people--community and parish representatives as well as healthcare professionals--discussed the matter. The meeting's participants identified 10 issues as essential in end-of-life care: decision making, pain management and comfort care, pastoral and spiritual care, psychosocial care, hospice and home care, cardiopulmonary resuscitation, futility, withholding and withdrawing treatment, artificial nutrition and hydration, physician-assisted suicide and euthanasia. The participants then divided themselves into 10 teams, each of which spent six months studying one of the identified essential issues. In each case, the team reviewed the relevant SFHS policies and procedures and compared them with national standards. The team also interviewed staff members about the policies and procedures, comparing the written versions with actual practices. Each team then wrote a chapter on its assigned issue, after which a core committee wove the chapters into an end-of-life care manual for SFHS. The manual was published in June 1997. The system's leaders currently use the manual to educate staff members in good end-of-life care.

Mrs. Fisher: A Case of Ministry for Spiritual Risk

Abstract: In response to George Fitchett's article, “Spiritual Risk and Spiritual Care” the author provides a brief example of a chaplain-patient enounter. What is meant by “spiritual risk” is identified and the pastoral intervention is discussed.

Expanding Our Practice: Integrating Body, Mind, and Spirit in Spiritual Care

Abstract: (1999). Expanding Our Practice: Integrating Body, Mind, and Spirit in Spiritual Care. Chaplaincy Today: Vol. 15, No. 2, pp. 2-3.

The spiritual care of the hospitalized patient: A nursing perspective

Abstract: The resurgence of holistic care in health care delivery poses a challenge to today's medical team. This is especially true for the nursing profession. Consequently, this poses a challenge for today's nurse to not only care for his/her patient's physical needs, but to attend to the psycho-spiritual aspects of the patient as well. This paper provides a training program for nurses to learn how to assess the spiritual needs of their patients. Based on a historical overview of nursing and the nursing process, it revisits the belief that the nursing profession's foundation is rooted in ministry to the sick as a reflection of the life and ministry of Jesus Christ. Thus, with this challenge in place, nurses are called forth to use the nursing process to assess, implement and evaluate care plans to address the spiritual needs of the patients they care for on a daily basis.

Religion and Spiritual Care

Abstract: The publication of the Department of Health's Patient's Charter in 1991 has stimulated thinking and practice concerning the provision of spiritual care within the National Health Service. This can give rise to some confusion between 'spiritual' and 'religious' care, not least in places where a number of different religions are practised. As a way of clarifying this issue, this article offers definitions of both 'spiritual' and 'religious', and refers to a practical way of keeping them separate but complementary in the provision of care.