scholarly journals Spiritual Diversity, Spiritual Assessment, and Māori End-of-Life Perspectives: Attaining Ka Ea

Religions ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 536
Author(s):  
Holly Nelson-Becker ◽  
Tess Moeke-Maxwell
Keyword(s):  
End Of Life ◽  
Rapid Assessment ◽  
Well Being ◽  
Spiritual Needs ◽  
Assessment Instruments ◽  
Spiritual Values ◽  
Spiritual Assessment ◽  
Contemporary World ◽  
Spiritual Diversity ◽  
Sense Of Satisfaction

The contemporary world is endowed with increasingly diverse spiritual and cultural perspectives, yet little is known about the spiritual concerns and spiritual resilience of Māori from Aotearoa New Zealand at the end of life. A context is provided for the value of spiritual assessment and identification of spiritual needs or concerns. Spiritual concerns and the desire to attain a state of ka ea (fulfillment, gratitude, or peace) may point to interventions, helping activities, or referrals that guide treatment. We reflect on qualitative findings from the 2017–2020 Pae Herenga study of 61 caregiving families, their helping professionals, and religious/spiritual leaders. We explore essential spiritual values and practices that support kaumātua (older tribal people) who have a life-limiting illness in achieving a sense of satisfaction and fulfilment at the end of life. Three themes emerged: the relational is spiritual, the need to live into the future, and value of spiritual end-of-life care. While some scholars have lamented the lack of culturally appropriate rapid assessment instruments, we suggest that a more open-ended assessment guide is better suited to understand key elements of spiritual diversity and spiritual concerns, particularly the spiritual strengths and resources that lead to well-being and even thriving at life’s end. Finally, learning about spiritual diversity can assist others to reconnect to lost meanings and regain a more holistic and centred view of life.

Life Review in Pastoral Counseling: Background and Efficacy for Use with the Terminally III

2003 ◽  
Vol 57 (3) ◽  
pp. 281-292 ◽  
Author(s):  
Robert G. LeFavi ◽  
Marcia H. Wessels
Keyword(s):  
Older Adults ◽  
Pastoral Counseling ◽  
Life Story ◽  
Terminally Ill ◽  
Well Being ◽  
Life Review ◽  
Systematic Theology ◽  
Spiritual Needs ◽  
Traumatic Death ◽  
Spiritual Assessment

Research continues to confirm that sharing one's life story through the process of life review enhances psychological well-being and increases life satisfaction. Although researchers have outlined techniques and activities that may be used in life review with older adults, little work has focused on the use of life review methods with terminally ill patients. Additionally, researchers have suggested that life review can take on the form of a spiritual assessment; and that such spiritually oriented life reviews may enhance a sense of meaning and foster reconciliation as one approaches dying. In this article, the authors provide a brief review of the research on and the practice of life review. Further, by merging concepts of life review with systematic theology, they offer a sample instrument—using the example of one faith framework—with which pastoral caregivers can better approach the spiritual needs of patients and facilitate a less traumatic death in the terminally ill.

scholarly journals Spiritual Experience in Dementia From the Health Care Provider Perspective: Implications for Intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 465-465
Author(s):  
Jennifer Palmer ◽  
Michelle Hilgeman ◽  
Tracy Balboni ◽  
Sara Paasche-Orlow ◽  
Jennifer Sullivan
Keyword(s):  
Spiritual Care ◽  
Qualitative Interviews ◽  
Well Being ◽  
Spiritual Experience ◽  
Assessment Tools ◽  
Spiritual Needs ◽  
Care Needs ◽  
Spiritual Assessment ◽  
Spiritual Distress ◽  
Linguistic Challenges

Abstract Spiritual care seeks to counter negative outcomes from spiritual distress and is notably needed in dementia. Such care needs disease-appropriate customization. Employing “cognitive apprenticeship” theory’s focus on learning from contrast, we explored spiritual needs salient within dementia as related to other disease states; we aimed to inform future dementia-focused spiritual care design. Accordingly, we conducted semi-structured qualitative interviews with 24 providers who serve older adults inclusive of persons with dementia. We sampled participants purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about the nature of spiritual needs in dementia and stakeholders’ roles in addressing them. Hybrid inductive/deductive thematic analysis was employed. A thematic structure emerged with two themes: 1) spiritual experience in dementia compared to other medical conditions (sub-themes: the salience of (a) fear; (b) loss of self; (c) dementia’s progressive and incurable nature; (d) dementia’s impact on accessing faith); and 2) the need for spiritual intervention at the mild stage of dementia (sub-themes: (a) awareness in mild dementia and its influence on spiritual distress; (b) a window of opportunity). These findings pointed to possibilities for the “what” of spiritual needs and the “who” and “when” of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss early in the disease, and stakeholder training. Researchers should study the “how” of dementia-appropriate spiritual care given recipients’ cognitive and linguistic challenges. Conjointly, these efforts could promote the spiritual well-being of persons with dementia worldwide.

Spiritual Screening, History, and Assessment

2019 ◽  
pp. 432-446 ◽  
Author(s):  
Elizabeth Johnston Taylor
Keyword(s):  
Palliative Care ◽  
Spiritual Care ◽  
Well Being ◽  
Care Recipient ◽  
Spiritual Needs ◽  
History Taking ◽  
Spiritual Assessment ◽  
Spiritual Well Being ◽  
Spiritual Screening ◽  
Screening History

Spiritual care is integral to palliative care. Palliative care patients and their family members often use spiritual coping strategies, and spiritual well-being is a commonly high-ranked pursuit for those at the end of life. Appropriate spiritual care, however, must reflect the spiritual needs and preferences of the care recipient. Thus, numerous approaches to spiritual screening, history-taking, and assessment exist. Whereas the spiritual screening is proposed as a skill and expectation that nurses and others can be trained to complete, the spiritual assessment is the domain of the spiritual care expert—typically, a skilled chaplain. These diverse approaches are described here along with some additional observations that can guide the process.

Development of a tool to identify and assess psychosocial and spiritual needs in end-of-life patients: The ENP-E scale

2018 ◽  
Vol 17 (04) ◽  
pp. 441-447
Author(s):  
Dolors Mateo-Ortega ◽  
Joaquín T. Limonero ◽  
Jorge Maté-Méndez ◽  
Elba Beas ◽  
Jesús González-Barboteo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
End Of Life ◽  
Depression Scale ◽  
Well Being ◽  
Face Validity ◽  
Spiritual Needs ◽  
Life Questionnaire ◽  
Psychosocial Needs ◽  
Emotional Wellbeing ◽  
European Organization

AbstractObjectiveThe goal of this study is to describe the development of a new tool, the Psychosocial and Spiritual Needs Evaluation scale Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida (ENP-E), designed to assess the psychosocial needs of end-of-life (EOL) patients. And, secondarily, to describe the face validity and psychometric properties of this instrument in the Spanish-speaking context.MethodThe scale was developed through a seven-stage process: (1) literature review; (2) expert panel establishment; (3) discussion and agreement on the most relevant dimensions of psychosocial care; (4) description of key indicators and consensus-based questions to evaluate such dimensions; (5) assessment of the scale by external palliative care (PC) professionals; (6) evaluation by patients; and (7) analysis of scale's psychometrics properties. To assess content validity, 30 PC professionals and 20 patients evaluated the questionnaire. To determine psychometric properties, 150 participants completed these scales: the ENP-E; the Hospital Anxiety and Depression Scale; item 15 from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative; and the Distress Thermometer.ResultAll respondents evaluated the tool as “excellent.” In terms of construct validity, the internal consistency (Cronbach's alpha = 0.74) and temporal stability (test-retest r = 0.74, p < 0.1) were both adequate. On the factorial analysis, four factors (emotional-wellbeing, social support, spiritual, and information) explained 58.4% of the variance. This scale has a sensitivity of 76.3%, specificity of 78.9%, and the cutoff is 28.Significance of resultsTo provide quality PC to EOL patients, it is essential to determine the psychosocial factors that influence well-being. This requires the use of reliable and specific instruments. The ENP-E is a novel tool that provides a systematic, holistic assessment of the psychosocial needs of EOL patients. Its routine use would allow clinicians to monitor such needs over time. This would, in turn, permit comprehensive, highly individualized interventions to improve effective PC approach.

End-of-life spiritual care at a VA medical center: Chaplains' perspectives

2012 ◽  
Vol 10 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Bei-Hung Chang ◽  
Nathan R. Stein ◽  
Kelly Trevino ◽  
Max Stewart ◽  
Ann Hendricks ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Spiritual Care ◽  
Medical Center ◽  
Healthcare Providers ◽  
Well Being ◽  
Care Patient ◽  
Care Plan ◽  
Spiritual Needs ◽  
Care Improvement

AbstractObjective:Spiritual care is an essential component of quality palliative care. Recognizing the importance, the Department of Veterans Affairs (VA) mandates the inclusion of chaplains in a palliative care consult team (PCCT). The purpose of this study is to explain the process and content of spiritual care provided in a VA Medical Center from chaplains' perspectives.Method:Five Christian chaplains who provide care to patients at end of life were interviewed. Each interview was recorded and transcribed. Analysis based on the grounded theory was used to identify themes from each interview question.Results:The PCCT in this study appeared to have a strong referral and communication system in which every palliative care patient was seen by a chaplain and the care plan was discussed with an interdisciplinary team. Chaplains reported providing a range of services, which addressed religious, spiritual, emotional, family, and illness concerns. Chaplains were aware of the unique spiritual needs of veterans, including working through guilt for killing in war and requiring forgiveness. Chaplains' ideas for improvement of spiritual care services included increasing time to provide care, providing bereavement care and support to families, and adding chaplains with different religious backgrounds. Chaplains reported how their own spirituality influenced the care they provided.Significance of results:Spiritual care in the VA can include a range of services and should consider the unique needs of the veteran population. Future studies can build upon our findings from chaplains to learn about the perspectives of patients, family, and other healthcare providers of spiritual care. This information would allow identification of strengths of current spiritual care practices and areas for care improvement, and ultimately could improve the well-being of patients at the end of life.

End-of-Life Needs of Dying Patients and Their Families in Mainland China: A Systematic Review

2021 ◽  
pp. 003022282199734
Author(s):  
Guobin Cheng ◽  
Chuqian Chen
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
Web Of Science ◽  
Empirical Studies ◽  
Symptom Control ◽  
Mainland China ◽  
Spiritual Needs ◽  
Care Needs ◽  
Dying Patients

Objective To map the current research status and understand existing findings regarding end-of-life care needs in Mainland China. Method First-hand, empirical studies on the needs of dying patients and/or their families in Mainland China were searched in Web of Science, Scopus, Proquest, Taylor & Francis Online and CNKI in December 2019. Findings were synthesized. Results A total of 33 (10 qualitative) studies were involved. Chinese dying patients and their families had physical, psychological, social, and spiritual needs and needs for knowledge and information. Prevalent needs of dying patients were mainly symptom control and decent look, being treated kindly by professional caregivers, family accompany, dignity, and comfortable environment. Families mainly need healthcare professionals to take good care of patients and wishes for information, knowledge, and facilities to help themselves become better caregivers. Conclusions Findings lay the foundation for effective and tailored services for Chinese clients and provided insights for future investigations.

Spiritual issues and needs: Perspectives from patients with advanced cancer and nonmalignant disease. A qualitative study

2004 ◽  
Vol 2 (4) ◽  
pp. 371-378 ◽  
Author(s):  
ELIZABETH GRANT ◽  
SCOTT A. MURRAY ◽  
MARILYN KENDALL ◽  
KIRSTY BOYD ◽  
STEPHEN TILLEY ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Health Resources ◽  
Well Being ◽  
Spiritual Needs ◽  
Policy Makers ◽  
Self Identity ◽  
Nonmalignant Disease

Objective: Health care professionals and policy makers acknowledge that spiritual needs are important for many patients with life-limiting illnesses. We asked such patients to describe their spiritual needs and how these needs may impinge on their physical, psychological, and social well-being. Patients were also encouraged to explain in what ways their spiritual needs, if they had any, could be addressed.Methods: We conducted two qualitative interviews, 3 months apart, with 20 patients in their last year of life: 13 patients with advanced cancer and 7 with advanced nonmalignant illness. We also interviewed each patient's general practitioner. Sixty-six interviews were tape-recorded, transcribed, and analyzed.Results: Patients' spiritual needs centered around their loss of roles and self-identity and their fear of dying. Many sought to make sense of life in relation to a nonvisible or sacred world. They associated anxiety, sleeplessness, and despair with such issues, which at times resulted in them seeking support from health professionals. Patients were best able to engage their personal resources to meet these needs when affirmed and valued by health professionals.Significance of results: Enabling patients to deal with their spiritual needs through affirmative relationships with health professionals may improve quality of life and reduce use of health resources. Further research to explore the relationship between spiritual distress and health service utilization is indicated.

The feasibility and acceptability of a chaplain-led intervention for caregivers of seriously ill patients: A Caregiver Outlook pilot study

2015 ◽  
Vol 14 (5) ◽  
pp. 456-467 ◽  
Author(s):  
Karen E. Steinhauser ◽  
Annette Olsen ◽  
Kimberly S. Johnson ◽  
Linda L. Sanders ◽  
Maren Olsen ◽  
...  
Keyword(s):  
Study Participant ◽  
Well Being ◽  
Spiritual Needs ◽  
Full Time ◽  
Advanced Illness ◽  
Loved One ◽  
Close Family Member ◽  
Seriously Ill Patients ◽  
Participant Screening ◽  
Anxiety Depression

AbstractObjective:When caring for a loved one with a life-limiting illness, a caregiver's own physical, emotional, and spiritual suffering can be profound. While many interventions focus on physical and emotional well-being, few caregiver interventions address existential and spiritual needs and the meaning that caregivers ascribe to their role. To evaluate the feasibility and acceptability of the process and content of Caregiver Outlook, we employed a manualized chaplain-led intervention to improve well-being by exploring role-related meaning among caregivers of patients with a life-limiting illness.Method:We conducted a single-arm pre–post pilot evaluation among caregivers of patients with advanced cancer or amyotrophic lateral sclerosis (ALS). Caregivers completed three chaplain-led intervention sessions focusing on (1) a relationship review, (2) forgiveness, and (3) legacy. Outcomes administered at baseline and at 1 and 2 weeks after the intervention included quality of life, anxiety, depression, spiritual well-being, religious coping, caregiver burden, and grief.Results:The sample (N = 31) included a range of socioeconomic status groups, and the average age was approximately 60 years. A third of them worked full-time. Some 74% of our participants cared for a spouse or partner, and the other quarter of the sample cared for a parent (13%), child (10%), or other close family member (3%). At baseline, participants did not demonstrate clinical threshold levels of anxiety, depression, or other indicators of distress. Outcomes were stable over time. The qualitative results showed the ways in which Caregiver Outlook was assistive: stepping back from day-to-day tasks, the opportunity to process emotions, reflecting on support received, provoking thoughts and emotions between sessions, discussing role changes, stimulating communication with others, and the anonymity of a phone conversation. Both religious and nonreligious participants were pleased with administration of the chaplain intervention.Significance of results:The acceptability and feasibility of Caregiver Outlook were demonstrated among caregivers of patients with an advanced illness. Our pilot findings suggest minor modifications to study participant screening, interventionist guidance, and the study measures.

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

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