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please formulate a response to this discussion with 5-6 points with explanation and references. This is a master’s level class for nursing. thank you. 

 

Theory Development: Creating Conceptual Meaning 

Conceptual meaning conveys thoughts, feelings, and ideas that reflect human experience more fully than term definitions. Below are the listed assumptions, attributes, antecedents, and consequences of the concept of spirituality. 
Attributes:
Spirituality is a process and journey that is always evolving and changing                                                                            
Feelings of communion with oneself and those around them which creates a positive approach towards life and having gratitude to be able to live life as a gift. (Vachon et al., 2009)                                                                           
Spiritual beliefs can provide meaning and hope to patients. According to Florence Nightingale, spirituality is the most powerful resource for healing and involves the evolution of human consciousness (Gray,2006).        
Antecedents:
Tragic or stressful life events make people turn to their spirituality 
Nurses may have a different level of insight into a patient’s needs if the patient also has a higher level of spiritual awareness (Gray,2006).
 Individuals question their reality and place in the universe spiritually.
Consequences:
Patients feel supported when their spiritual needs are met while under medical care 
There is no clear definition of spirituality; health care providers struggle with creating related nursing diagnosis, resulting in spirituality being left out of the patient’s care (Sessanna et al., 2007). 
Individuals reach a point of self-awareness and feeling of connectedness with the universe.
Assumptions:
 All humans are spiritual beings
To be spiritual you must also be religious 
Spirituality is a single path/belief system
Group Definition of Spirituality:
Spirituality is a spectrum, defined subjectively and dependent upon the individual’s belief system, culture, their personal worldview and life experiences. It is important to remember that the concept of spirituality is fluid and, therefore, can take on a different meaning/value to each human being.

Clarifying the Context:

Case study – The Elderly 
Nurse Anna arrives for her shift. While going over her assignment, one of her patients is an 88-year-old female who was admitted for community acquired pneumonia. While performing bedside shift report, Anna learns that her 88-year-old patient is requiring supplemental oxygen but is otherwise hemodynamically stable. While continuing to receive report, Anna observes her patient appearing sad and withdrawn. After finishing report, she goes back to assess her patient. During her physical assessment, Anna’s patient does not say much and responds with simple yes and no answers, while continuing to appear sad and withdrawn. Anna suspects there is more to her patient’s current situation other than her admitting diagnosis, given her melancholic demeanor. After spending additional time with her patient and building rapport, Anna learns that her patient was recently widowed. Her patient states, “I was married to my husband for 60 years. He was the love of my life and my rock. I don’t know how I am going to move forward without him or anything else in my life. I feel like my life has lost all meaning”. While conversing with her patient, Anna notices a room devoid of any religious items, such as roseries or crosses. Although Anna is a devout Christian, she acknowledges and understands that not all patients have or use religion to help give meaning and understanding to their lives. Sensing a feeling of hopelessness in her patient, Anna assesses her patient’s spirituality and coping skills. Her patient states that although she was raised in a religious household as a child, she did not continue to follow such beliefs as she grew older and admits to not giving much thought to religion or spirituality. After completing her assessment, Anna applies the nursing diagnosis of “spiritual distress” to her patient and begins to formulate appropriate interventions. After speaking with her patient more, Anna’s patient admits that she has always wondered what this world means to her, and how she is connected with everything, and that this has been exacerbated by the passing of her husband; she also states a desire to reconnect with God. Anna understands and acknowledges her patient’s need for spiritual reconnection and intervention and calls the chaplain to speak with her patient. At the end of her shift, Anna reassesses her patient and finds her patient to be in a better mood, and her patient thanks her for helping initiate the spiritual journey she is now going to embark on once discharged from the hospital. 

Relational Statements

Relationship statements describe, explain, or predict the nature of the interaction between the concept (including attributes, antecedents, and consequences) and the theory. 
When tragic or stressful life events occur in the lives of elderly adults that affect their health and well-being and they rely on their healthcare providers to assist them to practice their spiritual beliefs for meaning and hope, then they feel supported while under medical care. 
 When elderly adults question their reality and place in the universe spiritually and they surround themselves with those who share similar spiritual beliefs, and they feel a sense of communion with themselves and those around them then they reach a point of self-awareness and feeling of connectedness with the universe.
When elderly adults under the care of a nurse have a higher level of spiritual awareness and the nurse have a high level of insight into the patient’s needs and the patients evolving spiritual journey is supported through collaboration with the nurse then the nurse is able to develop nursing diagnoses, care plans, and interventions that support spiritual care.

 

Model Development

Image transcription text

Unique to everyone A journey that is always Each person see’s evolving and changing + spirituality as something
different Spirituality Spiritual beliefs can provide meaning and Feelings of communion with oneself and those =
Brings feelings of hope to patients around them positivity and peace Greater acceptance for Creates a… Show more

Application of Theory

Our theory model revolves around spirituality as a life process, and a process that is ever changing and fluid.  Feeling connected with oneself, and the world is a basic attribute of spirituality, along with providing purpose and meaning to life.  
The elderly is our chosen population.  Elderly people have had a lifetime of experiences that may deeply influence whether spirituality is an important life force for them. Due to aging, children being grown and living in a distant place, loss of family and friends due to death, and loss of personal autonomy and independence, and health issues, elderly persons may feel disconnected from themselves and/or displaced from lives that were previously familiar and comforting.  Due to these factors, it is important to determine if spiritual concerns are impacting our patients.
As our model case describes, Anna is working with a patient for whom life has lost its meaning due to the passing of her husband. Her husband had been the center of her life, and the loss of his presence in her life has created a void.  Though religion was a central part of her life as a young person, her personal spirituality had not taken shape as an adult.  When faced with the loss of her husband she lost her feeling of connectedness to the world, her place in it and she felt sad.
Following Anna’s assessment of her patient’s needs, she determines that spiritual support might be helpful and calls for chaplain support.  Though a nurse may have their own personal religious and spiritual beliefs, our theory believes that spirituality is personal and can mean different things to different people. Anna’s use of the nursing process allowed her to become aware of her patient’s need beyond the physical diagnosis of community acquired pneumonia, as Anna was attuned to her patient’s signs and symptoms of emotional distress.  
Initiating Chaplain support

Interventions:

Develop rapport with the patient through inquiry about their needs and personal preferences.
Assess for recent changes in the patient’s support system, living arrangements, opportunity for social contact or other life changes. 
Assess how the recent changes are perceived by the patient.
Provide preferred physical comfort measures 
Determine if there are ways to address the patient’s spiritual needs within the care setting, and if so, to initiate the referral process (Chaplain, Social Work, family contact as a few examples). 
Discuss with family (children, grandchildren) if they have any concerns in this area, or knowledge of spiritual based practices that the patient finds comforting, helpful, supportive. 
Follow up to see if referral interventions have been completed.

Evaluation

Effectiveness of the interventions can be evaluated by assessing the patient’s level of emotional comfort, positivity and acceptance following the intervention(s), looking for improvements.   

 

 

References

Gray, J.  (2006). Measuring spirituality: conceptual and methodological considerations. Journal of Theory Construction & Testing, 10(2), 58-64 https://go.openathens.net/redirector/lewisu.edu?url=https://www.proquest.com/scholarly-journals/measuring-spirituality-conceptual-methodological/docview/219177736/se-2

Sessana, L., Finnell, D., & Jezewski, M.A. (2007). Spirituality in nursing and health related literature: a concept analysis. Journal of Holistic Nursing 25(4), 252-262. https://journals.sagepub.com/doi/pdf/10.1177/0898010107303890

Vachon, M., Fillion, L., & Achille, M. (2009). A conceptual analysis of spirituality at the end of life. Journal of Palliative Medicine, 12(1), 53-59.  https://doi.org/10.1089/jpm.2008.0189open_in_new

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