Spiritual Needs Assessment

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Spirituality, according to Wallace (2007) is the essence of our being, which permeates our living and infuses our unfolding awareness of who and what we are, our purpose in being, and our inner resources; and shapes our life journey. There has been a renewed interest in the healthcare profession about spiritual care as we begin to grasp that Western Scientific medicine alone does not work and that there is a mind, body, spirit philosophy that has encompassed other types of medicine for some time (Hoffert, Henshaw, & Mvududu, 2007). This paper will attempt to devise a nursing assessment that can be skillfully used in assessing the spiritual needs of the patient. This writer will then take that tool and attempt to use it to help better understand a patient.

It might be noted that according to Hoffert et.al. (2007), one should assess the patient visually and observe things about the patient that come from observation before asking spiritual questions. One should also establish a relationship with the patient. For example, when entering the room, note any pictures, cards, flowers etc from family and friends. Also note any hobbies the patient has with them. Notice any religious pieces, caps, dress, and crosses in the room and note if there is a Bible, Koran, or Torah. Acknowledge these things and ask about them. This gives you the ability to see what is important to the patient and listen to how the patient feels at this time.

Question	Response	Observation
When you return home will there be someone there to care for you?		Observe the importance of this answer to the patient
What brings you joy? Makes you happy or makes you smile?		Listen
What are you most proud of?
Where does your strength come from?
What do you do when things are really tough?
What gives you courage?
Are there any religious needs that you have while here in the hospital?
What can I, as a nurse, do to help you have courage and support you?

Rose, a 59 year old female with breast cancer is on my floor. She has completed here surgery and is due to start chemotherapy.

Question	Response	Observation
When you return home will there be someone there to care for you?	My daughter is going to visit with me for awhile, most of my family lives pretty far away and they have lives of their own.	There is sadness and resignation in her voice. She glances at the picture on her night stand.
What brings you joy? Makes you happy or makes you smile?	Oh, my children and their families. The grandchildren, My husband died a couple of years back and I miss them a lot.	Her eyes have welled up some.
What are you most proud of?	My children and how they have done and my beautiful grandchildren	She smiles and nods
Where does your strength come from?	I get my strength from a higher power. I am not sure what that is but sometimes I just have to let it all go.	I had to ask if she had a religious preference and she did not. She does not celebrate a formal religion.
What do you do when things are really tough?	I used to lean on my husband a lot. He had this kind of inner strength. I still do in a way, I try to let go when I can.	I am not sure I understand what she means here but the look on her face shows it is important to her.
What gives you courage?	My belief in that higher power and support from my kids.	She does not seem sure about this right now.
Are there any religious needs that you have while here in the hospital?	No. Thanks.
What can I, as a nurse, do to help you have courage and support you?	You have, just sitting and talking we me. If you wouldnt mind and you have time to do that sometimes, it would give me strength.	I will attempt to visit with her during her first chemo.

It is interesting that it went better than I thought. I was a little anxious at first but she seemed comfortable. One of the barriers is privacy; it seemed there were people in and out of the room a lot. She seemed so happy to talk with someone and much more relaxed as I left. The conversation went well but it is easy to see that this assessment is not nearly enough to cover the issues. I would definitely expand the questions. I also would ask more personal questions, I was hesitant the first time but I think the patient really wanted me to ask more personal questions. I think the patients needs are met in a better way than just to worry about the scientific part of her care.

In conclusion, this was a good exercise and I can see the value of the assessment as well as the fact that it was a supporting measure for the patient. It is a step in the right direction. This particular tool will need revised but I will do that for future use.

Resources

Hoffert D., Henshaw C., Mvududu N. (2007). Enhancing the ability of nursing students to perform a spiritual assessment. Nurse Educator. 32(2) 66-72.

Wallace, M. & OShea, E. (2007). Perceptions of spirituality and spiritual care among older nursing home residents at the end of life. Holistic Nursing Practice.

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