ctc2013 9j finalpowerpoint sprituality of patients and...

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8/20/13 1 Nancy A. Jaworski DNP, RN, CNS Children’s Hospitals and Clinics of Minnesota with contributions from Reverend Hal Weldin Identify sources of spiritual strength as well as spiritual distress Competency – listening for opening in the conversation Discuss and address spiritual care dynamics with patients and families Competency – developing a common spiritual language Identify the multidisciplinary roles in spiritual care Competency – incorporating self‐assessment and practice

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Page 1: CTC2013 9J FINALpowerpoint Sprituality of Patients and ...nhpco.confex.com/nhpco/CTC2013/webprogram/Handout... · CTC2013_9J_FINALpowerpoint_Sprituality of Patients and Families in

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NancyA.JaworskiDNP,RN,CNSChildren’sHospitalsandClinicsofMinnesota

withcontributionsfromReverendHalWeldin

  Identifysourcesofspiritualstrengthaswellasspiritualdistress  Competency–listeningforopeningintheconversation

  Discussandaddressspiritualcaredynamicswithpatientsandfamilies  Competency–developingacommonspirituallanguage

  Identifythemultidisciplinaryrolesinspiritualcare  Competency–incorporatingself‐assessmentandpractice

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  5yroldwithDIPG(diffuseintrinsicpontineglioma)

 WeneedtorethinkSpiritualityandReligionintermsofwhatthatmeanstopatientsandfamiliestoday.

  Religion  Spirituality  Whatmattersmost?

Mattersthatariseinthecontextofultimatemeaningandconcern.

  ReligionindifferentareasoftheU.S.

  Changesinreligiousaffiliation

 Millennials

 Whydoesthismatter?

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  Children

  Adults,Family,Caregivers

  Relational

  Children

  Adults,Family,Caregivers

  HealthcareProviders

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Person

Health;Allevia1onofSuffering

Integra0veEnergy

Values,Beliefs

Rela0onal*Connectedness

>withself>withothers>withdeity

Love,hope,peacefulness,forgiveness,comfort

Behavioral*Religion*Interac0onwithothers

Transcendentquestformeaning/purpose/happiness

SpiritualityTheessenceofbeinghuman

Personal

Manifestation

ModelofSpirituality

Miner‐Williams,D.,2006

  Opportunitytodeepentheconversation  Attendingtokeywords/topics

  SpiritualHistory  CommonLanguage

  CapacityandCompetency  Usingthewholeteam

  ScopeofPractice

  AllChaplainsarenotthesame…Wait,What?

  LevelofTraining

  ScopeofPractice

  Chaplainsandcommunityclergy

  Roleinpromotingconnectiontocommunity

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  Culture

  SocialWork

  Psychology

  Community/LayPersons  Importance!

  Inpatient  PalliativeCareProviders/Chaplains  Nurses/AttendingMD’s/Chaplains

  Outpatient  ClinicRN,MD,APRN/SocialWork/Chaplain

  Community  Chaplain/CommunityAgencies

  Tools  FICA  FACT  SPIRIT  HOPE

  Documentation  Where?  Why?

  IdentifyopportunitiestodeepentheconversationandrefertoChaplaincy.

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  F–FaithandBelief

  I–Importance

  C–Community

  A–AddressinCare

FICASpiritualAssessmentTool©FFaith,Belief,MeaningIImportanceandInfluenceCCommunityAAddress,ActioninCare

  “Doyouconsideryourselfspiritualorreligious?”or

  “Doyouhavespiritualbeliefsthathelpyoucopewithstress?”

  Ifthepatientresponds"No,"thehealthcareprovidermightask,

  “Whatgivesyourlifemeaning?”  Sometimespatientsrespondwithanswerssuchasfamily,career,ornature.

 "Whatimportancedoesyourfaithorbeliefhaveinourlife?

 Haveyourbeliefsinfluencedhowyoutakecareofyourselfinthisillness?

 Whatroledoyourbeliefsplayinregainingyourhealth?"

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  "Areyoupartofaspiritualorreligiouscommunity?

  Isthisofsupporttoyouandhow?

  Isthereagroupofpeopleyoureallyloveorwhoareimportanttoyou?”

  Communitiessuchaschurches,temples,andmosques,oragroupoflike‐mindedfriendscanserveasstrongsupportsystemsforsomepatients.

 "Howwouldyoulikeme,yourhealthcareprovider,toaddresstheseissuesinyourhealthcare?"

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  Thoughts,Feelings,Beliefs

  “Justnotgettingit”

  “Notdoingeverythingisnotanoption”

  F–FaithandBelief  DoIhaveaspiritualbeliefthathelpsmecopewithstress?With

illness?Whatgivesmylifemeaning?  I–Importance  Isthisbeliefimportanttome?DoesitinfluencehowIthinkaboutmy

healthandillness?Doesitinfluencemyhealthcaredecisions?  C–Community  DoIbelongtoaspiritualcommunity(church,temple,mosqueor

othergroup)?AmIhappythere?DoIneedtodomorewiththecommunity?DoIneedtosearchforanothercommunity?IfIdon'thaveacommunity,wouldithelpmeifIfoundone?

  A–AddressinCare  Whatshouldbemyactionplan?WhatchangesdoIneedtomake?

AretherespiritualpracticesIwanttodevelop?Wouldithelpformetoseeachaplain,spiritualdirector,orpastoralcounselor?

  Literature  Children  Parents  Chaplains  Practice  SpiritualHistoryTools  Finance

  Discussion

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  SampleProject  FICA

  Partnerships  Chaplaincy

  PersonalPractice

Thinkofonewayinwhichyoucanincludethisinyourpractice?

  AdditionalEducationalResourcesforSpiritualAssessment/History

  AdditionalResourcesforSpirituality/Religion

  ActionPlan

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****CenterforSpiritualityandHealinghttp://www.csh.umn.edu/free‐online‐learning‐modules/ ClickonSpiritualityinHealthcare

****TheGeorgeWashingtonInstituteforSpiritualityandHealthhttp://www.gwish.org/ ClickonResources,thengotoAvailableonlineandselectSpiritualAssessmentinClinicalPractice

****growthouse.orghttp://www.growthhouse.org/spirit/

  http://religions.pewforum.org/reports

  http://www.pewforum.org/How‐Religious‐Is‐Your‐State‐.aspx

  http://www.pewforum.org/Age/Religion‐Among‐the‐Millennials.aspx

  Borneman,T.Ferrell,B.,&Puchalski,C.(2010).EvaluationoftheFICAtoolforspiritualassessment.JournalofPainandSymptomsManagement,40(2),163‐173.

  Clark,P.,Drain,M.,&Malone,M.(2003).Addressingpatient’semotionalandspiritualneeds.JointCommissionJournalonQualityandSafety,29(12),659‐670.

  Cotton,S.,Larkin,E.,Hoopes,A.,Cromer,B.,&Rosenthal,S.(2005).Theimpactofadolescentspriritualityondepressivesymptomsandhealthriskbehaviors.JournalofAdolescentHealth,36,529.e7‐529.e14.

  Cotton,S.,Zebracki,K.,Rosenthal,S.,Tsevat,J.,&Drotar,D.(2006).Religion/spiritualityandadolescenthealthoutcomes:Areview.JournalofAdolescentHealth,38,472‐480.

  Cotton,S.Kudel,I.,Roberts,Y.,Pallerla,H.,Tsevat,J.,Succop,P&Yi,M.(2009).Spiritualwell‐beingandmentalhealthoutcomesinadolescentswithorwithoutinflammatoryboweldisease.JournalofAdolescentHealth,44,485‐492.

  CurrentProblemsinCancer(2011).Spiritualcareforpalliativepatients.CurrentProblemsinCancer,35,365‐371.

  Fitchett,G.&Risk,J.(2009).Screeningforspiritualstruggle.JournalofPastoralCareCounsel,63(1‐2),1‐12.  Hanson,L.,Usher,B.,Spragens,L.,&Bernard,S.(2008).Clinicalandeconomicimpactofpalliativecareconsultation.JournalofPainandSymptom

Management,35(4),340‐346.  Hexem,K.R.,Mollen,C.J.,Carroll,K.,Lanctot,D.A.,&Feudtner,C.(2011).Howparentsofchildrenreceivingpediatricpalliativecareusereligion,

spirituality,orlifephilosophyintoughtimes.JournalofPalliativeMedicine,14(1),39‐44.

  Holmes,S.,Rabow,M.,&Dibble,S.(2006).Screeningthesoul:Communicationregardingspiritualconcernsamongprimarycarephysiciansandseriouslyillpatientsapproachingtheendoflife.AmericanJournalofHospice&PalliativeMedicine,23(1),25‐33.

  Kamper,R.,VanCleve,L.,&Savedra,M.(2010).Childrenwithadvancedcancer:Responsestoaspiritualqualityoflifeinterview.JournalforSpecialistsinPediatricNursing:JSPN,15(4),301‐306.

  Kane,J.(2006).Pediatricpalliativecaremovingforward:Empathy,competence,quality,andtheneedforsystematicchange.JournalofPalliativeMedicine,9(4),847‐849.

  King,D.&Wells,B.(2003).End‐of‐lifeissuesandspiritualhistories.SouthernMedicalJournal,96(4),391‐393.

  Knapp,C.,Madden,V.,Wang,H.,Curtis,C.,Sloyer,P.,&Shenkman,E.(2011).Spiritualityofparentsofchildreninpalliativecare.JournalofPalliativeMedicine,14(4),437‐443.

  Koenig,H.(2006).Thespiritualhistory.SouthernMedicalJournal,99(10),1159‐1160.

  Meyer,E.,Ritholz,M.,Burns,J.,&Truog,R.(2006).Improvingthequalityofend‐of‐lifecareinthepediatricintensivecareunit:Parents’prioritiesandrecommendations.Pediatrics,117(3),649‐57.

  Parker,J.,Mandleco,B.,Roper,S.,Freeborn,D.,&Dyches,T.(2011).Religiosity,spirituality,andmaritalrelationshipsofparentsraisingatypicallydevelopingchildorachildwithadisability.JournalofFamilyNursing,17(82),82‐104.

  Puchalski,C.&Romer,A.(2000).Takingaspiritualhistoryallowsclinicianstounderstandpatientsmorefully.JournalofPalliativeMedicine,3(1),129‐137.

  Rosenbaum,J.,Smith,J.,&Zollfrank,R.(2011).Neonatalend‐of‐lifespiritualsupportcare.TheJournalofPerinatal&NeonatalNursing,25(1),61‐69.  Wright,S.(2011).Theheartandsoulofnursing.NursingStandard,25(30),18‐19.

  Zelcer,S.,Cataudella,D.,Cairney,A.E.,&Bannister,S.L.(2010).Palliativecareofchildrenwithbraintumors:Aparentalperspective.ArchivesofPediatrics&AdolescentMedicine,164(3),225‐230.

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