Unity and Diversity in Spiritual Care

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Spiritual needs, and psychosocial needs are much less tangible than physical needs, because they are often abstract, complex and more difficult to measure. These more intangible needs have frequently been given a much lower priority than needs which are more obvious and more easily measurable. Spiritual needs, if expressed outside of a religious framework, are very likely to go unnoticed. So if we are to identify spiritual needs and provide spiritual care, it's first necessary to have some understanding of the nature of spirituality and how it may be expressed by different individuals.

In Australian society, and therefore in our health care setting, we encounter a diversity of cultures, philosophies and religious traditions, as well as individuals who have no clearly defined philosophy or belief system. Therefore it's important that we develop some general definitions which can help us to recognise spiritual needs when we encounter them in our clients. In recent years, a number of definitions have emerged which are helpful both for defining spirituality, and differentiating between spiritual needs and religious or psychosocial needs.

Simsen defines spirituality by saying... "THE SPIRIT is that part of man which is concerned with the ultimate meaning of things and with a person's relationship to that which transcends the material." (Simsen, 1985:10) Moberg says it is... "The totality of man's inner resources, the ultimate concerns around which all other values are focussed, the central philosophy of life which influences all individual and social behaviour." (Moberg, 1979) SPIRITUAL NEED has been variously defined as, "Any factor that is necessary (requisite, indispensable) to support the spiritual strengths of a person or to diminish the spiritual deficits." (Simsen, 1985:10). "The lack of any factor or factors necessary to maintain a person's dynamic relationship with God/Deity (as defined by that person)." (Stallwood, 1975: 1088), and "That requirement which touches the core of one's being where the search for personal meaning takes place." (Colliton, 1981: 492). I find all these definitions helpful because together they give a comprehensive (though not exhaustive) picture of what we are aiming to do in giving spiritual care.

We need to realise however that spirituality may not always be expressed within a religious framework. Therefore we need to make a distinction between spirituality and religion. One definition of RELIGION is, "a framework of spiritual beliefs, a code of ethics and a philosophy that governs a person's activity in pursuit of that which he holds as supreme, his God." In the book, Nursing and Spiritual Care, McGilloway says, "Religion helps people answer basic questions about life and death and the unexplained happenings in the world around them". (McGilloway, 1985: 23) As these definitions demonstrate, spirituality is not limited to religious affiliation and practices, but is a much broader concept. Another difficulty in identifying spiritual need is that we can fail to make the distinction between spiritual needs and psychosocial needs, since they are not always opposites, and may in fact overlap.

A model I find helpful in clarifying this, is one that describes a person in terms of three dimensions.... (1) The PHYSICAL or biological dimension which relates to the world around us through our five senses. (2) The PSYCHOSOCIAL dimension which relates to self and others, and involves our emotions, moral sense, intellect and will. (3) The SPIRITUAL dimension which transcends physical and psychosocial dimensions and has the capacity to relate to a higher being. (Stallwood, 1975: 1087) These three dimensions are distinct but overlapping. They cannot be sealed in separate compartments. A crisis or illness affecting our physical body will invariably affect the other dimensions as well.

SPIRITUALITY IN NURSING TODAY

How does nursing today view spiritual care? For a long time, nursing literature...
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