17.1 Spiritual issues in palliative medicine Flashcards
Four broad themes in understanding spirituality involve communion with what?
communion with self (self-identity, wholeness, inner peace)
communion with others (love, reconciliation)
communion with nature (inspiration, creativity)
communion with a higher being (faithfulness, hope, gratitude)
Three main spiritual issues for patients have been identified and involve searches for what three things
searching for meaning and identity within the illness experience
searching for peace of mind and freedom from the pervasive fear of dying
searching for a guide to help make sense of what was happening as death drew nearer
List two differences between spirituality and religion
religion is focused in institutions, concerning with defining orthodoxy and orthopraxy; spirituality is not institutionally bound.
religious meaning is transmitted through doctrine and stories of the community; spirituality is concerned with discovery of meaning in the context of the level of the individual
religion may provide and motivational and disciplined framework for spiritual growth; spirituality is concerned with self-directed spiritual growth
religion may or may not be part of a person’s spiritualtiy whereas spirituality always expressed within larger context expressed within religious, culture society
List 3 spiritual elements that atheists want their spiritual care to focus on
intrapersonal - focuses on issues of self acceptance
interpersonal - importance of family and friends
Interconnectedness with natural world
acknowledges the patient as caring and moral
What is the relationship between spiritual well-being and desire for hastened death? Hopelessness? Suicidal ideation?
reduced
What is the relationship between spiritual well-being and desire for hastened death? Hopelessness? Suicidal ideation?
All correlate negatively with spiritual well being
Define suffering
-an anguish that is experienced not only as a pressure to change, but as a threat to our composure, our integrity, our fulfillment of our intentions
Who on the multidisciplinary team can identify spiritual concerns? List three barriers to this
all members of team share the responsibility of identifying and being sensitive to spiritual concerns
marginalization and devaluing of psychosocial and spiritual care during training
lack of safe and supportive environment
time demands and busy clinical schedules
lack of training in spiritual assessment and care (nursing literature)
lack of training and skill in communication with patients about existential issues
List 3 physician traits that enhance the ability to provide spiritual care
awareness of spiritual dimension in one’s own life
honing communication skills
establishing trusting relationship
drawing on one’s own life experience
How should spiritual assessment be prefaced (two elements)?
acknowledgement of the sensitivity of the questions
Acknowledgement of the need for the assessment
What are the elements of the SPIRIT mnemonic
S - spiritual belief system
P - personal spirituality (views shaped by unique life experiences)
I - integration and involvement with a spiritual community
R - ritualized practices and restrictions that individuals embrace that may affect health
I - implications for medical care; how person’s spiritual beliefs influence their participation in healthcare
T - terminal events planning; end of life concerns
What the elements of the FICA mnemonic
F - faith or beliefs
I - importance and influence
C - community
A - address - how should your beliefs be addressed by your healthcare team?
List the three key elements of the demoralization syndrome
hopelessness
loss of meaning
Existential distress
List 4 areas of improvement after participation in group meaning centred psychotherapy
spiritual well being meaning hopelessness desire for death optimism, pessimism depression anxiety QOL
