Hospitalized Patients' Perspectives on Spiritual Assessment: A Mixed Methods Study.

BACKGROUND: Research shows that spirituality is important, but patients report that nurses rarely address spiritual issues, and research from the patient viewpoint is limited. AIM: The research objective was to gain knowledge about hospitalized patients' perspectives on spiritual assessment by nurses. METHOD: This is a mixed methods exploratory study reporting on quantitative/qualitative aspects of the patient perspective. Norwegian nurses in an acute care hospital distributed a 21-item spiritual assessment survey to patients they felt would not be burdened by completing it. Patients' demographic data were not identifiable, survey packets were returned anonymously via hospital mail by 157 hospitalized patients. Each survey item and several variables on the demographic sheet had space for comments. Quantitative analysis used SPSS 21, qualitative data were thematically analyzed. FINDINGS: Statistically significant correlations were found with all survey items. Hospitalized people reported high comfort with spiritual assessment by nurses. Qualitative findings revealed that patients had differing views on if, when, and how nurses should ask spiritual questions of them. CONCLUSIONS: It is important to identify patients' perspectives in order to provide patient-centered holistic care. Understanding patient views will enlighten nurses and may promote spiritual care and improve patient health outcomes.

Depression and suicidal ideation: association of physical, mental, social, and spiritual health status.

PURPOSE: The aim of this study was to determine if multidimensional (physical, mental, social, spiritual) health status could predict the presence of depressive symptoms and suicidal ideation in the general population. METHODS: We administered a population-based, cross-sectional survey to 1200 participants from the general Korean population. The survey included the 5 Health Status Questionnaire (5HSQ) for self-rated health status, Patient Health Questionnaire-9 (PHQ-9) for depression, and a question from the PHQ-9 for suicidal ideation. Multiple logistic regression was performed to estimate the association of significant socio-demographic factors and self-rated health status with depression and suicidal ideation. RESULTS: Physical health status was associated with depression in both men and women (men: adjusted odds ratio [aOR], 4.69; 95% confidence interval [CI] 2.44-9.00; women: aOR, 2.05; 95% CI 1.13-3.72) while spiritual health status only affected men (aOR, 5.50; 95% CI 2.59-11.65) and mental health status only women (aOR, 3.92; 95% CI 2.03-7.54). Social health status was associated with suicidal ideation in men (aOR, 4.87; 95% CI 2.74-19.99) while mental health status was associated with suicidal ideation in women (aOR, 4.31; 95% CI 1.90-9.76). CONCLUSION: Physical, mental, social, and spiritual self-rated health statuses were all found to be associated with an individual's predisposition to depression and suicidal ideation with notable differences between men and women.

Advance care planning for older people: The influence of ethnicity, religiosity, spirituality and health literacy.

In this discussion paper we consider the influence of ethnicity, religiosity, spirituality and health literacy on Advance Care Planning for older people. Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of advance care planning by this group across a number of countries where advance care planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions. Health literacy issues have been identified as one of the main reasons for a communication gaps between physicians and their patients in discussing end-of-life care, where poor health literacy, particularly specific difficulty with written and oral communication often limits their understanding of clinical terms such as diagnoses and prognoses. This then contributes to health inequalities given it impacts on their ability to use their moral agency to make appropriate decisions about end-of-life care and complete their Advance Care Plans. Currently, strategies to promote advance care planning seem to overlook engagement with religious communities. Consequently, policy makers, nurses, medical professions, social workers and even educators continue to shape advance care planning programmes within the context of a medical model. The ethical principle of justice is a useful approach to responding to inequities and to promote older peoples' ability to enact moral agency in making such decisions.

Spiritual distress of military veterans at the end of life.

OBJECTIVE: Although combat experiences can have a profound impact on individuals' spirituality, there is a dearth of research in this area. Our recent study indicates that one unique spiritual need of veterans who are at the end of life is to resolve distress caused by combat-related events that conflict with their personal beliefs. This study sought to gain an understanding of chaplains' perspectives on this type of spiritual need, as well as the spiritual care that chaplains provide to help veterans ease this distress. METHOD: We individually interviewed five chaplains who have provided spiritual care to veterans at the end of life in a Veterans Administration hospital. The interviews were recorded, transcribed, and analyzed based on "grounded theory." RESULTS: Chaplains reported that they frequently encounter veterans at the end of life who are still suffering from thoughts or images of events that occurred during their military career. Although some veterans are hesitant to discuss their experiences, chaplains reported that they have had some success with helping the veterans to open up. Additionally, chaplains reported using both religious (e.g., confessing sins) and nonreligious approaches (e.g., recording military experience) to help veterans to heal. SIGNIFICANCE OF RESULTS: Our pilot study provides some insight into the spiritual distress that many military veterans may be experiencing, as well as methods that a chaplain can employ to help these veterans. Further studies are needed to confirm our findings and to examine the value of integrating the chaplain service into mental health care for veterans.

We fall down: the African American experience of coping with the homicide of a loved one.

Rates of homicide among African Americans are much higher than those of other racial or ethnic groups. Research has demonstrated that homicide can be psychologically debilitating for surviving family members. Yet, exploring the experiences of homicide victims' surviving loved ones has received little attention. This study examined the coping strategies of African American survivors of homicide. Qualitative interviews were conducted with 8 African American family members (ages 18-82) of homicide victims. Survivors were recruited from the Massachusetts Office of Victim Services and from homicide survivor support, school, and community groups throughout the New England area. Interviews were conducted using open-ended questions derived from coping, support network, grief, and bereavement literatures. Results indicate that the primary coping strategies utilized by African American survivors of homicide victims are spiritual coping and meaning making, maintaining a connection to the deceased, collective coping and caring for others, and concealment. Implications for research and practice are discussed.

[Equivocal quintessence. Spiritual alchemy and counterfeit money in 16th-century Spain]. / Equívoca quintaesencia. Alquimia espiritual y moneda falsa en la España del siglo XVI.

One of the main obsessions of the early modern era was that of determining the notions of true and false, in order to apply them to various fields of knowledge and thus establish the divide between the lawful and unlawful. This trend was to have a particular impact on the fields of religion and science, where it became necessary to distinguish not only between true and false spirits, relics or miracles, but also between genuine and fake astrologers and alchemists. Situated in the middle ground between idealism and materialism, alchemy was prime territory for such tensions, as was demonstrated by a trial held in 1593 at the Jeronymite monastery of Santa Enracia in Saragossa, whose prior accused a friar of making "silver out of smoke and jewels from goblins".

R.D. Laing and theology: the influence of Christian existentialism on "The Divided Self".

The radical psychiatrist R.D. Laing's first book, "The Divided Self" (1960), is informed by the work of Christian thinkers on scriptural interpretation -- an intellectual genealogy apparent in Laing's comparison of Karl Jaspers's symptomatology with the theological tradition of "form criticism." Rudolf Bultmann's theology, which was being enthusiastically promoted in 1950s Scotland, is particularly influential upon Laing. It furnishes him with the notion that schizophrenic speech expresses existential truths as if they were statements about the physical and organic world. It also provides him with a model of the schizoid position as a form of modern-day Stoicism. Such theological recontextualization of "The Divided Self" illuminates continuities in Laing's own work, and also indicates his relationship to a wider British context, such as the work of the "clinical theologian" Frank Lake.

Inca of the blood, Inca of the soul: embodiment, emotion, and racialization in the Peruvian mystical tourist industry.

In the context of the globalizing New Age movement and of the "turismo mistico" (mystical tourism) industry emanating from Peru, white and mestizo New Age practitioners and tourists fashion ideologies emphasizing the spiritual energy which supposedly resides in Quechua bodies, even as they freely appropriate Quechua cosmology and ritual for a hybridized New Age Andean spirituality. This case shows how racialized structural inequalities are expressed and experienced by tourists and New Age movement leaders through particular, essentialist representations of the body and through a common repertoire of emotional responses to inequality, commodification, and privilege. The paper provides an ethnographic account of how racialization may be perpetuated, negotiated, and resisted through religious systems, particularly through the work of constructing ideologies and experiences of the body and of emotional subjectivity.

More lurid than lucid: the spiritualist invention of the world "sexism".

Nineteenth-century American spiritualists coined the word sexism long before its modern incarnation in order to refer to a complex of ideas about human sexuality and reproduction that were consonant with the general advancement of women's rights. Among these ideas was the belief that spirit and mind were ascendant over matter and could act directly on it. In their view, a woman's sensitive spiritual nature gave her the power to join spirit and matter. She could provide a way for exalted spirits to enter the world through her, in the mental character and even the physical form of her offspring, by focusing her own and others' spirits into the embryo growing within her, as if she were making a photograph. The goal of enhancing this ability would justify changing law and custom to ensure women's autonomy and freedom, especially to protect their decisions about sexual relations in order to regulate favorable and unfavorable impressions on the embryo. Emphasizing the embryo's sensitivity to spiritual impressions, however, also led some progressives to the conclusion that women's autonomy should be restricted. Women had to be kept away from even immaterial influences that would adversely affect them during pregnancy.

The Victorian female civilising mission and women's aspirations towards priesthood in the Church of England.

This article analyses the effects of the Victorian female civilizing mission, with its central motif of spiritual womanhood, in shaping women's aspirations towards the Anglican priesthood during the twentieth century. The considerable development of nineteenth-century women's ex officio ministry is documented, and the ensuing clash in early twentieth-century male/clerical and female perspectives on women's appropriate role within church life is analysed. The article concludes with a brief discussion of the legacy of the Victorian civilising mission evident within the post-1960 Anglican debate over women's ordination.