18.2 Basic Concepts
Open Resources for Nursing (Open RN)
Spiritual Distress
When clients are initially diagnosed with an illness or experience a serious injury, they often grapple with the existential question, “Why is this happening to me?” This question is often a sign of spiritual distress. Spiritual distress is defined by NANDA-I as, “A state of suffering related to the impaired ability to integrate meaning and a purpose in life through connections with self, others, the world, and/or a power greater than oneself.”[1] Nurses can help relieve this suffering by therapeutically responding to a client’s signs of spiritual distress and advocating for their spiritual needs throughout their health care experience.
Spirituality
Provision 1 of the ANA Code of Ethics states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person” and “optimal nursing care enables the client to live with as much physical, emotional, social, and religious or spiritual well-being as possible and reflects the client’s own values.”[2]
Spirituality is defined by the Interprofessional Spiritual Care Education Curriculum (ISPEC) as, “A dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose, and transcendence and experience relationship to self, family, others, community, society, nature, and the significant or sacred.”[3] Spiritual needs and spirituality are often mistakenly equated with religion, but spirituality is a broader concept. Elements of spirituality include faith, meaning, love, belonging, forgiveness, and connectedness.[4] Spirituality and spiritual values in the context of nursing are closely intertwined with the concept of caring.[5] See Figure 18.1[6] for an illustration of the concept of spirituality.
An integrative review of nursing research and resources was completed in 2014 to describe the impact of spirituality and spiritual support in nursing.[7] See the following box for discussion of findings from this integrative review.
Integrative Review of Spirituality in Nursing[8]
An integrative review of nursing literature selected 26 articles published between 1999 and 2013 to describe the experiences of spirituality and the positive impact of spiritual support in nursing literature.[9] Spirituality was described as the integration of body, mind, and spirit into a harmonious whole (often referred to as holistic care). Spirituality was associated with the development of inner strength, looking into one’s own soul, believing there is more to life than worldly affairs, and trying to understand who we are and why we are on this earth.
Transcendence was described as an understanding of being part of a greater picture or of something greater than oneself, such as the awe one can experience when walking in nature. It was also expressed as a search for the sacred through subjective feelings, thoughts, and behaviors. Spirituality was found to have a positive effect on