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Source: http://nursing.cua.edu/faculty/obrienm.cfm
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Purpose
This middle-range nursing theory on spiritual well-being in illness, based on the work of Joyce Travelbee and earlier conceptualizations of spiritual well-being, will help nurse practitioners and nurse researchers assess and evaluate the seriously ill patient's spiritual needs and institute appropriate spiritual care interventions. |
Conceptual
Model of Spiritual Well-Being in Illness. Source: O'Brien (2003)
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Key Concepts
Spiritual Well-being
The state of acceptance or transcending pain and suffering brought about by chronic illness or disability by allowing in the light of an individual's better nature. Individuals who achieved this spiritual well-being in illness are more positive about and satisfied with other aspects of their lives. They also were more optimistic about the future.
Spiritual well-being comes after a spiritual meaning of his illness experience has been achieved. A person's ability to achieve spiritual meaning is related to his spirituality and religiosity - his spiritual attitudes and behaviors - and intervening variables related to his illness and his environment.
Spirituality
This is one of two dimensions of spiritual well-being that deals with an individuals personal relationship with God. It is composed of personal faith and spiritual contentment.
Personal faith, one's belief or disbelief in God's existence, is critical to an individual's ability to find meaning in his illness. Aside from faith, an individual must trust in God's power and providence and find peace, courage and strength in his beliefs. All of this must come together for meaning to take root.
Spiritual contentment is the feeling of personal closeness to God and security in his love. The individual is faithful in his beliefs because of this satisfaction in his faith and not because he fears God's wrath and judgment.
Personal faith, one's belief or disbelief in God's existence, is critical to an individual's ability to find meaning in his illness. Aside from faith, an individual must trust in God's power and providence and find peace, courage and strength in his beliefs. All of this must come together for meaning to take root.
Spiritual contentment is the feeling of personal closeness to God and security in his love. The individual is faithful in his beliefs because of this satisfaction in his faith and not because he fears God's wrath and judgment.
Religiosity
The second dimension of spiritual well-being that reflects an individual's practice of his faith belief,which may or may not include involvement in an organized religious tradition.
Prayer and spiritual reading are helpful coping mechanisms, along with church attendance, although this need not be necessarily formal. Encouragement given by the faith community, the member's prayer and the guidance of pastors or spiritual companions can be comforting in times of illness and suffering.
Prayer and spiritual reading are helpful coping mechanisms, along with church attendance, although this need not be necessarily formal. Encouragement given by the faith community, the member's prayer and the guidance of pastors or spiritual companions can be comforting in times of illness and suffering.
Intervening Variables
Intervening or confounding variables that affect the achievement of spiritual meaning includes
- the severity of the illness or the degree of functional impairment
- the degree of social support by family, friends and caregivers
- stressful life events that could be emotional, sociocultural and financial in context
Major Paradigms
Person
A human being is a spiritual being, along with his physical and psychosocial nature. He is a rational being who will struggle to find meaning in the illness or disability experienced or will find a sense of acceptance or find peace amidst his suffering.
He, therefore, has the ability to find spiritual meaning in the experience of illness leading to spiritual well-being in illness. This ability to find acceptance, or even embrace his illness, depends on his spiritual attitudes and behaviors and influenced by intervening variables like severity of illness, available social support and stressful life events.
Health
A healthy person is someone who remains optimistic, satisfied and hopeful in spite of his chronic illness or disability. He is spiritually well even in illness. Perception of illness and suffering is dependent on the symbolic meaning attached to it by the individual.
There is a positive association between spiritual well-being and quality of life. The higher a person's personal faith, spiritual contentment and the more meaningful the religious practice the greater the satisfaction, optimism and hope experienced by the chronically ill person.
Environment
It directly affects a person's ability to find spiritual meaning in his experience. It is composed of the faith community, the family unit, friends and caregivers. The events that happened within the environment, emotional or financial changes, the support given by his significant others and the sociocultural context in which a person lives are considered intervening variables in the quest to reach spiritual well-being in illness.
Nursing
It is the goal of nursing to assist the ill patient to experience hope as a means of coping with illness and suffering. Nurses must be prepared to assist individuals to a not just cope with the illness but also to assist families and individuals to find meaning in the experience. Nurses must help identify, support and strengthen the spiritual resources an ill person has in relation to the sickness or disability.
Nurses can facilitate the enhancement or return to religious practice that might have waned or was abandoned with the onset of illness. Nurses can intervene in correcting or minimizing potentially confounding variables that may interfere with an ill person's ability to achieve spiritual well-being. This can be achieve in a nurse's role as
Reference:
There is a positive association between spiritual well-being and quality of life. The higher a person's personal faith, spiritual contentment and the more meaningful the religious practice the greater the satisfaction, optimism and hope experienced by the chronically ill person.
Environment
It directly affects a person's ability to find spiritual meaning in his experience. It is composed of the faith community, the family unit, friends and caregivers. The events that happened within the environment, emotional or financial changes, the support given by his significant others and the sociocultural context in which a person lives are considered intervening variables in the quest to reach spiritual well-being in illness.
Nursing
It is the goal of nursing to assist the ill patient to experience hope as a means of coping with illness and suffering. Nurses must be prepared to assist individuals to a not just cope with the illness but also to assist families and individuals to find meaning in the experience. Nurses must help identify, support and strengthen the spiritual resources an ill person has in relation to the sickness or disability.
Nurses can facilitate the enhancement or return to religious practice that might have waned or was abandoned with the onset of illness. Nurses can intervene in correcting or minimizing potentially confounding variables that may interfere with an ill person's ability to achieve spiritual well-being. This can be achieve in a nurse's role as
- a referral agent (e.g. a patient with hard of hearing can be referred for audiology testing or acquisition of a hearing aid)
- a bridge between families and friends with whom the patient has a strained relationship
- an educator
- a counselor
- a patient advocate
Reference:
O’Brien,
M.E. (2003). A middle-range theory of spiritual well-being in illness. Parish nursing: healthcare ministry within
the church. Retrieved from http://www.jblearning.com/samples/0763746487/46487_ch04_085_094.pdf