PHI 413 Ethical and Spiritual Decision Making of Barriers and Challeng

This assignment requires you to interview one person and requires an analysis of your interview experience.

Select a patient, a family member, or a friend to interview. Be sure to focus on the interviewee's experience as a patient, regardless of whom you choose to interview.

Review The Joint Commission resource found in topic materials, which provides some guidelines for creating spiritual assessment tools for evaluating the spiritual needs of patients. Using this resource and any other guidelines/examples that you can find, create your own tool for assessing the spiritual needs of patients.

Your spiritual needs assessment survey must include a minimum of five questions that can be answered during the interview. During the interview, document the interviewee's responses.

Part II: Analysis

Answer

Spiritual Assessment Tool:

Spiritual beliefs of patients play important role in healthcare issues and managements of the patients. Studies are therefore of the opinion that besides considering the physical, social as well as biological determinants of health, the spiritual beliefs also need to be assessed by practitioners (Gomez et al., 2015). Spiritual beliefs of patients might have positive or negative interferences with healthcare interventions and therefore, professionals need to take in consideration of the spiritual beliefs of patients while designing their care plan. Researchers are of the opinion that spiritual assessments allow the healthcare professionals in supporting patients by stressing empathetic listening, effective documentation of the spiritual preferences for the future visits and incorporation of the precepts of the patient’s faith traditions into the treatment plans (Hodge et al., 2015). It also involves effective encouragement of the patients in using resources of the spiritual traditions and communities for overall wellness (Goncalves et al., 2016). The assignment will exhibit analysis of the information provided by a patient regarding her culture and will show how spiritual beliefs need to be incorporated by professionals during healthcare planning. This will exhibit the importance of spiritual assessment of patients for developing healthcare interventions that develop the quality of life of the patients.

Spiritual Assessment Tool:

FACT tool will be used in the assignment. This tool is a spiritual assessment tool that is developed for the chaplaincy utilization in the acute care settings. Even other healthcare professionals who are also interested in the spiritual acre of their patients can also utilize this tool (LaRocca et al., 2012).  One of the most important features is that the tool does not gather history as done by the healthcare professionals while documenting medical history. In place, it helps in providing information for the assignment based which healthcare interventions would be planned. The four letters of the word FACT stand for four important elements in the spiritual assessment of the patients who come for treatment. The first element would mainly discuss the faith or the spiritual beliefs of the patient. The second element discusses availability, accessibility as well as applicability of the spiritual support from the religious communities or not (LaRocca-Pitts, 2015). The third element mainly involves effective cooing or comforting as well as conflicting aspects of the spiritual values of the patient with the regular healthcare diagnosis of the patient. The fourth element is called the treatment plan that would mainly describe the treatment plans that would be developed depending upon the spiritual requirements of the patients.

Interview:

A patient named Savanna Morris came to the acute care centre with poorly managed diabetes and osteoarthritis. She was 42 years of age and was of African American origin. I chose the patient as she was from a different cultural background and was having different spiritual beliefs.

1. Professional: Hi, Mrs. Morris, How can I help you?

Patient: my diabetes and osteoarthritis are giving me very hard time. I need to undertake proper care plans so that I can overcome such suffering. However, I prefer spiritual healing method rather than western healthcare that my son is forcing to take.

2. Professional: what are your faiths and beliefs about spiritual healing and why are you not comfortable with western healthcare?

Patient: I have seen my mother and grandmother to suffer from similar problems and they used to feel well after undertaking spiritual healing process. I also want to follow their footsteps and take the help of spiritual leaders only. I do not trust western healthcare as it had caused amputation of foot in one of my friend.

3. Professional: are you being able to access the spiritual care that you want?

Patient: I am not being able to get any contacts of such African spiritual leader and hence I cannot seek for their service.

4. Professional: what are acting as the conflicts that you are making you prevent taking western healthcare and be more dependent on spiritual education?

Patient: my spiritual beliefs say that I am suffering because I might have conducted certain sins and therefore the god is punishing me by making me suffer through the disorders. The western healthcare professionals can never help me to establish a connection with God and help me to apologize to him.

5. Professional: do you really believe so?

Patient: Yes, I have no problem in undertaking healthcare support from western healthcare professionals and taking medications. However, I urgently need spiritual leaders who would worship the ancestors and spirits and ask them to provide solutions to my disorders. Such solutions would help me to apologize to god and overcome my suffering.

Analysis:

What went well?

I was entirely calm and composed throughout the interview. My high level of self –regulation helped me in not being annoyed, agitated, and helped me to manage the emotions of the patient. The patient highly criticized the western healthcare system, even her frustration came out through her anger, and she started shouting. Although I felt disappointed, I did not react negatively. Instead, I applied effective communication skills to bring the situation under control. Respecting dignity and authority of the patient along with compassion and empathy as communication skills helps professionals to develop trust and mutual respect among the patients (Timmins et al., 2015). These skills therefore, helped me to establish effective therapeutic relationship with the patient.

What to do differently in the future:

While taking the interview of the person and assessing his spiritual beliefs, I was quite surprised at a number of times. Therefore, I was often becoming judgmental with the patient, as I was not being able to find any scientific rationale of the beliefs of the African American female patient. Therefore, often my facial expressions and gestures of the body were expressing my biased attributes and thinking procedures about the spiritual beliefs of the patient. Researchers are of the opinion cultural competency of the professionals is important to ensure that patients feel respected. Being unbiased about cultural and spiritual traditions, preferences and inhibitions of the patients are important to make the patient comfortable and communicate effectively (Stewart, 2014). However, I was often being judgmental and biased and this affected my care service to the patient. Therefore, I need to make sure that I develop high level of cultural competence and overcome cultural biasness to provide person centered and therapeutic acre to the patients.

Barriers and Challenges

I need to develop cultural competency as I often become judgmental and biased about spiritual beliefs and values about patients from different backgrounds. I need to overcome these barriers for establishing effective relationship with patients that would be based on trust and respect.

How to address challenges and changes that are necessary

I would be joining training sessions provided by stalwart professionals in the healthcare domains on development of cultural competency. I would also undertake reflective practices as this would help me to identify the weakness and develop the skills to provide effective care. I would also discuss with my mentor about the issue and work according to his guidance.

Spiritual experiences:

I was initially judgmental about the spiritual beliefs of the patient that mainly relied on worshipping spirits and seeking advice from dead ancestors. I could not relate the rationale of their beliefs with healthcare issues faced by the patient. However, I was quite with the dedication and the trust they had developed with their traditional cultures and spiritual beliefs of the land. Gradually, I tried to analyze her situation from her point of view and this helped me to understand that her spiritual beliefs are intricately associated with her emotional health. Therefore, I realized that I order to ensure her emotional stability, her spiritual requirements need to be taken care and accordingly I helped her with the references of experts who provide traditional a healthcare according to African culture in the community.

Tools ability to meet needs of the patient

The four components of the tool helped me to identify the spiritual faith and belief of the patient and understand whether she was being able to access the spiritual community to fulfill her spiritual needs and requirements. Moreover, it also helped me to realize that her spiritual beliefs were contradicting her thoughts of undertaking help of western medication, as she was confused and could not understand what kind of interventions she would undertake. This helped me to develop a treatment plan for her that would be based on amalgamation of western healthcare interventions along with African spiritual healthcare regimens. This tool helped to identify the specific needs of the patient in the spiritual domain as well as healthcare domain and hence helped to understand that aspects that would ensure emotional and mental stability (Hodge, 2015).

How did the illness and stress amplify the spiritual concerns and needs of interviewee?

The patient was suffering from unmanaged diabetes and osteoarthritis and was having very poor quality life. Her son forced her to take help from western healthcare while she is keen on taking help from spiritual healers of African origin. Therefore, she was quite stressed, as she could not understand what decisions she would be taking to develop the conditions of her health. She was also not being able to locate any spiritual leaders of African origin and was feeling helpless as well. She believed that she might have sinned and that had resulted of the God being disappointed on her making her suffer more. All these beliefs were giving her a stressful time in relation to her physical suffering.

Conclusion:

FACT spiritual assessment tool helps understanding the spiritual beliefs and requirements of the patients and thereby help in developing treatment plans for the patient.  This tool helped to identify that the African American patient was tore apart between undertaking western healthcare treatment of spiritual treatment. She had a strong belief that she has sinned and therefore, the disorders are curse from god. Therefore, she needed help of spiritual leaders who would talk with spirits and help her. It was effectively identified that her spiritual beliefs were creating stress for her and made her concerned about her fate. Therefore, depending on the spiritual needs, proper references of spiritual leaders in her community had been provided and along with it, western healthcare interventions were also proposed. She was encouraged to carry on both spiritual and western treatment for betterment of her health.

References:

Gomez-Castillo, B. J., Hirsch, R., Groninger, H., Baker, K., Cheng, M. J., Phillips, J., ... & Berger, A. M. (2015). Increasing the number of outpatients receiving spiritual assessment: a pain and palliative care service quality improvement project. Journal of pain and symptom management, 50(5), 724-729. https://doi.org/10.1016/j.jpainsymman.2015.05.012

Gonçalves, L. M., Osório, I. H. S., Oliveira, L. L., Simonetti, L. R., dos Reis, E., & Lucchetti, G. (2016). Learning from listening: helping healthcare students to understand spiritual assessment in clinical practice. Journal of religion and health, 55(3), 986-999. https://doi.org/10.1007/s10943-015-0146-y

Hodge, D. R. (2015). Administering a two?stage spiritual assessment in healthcare settings: a necessary component of ethical and effective care. Journal of nursing management, 23(1), 27-38. https://doi.org/10.1111/jonm.12078

LaRocca-Pitts, M. (2012). FACT, A Chaplain's Tool for Assessing Spiritual Needs in an Acute Care Setting. Chaplaincy Today, 28(1), 25-32. Retrieved from https://library.gcu.edu:2048/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=76285077&site=eds-live&scope=site

LaRocca-Pitts, M. (2015). Four FACTs Spiritual Assessment Tool. Journal of health care chaplaincy, 21(2), 51-59. https://doi.org/10.1080/08854726.2015.1015303

Stewart, M. (2014). Spiritual assessment: A patient-centered approach to oncology social work practice. Social work in health care, 53(1), 59-73. https://doi.org/10.1080/00981389.2013.834033

Timmins, F., Murphy, M., Neill, F., Begley, T., & Sheaf, G. (2015). An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks. Nurse education today, 35(1), 277-282. https://doi.org/10.1016/j.nedt.2014.05.008