Perceptions and understandings of dignity. Kap. 2

I: L. Rykkje & A. Austad (Red.), Eksistensielle begreper i helse- og sosialfaglig praksis‘Dignity’ is a term used widely, often interchangeably, with the term ‘respect’. It is challenging to illustrate these concepts as they relate to health and social care. Through a retrospective analysis of our research, we explore the meaning and rele-vance of dignity in care through the participants’ narratives. Although human dignity is complex to define and operationalise in practice, it is quite clear when it is lacking. Par-ticipants referred to key attributes of holistic care and treating patients as people, through establishing and maintaining meaningful interpersonal relationships, and the implications when human dignity is not maintained.publishedVersio

Achieving fulfilment in life: Cultivating the mindset of gratitude among thai adolescents

This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).Gratitude plays a significant role in nurturing holistic health and wellbeing in adolescent. However, cultivating the mindset of gratitude is associated with several factors, in particular, culture and religion. Therefore, an opportunity exists for studies to be undertaken, exploring gratitude specifically within the Thai culture. This grounded theory study aimed to understand how Thai adolescents cultivated a mindset of gratitude. Data were gathered from 27 participants, aged 15 to 19 years. Purposeful and theoretical sampling techniques were used to select participants. Data were collected through in-depth interviews, written stories, and drawn pictures. Data analysis was guided by Strauss and Corbin’s grounded theory. The core category of “Achieving Fulfilment in Life”—reflecting the process of cultivating the mindset of gratitude among Thai adolescents— comprised three categories: (a) condition: appreciating the value of oneself and others; (b) strategies: committing to live life on a positive life path; and (c) consequence: attaining true happiness. The findings illustrated the processes involved in cultivating the mindset of gratitude, highlighting how this may help in the development of a holistic health promotion program using the concept of gratitude to enhance the health and wellbeing of adolescents.publishedVersio

Spirituality and Dignity of Thai Adolescents Living with HIV

Abstract: (1) Background: Adolescents are a key asset and resource for the social and economic development of any country, with the potential to make a significant contribution to their families, communities and countries. Healthy and educated adolescents are important. However, there are still significant rates of death, illness and disease among adolescents in some countries, where HIV is one of the most prevalent causes of death in this group. Adolescents living with HIV may experience and encounter social restrictions and physiological limitations. Therefore, this investigation explored whether the concepts of spirituality and dignity had any relevance to participants sense of meaning and purpose and whether these had any impact upon their health and well-being (2) Methods: A qualitative descriptive design was used involving twenty-two adolescents living with HIV attending one regional hospital in Southern Thailand. One to one interviews and descriptive diaries were used to collect the data and thematic analysis enabled the identification of attributes of spirituality and dignity. (3) Results: The findings revealed that spirituality and dignity were present in the lives of Thai adolescents living with HIV expressed in the main category of living life responsibly. This comprised of six themes: (a) Understanding the disease and accepting the truth about life, (b) Maintaining hope for a cure, (c) Focusing on life’s purposes, (d) Making life choices, (e) Caring for oneself and (f) Responsibility towards other. (4) Conclusions: The findings provide helpful insights for parents, nurses, and other health professionals supporting adolescents living with HIV to obtain a holistic, dignified approach to care that includes attention to the spiritual dimension

Chaplains for Wellbeing" in primary care: A qualitative investigation of their perceived impact for patients' health and wellbeing

Although Health Chaplaincy services are well-established in hospitals in the United Kingdom and across the world, Primary Care Chaplaincy is still in its infancy and much less extensively developed. This study explored the impact the introduction of a Primary Care "Chaplains for Wellbeing" service had upon patients' experience and perceived health and well-being. Sixteen patients participated in one-one interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA). Patients reported circumstances that had eroded perceived self-efficacy, self-identity, and security manifesting as existential displacement; summarized under the superordinate theme of "loss." "Loss" originated from a number of sources and was expressed as the loss of hope, self-confidence, self-efficacy, and sense of purpose and meaning. Chaplains used a wide range of strategies enabling patients to rebuild self-confidence and self-esteem. Person-centered, dignified, and responsive care offered in a supportive environment enabled patients to adapt and cope with existential displacement

From the struggle of defining to the understanding of dignity: A commentary on Barclay (2016) “In sickness and in dignity: A philosophical account of the meaning of dignity in health care”

We were pleased to see that Barclay (2016) very recently addressed the important issue of dignity in health care. In the paper entitled “In sickness and in dignity: A philosophical account of the meaning of dignity in health care”, the author (Barclay, 2016:136) promotes an understanding and sensitivity for patients’ dignity as ‘core’ outlining critical responsibilities of health care practitioners. This enticing title left us very curious to know more about the philosophical perspective of dignity in health care that the paper purports to offe

Understanding spiritual care-perspectives from healthcare professionals in a norwegian nursing home

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/)Nursing home professionals have reported that spiritual care is an unclear concept, and research suggests that healthcare professionals have a limited understanding of this dimension of care. The provision of spiritual care is well-investigated internationally, but research is sparse within Norway’s secularized society. This study investigated healthcare professionals’ understanding of spiritual care in one nursing home. Methods: Data were collected from individual interviews (N = 8) and one focus group (N = 5) of nursing home personnel; the study used qualitative content analysis and a hermeneutic methodology. Results: One central question emerged during the data analysis: what is spiritual care versus good care? This starting point resulted in four themes (1) caring for the whole person, (2) having a personal touch, (3) seeing the person behind the diagnosis, and (4) more than religiousness. Some healthcare professionals had not heard of spiritual care, and many were not aware of this in their daily work with older patients. Nevertheless, they facilitated and cared for the patient’s spiritual needs, but they did not address it as spiritual care. Other participants were familiar with the concept and understood spiritual care as an essential part of daily care. Conclusion: healthcare professionals’ understanding of spiritual care is broad and varied, including practical and non-verbal aspects. The results indicated a need for an open dialogue about spiritual needs and resources in clinical practice and the teaching of personnel about how to facilitate older people’s spirituality. Moreover, there is a need for more research into spiritual care and how it differs from the concept of good fundamental care.publishedVersio

The qualitative findings from an online survey investigating nurses perceptions of spirituality and spiritual care

Aim: This paper presents the qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. Background: The role and place of spirituality within nursing has been contested by academics and wider society. One argument posited is supporting patients with their spiritual needs is not the responsibility of nurses. This is despite a clear professional requirement for nurses to achieve competence in the delivery of spiritual care. Design: The Royal College of Nursing (RCN) conducted an online survey of its membership to ascertain their perceptions of spirituality and spiritual care identifying current practice. Method: This paper presents the findings from the final part of the survey that asked respondents to use a free text facility to add comments on the subjects of spirituality and spiritual care. Results: Overall, 4054 RCN members responded, of these 2327 provided additional comments. These comments were analysed using keyword and content/thematic analysis. Five broad themes emerged: 1) theoretical and conceptual understanding of spirituality 2) fundamental aspects of nursing 3) notion of integration and integrated care 4) education and professional development; 5) religious belief and professional practice. Findings suggest that nurses have diverse understandings of spirituality and the majority consider spirituality to be an integral and fundamental element of the nurses’ role. Conclusion: Generally nurses had a broad, inclusive understanding of spirituality considering this to be ‘universal’. There was some uncertainty and fear surrounding the boundaries between personal belief and professional practice. Respondents advocated formal integration of spirituality within programmes of nurse education. Relevance to clinical nursing: The concept of spirituality and the provision of spiritual care are now recognised as fundamental aspects of the nurse’s role. There is a need for greater clarity between personal and professional boundaries to enable nurses to feel more confident and competent in delivering spiritual care

An Online Survey of Nurses’ Perceptions of Spirituality and Spiritual Care

Background: There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently the area of spirituality has come under criticism bringing into question the role of the nurse with regards to the provision of spiritual care. Aim: This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing (RCN) to ascertain members’ perceptions of spirituality and spiritual care. Design: A descriptive online survey was conducted of all RCN members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regards to this aspect of nursing practice. Method: An online survey consisting of a five part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale (SSCRS). Members were asked to complete the survey during a 3 week period in March 2010. Results: Overall, 4054 RCN members responded, making this probably the largest UK survey ascertaining nurses’ perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach’s Alpha of .80 was obtained for the SSCRS. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing. Conclusion: The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients’ spiritual needs

Editorial: Special Issue “International Conference of Spirituality in Healthcare. Sowing the Seeds”—Trinity College Dublin 2015

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“Enablement”—Spirituality Engagement in Pre-Registration Nurse Education and Practice: A Grounded Theory Investigation

Historically, spirituality in nursing was considered a fundamental dimension, contributing to patients’ wellbeing. Accordingly, nurses are expected to attend to the spiritual needs of patients as a part of holistic nursing care, and pre-registration nurse education (that is undergraduate nurse education) has a responsibility to equip them to fulfil this aspect of their role. However, the content of spirituality in nurse education programmes lack structure and consistency, hence further investigation into the value of such education and its transferability in clinical practice is needed. Data collection was by individual interviews with 13 pre-registration participants undertaking adult nursing between March 2012 and May 2014. Each interview was digitally recorded and transcribed verbatim. Through theoretical sampling, data collection and analysis occurred in a cyclical manner until theoretical saturation/sufficiency was reached. The participants’ main concerns were: explaining spirituality, remembering spirituality education and content, and uncertainties about facilitating patients’ spiritual needs; these combine to form ‘having sufficient spirituality education to facilitate patients’ spiritual needs’. The substantive theory of ‘Enablement’ (make possible) was constructed to explain how the participants resolved their main concern. This investigation reveals how the participants acquire and translate spirituality education to practice, so realising holistic care. View Full-Tex