Different Spiritual Concepts with Model Cases
Nguyen Thi Bich Tram1, Nguyen Thi Le1 and Ya-Lie Ku2*
1Lecturer, Faculty of Nursing, Duy Tan University, Vietnam
2Associate Professor, College of Nursing, Fooyin University
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Submission: March 11, 2019; Published: March 22, 2019
*Corresponding author: Ya-Lie Ku, MSN, RN, Associate Professor, College of Nursing, Department of Nursing, Fooyin University, No. 151, Jinxue Rd., Daliao District, Kaohsiung City 83102, Taiwan
How to cite this article:Nguyen T B T, Nguyen T L, Ya-L K. Different Spiritual Concepts with Model Cases. Psychol Behav Sci Int J. 2019; 11(1): 555804. DOI: 10.19080/PBSIJ.2019.11.555804
Abstract
This article introduces the different spiritual concepts with model cases, including spiritual well-being, crisis, distress, and suffering, from the positive to negative perspectives. The purpose of this article is expected to clarify the different spiritual concepts with the model cases so that healthcare professionals could distinguish the different spiritual status of various patients. Therefore, healthcare professionals could provide the specific spiritual nursing interventions according to the different levels of spiritual status.
The Concept of Spiritual Well-Being with Model Cases
Yang, Yen & Chen [1] defined attributes of spiritual well-being including the feeling of happiness; self-worth; an open and accepting attitude toward the interpersonal relationships; an internal energy [1]. Following are two model cases:
Model Case 1 of Spiritual Well-Being
An 89-year-old man who could not walk and sit in a wheelchair after a stroke. Although he was cared, he was very happy for the care by his son and daughter-in-law at home. Every day he helped the daughter-in-law do chores in the house such as cleaning the tables and chairs, watering plants, and playing with his grandson. He felt himself still could help the children. He loves his children and grandchildren and gets along with his neighbors. He was a retired veteran who has experienced many physical and mental pain; however, his internal energy is great. All attributes of spiritual well-being in the case have helped him recover quickly after a stroke.
Model Case 2 of Spiritual Well-Being
The aunt was 65-years-old with hypertension for 2 years. I asked her “are you worried about your disease?”. She answered “ No, I didn’t worry because God blessed me, and I have lived until now which already felt happiness. I took the medications every day in the morning and changed my lifestyle following the physician’s advices. Additionally, the aunt went to the church every day to pray and learn the information about the prevention of hypertension and its complications. Therefore, “I’m Ok now”. Furthermore, the aunt shared the experiences of treating and preventing the symptoms of hypertension with the other patients. Finally, she said hypertension is already a part of her life.
The Concept of Spiritual Crisis with Model Cases
Agrimson & Taft [2] defined the antecedents of spiritual crisis including the sudden acute illness, loss of important relationships, and other similar phenomena; the attributes of spiritual crisis including the questioning about the meaning of life, grief or a deep feeling of loss, and turning point; the positive or negative consequences [2]. Following are two model cases:
Model Case 1 of Spiritual Crisis
There was a young couple just married. They worked very hard and were planning to have the children. Unfortunately, her husband had brain cancer and died. She felt extremely painful and was unable to do anything because every planning could not be accomplished. She did not know what to do for the next life stage. She was grief and had the deep feeling of loss. Her life was disturbed and had the mental crisis as well as the economic crisis. She locked herself in the room and did not want to talk to anyone including her parents.
Model Case 2 of Spiritual Crisis
My friend’s grandparents were 80-years-old and lived together for taking care each other. Two years ago, grandmother had a stroke and died. Her husband missed her very much and could not sleep. He drank the alcohols every day to sleep easily and did not want to eat anything. He was hospitalized after 3 months because of the acute stomach pain.
The Concept of Spiritual Distress with Model Cases
Ku, Kuo, & Yao [3] defined the spiritual distress in terms of the relationship with self, with others, with God, and facing death on cancer patients [3]. Schultz, et al. [4] further identified that not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one’s illness were three parameter model of spiritual distress on cancer patients [4]. Following are two model cases
Model Case 1 of Spiritual Distress
Mrs. Trang was a 62-year-old woman. She had complained of the severe upper abdominal pain and weight loss increasingly during the past few months. An ultrasound revealed a mass with the suspicious of primary liver cancer. Mrs. Trang became resistant and didn’t confront her illness because of the fact being dying. She told me that there’s nothing wrong with her and refused to enter the hospice care because she felt that she did not need it. She was upset with the other patients in facing the terminal illness. When the nurse entered to her bedroom, Mrs. Trang resisted to talk to the nurse, and it was difficult to connect with her. Mrs. Trang was credited by her family and God was her strength. Although Mrs. Trang was defensive at first and reluctantly admitted her resistance in the early stage of her illness, God had answered her pray many times. However, it seemed that her pray had gone unanswered lately and she started to worry about where she will be going after death and where her soul went.
Model Case 2 of Spiritual Distress
One girl was 24-years-old, and her family believed the Catholic. She was fall in love with a man who was 28-years-old. However, her family didn’t permit them to get married because they have the different religion and he didn’t have job. He wanted to go abroad to earn money and promised her that he will come back to convince her parents. Unfortunately, he went to Japan for the work and after one year he got married to another girl. Once She has known the information and she became very depressed, cried a lot, and blamed the family, and alienated from others. She also started to feel no respectful of her believed God and she would like to die.
The Concept of Spiritual Suffering with Model Cases
Chio, et al. [5] identified the spiritual suffering from patients with terminal cancer including physical pain, sad and hopeless because of disability problems, self-blame for doing wrong things, sense of guilt for being the family’s burden, feeling sad and hopeless because of lack of support from some family members or friends, pessimistic thoughts about wanting to die, and feeling a fear of death [5]. Following are two model cases:
Model Case 1 of Spiritual Suffering
There was a 24 year-age girl. She was an orphan and raised by her grandmother. She was diagnosed with blood cancer when she was a new graduate student and yet obtained a job. Her grandmother was very old and unable to take care of her so that no one was present with her and she felt extremely lonely. After receiving the diagnosis of blood cancer, she felt shock and extremely pessimistic and always thought when she might die and where she could go after dying. She alienated from people around her including other cancer patients. She wasn’t satisfied with any nursing care and always angry at the nurses. She felt no protection from her ancestors, especially from her parents, as well as no respect of God. She was afraid of death and hate to talk to anyone about death. She was worried about who would help her grandmother organizing a funeral for her after her death.
Model Case 2 of Spiritual Suffering
A woman was 72 –years-old, her husband passed away during the war 30 years ago. She has two children. One daughter got married and live in the other city and one son got married and lived in the areas closed to her. However, she had a bad relationship with the son and daughter-in-law. Her son drank alcohols, beat the wife, and cursed at her badly. Additionally, daughter-in-law always blamed to her because of her son’s misbehaviors. She had diabetes and felt depressed. She said that “Every month I have to go to the hospital to take medicines, even my eyes are very poor, and no one pick up me. I have 2 children, but I’m alone. Every day I must go to clinics to inject insulin and I had to pay 10.000 VNĐ per time by myself. I don’t have enough money. When I was young, I took care of many soldiers but now I’m sick and no one takes care of me”. She cried during talking.
Conclusion and Suggestions
The concepts of spiritual well-being, crisis, distress, and suffering are the continuously flowing from the positive to negative perspectives. In terms of illness stages, the patients were diagnosed with any kind of disease at the initial stage, they could go to the spiritual crisis. Once the illness was becoming serious, the patients might go to the stage of spiritual distress. Finally, when the patients are going to the terminal stage of the illness, they would go to the spiritual suffering. Nevertheless, what if the patients do have the stronger inner power, faith on God, support system both from family and friends, they could own the spiritual well-being no matter which stage of the illness. Similarly, sometimes the spiritual crisis does happen during the critical life events such as accidents, broken and violent relationship, misbehaviors, facing grief and sorrow…and so on. Once the spiritual crisis was unsolved, it will become spiritual distress and lately being suffering. Following is the concept map of spiritual well-being, crisis, distress, and suffering (Figure 1).
Following the concept map of spiritual well-being, crisis, distress, and suffering, healthcare professionals could design the specific and individual interventions for the patients who are in the different spiritual stages. The authors also provided two model cases of spiritual well-being, crisis, distress, and suffering for healthcare professionals to discuss and analyze the different spiritual problems as well as deign the unique spiritual care interventions. Overall, this article is expected to inspire the healthcare professionals to sensitively aware, recognize, assess, and identify the different kinds of spiritual problems on the patients. Therefore, the healthcare professionals could provide the appropriate spiritual care for the patients in terms of their individual levels of spiritual stages. Hopefully, no matter which levels of spiritual stage, the patients could be always in the spiritual well-being beyond the critical events and illness which means that transcending could be existed.
References
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- Agrimson LB, Taft LB (2009) Spiritual crisis: Concept analysis J Adv Nurs 65(2): 454-461.
- Ku YL, Kuo SM, Yao CY (2010) Establishing the validity of a spiritual distress scale for cancer patients hospitalized in southern Taiwan. Int J Palliat Nurs 16(3): 34-138.
- Schultz M, Meged Book T, Mashiach T, Bar Sela G (2017) Distinguishing between spiritual distress, general distress, spiritual well-being, and spiritual pain among cancer patients during oncology treatment J Pain Symptom Manage 54(1): 66-73.
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