Nursing Care Plan: Spiritual distress related to physical/ psychological stress; energy-consuming anxiety, situation, loss(es)/intense suffering, separation from religious/cultural ties, and challenged belief and value system.

Scientific Basis:

Spiritual distress is an experience of profound disharmony in the person’s belief or value system that threatens the meaning of his or her life. During spiritual distress the patient loses hope, questions his or her belief system, or feels separated from his or her personal source of comfort and strength. Pain, chronic or terminal illness, impending surgery, and the death or illness of loved ones are crises that may cause spiritual; distress. Being physically separated from family and family culture contributes to feeling alone and abandoned. Nurses in the hospital, home care, and ambulatory settings can assist the patient in reestablishing a sense of spiritual being.

Spirituality refers to that of being human that seeks meaningfulness through intra-, inter-, and transpersonal connection. Spirituality generally involves a belief in a relationship with some power, creative force, divine being, or infinite source of energy.

Spiritual distress refers to a change to the spiritual well-being or the belief system that provides strength, hope, and meaning to life. Some factors that may be associated with or contribute to person’s spiritual concerns. Physiologic problems, treatment related concerns, and situational concerns. Physiologic problems include having a medical diagnosis of a terminal of debilitating disease, experience pain, experiencing the loss of a body part or function. Treatment related factors include recommendation to dietary restriction, surgery, amputation of a body part.

Carpenito-Moyet, 2006; Gulanick, 2007; Berman, et al, 2008

Intervention and Rationale

I: Determine client’s religious/spiritual orientation, current involvement, and presence of conflicts.
R: Provides baseline for planning care and accessing appropriate resources.

I: Be aware of influence of caregiver’s belief system.
R: It is still possible affect to be helpful to client while remaining neutral/ not espousing own beliefs.

I: Establish environment that promotes free expression of feelings and concerns. Provide calm, peaceful setting when possible.
R: Promotes awareness and identification of feelings so they can be dealt with.

I: Listen to client/SO’s reports/expressions of anger, concern, alienation from God, belief that situation is a punishment for wrongdoing, and so forth.
R: Helpful to understand client/SO’s point of view and how they are questioning their faith in the face of tragedy.

I: Note sense of futility, feelings of hopelessness and helplessness, lack of motivation to help self.
R: These thoughts and feelings can result in the client feeling paralyzed and unable to move forward to resolve the situation.

I: Listen to expressions of inability to find meaning in life, reason for living. Evaluate for suicidal ideation.
R: May indicate need for further intervention to prevent suicide attempt.

I: Determine support systems available to client/SO(s).
R: Presence or lack of support systems can affect client’s recovery.

I: Ask how you can be most helpful. Convey acceptance of client’s spiritual beliefs/concerns.
R: Promotes trust and comfort, encouraging client to be open about sensitive matters.

I: Make time for nonjudgmental discussion of philosophic issues/questions about spiritual impact of current events/situation.
R: Helps client to begin to look at basis for spiritual confusion. Note: There is a potential for care provider’s belief system to interfere with client finding own way. Therefore it is most beneficial to remain neutral and not espouse own beliefs.

I: Discuss difference between grief and guilt and help client to identify and deal with each, assuming responsibility for own actions, expressing awareness of the consequences of acting out of false guilt.
R: Blaming self for what has happened impedes dealing with the grief process and needs to be discussed and dealt with.

I: Use therapeutic communication skills of reflection and Active-Listening.
R: Helps client find own solutions to concerns.
I: Discuss use of/provide opportunities for client/SO to experience meditation, prayer and forgiveness. Provide information that anger with God is a normal part of the grieving process.
R: Can help to heal past and present pain.

I: Assist client to develop goals for dealing with life situation.
R: Enhances commitment to goal, optimizing outcomes and promoting sense of hope.

I: Develop therapeutic nurse-client relationship. Ask how you can be most helpful. Convey acceptance of client’s spiritual beliefs/ concerns.
R: Promotes trust and comfort, encouraging client to be open about sensitive matters.

I: Help client find a reason for living.
R: Promotes sense of hope and willingness to continue efforts to improve situation.

I: Identify and may refer to resources that can be helpful (e.g., pastoral/parish nurse or religious counselor, crisis counselor, psychotherapy)
R: Specific assistance may be helpful to recovery, (e.g., relationship problems, suicidal ideation).

I: Encourage participation in support groups if possible.
R: Discussing concerns and questions with others can help client resolve feelings.

Doenges, et al, 2002; Gulanick, 2007

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Nursing care plan: spiritual distress related to physical/ psychological stress; energy-consuming anxiety, situation, loss(es)/intense suffering, separation from religious/cultural ties, and challenged belief and value system. 1

"Looking for a Similar Assignment? Order now and Get a Discount!

Nursing care plan: spiritual distress related to physical/ psychological stress; energy-consuming anxiety, situation, loss(es)/intense suffering, separation from religious/cultural ties, and challenged belief and value system. 2
Nursing care plan: spiritual distress related to physical/ psychological stress; energy-consuming anxiety, situation, loss(es)/intense suffering, separation from religious/cultural ties, and challenged belief and value system. 3