Interview
Then complete a spiritual assessment on someone in your community. Use the form
found below the rubric. Use bullet points or numbers rather than complete sentences.
Be sure to choose an appropriate tool. You can use the assessment from the chapter
on spirituality found in your textbook, or choose one found in the literature or online
such as the
HOPE tool: http://www.aafp.org/afp/2001/0101/p81.html
FICA tool: http://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool
FACT tool: http://www.professionalchaplains.org/files/resources/reading_room/
spiritual_history_tool_fact_larocca_pitts.pdf
During the interview you will choose an appropriate spiritual nursing action based on
your assessment and state how/why you chose the nursing action. What was the result
of the action (e.g. what did the interviewee think of the nursing action and/or how did
they respond to the nursing action?). What are your thoughts on the experience of doing
this assessment (e.g. main takeaway(s), surprises, reactions). Please keep the form to
three or fewer pages.
SPIRITUAL ASSESSMENT ASSIGNMENT INSTRUCTIONS
Overview-Important Definitions
Holistic Nursing: The American Holistic Nurses Association (AHNA & ANA 2013. p. 1) created the following definition in 1998; “all nursing practice that has healing the whole person as its goal….honors the interconnectedness of self, others, nature, and spirituality.”
Spirituality: The feelings thoughts, experiences, and behaviors that arise from a search for meaning. That which is generally considered sacred or holy. Usually though not universally, considered to involve a sense of connection with an absolute, imminent, or transcendent spiritual force, however named, as well as the conviction that meaning, value, direction, and purpose are valid aspects of the individual and universe. The essence of being and relatedness that permeates all life and is manifested in one’s knowing, doing and being. The interconnectedness with self, others, nature, and God/Life Force/Absolute/Transcendent. Not necessarily synonymous with religion (AHNA & ANA, 2013, p. 91)
“Spiritual assessments not only glean religious beliefs and practices, but also query a person’s meaning and purpose in life and how that may have changed due to the present health experience” (AHNA & ANA p. 12).
AHNA & ANA. (2013). Holistic Nursing: Scope and standards of practice, 2nd Edition. Silver Spring, MD: Nursebooks.org.
Preparation
First read chapter 22 in Blais and Hayes and complete the Spiritual Assessment online learning module.
I
nterview
Then complete a spiritual assessment on someone in your community. Use the form found below the rubric. Use bullet points or numbers rather than complete sentences. Be sure to choose an
appropriate tool. You can use the assessment from the chapter on spirituality found in your textbook, or choose one found in the literature or online such as the
HOPE tool:
http://www.aafp.org/afp/2001/0101/p81.html
FICA tool:
http://smhs.gwu.edu/gwish/clinical/fica/spiritual-history-tool
During the interview you will choose an appropriate spiritual nursing action based on your assessment and state how/why you chose the nursing action. What was the result of the action (e.g. what did the interv
Spiritual Assessment Form
(Please keep information you fill in to one-two pages)
Date:
XX/XX/20XX Interviewee Initials:
XX Age:
XX Gender:
Female Pertinent Medical Diagnosis (if any):
Cataract surgery on on her right eye.
Complication of increased intraocular pressure, resulting in blurred vision.
Short description of interviewee and how you know them (don’t give away person’s identity however):
She is a longtime family friend.
Name of tool:
A Spiritual Assessment Tool: FACT
Source:
LaRocca-Pitts, M. (2007).
Questions Asked (use bullet points) |
Interviewee Responses (use bullet points) |
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F – Faith (and/or Beliefs, Spiritual Practices) 1. What is your faith or spiritual beliefs? 2. Do you consider yourself spiritual or religious? 3. Tell me more about what you mean when you say “it’s more than going to church.” 4. What things do you believe that give your life meaning and purpose? A – Active (and/or Availability, Accessibility, Applicability) 5. Are you part of a religious or spiritual community? 6. Can you tell me about how you are active in your faith community? 7. Is support for your faith available to you? 8. Do you have access to what you need to apply your faith (or your beliefs)? 9. It sounds like reading the Bible is important to you. Can you tell me more about that? 10. Is there a person or a group whose presence and support you value at a time like this? C – Coping (and/or Comfort); Conflict (and/or Concern) 11. How are you coping with your medical situation? 12. Is your faith (your beliefs) helping you cope? 13. How is your faith (your beliefs) providing comfort in light of your diagnosis? 14. Do any of your religious beliefs or spiritual practices conflict with medical treatment? |
1. I am a Christian. I believe in Jesus Christ, the Father God, and the Holy Spirit. 2. I would consider myself more spiritual than religious. I have a personal relationship with God. It’s more than just “going to church.” 3. For me it’s a part of me. It’s not a building, or a set of rules, that sometimes people think of when they hear the word “religion.” 4. The two biggest things that keep me going is my faith and my family. I have a wonderful family. I’m blessed, with my husband, kids, and grandkids. I pray for them every day. My faith in Jesus is what gives it all meaning. 5. Yes, I am. I attend a nondenominational Christian church. 6. I Spiritual Assessment FormStudent: Date: XX/XX/20XX Pertinent Medical Diagnosis: Name of tool: SPIRIT Model for Assessing Spirituality Source: Blais and Hayes, 2016, p. 435
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