10th annual israeli spiritual care confernece for professionals 5 – 6 nov 2013 tove giske...
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How to recognize and verbalize spirituality in its diverse
expressions?10th Annual Israeli Spiritual Care Confernece for professionals
5 – 6 Nov 2013
Tove Gisketove.giske@haraldsplass.no
Associate ProfessorHaraldsplass Deaconess University College
Bergen, Norway
Giske; How to recognize & verbalize spirituality
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Bergen, Norway
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Overview of presentation1. Theoretical backdrop2. How to recognize spiritual concerns
& resources3. Presentation of spiritual care
research – how undergraduate nursing students learn
4. Recommendations for universities and clinical practice
Giske; How to recognize & verbalize spirituality
1. Theoretical backdrop – help to think professionally
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Victor FranklCarl Jaspers
Giske; How to recognize & verbalize spirituality
Victor Frankl & LogoterapiAustrian & American
psychiatrist1905 – 1997
Imprisoned in Auschwitz 2nd world war
Develop LOGO THERAPY:Humans seek and can find meaning through:Accomplish somethingBy receivingAn attitude of living
through suffering
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Limit situations - grensesituasjoner
Carl Jaspers (1883 – 1969)
German philosopher and psychiatrist
Some situations in life we cannot change – he calls them ”limit situations”
• Illness• Different kinds of loss• Death• Threaths of such
situations
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- But also make one wonder and reflect…
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Limit situations can cause pain and suffering
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Limit situations make us stop
•Realise that life cannot be taken for granted•That I am vulnerable
•That my life esily can be over •or someone I love/are connected with can die
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Limit situations can•Lead us to become more aware of what is important in life
•Challenge us to reflect more deply about life
•Mature us ethically and intelectually
Have you experienced ”limit situations”?
Giske; How to recognize & verbalize spirituality
2. How to recognize spiritual concernsPainAgonyQuestionsWonderingRestPeace
Many expressions – listen to the meaning for the individual person
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WE HAVE TO LISTEN WITH 2 EARS
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What is the person’s concern?And how is it expressed?
?- Who am I?- Who loves me?- Is there a meaning in
what happens?- What about guilt – am I
guilty?- How can I live with pain
and suffering?- How will my future be?
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What frame of reference do the person have??
What about- faith- View of life- tradition- culturDoes this person
have?
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Art & Science of Spiritual Care
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McSherry & Ross (eds.) (2010) Spiritual Assessment in health care Practice. M&K Publishing
Giske; How to recognize & verbalize spirituality
3. Presentation of spiritual care research amongst undergraduate
nursing students AIM:to determine undergraduate nursing students’ perspective on spiritual care and how they learn to practice it
Giske, T. & Cone P.H. (2012) Opening up to learning spiritual care of patients: A grounded theory study of nursing students. Journal of Clinical Nursing, 21(13-14), 2006 - 2015
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Participants:8 focus groups with 42 undergraduate
students3 1st year3 2nd year2 3rd year
Average age 25,6 (20 – 45)Life view
30 Christian, 2 ”religious”, 1 Cathlic3 Agnostic, 3 Atheist, 2 Gnostic, 1 Naturalist
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Giske; How to recognize & verbalize spirituality
Questions to the focus groups:What is spiritual care?
How do you learn to practice it?
Tell us about your experiences
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Giske; How to recognize & verbalize spirituality
AnalysisInterviews transcribed and
analysed accoding to Grounded Theory: Constant comparison
CodingOpen codingSelevtive codingTheoretical coding
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Giske; How to recognize & verbalize spirituality
Norwegian context1000 years of Christianity85 % of 5 million belonging
to a Christian demonination2nd largest group: Muslims (1,9 %)3rd Norw. Humanistic Association (1,7 %)Most Norwegians believe in God
Faith is seen as private.Taboo to talk about
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Spiritual care – the whatNo clear definitionBeing concerned with the whole person,
the soul and what could not be seenReligious faith; reading holy books,
prayerSeen as part of nurses responsibility BUT
Poorly defined in litterature,Least focused on professionallyWhat nurses knew least aboutSeen few role models in clinical studies
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Giske; How to recognize & verbalize spirituality
Participants main concernHow to create a professional relationship with patients and maintain it when spiritual concerns were recognised
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Giske; How to recognize & verbalize spirituality
Students solve this concern byOpening up for learning spiritual care3 intertwined phases Learning develope as a spiral through out
the nursing training
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Preparing for connection
Connecting with and supporting patients
Reflecting on experiences
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Categories – Three iterative phases Sub-categories of each phase
1 Preparing for connection
Knowing oneself more deeply
Preparing in class and on your own
2 Connecting with and supporting patients
Connecting in mutual vulnerability
Supporting patients respectfully
3 Reflecting on experiences
Thinking through what you did
Sharing experiences with others
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4. Recommendations Universities:Separate and clear themes in teaching at
universityRepeated focus with increasing complexity
throughout the studyChoose methods that promote self-awareness,
understanding own spirituality and valuesUse interactive methods - Share examples, use
role play, reflect in a safe environment with the support of fellow students and teacher
Requirements to read literature - theories and research related to spirituality. Be part of exams
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Recommendations for clinical studiesTeachers can be key person to help students recognize
possibilities for learning related to spiritual careUse the rich possibilities for learning the uniqueness
in diverse situationsTeachers work together with supervisor in practice to
emphasize data collection and interventions including spirituality
Facilitate for students to experience role modelsSupport & challenge students to involve themselves
with patients in a respectful mannerCreate time & room for reflection in and after
practice
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