Spiritual Needs Identified as an Influence on Health
Virginia L. Hart-Kepler RN, C, FNP, MN

The spiritual dimension is an important, interactive element of a person. The state of health of the human spirit is essential to the person's overall wholeness. Just as the physical, psychological and socio-cultural aspects of a person interact and affect each other, the same is true of the spiritual component. When the needs of the human spirit are not adequately met, the spirit may become ill or display deficits, as occurs when needs of the body or mind go unmet. The purpose of this study was to determine whether ambulatory adults believe that their spirituality/spiritual needs influence or affect their health and what, if anything, they want or expect nurses to do to address these needs. The nursing theory "Nursing as Human Science and Human Care", by Dr. Jean Watson forms the theoretical basis for this study. Dr. Watson has defined and integrated the concept of spirituality with the discipline of nursing. Three world theologies (Judeo-Christianity, Zen Buddhism and Animism) and works by various philosophers were integrated to augment Watson's theoretical work. This qualitative, descriptive survey utilized an investigator-devised questionnaire to privately interview a convenience sample of 16 adults in the Los Angeles area. Subjects individually defined spirituality and spiritual needs, how the spiritual aspect affects health and what they expect of nurses regarding the spiritual dimension. The results of content analysis revealed that each subject identified spirituality as a functional aspect of themselves, whether or not they had a perceived religious orientation. The subjects believe that spirituality and spiritual needs impact upon health. They described how their spiritual needs influence their physical, psychological and relational health. The subjects also indicated they want nurses to participate in many, unique ways to address their spiritual needs. Subjects indicated nurses can demonstrate care by such things as being aware of, recognizing, showing respect for and acknowledging their client's spiritual needs and facilitating for these needs being met. Those factors which were said to be most important to the subjects' spiritual health included: the recognition and treatment of themselves as unique individuals; the importance of and the impact of their beliefs upon their health; the value of relationships; and the integrative quality of the human spirit. Preliminary implications indicate that nursing professionals need to be aware of the unique spiritual aspect of each client. Nurses also need to facilitate for their clients' spiritual needs in pragmatic ways such as listening to the client's spiritual concerns, being a support system, explaining available spiritual resources, and notifying appropriate clergy/spiritual advisors of a client's needs. In addition, nurses need to encourage clients to maintain those personal beliefs, practices and/or rituals which promote the client's overall health and healing. Recommendations for additional research in the area of spirituality and health include further identification of the attitudes and needs of clients, along with the opinions, abilities and educational backgrounds, as regards spiritual assessment, of nursing professionals in varied settings. Additional studies examining the benefits of nursing care which includes spiritual assessment and facilitation, would add greatly to the body of nursing research.