Holistic health care recognises that body, mind and spirit operate as an integrated whole yet spirituality remains a neglected element of total health care. A co-operative inquiry group, comprising staff from two cancer care centres, met for one year to explore spirituality. The aim of the inquiry was to explore participants' own spirituality with a view to how that affected their work. The eight health care professionals involved in the co-operative inquiry brought varied religious and non- religious perspectives as well as different professional roles. A church based journey into faith group also contributed to the research. A significant outcome of the co- operative inquiry group was the development of a continuing professional education module for health care staff about spiritual care. Although spirituality is a word used increasingly today, there seems little clarity about the concept. Confusion between spirituality and religion aggravates this lack of clarity. Significant influences in the development of the post modern, western world have marginalised the spiritual to the extent that it can be argued that people have lost a cohesive voice with which to discuss spirituality. For those contributing to this research, the experience of talking about spirituality with others in a safe but challenging environment was both enlightening and encouraging. From this experience emerged a greater clarity about spirituality which influenced both personal and professional experience. Clearer understanding led to greater confidence, enabling individuals from different professions to become more effectively involved in spiritual assessment and spiritual care. Continuing professional education about spirituality, particularly involving reflection on experience, offers an opportunity to extend this work to others.

Thesis (M.S.)--University of Michigan, 1994. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1994. / Includes bibliographical references.

Thesis advisor: Eva M. Garroutte / Biomedicine has become a gatekeeper to numerous social opportunities and has gained power through the ritual inscription of individual bodies. Bodies serve as intermediaries between personal identities and biomedicine; individuals can reclaim bodies as sites of "identity projects" (Giddens 1991) to resist biomedical power. This project examines the intersection of the societal preoccupations with biomedicine, bodies, and identity through the lens of the religious and healing tradition of Christian Science. Christian Science theologically rejects biomedicine in favor of spiritual healing treatment. Christian Science is an especially appropriate venue for exploring relationships between biomedicine, bodies, and identities because its teachings require not only belief in the ineffectiveness of biomedicine but also embodied resistance to it. Drawing on the work of Foucault (1977), Giddens (1991), and Frank (1995) and using information gleaned from semi-structured interviews--averaging 1.5 hours in length--with 12 Christian Scientists, I argue that Christian Scientists use religious identities to (1) evade biomedical risk society, (2) resist external authority and reclaim bodies as sites of knowledge and power, and (3) build spiritual community. / Thesis (MA) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Sociology.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

Thesis advisor: Callista Roy / Despite the concept of healing being central to nursing, there has been a lack of conceptual clarity. This study sought to understand how expert nurses in practice conceptualize healing and how this conceptualization affects their practice. The sample consisted of 50 practicing nurses from multiple practice settings in an academic health system in Western Massachusetts. The study used a mixed method design using an electronic adaptation of the Delphi method. Findings from the study suggested a high level of consensus about the concept of healing in nursing. Qualitative data from the open-ended questions of Round 1 were coded into items about healing on subsequent quantitative surveys in Rounds 2 and 3. Participants ranked their level of agreement or disagreement with these statements. Ultimately, 49 statements met the a priori criteria for consensus as to what healing means from a nursing perspective. The overarching themes of statements were comprised of Nursing Actions to Promote Healing, Theoretical Understanding of Healing, Nurse Attributes to Promote Healing, Other Factors that Promote Healing, Types of Healing and Assessment of Healing. This study adds to the literature an exclusively nursing perspective on healing. The nursing-specific concept of healing synthesized from the data could be described as progression towards wholeness, with subjective and objective outcomes, promoted by the actions of nurses. The clarification of the concept of healing can inform research to create measurements for healing. It also can improve practice by articulating an existent conceptual framework, allowing nurses and administrators to better promote healing both directly and indirectly. Lastly, the results of this study offer students a simple yet accurate way of prioritizing nursing interventions. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO databases were searched for the literature review. Keywords and phrases used included spirituality, spiritual nursing care, holistic health practices, inpatient, hospital, and preoperative care. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) II tool was used for data analysis. Interventions found in the literature to be supportive of spirituality included healing presence; providing effective communication; praying with the patient and family or facilitating other religious rituals; using the therapeutic self to be with the patient; listening to and exploring the patients' spiritual perspectives; and showing support and empathy through patient-centered caring, nurturing spirituality, and creating a healing environment. Employing these nursing actions might promote positive social change by contributing to a sense of well-being as patients find meaning and purpose in their illness and life overall, which will promote improved surgical outcomes and better patient satisfaction with care.

The overall goal of the thesis was to investigate the nature of the healthy human self and the process of achieving health. This was undertaken by reviewing established self-theory and presenting a summary of each theory and its position with regard to self-composition, self-agency and the nature of the healthy self. An inclusive self-theory was then developed, congruent with reviewed literature, which positioned spirituality as the essential core of self. From the foundational Spiritual Theory of Self and the findings of the first study in this thesis, the Health Change Process Theory was developed to explain and predict how people achieve sustainable health. Three subsequent studies resulted in the construction and testing of a quantitative measure which enabled scientific investigation of the nature of the healthy self and the process of achieving health. Method The methodology of the four studies in this thesis was based on the instrumental approach which posits that, while there are procedural differences between qualitative and quantitative methodologies, philosophically speaking, there is no fundamental difference as they are both equally applicable and valuable. Consequently, the methodology judged to be the most appropriate instrument to investigate each study's topic of inquiry was chosen rather than allegiance to either qualitative or quantitative methodology. The first study was qualitative, as it investigated the definition of health and the process by which it was achieved from the perspective of 30 people with chronic musculoskeletal impairments. The findings from this study provided the theoretical basis for the three subsequent questionnaire development and validation studies. The second study used qualitative methodology with 59 participants to identify participant-generated items used in a new quantitative holistic health questionnaire and then employed quantitative methods to perform preliminary tests of the reliability and validity of this measure. The third study used quantitative methods with 233 participants to evaluate more robustly the reliability, content and concurrent validity of the original developmental measure and another, behaviourally-orientated assessment instrument, which used the identical item content but re-framed in the past tense. The fourth study employed qualitative and quantitative methods with 205 participants to evaluate the clinical validity of the scale found to possess reliability and validity in the previous investigation. Results The critical review of self-theory concluded with the development of the Spiritual Theory of Self. The initial study supported this theory as a robust explanation and predictor of the determinants of a healthy self. Furthermore, the findings of this study and a review of relevant literature concluded with the development of a Health Change Process Theory, which was based on the Spiritual Theory of Self. The Health Change Process Theory explains and predicts the process by which a healthy self develops. The subsequent questionnaire development and validation studies sought to provide a quantitative holistic assessment tool, congruent with the Health Change Process Theory, and found the 28-item QE Health Scale (QEHS) to be a reliable and valid measure of holistic health. These results also demonstrated that the Health Change Process Theory and the underpinning Spiritual Theory of Self were robust. With regard to clinical application, the QEHS was found to aid assessment, therapeutic intervention, a client-centred holistic approach to healthcare and evidenced-based practice. The Patient Profile, derived from QEHS responses, provided a tool that enabled theory to be applied to practice by identifying the key indicator personal attributes determining holistic health status. Conclusion The research results demonstrated that the Spiritual Theory of Self and the Health Change Process Theory provide valid explanations of the constructs that enable people with musculoskeletal disorders to remain otherwise healthy with such conditions. Furthermore, the relationship between the findings and established self-theories suggest that the Spiritual Theory of Self and the Health Change Process Theory may advance knowledge of the predictors and interventions that enable all people to undertake a health-enhancing process of change when confronted with adversity. The QEHS and associated Patient Profile were found to be reliable and valid tools that facilitated assessment and enhancement of the holistic health status for people with musculoskeletal impairments. These tools identified barriers to achievement of holistic health, predicted by the Health Change Process Theory; facilitated the therapeutic process through a focus on issues meaningful to those receiving healthcare; aided treatment decision making; and enabled quantitative evidence-based evaluation of the efficacy of interventions. Moreover, the overall results have advanced psychological knowledge with implications for all fields of psychology involved in the study of people. The evidence of the research undertaken provides a basis for promoting knowledge and research of chronic healthcare delivery and a spiritually based conception of self and health. The QEHS and associated theories provide a tool and basis for investigations where people are experiencing traumatic, irreversible crises. However, the initial aims of further research should be to refine the QEHS and the associated Patient Profile to enable the use of theory and the QEHS across a diverse range of research populations and to investigate the applicability of these to facilitate the maintenance or achievement of a healthy self.

Den andliga dimensionen ingår i den holistiska människosynen som sjuksköterskan skall utgå från. I Socialstyrelsens Kompetensbeskrivning för legitimerad sjuksköterska står det att sjuksköterskan ska ha förmåga att bemöta patienters andliga behov. Syftet med litteraturstudien var att belysa faktorer som påverkar sjuksköterskans bemötande av andliga behov. Polit och Becks (2012) niostegsmodell användes för litteraturstudien. Litteratursökning genomfördes i databaserna CINAHL och PubMed samt genom en manuell sökning. Därefter gjordes en kvalitetsgranskning enligt Forsberg och Wengströms (2013) protokollgranskning. Resultatet baserades på 15 artiklar. Efter dataanalysen redovisades resultatet i fem kategorier: Sjuksköterskans inställning till andlighet, tro och religion, Vårdrelationen, Kunskap, Miljö och Tid. Det finns ett samspel mellan faktorer som påverkar sjuksköterskans bemötande av andliga behov. Flera olika faktorer som religion, tro och egen andlighet influerade bemötandet. Sjuksköterskor uppgav att det var nödvändigt att bygga en tillitsfull nära relation med patienter för att bemötande av andliga behov skulle vara möjligt. Kunskapsbrist utgjorde ett av de största hindren och fortlöpande utbildning föreslogs för att uppnå förbättring i bemötande av andliga behov. Den fysiska och psykosociala miljön som råder där sjuksköterskor arbetade, samt tidsaspekten, kunde upplevas som influerande faktorer på bemötandet. Allt detta bidrog till att de andliga behoven hamnade i skymundan. Sjuksköterskans inre och yttre resurser ligger alltså till grund för hur hon bemöter andliga behov.