GEN 017: Religions, Religious Practices and Spirituality

Student Activity Sheet

Lesson #1

Spiritual practices around the world can be influenced by one’s beliefs, religion and tradition. Nevertheless,
these practices can be summarized by:
1. Personal cultivation. This can be in the form of praying and meditation.
2. Personal exploration. This can be in the form of reading and pondering of uplifting
materials.
3. External action. This can be through service. The act of service is an outward expression of
spiritual belief.

Personal Cultivation

Meditation – an exercise of controlling attention. It can be through concentrating one’s mind to a

single point; paying attention to an experience at the present moment, and pure awareness.
Meditation is emphasized in spiritual traditions that originated from Buddhism practices.

Prayer – an exercise of directing the mind to the Divine. This can be spoken out loud or done
silently.

Somatic Techniques – a combination of breathing exercises and body postures. This can be in
the form of yoga.

Personal Exploration

Study & Contemplation – involvement of listening to talks or readings of spiritual texts. The
knowledge can be a framework of how to relate to things, and how to practice the path – and as
such is either useful or not-useful.

External action

Service – Feeding the poor, social reform, translation of scriptures, supporting online
communities, etc are expression of one’s spiritual commitment.

Definition of terms:

Agnostic: believe in no known ultimate reality

Atheist: do not believe in the existence of a god

Connectedness: being intrapersonally connected within oneself; interpersonally connected

with others and environment; and transpersonally connected with a god or unseen higher
power

Faith: allows people to have firm beliefs despite lack of evidence; enables people to believe in
and establish transpersonal connections

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #1

Holistic: a view that enables a helping role and a healing relationship

Hope: an energizing source that has an orientation to future goals and outcomes

Self-transcendence: a sense of authentically connecting to one’s inner self

Spiritual distress: a disruption in the life principle that pervades a person’s entire being and transcends
the person’s biologic and psychosocial nature

Skill-building Activities

Direction: Let’s do it again. Please read the statement, and answer it with True or False.

__TRUE___ 1. Hope is an energizing source that has an orientation to future goals and outcomes
__FALSE___ 2. Self-transcendence is a combination of breathing exercises and body postures.
__TRUE___ 3. A nurse needs to check their personal spiritual beliefs before doing spiritual assessment on patients.
__TRUE___ 4. Spiritual practices around the world will not influenced one’s beliefs, religion and tradition
__FALSE___ 5. Physical view enables a helping role and a healing relationship

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #2

B. MAIN LESSON Topic

#1
“For the word of God is living and active. Sharper than any double-edged sword, it dividing even to
dividing (soul) and (spirit), joints and marrow (body). It judges the thoughts and intentions of the
heart. (soul)”
Hebrews 4:12

Body
- The physical structure of a person, including the bones, flesh, and organs.

Soul
- It is being believed that is the nonphysical part of the person, which is the seat of emotions and
character of a person.

Spirit
- The spirit is the element in humanity that gives us the ability to have an intimate relationship with
the divine. Whenever the word spirit is used, it refers to the immaterial part of humanity that
“connects” with God, who Himself is spirit (John 4:24).

Spiritual
- It is referred to any that affects the spirit. It also relates to religion or religious beliefs.

Spirituality
- as a personal concept, is generally understood in terms of an individual's attitudes and beliefs r
elated to transcendence (God) or to the nonmaterial forces of life and of nature.

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #2

Religious practice or Religiosity

- however, relates to a person's beliefs and behaviors associated with a specific religious
tradition or denomination. Nurses need to clearly understand this distinction or neglect
spiritual needs in focusing only on a patient's religious practice.

Skill-building Activity

a. a variety of worldviews and the opinions of people from divergent walks of life.”
– Carson, 1993.

b. “Nursing as a profession, will embrace more than an art and a science; it will be
a blending of three factors: of art and science, and the spirit of unselfish
devotion to a cause primarily concerned with helping those who are physically,
mentally or spiritually ill.” – Price, 1954

2. An emergency department nurse is caring for a patient who was severely injured in a car accident.
The patient's family is in the waiting room. They are crying softly. The nurse sits down next to the
family, takes the mother's hand, and says, "I can only imagine how you're feeling. What can I do
to help you feel more at peace right now? " The patient’s family requested for a prayer, as a nurse
what should you do?

ANSWER: (French & Narayanasamy 2011) stated that the practice of prayer in health care raises a
slew of ethical issues. While some argue that the absence of informed consent is important for
perfect blinding and a non-prayer-receptive population, others argue that it is unethical and that
such studies should be discontinued. In practice, a nurse must acquire agreement prior to praying,
but must follow local policies and protocols regarding prayer. A nurse should possess the following
characteristics: honesty, compassion, authenticity, and the capacity for respectful, candid self-
disclosure. A nurse should not misuse the authority bestowed upon them, promote their own
religious objectives, or engage in insensitive self-disclosure. They must strike a difficult balance
between their professional responsibilities as nurses and their more personal, religious responsibilities
as individuals. It appears premature to advocate prescribing prayer, as many would argue that we
cannot justify the prescription of prayer or distant healing without clear evidence from rigorous trials
(Targ, 2002).

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #3

B. MAIN LESSON

Topic # 1

RELIGIOUS OR
CULTURAL GROUP IMPLICATIONS FOR HEALTH
HEALTH CARE RESPONSE TO ILLNESS AND NURSING
BELIEFS

Hinduism Accepts modern Past sins cause illness. Allow time for prayer and
medical science Prolonging life is purity rituals.
discouraged.

Buddhism Accepts modern Followers sometimes refuse Health is an important part of

medical science treatment on Holy Days. life.
Nonhuman spirits invading Good health is maintained by
the body cause illness. caring for self and others.
Sometimes followers want a Medications are not always
Buddhist priest. accepted because of belief that
They usually accept death as chemical substances in the
last stage of life and usually body are harmful
permit withdrawal of life
support.
Followers do not practice
euthanasia.
They often do not take time
off from work or family
responsibilities when sick.

Islam Must be able to Muslim use faith healing. Women prefer female health

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #3

practice the Five Pillar card providers.

of Islam Family members are a During month of Ramadan
comfort
Sometimes has a Muslims do not eat until after
Group prayer is
Fatalistic view of the sun goes down.
strengthening. They often
health Health and spirituality are
permit withdrawal of life
connected.
support. They do not
Family and friends visit during
practice euthanasia.
time of illness.
They believe that time of
They usually do not consider
death is predetermined organ transplantation or
and cannot be changed. donation and postmortem
They maintain a sense of examinations.
hope and often avoid
discussions of death.

Judaism Belives in the sanctity Visiting the sick is an Jews believe that it is
of life obligation. important to stay healthy,
Balance between God There is an obligation to They expect the nurse to
and medicine seek care, exercise, sleep, provide competent health
Observance of the eat well and avoid drug and care.
Sabbath important alcohol abuse. Allow patients to express their
Treatments Euthanasia is forbidden. feelings.
sometimes refused on Life support is discouraged. Allow family to stay with dying
the Sabbath patient.

Christianity/Catholicism Accept modern Followers use prayer, faith Christians are usually in
medical science healing. favor of organ donation.
Complementary or They appreciate visits from Health is important to
alternative medicine the clergy. maintain.
often followed. Some use laying on of Allow time for patients to pray
hands. by themselves, with family or
Holy Communion is friends.
sometimes practiced.
Anointing of the sick is given
when patient is ill or near
death (Catholic)
This guide is not intended to be a comprehensive study of world religions. Above is a brief description of
the religious groups addressed. Involve patients of many faiths with this collection of spiritual and religious
beliefs and practices. Always ask the patient or a family member about their religious beliefs and practices,
especially those connected to health and illness.

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #3

CHECK FOR UNDERSTANDING (30 minutes) Matching Type

A nurse is providing spiritual care to a group of patients. Match the group to their belief. a.
Nature controls life and health.
b. Organ transplantation or donation is not considered.
c. Observance of the Sabbath is important.
d. Past sins cause illness.
e. Nonhuman spirits invading the body cause illness.

_D___ 1. Hinduism

__E__ 2. Buddhism

__B__ 3. Islam

__C__ 4. Judaism

__A__ 5. Appalachians

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #4

1. When caring for patients, the nurse must understand the difference between religion and spirituality. Religious
care helps individuals:
A. maintain their belief systems and worship practices.
Rationale: Religion is associated with the “state of doing,” or a specific system of practices related to a
particular denomination, sect, or form of worship. It is a system of organized beliefs and worship that a
person practices to express spirituality outwardly. Religious care helps patients maintain their faithfulness to
their belief systems and worship practices. Spiritual care helps people identify meaning and purpose in life,
look beyond the present, and maintain personal relationships and relationships with a higher being or life
force.

B. MAIN LESSON

Topic # 1
Spiritual health

Spiritual health represents a balance. (Potter et al., 2019)

Spiritual health matures with increasing awareness of meaning, purpose, and life values. (Potter et al.,
2019)
Spiritual beliefs change as patients grow and develop. (Potter et al., 2019)
can be defined as "a state of well-being and equilibrium in that part of a person's essence and existence
which transcends the realm of the natural and relates to the ultimate good. Spiritual health is recognized
by the presence of an interior state of peace and joy;, freedom from abnormal anxiety, guilt or a feeling of
sinfulness; and a sense of security and direction in the pursuit of one's life goals and activities" (O'Brien,
1982a, p. 98).
Spiritual health is also understood as relating to the ability to identify and describe one's purpose in life
(Chapman, 1986; Levin & Schiller, 1987). Health care researchers found a significant correlation between
spiritual health and an individual's subjective evaluation of overall physical health (Michello, 1988), and
that spiritual health can be predictive of how a person confronts their personal mortality (Hart, 1994).
Spiritual Contentment, the opposite of spiritual distress, is likened to spiritual peace (Johnson, 1992), a
concept whose correlates include "living in the now of God's love," "accepting the ultimate strength of
God," knowledge that all are "children of God," knowing that "God is in control," and ''finding peace in
God's love and forgiveness" (pp. 12–13). When an individual reports minimal to no notable spiritual
distress, he or she may be considered to be in a state of "spiritual contentment."

Topic # 2

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #4

Spiritual distress

Spiritual distress is “a state of suffering related to the impaired ability to experience meaning in life
through connections with self, others, the world, or a superior being (Potter et al., 2019)
such as "sudden changes in spiritual practices [rejection, neglect, fanatical devotion]; mood changes
[frequent crying, depression, apathy, anger]; sudden interest in spiritual matters [reading religious
books or watching religious programs on television, visits to clergy]; and disturbed sleep" (Taylor,
Lillis, & LeMone, 1993, p. 1174).
Spiritual distress causes a person to feel doubt, loss of faith, and a sense of being alone or
abandoned. Individuals often question their spiritual values, raising questions about their way of life,
purpose for living, and source of meaning. Spiritual distress also occurs when conflict arises between
beliefs and prescribed health regimens or the inability to practice usual rituals. (Potter et al., 2019)
It causes people to question their identity and feel doubt, loss of faith, and a sense of being alone or
abandoned. Individuals often question their spiritual values, raising questions about their way of life,
purpose for living, and source of meaning. (Potter et al., 2019)
Sudden, unexpected illness often creates spiritual distress. People often look for ways to remain
faithful to their beliefs and value systems. Nurses use knowledge of a person’s spiritual well-being
and implement spiritual interventions to maximize inner peace and healing. (Potter et al., 2019)
Many chronic illnesses threaten a person’s independence, causing fear, anxiety, and spiritual distress.
Dependence on others for routine self-care needs often creates feelings of powerlessness. (Potter et
al., 2019)
Some nurses care for patients who have had a near-death experience (NDE). An NDE is a
psychological phenomenon of people who either have been close to clinical death or have recovered
after being declared dead. (Potter et al., 2019)
Commonly patients who experience an NDE describe feeling totally at peace, having an out-of-body
experience, being pulled into a dark tunnel, seeing bright lights, and meeting people who preceded
them in death. (Potter et al., 2019)
Patients with an NDE are often reluctant to discuss it, thinking family or caregivers will not
understand. Isolation and depression often occur. (Potter et al., 2019)
After patients have survived an NDE, promote spiritual well-being by remaining open, giving
patients a chance to explore what happened. and supporting them as they share the experience with
significant others. (Potter et al., 2019)
Impaired ability to experience and integrate meaning and purpose in life through connectedness with
self, others, art, music, literature, nature, and/or a power greater than oneself. (Potter et al., 2019)
A patient's experience of spiritual suffering, or spiritual distress, may pose unique challenges for
nursing intervention (Kahn & Steeves, 1994).
Spiritual distress may be experienced by any ill person questioning the reason for his or her suffering
(Harrison, 1993).

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheet
Lesson #4

Defining characteristics of spiritual distress include questioning one's relationship with God,
attempting to identify religious idols, guilt feelings, and a variety of somatic symptoms (Heliker,
1992, p. 16); questioning the meaning and purpose of life; expressing anger toward God; refusing to
participate in usual religious practices; regarding illness as God's punishment; and seeking spiritual
assistance, other than usual spiritual or religious support (Tucker, Canobbio, Paquette, & Wells,
1996, p. 52).
The nurse does not need religious training to meet a patient's needs in spiritual distress (DiMeo,
1991, p. 22);
nurses continually engage in assessing, planning, intervening, and evaluating (the nursing process)
related to physical and emotional nursing diagnoses. In assessing spiritual need, the nurse must
determine whether they may provide the spiritual care, such as listening and counselling, or whether
a referral should be made to a chaplain or formally trained minister of the patient's denomination
(Duff, 1994)

The story of Job (CLICK HERE)

Ask the students to read in advance the Book of Job Chapters 1-16 or provide a short video presentation about his
life.

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheets
Lesson #5

I look at nursing's role definitely as a calling to serve the sick. Because I think any nurse has to give 100% of
themselves into the profession and truly be a professional, they have to look at it beyond being an ordinary job,
including spiritual and physical and psychosocial care. I think it is truly a caring profession; nurses need to give of
themselves sometimes when they are not feeling up to giving of themselves. I think I recognized from the time I
became a nurse that in order to find it a satisfying and fulfilling career, you have to look at nursing and see it as much
more than just an ordinary job.

(ANNEMARIE, SCHOOL HEALTH NURSE)

[Link] LESSON
Topic # 1
THE NURSE'S ROLE IN SPIRITUAL CARE

Clinical and research specialists occasionally debate the nurse's role in providing spiritual care to
patients. Identifying the nurse's involvement in spiritual care does not minimize the work of the
hospital chaplain or the pastor ministering to the sick in the community. Rather, the nurse and
pastoral care practitioner may collaborate to analyze the patient's spiritual needs and develop a
complete plan. While not all nurses are comfortable giving spiritual care, they should constantly be
attentive to their patients' spiritual needs. "Nursing profession must extend its knowledge and skill
in the spiritual direction" with the introduction of holistic healthcare.
The nurse's involvement in both assessing patients' spiritual needs and providing spiritual care is
shown in contemporary nursing textbooks, especially those covering nursing fundamentals and
medical-surgical nursing. "Spirituality," "Spiritual Health," and "Spirituality and Religion" are all
topics covered in many basic literature (Kozier, Erb, Blais, & Wilkinson, 1995; Potter & Perry,
1997; Taylor, Lillis, & LeMone, 1997). A spiritual health evaluation of patients' needs is included in
this chapter. Spirituality and the nursing process are also discussed. Many modern medical-surgical
nursing textbooks highlight the nurse's role in patient spiritual care. There is also a section on
spirituality and nursing practice (Black & Matassarin-Jacobs, 1997; Ignatavicius, Workman, &
Mishler, 1995; Phipps, Cass- meyer, Sands, & Lehman, 1995; Smeltzer 6r Bare, 1996). "Meeting
the spiritual needs of clients has become a recognized aspect of nursing care," Edmision (1997)
But how can a nurse without a religious or spiritual background provide spiritual care? Should a
nurse try to meet a patient's spiritual needs? Ultimately, the nurse must respond. As part of holistic
health care, all nurses must be aware of and attentive to their patients' spiritual needs. Many
nurses are comfortable and confident praying with patients, reading Scripture passages with
patients, and listening to and counseling patients about spiritual difficulties. If the patient and
family agree, a nurse may do these tasks. If a nurse does not feel fully equipped to provide
spiritual care, they should send the patient to another nurse who is or to a pastoral caregiver.

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheets
Lesson #5

Spirituality as Nurse Self-Care

Many nurses join the job out of a sense of duty. The issue occurs when the nurse delivers more
care to those served than to herself. In turn, this causes compassion fatigue, burnout, and moral
and spiritual suffering. For many healthcare workers, coping mechanisms include eating, drinking,
exercising, sexual activity, smoking, drugs, music, yoga, painting, and other outlets.
Conclusions: Several studies (Phelps et al., 2012) and nursing organizations have advised that
nurses and doctors provide spiritual care (NANDA 2014). Despite this, nurses have obstacles in
delivering such care due to a lack of training and knowledge. Two major flaws lead to two crucial
suggestions. First, the nursing program lacks spiritual care instruction. Recent research (Ali et al.,
2015) revealed few studies focused on establishing spiritual care abilities in nursing students or
nursing educators' perspectives on creating such competencies in students. This is a serious deficit
that both academics and educators must address. Second, patients, particularly those with severe
illnesses, require spiritual support. “Physicians and nurses may be overlooking a crucial opportunity
to enhance patient care...” (Phelps et al., 2012, p2543).

Topic # 2

Spiritual Screening and Spiritual History: A spiritual needs assessment is the first step in delivering
wellintegrated spiritual care. This contains a spiritual screen, a spiritual history, and a spiritual evaluation.
Depending on the institution, the nurse may do one or more of these.
Spiritual Screening: Simple inquiries can determine the patient's spiritual preferences and any anxiety so a
chaplain may be sent. This protocol (Fitchett & Risk, 2009) is one such instrument.
How to do a Spiritual History: This test assesses the patient's religious/spiritual background and decides
what form of assistance may be most beneficial. This brief talk may unearth significant difficulties that need a
referral to a chaplain (Phelps et al., 2012). Also, addressing spiritual and religious elements of disease is
possible while using this evaluation. Several spiritual history instruments have been created, including the
HOPE and SPIRIT (Anandarajah & Hight, 2001). Still, the FICA (Faith, Importance Community, Address in
Care) (C. Puchalski & Romer, 2000) is the most extensively used (C. Puchalski & Romer, 2000).
In this case, a spiritual care professional such as a chaplain should finish the procedure. When the patient is
listened to, it is a discussion, and spiritual needs are assessed (Bowden, J., Murphy, P., & Peery, B, 2016). The
spiritual evaluation generates a spiritual care plan and intended contributing results. This evaluation is usually
documented in the patient's file, but it is often hidden under the "ancillary notes" section, which healthcare
professionals seldom examine. The nurse must know where information is filed and evaluate it since it may
directly affect the patient's treatment.
Spiritual Care: Nurses may offer spiritual care by addressing various key spiritual factors. This involves
addressing the patient's spiritual needs and beliefs. This includes expressing compassion, listening actively,
and supporting the patient's health care journey. Nurses should be aware of the spiritual effect of

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheets
Lesson #5

hospitalization on patients and families and the necessity to incorporate spiritual resources. To prevent possible
HIPAA concerns, this may include partnering with local community church leaders to give more indepth
spiritual assistance as needed. Many individuals express their spirituality in a variety of religious or spiritual
ways, even in the overwhelmingly Christian US (Eric J Hall, Brian P. Hughes, & George H. Handzo, 2016).
Nurses should be sympathetic to the patient's religion tradition, spiritual beliefs, and priorities.

PATIENTS OFTEN ASK THE NURSE TO To allude to a religious leader; the nurse may remark, for example,
“I don't generally pray with my patients directly.” But I can contact the chaplain/minister. I pledge to keep you
in my thoughts and prayers now and always.” If the nurse is comfortable, ask what the patient wants the
nurse to pray for. This enables the patient to decide what, when, and who participates in the prayer, which
many consider an intimate shared activity. Non-Christian patients should not pray "in the name of Jesus".
Finally, if a nurse feels a patient is experiencing spiritual anguish, she may take appropriate action. The NIC
(Nursing Interventions and Rationales, 2013) suggests that the nurse:
1. Observe client for self-esteem, self-worth, feelings of futility, or hopelessness.
2. Monitor client’s support systems.
3. Be physically present and available to help client determine religious and spiritual needs.
4. Provide protected quiet time for meditation, prayer and relaxation.
5. Help client make a list of important and unimportant values.
6. Ask how to be most helpful, then actively listen, and seek clarification.
7. If client is comfortable with touch, hold client’s hand or place hand gently on arm. Touch makes nonverbal
communication more personal.
8. Help client develop and accomplish short-term goals and tasks.
9. Help client find a reason for living and be available for support.
10. Listen to client’s feelings about death. Be non-judgmental and allow time for grieving.
11. Help client develop skills to deal with illness or lifestyle changes. Include client in planning of care.
12. Provide appropriate religious materials, artifacts or music as requested.
13. Provide privacy for client to pray with others or to be read to by members of own faith.

Check for Understanding

Roles of Nurses for Clients in spiritual distress

1. What is mean to be to stand in holy ground?

Answers: To stand what is being believed in but not imposing beliefs to clients.
The ability of the nurse to understand others’ beliefs without prejudice.

2. Can be a nurse a healer even wounded? Justify

Answer: Yes. All of us have our own pains and sufferings. Hence, from our own experiences we can be able to
understand others that can help in relieving their pains. It can be known that the healing abilities of a nurse
may come from his/her experiences of pain and sufferings.

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 GEN 017: Religions, Religious Practices and Spirituality
Student Activity Sheets
Lesson #5

Skill-Building Activity
Let us watch the video regarding Jesus Christ as Ultimate Healer. Complete the following statements:

1. The nurse as a healer is manifested by his/her ability to listen

2. As the nurse listens to others, a non-judgemental attitude can help in understanding the patient’s situation.
3. The nurse respects other beliefs.

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PURPOSE

The goal of relaxation therapy is to calm the brain or brain, to permitthinking process to stream
in an even, smooth pace, and trigger the relaxation reaction.

● To improve the circulation.

● To relieve muscle fatigue
● To improve the physical and mental health.
● To improve the physiological function.
● Lower the blood pressure.
● Increase concentration and memory.
● Reduce sleep deprivation.
● Increase in energy.
● Reduction of frequency and severity of panic attacks
● Increase in ability to focus
● Reduction of insomnia and fatigue

MEDITATION:

Meditation involves focusing the mind upon a sound, phrase, prayer, object, visualized image,
the breath, or consciousness in order to increase awareness of the present moments, promote
relaxation, reduce stress, and also enhance the spiritual growth.

PURPOSE:
1. Promote well-being in healthy people.
2. Meditate regularly experience less anxiety and depression.
[Link] more enjoyment and appreciation of the life.
4. Facilitates a greater sense of calmness, empathy, and acceptance to self and others

Based on the clinical evidence, meditation is seen as an appropriate therapy for panic disorder,
anxiety disorder, substance abuse. It may improve function or reduce symptoms of patients with
neurotic disorder that is Parkinson's diseases, epilepsy, etc.

TYPES OF MEDITATION:

I-CONCENTRATION MEDITATION: It involves focusing once attention on the breath, an

imagined or real image, sound, or word, or phrase that is repeated silently.

II. MINDFUL MEDITATION:

It involves becoming aware of the entire filed of attention. There is an awareness of all thought,
feelings, perceptions or sensation as they arise from moment to moment.
YOGA:

Yoga is an ancient system of breathing practice, physical exercise, and postures and meditation
intended to integrate the practitioner's body, mind, and spirit.

Yoga uses combination of physical postures (asanas), breathing techniques (pranayamas) and
meditation to promote relaxation and enhance the flow of vital energy called prana. It is
essential for a nurse to have baseline information and awareness of yoga which is purely Indian
in origin

INDICATIONS:
●
● High blood pressure.
● Eating disorder.
● Anxiety disorder.
● Substance abuse.
● Attention deficit disorder.
● Depression.
● Sleep disorder.
● Migraine headache.

DEEP BREATHING

EXERCISES:
• Tension is released when the lungs are allowed to breathe in as much oxygen as possible.
• Breathing exercise has been found to be effective in reducing anxiety, depression, irritability,
fatigue and muscular tension.

TECHNIQUES:

[Link] or lie down comfortably, inhale slowly through the nose and exhale through the mouth.
2. While inhaling, place one hand below the ribs, allow the hand to expand outward when
inhaled.

ROLE OF NURSE

[Link] the individual to recognize the source of stress.

2. Help to identify the method of coping.
3. To identify the individual adaptation to stress.
[Link] assess the individual to achieve their highest potential for wellbeing [Link] plan
alternative/modification.
[Link] evaluate the effectiveness of the therapy.
6. And main is documentation.
[Link] role while the therapy.
CONCLUSION:
• Relaxation produces physiological effects opposite those of anxiety: slow heart rate, increased
peripheral blood flow and neuro- muscular stability.

What is the Soul?

Some Christian (and other!!) Ideas

The soul, in many religions, spiritual traditions, and philosophies, is the spiritual and eternal part
of a living being

>It is separate from the body which is material.

Ancient Greek Ideas of the Soul-

►Christian ideas of the soul are likely to have come from the ancient Greeks.

The Greeks were great philosophers.

Plato-

►Plato considered the soul as the essence of a person- that which decides how we behave.
►For Plato the soul consists of the Logos (mind), Thymos (emotion) and Eros (desire)
►Plato believed the soul was eternal and could exist without the body
►Plato believed the mind part of the soul had to keep emotion and desire under control or it
would lead a person's ruin!!

Aristotle-

Aristotle, following Plato, defined the soul as the core or "essence" of a living being
A thing has a soul because it lives and because it is active

In the Bible-
And the LORD God formed man from the dust of the ground, and breathed into his nostrils the
breath of life; and man became a living soul (Genesis 2.7)

► Christians regard the soul as the immortal essence of a human and that after death, God
either rewards or punishes the soul

HOLY
The soul (the spiritual part of God) and the body (the material part of us which craves pleasure)
are often in conflict
►The conscience is believed by some Christians to be the voice of God in us which warns us to
follow the spiritual and not material path

Other ideas on the soul-

►The belief among scientists is that the mind, or consciousness, is the operation of the brain.
Some scientists think that the brain is to the mind as computer hardware is to computer software
Spiritual practices in
Healthcare:
 Learning Targets:
Lesson title:
Spirituality – A
self-assessment
At the end of the module,
students will be able to:
• 1. Assess their own spiritual belief
• 2. Determine their basic
understanding regarding
Spirituality.
Spiritual practices
around the world 1. Personal cultivation. This can be in
the form of praying and meditation.
can be influenced
by one’s beliefs,
religion and 2. Personal exploration. This can be in
the form of reading and pondering of
tradition. uplifting materials.
Nevertheless,
these practices 3. External action. This can be through
can be service. The act of service is an
outward expression of spiritual belief.
summarized by:
 Meditation – an exercise of controlling attention. It can be
through concentrating one’s mind to a single point; paying
attention to an experience at the present moment, and pure
awareness. Meditation is emphasized in spiritual traditions
that originated from Buddhism practices.

Personal Prayer – an exercise of directing the mind to

the Divine. This can be spoken out loud or done
Cultivation silently.

Somatic Techniques – a combination of

breathing exercises and body postures. This can
be in the form of yoga.
 • Study & Contemplation –
involvement of listening to talks or
Personal readings of spiritual texts. The
Exploration knowledge can be a framework of
how to relate to things, and how to
practice the path – and as such is
either useful or not-useful.
 • Service – Feeding the poor, social
External action reform, translation of scriptures,
supporting online communities,
etc are expressions of one’s
spiritual commitment.
 Definition of terms:

• Agnostic: belief in no known ultimate reality

• Atheist: do not believe in the existence of a god
• Connectedness: being intrapersonally connected within oneself; interpersonally associated with
others and the environment, and transpersonally associated with a god or unseen higher power
• Faith: allows people to have firm beliefs despite lack of evidence; enables people to believe in and
establish transpersonal connections
• Holistic: a view that enables a helping role and a healing relationship
• Hope: an energizing source that has an orientation to future goals and outcomes
• Self-transcendence: a sense of authentically connecting to one’s inner self
• Spiritual distress: a disruption in the life principle that pervades
 Objectives

To identify elements of prayer, meditation

and somatic techniques in the context of
healthcare.
To describe teaching methods that are
useful to prepare healthcare providers to
respond to patient request for prayer
To identify pitfalls for praying with patients
in a professional context
Background

• According to Barna Research Group (2017) prayer is:

• the most common faith practice among American Adults
• 79% say that they prayed at least once in the last three month

• Prayer is the most complex and multifaceted faith practice

”Perhaps the only consistent thing about people’s prayers is that
they are different”
David Kinnaman & Roxy Lee Stone, Barna Research Group
Fast facts The majority of American Adults pray to God.
on Prayer in
Prayer is typically practiced in a communal
American way

Adults – Of those who pray (at least 1 time in past 3

months) most prayed aloud with others.

true or Of those who engaged in communal prayer

only 2% prayed audibly with another person.
false?
 Barna study
(2017)
Silent & Solo:
How Americans
Pray
 Barna study
(2017)
Silent & Solo:
How Americans
Pray
 Barna study
(2017)
Silent & Solo:
How Americans
Pray
 Grant (2004) asked N = 299 RNs if they had ever
offered/ provided prayer to a patient; 71%
responded they had.

Mamier (2009) studying 4 LLUH hospitals found

Background that out of 554 RNs 326 indicated they had

offered to pray with a patient/ family in the
past 72-80 hours at work

In the same study, of the 12 participants who

responded to a prayer vignette that they would
not pray with a patient who asked them to pray
with them, 10 never prayed privately.
Emerging Conceptual Model for Praying with
Patients/Families

1 2 3 4 5
1) Open (identify 2) Set the stage 3) Request (link 4) Wrap-up 5) Close (signal
divine listener) (connect with the perceived needs (prepare for the end of prayer)
here and now) with how God can closing)
help)
 Nurses opened prayers in one of three ways
Open • “Dear …”.

(identify
• Directly addressing the Divine (e.g., Father, God, Jesus, Lord)
• Using descriptive adjectives such as “gracious …”; “heavenly …”,
“Our Creator”, etc.

the divine All prayers open in one of these three ways.

listener by One of the first decisions that a praying healthcare

provider makes is how to refer to the Divine.

name) Unless the healthcare provider asks, they don’t know

if the patient addresses God in the same way.
 Does not occur in every prayer.

Set the Signals arrival to God’s presence: “We are here now!”
• focus on God’s attributes & actions,

stage • thankfulness/praise
• Patient, or activity of praying

Builds a sense of connection and intimacy

(connect Connects with the patient and his/her situation:

with here & • Identifies the patient by name

• how the patient feels and/or
• the immediate experience

now)
• where the patient is in relation to God
• or the activity of praying together

Focus direction on God’s attributes, express thanks & praise

Request
(link perceived needs with how God can help)

Request lay at the • maybe because of the pre-surgery scenario?

core of every prayer

All requests link • Requests for God’s qualities (peace, love, presence,
strength, calmness, faith, knowledge, comfort)
perceived needs with
• Requests for God’s action (through the healthcare
how God can be professional, divine action, preparing the patient, safe
involved through: procedure, or providing good outcome/recovery)
Wrap-up
(prepare for closing)
There is either a wrap-up Wrap-up phase signals the
phase or nurses move leaving of requests and
directly to the Close prepares for closing the
phase. prayer. It may include:

Making faith statements

Thanking/praising (e.g.,
(“We trust in You!” or
“thank you for hearing our
“You always hear our
prayer”) and/or by
prayers!”)
Close
(signal end of prayer)
The last phase signals that the prayer has ended.

This is accomplished through wording such as:

• “in the name of Jesus” or “in your name we pray!”

• This wording is sometimes accompanied by a statement about the will of God
• Almost all prayers end with “AMEN”

Opportunity for the healthcare provider to become aware of their own habits in closing prayer and
to consider contextualizing prayer ending in a way that is consistent with patient’s spiritual
orientation.
Guidelines derived from the data

• Ask permission/obtain consent to pray with patient/family

• Explore if they want to be prayed for or take the lead in prayer themselves
• Ask permission if holding patients’ hands or touch patient’s shoulder.
• Ask patients how they typically pray (consider religious traditions, name of the Divine,
possibility of quiet prayer).
• Ask what exactly they want the healthcare provider to address in prayer (requests).
• Provide privacy (e.g., draw a curtain, shut door, etc.)
• If possible, be on eye-level or below during prayer
• Pray sincerely, confidently, in a soft voice, with reverence for the patient, with authenticity,
short and to the point
Conclusions

• People continue to have active prayer lives even if many do not attend church
(Barna Group, 2017).
• Given prayer is so common in adult Americans, health-care providers should be
prepared to know how they will handle a request for prayer in an patient-
honoring way.
• If not comfortable praying, be prepared to know how you will respond
(e.g., refer, let patient lead prayer)
• If you do pray, be aware of cultural diversity, assess and consider need to
contextualize to individual patients.
• The model describes five elements of prayer in a professional context which
healthcare providers contextualize to the individual patient/situation.
Conclusions

• More developed prayers include the following: “Set the stage” and
“wrap-up” – elements which create intimacy and connection with the
divine in prayer.
• Educators who want to promote whole person care should prepare
students for this situation.
• Writing out one’s own prayer may increase awareness for one’s
own preferences.
• Being aware of diverse ways in which people pray guards against
assuming that everyone means the same thing by praying.
• Peer feedback may allow for helpful reflections on how one’s
prayer comes across with an imaginary patient and may increase
the healthcare provider’s confidence in praying with patients.
Thank you!

Any questions?
Patient expresses the desire to learn how to
meditate. What does the nurse need to do first?

A. Answer the patient's questions

B. Help the patient get into a comfortable position

C. Select a teaching environment that is free from distractions

D. Encourage the patient to meditate for 10 to 20 minutes 2 times a

day
The nurse learns that a client routinely engages in spiritual practices. Which
activities should the nurse document as being spiritual in nature? Select all that
apply.

a) Knitting
b) Prayer
c) Baking bread
d) Attending church
e) Yoga
 a) "What do you think is going to
While completing a happen to you?"
spiritual
assessment, which b) "Is prayer helpful to you?"
question would
provide the most
information about
a patient's sources
c) "What religious symbols are
of hope and helpful to you?"
strength?
d) "Who is the most important
person to you?"
References

• Barna Group (2017, August 15). Silent and solo: How Americans pray. Retrieved from URL
[Link]
• Grant, D. (2004). Spiritual interventions: How, when, and why nurses use them. Holistic Nurse Practitioner, 18(1),
36-41.
• Mamier, I. (2009). Nurses’ spiritual care practices: Assessment, type, frequency, and correlates. (Dissertation). Loma
Linda University.
• Mamier, I., Ramal, E., Petersen, A.B. & Elder, H. (2017). Inviting spiritual dialogue: A Loma Linda Perspective. Journal
of Adventist Education 79(5).
• Taylor, E. J., Gober, C., Schoonover-Shoffner, K., Mamier, I., Somaiya, C., Bahjri, K. (2017). Nurse religiosity and
spiritual care: An online survey. Clinical Nursing Research. DOI: 10.1177/1054773817725869 epublished ahead of
print
• Taylor, E. J., Gober-Park, C., Mamier, I., & Schoonover-Shoffner, K., (in press). Religion at the Bedside: Reporting
Results from an Online Survey. Journal of Christian Nursing.
• Taylor, E. J., Mamier, I., Ricci-Allegra, P., & Foith, J. (2017). Self-reported frequency of nurse provided spiritual care.
Applied Nursing Research, 35(17), 30-35. doi:10.1016/[Link].2017.02.019
Spirituality(our spirit) may include
• Spiritus (in Latin)
• Awareness of one's inner self and a sense of connection to a higher being.
• Meaning and purpose, what we value
• Seeking well-being, inner freedom, and inner peace

14
Spirituality and Religion-
Why They Matter

• Survival: Attending religious services

at least once a week decreases risk
of death by 23%
• Coping: Spirituality and religion help
people handle things better,
including overall stress, cancer,
chronic diseases, natural disasters,
and the effects of war Photo: [Link]

15
Spirituality and Religion-
More on Why They Matter
Mental health: Tying them in with mental
health care (when patients want to)
improves outcomes

Healthy behavior: People are less likely to

smoke, drink, etc.

Photo: [Link]

Benefits of prayer:
Prayer activates different Seems to help with chronic
parts of the brain pain and mood problems
16
Mindful Awareness-
Spirit Writing Exercise

An important piece of
self-care is connecting This is an exercise to
with what gives you help with that
meaning and purpose

Note what comes up for

There will be time to Photo: [Link]
you – thoughts, emotions,
discuss as a group when
sensations – as you work
we finish
through this exercise

17
Six Aspects of Spirituality

Religious
Humanistic You might find that
more than one of these
Nature apply to you. Also, you
Experiential might be drawn to
others besides these.
Cosmos
Mystery
 1. Religious
• Closeness and connection to the sacred as
described by a specific religion. Sense of
closeness to a particular Higher Power

• 83% of US adults belong to a religious

group
• 91% believe in God or a universal spirit

Photo credit: Lel4nd via [Link]

2. Humanistic Spirituality
Closeness and
connection to
humankind.

May involve feelings

Photo: [Link]
of love, reflection,
service, and
altruism.
 3. Nature Spirituality
• Closeness and connection to nature
or the environment. Like the wonder
you feel walking in the woods or
watching a sunrise.

• An important focus for many

traditional healing approaches.

Photo credit: WherezJeff via [Link]

4. Experiential spirituality

• Shaped by personal life events

Photo [Link] • Influenced by our individual

stories
Photo: [Link]

• Informed by what we love to do

and be
Photo: [Link]

• Experience in war influences

Photo: [Link]
Veterans profoundly
5. Cosmos Spirituality
• Feeling connected to all of
creation.

• Can come up when you

think about just how big it Photo: Sweetie187 via [Link]

all is...

• ...like when you look up at

the stars or down at a
handful of grains of sand Photo: [Link]
6. Mystery

• There is much that we

simply cannot know or
understand

• Perhaps it is not
possible to fully grasp or
know, and that is okay.

Photo credit: _Hadock_ via [Link]

What is a Spiritual Practice?

Something you do that reminds you

about what really matters Photo: World Network of Prayer

An activity that brings peace and ease Photo: KHVN [Link]

Something that helps you feel a sense

of connection to something more
Photo: [Link]

Photo: [Link]
A patient states that he does not
believe in the existence of God. This
patient most likely is an:
1. Academic.
2. Atheist.
3. Agnostic.
4. Anarchist.
The word a. Awareness of one's inner self and a
spirituality derives sense of connection to a higher being.
from the Latin b. Less important than coping with the
patient's illness.
word spiritus, c. Patient centered and has no bearing
which refers to on the nurse's belief patterns.
breath or wind. d. Equated to formal religious practice
Today, spirituality and has a minor effect on health care.
is
 ANS: A
The word Today, spirituality is often defined as an awareness of one's
inner self and a sense of connection to a higher being, to
spirituality nature, or to some purpose greater than oneself.
Spirituality is an important factor that helps individuals
derives from the achieve the balance needed to maintain health and
Latin word well-being and to cope with illness. It positively affects and
enhances health, quality of life, health promotion
spiritus, which behaviors, and disease prevention activities. Nurses need
refers to breath an awareness of their own spirituality to provide
appropriate and relevant spiritual care to others. The
or wind. Today, concepts of spirituality and religion are often interchanged,
spirituality is but spirituality is a much broader and more
unifying concept than religion. The human spirit is
powerful, and spirituality has different meanings for
different people.
The nurse is caring for a
patient who is terminally
ill with very little time left
to live. The patient states,
a. Strengthen the patient's religion.
"I always believed that b. Provide hope.
there was life after death. c. Support the patient's agnostic beliefs.
Now, I'm not so sure. Do
you think there is?" The d. Support the horizontal dimension of
nurse states, "I believe spiritual well-being.
there is." The nurse has
attempted to
 ANS: B
The nurse is caring for a When a person has the attitude of something to
patient who is terminally look forward to, hope is present. Religion refers to
ill with very little time left the system of organized beliefs and worship that a
to live. The patient states, person practices to outwardly express spirituality.
"I always believed that This is not evident here. Agnostics believe that
there was life after death. there is no known ultimate
Now, I'm not so sure. Do reality. This would indicate a lack of belief in life
you think there is?" The
after death. The horizontal dimension of spiritual
well-being describes positive relationships and
nurse states, "I believe connections people have with others. In this case,
there is." The nurse has the patient is more concerned with the vertical
attempted to dimension, which supports the
transcendent relationship with God or some
other higher power.
INFLUENCE OF
RELIGIOUS
BELIEFS O N
HEALTHCARE
PRACTICE
Akpenpuun Joyce Rumun
CONCEPTUALIZING SPIRITUALITY AND
RELIGION
I n healthcare literature, religion a n d
spirituality a r e most of the times u s e d
interchangeably, although they h a v e
different m e a n i n g s ( A da m s &
Leverlands, 1986).
CONCEPTUALIZING SPIRITUALITY AND
RELIGION
SPIRITUALITY is defined in individual terms,
characterized by experiences involving
meaning, connectedness, a n d transcendence.
SPIRITUALITY is derived from the Latin word
spirare, which means, to breathe. I n
m o d e rn us a g e it inc lud e s s uc h a wid e
r a n g e of h u m a n experience: traditional
religions, New A g e teachings, personal
mystical experience a n d the quest for
m e a ning in life (Mille r & Tho re ns e n, 20 0 3)
CONCEPTUALIZING SPIRITUALITY AND
RELIGION

RELIGION is defined in c o m m u n a l
terms, characterized by
institutionalized practices a n d
beliefs, memb ershi p a n d m o d e s of
organization.
“RELIGION” derives from religio, “to
bind b a c k or to tie.”
CONCEPTUALIZING SPIRITUALITY AND
RELIGION
A r esea rcher o n religion a n d
healthcare D a r e Matthews (1996),
define religion a s “An organized system
of beliefs, practices, a n d symbols
d e s i g n e d to facilitate c l o s e n e s s to
god.”
RELIGION is a n y set of beliefs a n d
practices c o n c e r n i n g our relationship
with the sacred.
 THE INFLUENCE OF
SPIRITUALITY/RELIGION
O N HEALTH
There a r e four prominent pathways in which
religion influence health:

[Link] BEHAVIORS -
2 . S O C I A L SUPPORT
 THE INFLUENCE OF
SPIRITUALITY/RELIGION
O N HEALTH

[Link] STATES

4. 'PSI' INFLUENCES
PA TIEN TS EX IS TEN TIA L
QUESTIONS
I t is c o m m o n for patients to h a v e
existential questions about their
illnesses, a n d m a n y inquire "Why m e ? "
when given a devastating diagnosis. A
sick patient m a y feel that the medical
illness is a punishment from God. This is
s o because, if devout religious faith is a
pathway to g o o d health a n d protection
fro m a ll d is e a s e s , th e n it is b e lie ve d th a t
illness/sickness results from lack of
devotion to the s a i d faith.
 This notion c a n b e harmful to the
patient in question b e c a u s e the
patient believes that the illness h a s
c o m e u p o n him/her a s a result of
lack of devotion a n d thereby affect
h ow the patient views the sickness,
treatment modalities a n d g a i n i n g
g o o d health.
Consequently, those with the most
a d v a n c e d illness often e n d u p b e i ng
those who a r e the most spiritual. Thus, it
is impossible a n d often completely
w rong to c o n c l u d e that a patient's p o o r
physical health is d u e to lack of faith
a n d Health Practitioners should never
imply this (Koenig, 2007).
DIVERSE
RELIGIONS AND
THEIR BELIEFS
ABOUT HEALTH,
DIET, ILLNESS
AND DEATH
BUDDHISM Buddhist faith centres o n the Buddha, w ho is
revered, not a s a god, but a s a n example of a
wa y o f life .Bud d h is ts b e lie ve in re in c a rn a tio n
a n d s o a c c e p t responsibility for their actions.
The chief doctrine is that of ‘Karma’, g o o d or
evil d e e d s resulting in a n appropriate reward or
punishment either in this life, or through
reincarnation a l o n g a s u c c e s s i o n of lives.
Buddhism e n c o u r a g e s its followers to practice
non-violence, Buddhists will mostly b e
vegetarian. Meals will vary considerably
d e p e n d i n g u p o n their country of origin.
Buddhists believe that life b e g i n s at conce p ti on
a n d s o d o not c o n d e m n contraception. However
a s abortion a n d active e utha nasia a r e s e e n a s
taking life they a r e cond e m ne d .
BUDDHISM
Blood transfusion a n d o r g a n transplantation
a r e allowed.
The Buddhists believe in rebirth after death. The
state of mind of a p e r s o n at the m o m e n t of
death is important in determining the state of
rebirth. They like to h a v e full information a b out
their imminent death to e na b le them to m a k e
preparation.
S o m e Buddhists m a y not wish to h a v e sedatives
or p a i n killing d r u g s administered at this time.
P e a c e a n d quiet for meditation a n d visits from
other Buddhists will b e appreciated.
BUDDHISM
S o m e form of chanting m a y b e u s e d to
influence the state of mind at death s o that it
m a y b e peaceful.
I n the situation where death occur, if other
Buddhists a r e not in attendance, then a
Buddhist minister should b e informed of the
death a s s o o n a s possible. Routine Last Rites
a r e appropriate.
Cremation is preferred a n d post mortem is
unlikely to b e objected (McCabe,2005).
CATHOLIC Although the doctrines of Catholic c h u r c h e s vary
greatly both within a n d between countries, there
a r e four features of Catholics that a r e nearly
universal: initiation (baptism), worship, ministry
a n d ‘good works’. The s a c r e d writings of Catholic
religion a r e in the Bible. A Catholic’s individual
faith a n d religious practice will b e influenced by
the tradition of the c h u r c h to which they b e l o n g a s
well a s their ow n p e rs ona l relationship with God.
Diet – There a r e n o ge ne ral dietary requirements.
S o m e Catholic ob s e rve Friday a s a d a y when
they d o not eat meat. S o m e Catholic m a y wish to
abstain from f o o d (fast) before receiving Holy
Communion. S o m e abstain from alcohol.
CATHOLIC Family Planning varies from Religion to Religion. N o
religious objections a b out b l o o d transfusion a n d
o r g a n transplantation. Routine last rites a r e
appropriate for all Catholic after death. There is
n o a g e limit for baptism. When b a b i e s or children
a re ve ry ill, b a p tis m s h o u ld b e o ffe re d .
Ro m a n Catholics – Baptism – A lay p e r s o n m a y
perform this c e r e m o n y if death is imminent. I n the
a b s e n c e of a Minister of Religion, a n y o n e m a y
perform a baptism. This is d o n e by m a k i n g the
s i gn of the c r o s s o n a person’s forehead. A little
water is p o u r e d o n the fore he a d (or another
a cce s s i b le part of the body), with the words, “…
(N a m e of the person)…”, I baptize y o u in the n a m e
of the Father, a n d of the Son, a n d of the Holy Spirit.
Amen”.
CATHOLIC

A Catholic patient will probably wish to b e visited

by a Catholic Priest a n d to receive Holy
C o m m u n i o n a n d the “Sacrament of the Sick”. This
is not only for the dying, but a ls o for the sick,
especially before a n operation. The S a c r a m e n t s
a r e very important. The Catholic Priest must b e
called to the dying patient a n d if the death is
sudden, immediately afterwards.
CATHOLIC
The cha p la in should b e informed a s s o o n a s
possible. I f a child dies unbaptised the C ha p la in
will offer a Blessing a n d N a m i n g service a n d a
certificate to c o m m e m o r a t e this will b e given to
the parents. This is particularly appropriate
following a m i s ca rri a ge or stillbirth. Christmas a n d
Easter a r e the most important
festivals/celebrations. Christians will usually wish
to receive Holy C o m m u n i o n at these times. There
is n o religious objection a b out post mortem
(McCabe, 2005& Multi-Faith G r o u p for Healthcare
C ha p la i ncy 2005)
IS LAM Great importance is attached to cleanliness. Therefore,
before every act of prayer the patient will want to w a s h
his/her f a c e h a n d s a n d feet. Times of prayer a r e dawn,
noon, mid afternoon, just before sunset a n d before
retiring for sleep. The patient will n e e d to stand – if h e c a n
– o n cle a n sheets or a prayer mat fa ci ng M e c c a (south-
east). Privacy will b e a p p re ci a ted but not essential. An
offer of a c o p y of the Qur’an will b e appreciated. This
must b e ha nd le d with the greatest respect, n o object or
b o o k b e i ng p l a c e u p o n it. This c a n b e supplied by the
local Mosque. Both m a le a n d female Muslims a r e very
m od e s t in their d re s s a n d outlook. A female m a y request
that s h e is e xa m i ned by a female d octor or nurse, or that
her h u s b a n d or a female c o m p a n i o n b e present during a
medical examination.
IS LAM
Diet – Both pork a n d alcohol a r e forbidden in all
forms, all ye a r round. “Hallal” m e a l is required,
otherwise Kosher or s e a f o o d a n d vegetarian meal.
During the month of R a m a d a n a c c o r d i n g to the
Muslim c a l e n d a r all Muslims fast by not eating or
drinking from d a w n to sunset, but ill patients a r e
exempted from this. F o o d should b e m a d e available
for a n y fasting patient before d a w n a n d after sunset.
The taking of medication during a fasting d a y m a y
c a u s e difficulties to the patient, n o u n d u e pressure
should b e applied. This could b e d i s c u s s e d with the
patient a n d family.
IS LAM
Hygiene/Cleanliness – Hands, feet a n d mouth a r e
always w a s h e d before prayer. H a n d w a s hi ng is
c o n s i d e r e d essential before eating. Water for
w a s hi ng is n e e d e d in the s a m e r o o m a s the WC itself,
i.e. patients should b e provided with bowls/ jugs of
water/bidet etc.? I f a b e d p a n h a s to b e used,
bowls/jugs of water should a ls o b e provided. Patients
prefer to w a s h in free flowing water, e.g. a shower, a s
baths a r e c o n s i d e re d unhygienic. I f a shower is
unavailable, a s k the patient if they would like to u s e a
jug in the bath.
IS LAM Modesty – Wo m e n prefer to b e treated by female
staff where appropriate.
Dress/Jewellery – A locket containing religious writing
is sometimes worn a r o u n d the n e c k in a small leather
bag. These a r e kept for protection a n d strength a n d
therefore should never b e removed.
Family Planning – Strictly s p e a k i n g orthodox Muslims
d o not a p p r o v e of contraception, in practice,
individuals vary widely in their a p p roa ch. Abortion is
frowned upon, but is often tolerated if it is for medical
reasons.
Blood Transfusion – N o religious objection.
O r g a n Transplantation – N o specific rulings
prohibiting transplantation. However, strict Muslims
will not a g r e e to o r g a n transplants.
IS LAM C a r e of the Dying – They m a y wish to sit or lay fa ci ng
M e c c a a n d r e a d i ng the Qur’an. Family or friends m a y
wish to quietly r e a d the Qur’an or s a y a prayer. After
death the b o d y should not b e touche d by n o n -
Muslims. Health workers w ho n e e d to touch the b o d y
should wear d i s p os a b le gloves. The b o d y should b e
p r e p a r e d a c c o r d i n g to the wishes of the family.
Proce d ure s at Death: The b o d y is w r a p p e d in o n e or
two plain white sheets; the foot of the b e d is p l a c e d
fa ci ng M e c c a or the patient is turned onto their right
side in order that the d e ce a s e d ’s f a c e looks towards
M e c c a a n d the b o d y is not allowed to b e w a s h e d nor
cutting of nails or hair.
 Burial – The family a n d the local M o s q u e a r e

IS LAM conta cte d to handle w a s h i n g of the b o d y in the

hospital or the funeral house, a n d then the prayer at
the M o s q u e or at the Muslim section of the cemetery.
Cremation is not allowed, a n d the burial should take
p l a c e within 24 hours if possible.
Post-mortems – S o m e Muslims m a y o p p o s e a post-
mortem but n o restrictions if required by law.
Special Considerations – There a r e m a n y Muslim
festivals, all calculated by the lunar calendar. There
is n e e d to a s k the patient or family if a n y important
o c c a s i o n s for their faith o c c u r during their stay in
hospital. The most important is the month of
R a m a d a n during which Muslims practice self-
discipline in order to a chi e ve tolerance, love,
sacrifice a n d equality (McCabe, 2005& Multi Faith
G r o u p for Healthcare C ha p la i ncy 2005).
JEHO VAH'S Jehovah’s Witnesses try to live their lives a c c o r d i n g to
the c o m m a n d s of G o d a s written in the Old a n d New

WITNESSES Testaments. They r e g a r d Jesus Christ a s the S o n of

God, but not in the s e n s e of b e i ng equal with G o d or
o n e with God.
Diet – F o o d containing b l o o d or b l o o d products is
not acceptable. Jehovah’s Witnesses d o not smoke.
Blood Transfusions – Jehovah’s Witnesses h a v e
religious views that taking b l o o d into one’s b o d y is
morally w r o n g a n d is therefore prohibited. This
includes whole b l o o d or its components, s u c h a s
p a c k e d red cells, plasma, white cells a n d platelets.
Jehovah’s Witnesses c a n c h o o s e whether to a c c e p t
products s u c h a s albumin, i m m unoglob ins or clotting
factors.
JEHO VAH'S Blood s a m p l e s m a y b e taken for pathological testing

WITNESSES providing a n y u n u s e d b l o o d is d i s p o s e d of. Dialysis is

usually accepted. Jehovah’s Witnesses a c c e p t
medical treatment in all other respects apart from
those involving the u s e of b l o o d or b l o o d
components.
O r g a n Transplantation – this is generally not
permitted. C o m p o n e n t s where b l o o d is not involved,
e.g. corneas, a r e m o r e likely to b e acceptable.
Jehovah’s Witnesses a r e not likely to b e willing either
to d o n a t e or receive a n o r g a n through which b l o o d
flows. They will want r e a s s u r a n c e that b l o o d will not
b e u s e d a ga i ns t their wishes.
JEHO VAH'S
WITNESSES
C a r e of the Dying – There are n o special rituals
for the dying but they will usually appreciate a
visit from o n e of the Elders of their Faith. (There
are n o separate clergy).
Death – Routine Last Rites are not appropriate.
Post Mortem – This is a matter of individual c h o i c e
for the family.
JUDAISM
I n Judaism, religion a n d culture a r e entwined. I t is
b a s e d o n the worship of o n e God; carrying out the
Ten C om m a ndme nts; a n d the practice of charity a n d
tolerance towards one’s fellow h u m a n beings.
There a r e different g r o u p s within Judaism:
-Orthodox Jews – they a r e usually m o r e traditional a n d
observant of the religious/dietary laws.
-Non-Orthodox Jews (includes:
Conservative/Liberal/Reform) – they m a k e their religious
o b s e rva nc e fit in to m o d e rn s o c ie ty.
JUDAISM D ie t – Ma n y Je ws will a s k fo r Ko s h e r fo o d , i.e .m e a t
that h a s b e e n p r e p a r e d in a special way a c c o r d i n g
to Jewish Law. Shellfish, pork, rabbit a n d derivatives
a r e strictly prohibited. Milk a n d m e a t products a r e
not eaten in the s a m e meal. This m e a n s that they d o
not h a v e milk in their drinks or c r e a m with their
desserts after their m e a t m e a l a n d d o not u s e butter
o n m e a t sandwiches. The patient should b e
consulted over his/her level of dietary o b s e r v a n c e
a n d the n e c e s s a r y a r r a n g e m e nt s made. Orthodox
Jews m a y not b e h a p p y to take non -Kos he r
medication.
Fasting – I f fasting would b e a danger, e ve n Orthodox
patients will a c c e p t medical advice.
JUDAISM Modesty – Orthodox Jewish w o m e n would prefer to
h a v e their b o d i e s a n d limbs covered. They m a y a ls o
prefer to k e e p their hair c o v e r e d with a h e a d scarf
while Orthodox m e n k e e p their h e a d c o v e r e d with a
hat or skull c a p (Kappel).
Family Planning – S o m e Orthodox Jews forbid
contraception or family planning unless the woman’s
health is at risk.
Birth – Nearly all Jewish b o y s a r e circumcised, usually
eight d a y s after birth. This is performed by a trained
a n d medically certificated religious functionary
called a “Mohel” I f there is a n y doubt a b out the
child’s health the circumcision is delayed.
JUDAISM O r g a n Transplantation – O r g a n transplants a r e
usually forbidden by Orthodox Jews. However
opinions vary a n d decisions m a y rest with the
rabbinic authority.
C a r e of the Dying – The patient m a y wish to recite or
h e a r special p s a l m s or prayers, especially Psalm 23
(The Lord is My Shepherd), a n d m a y a p p re ciate
b e i ng able to hold the p a g e o n which it is written.
Prayers m a y b e s a i d by the relatives a n d they m a y
wish a Rabbi to b e called to help the dying p e r s o n
with their formal confe s s i on a n d to bring comfort.
Death – I n s o m e c a s e s the s o n or nearest relative, if
present, m a y wish to clos e the e y e s a n d mouth. The
b o d y should b e ha nd le d a s little a s possible by n o n -
Jews.
JUDAISM
D e p e n d i n g o n the sex of the patients a fellow m a le or
female w a s h e s a n d p r e p a r e s the b o d y for burial.
Usually three m e m b e r s of the community a r e
present. Traditional Jews will a r r a n g e for this to b e
d o n e by the Jewish Burial Society. If, however,
m e m b e r s of the family a r e not present, most n o n
Orthodox Jews would a c c e p t the usual w a s hi ng a n d
last rites performed by hospital staff. The b o d y is
c o v e r e d with a cle a n white sheet. The family m a y
wish for the b o d y to b e p l a c e d with the feet pointing
towards the d o o r w a y a n d to light a candle.
JUDAISM S o m e Orthodox Jewish g r o u p s m a y wish to appoint
s o m e o n e to stay with the b o d y from the time of
death to the burial, which usually takes p l a c e within
24 hours. This p e r s o n is called a “watcher” a n d h e or
s h e m a y n e e d to stay with the b o d y throughout the
night. I n the a b o v e instance or if the family wish to
view the body, staff should a s k the Mortician to
ensure that the r o o m is free of a n y religious
“symbols”. I f the death h a s to b e reported to the
Coroner, s/he should b e informed that the patient
w a s Jewish a n d b e a s k e d if the p r o c e d u r e s c a n take
p l a c e a s s o o n a s possible. Orthodox Jews a r e always
buried but n o n Orthodox Jews allow cremation. The
funeral h a s to take p l a c e a s s o o n a s possible.
 Post Mortem – Post m orte ms a r e not permitted unless

JUDAISM legally required.

Special Considerations – The S a b b a t h (Shabbat)
b e g i n s at sunset o n Friday a n d lasts until sunset o n
Saturday. O n the S a b b a t h ‘work’ is prohibited a n d this
includes things s u c h a s writing, travelling a n d
switching o n lights or electrical appliances. Pa s s ove r
(in M a r c h or April) is when special f o o d s m a y b e
required by s o m e Jewish patients. D a y of Atonement
or Yo m Kippur (in September or October). This is a
special d a y of fasting. A Jewish patient will normally
wish to k e e p that d a y to p ra y a n d b e quiet. I t is the
holiest d a y of the Jewish C a l e n d a r a n d is c o n s i d e re d
to set the path for the ye a r to follow. Orthodox
patients must b e offered alternatives to oral
medication, s u c h a s injections or suppositories
((Diversiton, 2008).
CHRISTIAN SCIENCE
Established in the United States of America in 1879.
Christian S c i e n c e t e a c h e s a reliance o n G o d for
healing, rather than o n medicine or surgery. I t will
b e unusual, therefore, for Christian Scientists to b e
patients in ordinary hospitals. They will usually s e e k
nursing c a r e at h o m e or in a Christian S c i e n c e
Nursing home. They may, however, b e admitted to
hospital following accidents, or during p r e g n a n c y
a n d childbirth, a n d b e c a u s e of family or legal
pressures. They will a c c e p t medical c a r e for their
children where the law requires them to d o so.
CHRISTIANITY
• Christians are monotheistic, i.e., they believe there’s only
one God, and he created the heavens and the earth. This
divine Godhead consists of three parts: the father (God
himself), the son (Jesus Christ) and the Holy Spirit.
• The essence of Christianity revolves around the life, death
and Christian beliefs on the resurrection of Jesus. Christians
believe God sent his son Jesus, the messiah, to save the
world. They believe Jesus was crucified on a cross to offer
the forgiveness of sins and was resurrected three days after
his death before ascending to heaven.
• Baptism of Water and the Holy Spirit is essential for the
salvation of Christians.
• Christians contend that Jesus will return to earth again in
what’s known as the Second Coming
CHRISTIANITY
The Holy Bible includes important scriptures that outline Jesus’s
teachings, the lives and teachings of major prophets and
disciples, and offer instructions for how Christians should live.
Both Christians and Jews follow the Old Testament of the Bible,
but Christians also embrace the New Testament.

Diet -Most Christians follow the New Testament rules and eating
freedom, which allow them to eat anything as long as it does not
destroy the body (which for them is a sin to temple of God).

Most Christians do not practice heavy drinking of alcohol,

cigarettes, drugs and other vices.
CHRISTIANITY
• The Holy Bible includes important scriptures that outline
Jesus’s teachings, the lives and teachings of major prophets
and disciples, and offer instructions for how Christians should
live.
• Both Christians and Jews follow the Old Testament of the
Bible, but Christians also embrace the New Testament.

• Diet -Most Christians follow the New Testament rules and

eating freedom, which allow them to eat anything as long as it
does not destroy the body (which for them is a sin to temple
of God).

• Most Christians do not practice heavy drinking of alcohol,

cigarettes, drugs and other vices.
CHRISTIANITY
• O r g a n Transplantation – a l l o w e d

• C a r e of the Dying – The patient m a y want to

include the nurses and healthcare providers in
prayers and reading of scriptures.

• Prayers m a y b e s a i d by the relatives, a n d they

m a y wish a p a s t o r to b e called to help the dying
person

• There a r e n o special rituals for the dying but

pastors may be called in to provide comfort to
the relatives.
C O NC LUS IO N
Most patients don't know the difference between
religion a n d spirituality a n d tend to understand
religion a n d spirituality a s the s a m e thing.
There a r e also beliefs about spirits, spiritual bei n g s
or spiritual forces that c a n induce psychological
or even physical h a r m to people (as in v o o d o o or
witchcraft). Belief in d e m o n i c or evil spirits m a y
lead to great distress in patients from spiritual
traditions in which s u c h forces a r e emph a s iz ed
a n d where there is belief that people c a n b e c o m e
inhabited by s u c h spirits.
C O NC LUS IO N
Spiritual practices s u c h a s
transcendental meditation, mindfulness
meditation, healing touch (involving
"subtle energies"), acupuncture, m a y at
times b e offered to Christian patients a s
part of alternative or complementary
medicine programs. S u c h spiritual
practices m a y b e presented by
practitioners with a n almost evangelical
zeal to patients who a r e desperate for
help after allopathic medical treatments
h a v e failed.
C O NC LUS IO N
Patients from conservative Christian g r o u p s
m a y know very little about s u c h practices,
which a r e rooted in Eastern or New A g e
religious traditions a n d m a y directly conflict
with their Christian religious beliefs.
Health Practitioners not knowledgeable about
or insensitive to conservative Christian beliefs
m a y i m p o s e these foreign spiritual practices
o n patients without fully explaining their origins
a n d without providing traditional Christian
alternatives m o r e consistent with patients'
beliefs -
C O NC LUS IO N
By a c k n o w l edg i n g their beliefs a n d g a i n i n g a n
understanding of how they relate to their
health. Being attentive to clues about
spiritual/religious beliefs a n d practices is a
useful starting point for health practitioners.
Clues m a y b e comments, actions, p o s s e s s i o n s
or clothing with spiritual/religious significance
Health c a r e staff c a n a s k patients where they
get their strength from; who or what supports
them in life. These a r e non-intrusive ‘open’
questions.
Thank you
for
listening!