Videothoracoscopy for diagnosis and treatment of respiratory tract diseases

Orthopaedic nurses often are well-educated in dealing with patients' physical and psychologic needs but lack education in caring for the spiritual needs of man. Nurses must realize they, themselves, have spiritual needs and must invest in clarifying their own values and beliefs as well as their patients. To perform a complete spiritual assessment, nurses need to become familiar with the concept of spirituality and what it means in the care of patients. Providing spiritual care is individualized and often complex. The nursing process enables the nurse to plan patient care. Providing spiritual care is a challenge orthopaedic nurses must recognize and assume responsibility for.     

Spiritual nursing interventions

Oncology, parish, and hospice nurses in the Midwest were surveyed to explore what nursing interventions they implement to enhance the spirituality of clients and how they learned about these interventions. Some 95 spiritual nursing interventions were identified and ranked according to frequency of implementation. The most frequently identified nursing interventions were referral, prayer, active listening, facilitation and validation of clients' feelings and thoughts, conveying acceptance, and instilling hope. The most frequently ranked implemented interventions were communication and religious nursing interventions. Only 15% of the participants indicated that they learned the most about spirituality and spiritual nursing interventions from basic and advanced nursing education combined. Findings support the need for increased emphasis of theoretical and clinical spiritual knowledge in nursing education and the development of a typology of spiritual nursing interventions to direct nurses in enhancing the spirituality of clients and implementing holistic nursing care.     

Developing curricula in spirituality and medicine

In recent years patients and some members of the medical community have expressed the concern that doctors have forgotten about compassion and too often ignore their patients' spiritual concerns. Patients can and should expect their physicians to respect their beliefs and be able to talk with them about spiritual concerns in a respectful and caring manner. Medical schools must teach their students how to meet these expectations, and health care systems need to provide practice environments that foster compassionate caregiving. Medical educators are recognizing the need to bring the art of compassionate caregiving back into the medical school curriculum. This paper focuses on one approach to achieving this goal, the study of spirituality and medicine. The authors discuss the relationship of spirituality and healing, and describe studies that have shown patients' desire to have spiritual issues addressed by their physicians and the potential health benefits of spiritual beliefs. Finally, they describe common elements of the spirituality courses offered by approximately 50 U.S. medical schools, including 19 schools that have been awarded grants from the National Institute for Healthcare Research for the development of curricula in spirituality and medicine.     

Diminished hyperaemic response of the hepatic artery to portal venous occlusion (the buffer response) in Asian hybrid minipigs: a comparison of the response to that observed in dogs

This study is part of a larger study of the effect of integrity-promoting care in a Swedish nursing home ward. Compared with assessments on a control ward, improvements were found in the patients' behaviour and in the quality of care after a three-month intervention period. This paper reports on parts of a questionnaire survey on the nursing staff's opinions of their working conditions and demented patients. Most staff members on both the intervention ward and the control ward found their jobs meaningful, engaging and stimulating, but they also felt that they had a heavy work-load. Most of the staff members experienced mental strain because of the patients' disturbed behaviour. Many did not think that the care on their ward would have been good enough for their own close relatives, if they had been suffering from dementia. Only slight changes were found in the staff members opinions after the intervention.     

Spiritually conscious psychological care.

There is increasing recognition of the importance of identifying and perhaps incorporating into psychological services the spiritual and religious beliefs and practices (SRBP) of patients. Research suggests that psychologists are reluctant to address the SRBP of their patients, because they are unsure how to do so without contravention of ethical standards. Moreover, numerous approaches have been published and promoted, and psychologists may feel overwhelmed by the profusion of advice. We organize the suggested approaches into four categories and place them on a continuum, and we discuss the ethical concerns related to each. At one end is spiritually avoidant care, which entails the attempt to avoid conversations with patients about their SRBP. Given the importance of these issues to psychological health and to understanding the patient, this approach is untenable. At the other end of the continuum, spiritually directive psychotherapy is characterized by an explicit attempt to maintain or change the SRBP of patients. Spiritually integrated psychotherapy entails utilizing SRBP to ameliorate patients' emotional distress. We suggest that psychologists should at least engage in spiritually conscious care, which we characterize as the explicit assessment of the general importance of SRBP to the patient, its influence on the presenting problem, and the potential of SRBP as a resource to help recovery. Specific suggestions are presented for how spiritually conscious care might be implemented. Finally, the need for better training in both basic and specific competencies needed to address patients' SRBP is reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characterization of the M(r) 65,000 lymphokine-activated killer proteins phosphorylated after tumor target binding: evidence that pp65a and pp65b are phosphorylated forms of L-plastin

Nursing, over the past 2 decades, has been concerned with the development of theories which will inform practice and help to establish nursing as an emerging discipline. The view that the individual is a biopsychosocial being has occupied a prominent position in the existing catalogue of nursing theories. The literature reveals that, although some existing theories do acknowledge that humans do have the advantage of a spiritual dimension, very little significant work appears to have been done in this area. This paper explores some of the difficulties in arriving at a definition of spirituality and goes on to examine the extent to which nursing theories incorporate the concept of spirituality. Additionally, nurse education does not appear to prepare practitioners adequately to meet the spiritual needs of patients. The paper concludes with a discussion of the potential for meeting the spiritual needs of patients in the context of the changes occurring in the British National Health Service.     

A liver-specific isoform of the betaine/GABA transporter in the rat: cDNA sequence and organ distribution

This paper discusses the findings of a quantitative study of nurses' willingness to care for patients with AIDS. It identifies several factors that enable nurses to confront the fear of AIDS nursing and to turn fear into compassion, and negative attitudes into positive ones. These factors include professional values, organizational support, group identity, patients' responses, spirituality, family and friends with AIDS, knowledge about AIDS, and the importance of personal choice. The value of these factors are further supported through personal statements made by nurses on AIDS-dedicated units as they express their feelings, thoughts, and positive experiences and expectations regarding AIDS nursing.     

Religious/spiritual psychotherapy behaviors: Do we do what we believe to be important?

Professional psychologists have recently been encouraged to sensitively address religious/spiritual issues in psychotherapy. But how frequently do practitioners make religiously/spiritually informed interventions with their clients, and how important do they think it is to do so? Based on the existing literature, the authors identified 29 recommended religious/spiritual psychotherapy behaviors and surveyed 96 psychologists regarding perceived importance and use of these behaviors. The most and least frequently endorsed behaviors were identified. The greater the practitioners' religious/spiritual self-identification, the more likely they were to report using these behaviors in psychotherapy. However, overall, and for 90% of the individual items, clinicians engaged in these religious/spiritual psychotherapy behaviors less frequently than their importance ratings suggested they should. Practice implications and suggestions for educators are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identity and spirituality: A psychosocial exploration of the sense of spiritual self.

The authors examined the structure and content of adults' sense of spiritual identity by analyzing semistructured interviews with 13 spiritually devout men and 15 devout women, ages 22 to 72. Individuals' responses to the Role-Related Identity Interview (G. T. Sorell, M. J. Montgomery, & N. A. Busch-Rossnagel, 1997b) were content analyzed and rated on the role-related spiritual identity dimensions of role salience and flexibility. Individuals were categorized as spiritually foreclosed, achieved, or in moratorium, on the basis of their motivational, affective, self-evaluative, and behavioral investments in spiritually defined roles and their reflectiveness about and behavioral changes in role-related spiritual identity. Similarities and differences within and between spiritual identity status groups were observed, suggesting a variety of ways that spiritual identity provides a sense of continuity as well as a domain for adult developmental change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nursing, healing and spirituality

The premise of this article is that nurses are healers, primarily through the caring relationships they form with patients. Caring calls out an individual's inner strengths. These strengths include spiritual resources which support integration or wholeness of body, mind and spirit. Many nurses are unsure about giving spiritual care. This author encourages nurses to reflect on their own spirituality and learn spiritual care skills. By addressing the spiritual dimension in patient care, nurses can truly be holistic practitioners and positively affect the mental and physical health of their patients.     

Religion and spirituality.

We define religion and spirituality and discuss five scenarios in which they will probably emerge in psychotherapy. We review empirical research on religion and spirituality as they pertain to psychotherapy outcomes and relationships. Most research has been unsophisticated relative to the general status of psychotherapy research. Nonetheless, therapists are urged to assess for religion. and spirituality and, if possible, intervene in religiously and spiritually sensitive ways. Nine empirical studies of religiously accommodative Christian (n = 6) and Muslim (n = 3) psychotherapy have provided limited support for its efficacy, especially with depressed clients. Highly religious clients appear to desire therapy that respects (if not integrates) their religion, but research is unclear about the degree to which they can benefit from secular therapies, especially when they request religious therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spirituality and practice. Stories, barriers and opportunities. Interview by Laurence A. Savett

What are "spiritual matters?" Are "spiritual matters" the same as "religious matters?" What is spiritual inquiry? Are such questions appropriate for those of us in the caring professions, other than clergy, to consider? If we accept that role, how far should we go? When should we call for help? Whom should we call? We convened a gathering of a hospital chaplain, a social worker, a hospice nurse and a physician to discuss many of the dimensions of spirituality and then to apply their personal and professional paradigms of care to a discussion of an actual case. This article is a record of that conversation. It is actually several articles in one, for it deals with their own views of the meaning of spirituality, the degree to which their spirituality has impact on their practice, what they see as the merit of spiritual matters in the caring professions, barriers to collaboration among their professions and to addressing these issues with patients, and boundaries beyond which one should not go. One way to read this conversation is to include yourself; that is, to reflect on the points the participants make and the ways in which you might integrate their insights into your personal practice. We hope that you find this task worthwhile and that it provokes further thought and discussion. The discussion began with participant introductions.     

Relational spirituality and the development of the Similarity of the Offender’s Spirituality Scale.

We present a model of relational spirituality and forgiveness that considers how a victim’s spirituality affects his or her experience of and response to a transgression. In 2 studies, we investigate the psychometric properties of the Similarity of the Offender’s Spirituality Scale (SOS), which assesses the extent to which the victim sees the offender as spiritually similar. Results suggest the SOS has 2 factors that assess the offender’s spiritual and human similarity. The SOS showed initial evidence of construct validity, being related to other measures of spirituality and to measures of the victim’s response to a transgression. The overall model was found to offer incremental validity beyond known predictors of forgiveness. We suggest directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generativity and spiritual disclosure in close relationships.

This exploratory study examines the link between generativity and an interpersonal aspect of religion and spirituality, spiritual disclosure, in close relationships. Three hundred seventy-eight adults aged 18 to 85 years were asked about their use of spiritual disclosure with close friends, views on their own generativity, questions related to personality characteristics, and level of general self-disclosure. This community sample’s reports on higher levels of spiritual disclosure were tied to higher levels of generativity and general self-disclosure. Spiritual disclosure also predicted unique variance in generativity beyond general self-disclosure, personality, and intrapersonal aspects of religion and spirituality. These findings suggest spiritual disclosure in close relationships is an important part of the religious/spiritual landscape, which merits further study in relation to generativity and other prosocial indices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Good practice in the management of adults with malignant cerebral glioma: clinical guidelines. Working Group, Royal College of Physicians

This paper proposes guidelines for good practice in the management of adults with malignant cerebral glioma. These guidelines were developed by a working group comprising representatives of the medical specialties involved in patient care, specialist nursing staff, purchasers, charitable bodies, and patient and relative representatives. Both the research literature on the effectiveness of medical intervention, and the views of patients and relatives about the care they had received were considered. The document proposes a consensus view about ways to improve patient care and considers several stages of the illness and its care: I, the diagnostic phase; II, deciding on an appropriate treatment plan; III, the organization of follow-up services; IV, the management of transitions from hospital to community settings; and V, purchasing care for patients with malignant brain tumours. An audit package derived from the guidelines is available which will enable staff within a treatment centre to compare their practice against these standards. A final section suggests topics which require further research, and sets out the core requirements for studies that will help answer questions about treatment and the benefits for patients in terms of improved quality of life.     

Spirituality in medical practice

Body, mind, and spirit are integrally connected. Medical training in the Western world has been strong concerning the more easily measured physical aspects, and on the mental needs it has been virtually mute on how to minister to the spiritual needs of our patients. Learning the spiritual aspects of medical care is not a typical part of the medical school curriculum, and yet it is emerging as something that our patients want and expect us to do as part of our caring for them. Herein I discuss the role of spirituality in medical practice, how it relates to alternative medical practices, methods to use to grow spiritually, and ways to apply your spirituality to medical practice.     

Improving nursing practice with staff education: the challenges of dysphagia

The 15 million Americans who experience some degree of dysphagia risk choking, airway obstruction, aspiration-related pulmonary disease, and/or death. These complications increase mortality, morbidity, length of hospitalization, and healthcare costs, but may be preventable through nursing intervention. Fifty-four nursing care workers (NCWs) from medical/surgical units in two acute care hospitals were assigned by convenience to two experimental groups and a control group. Experimental groups A and B participated in an educational program on dysphagia designed to increase their knowledge of dysphagia, knowledge attention, and the number of dysphagic patients identified and referred. Group B received deliberate reinforcement of program content over a 1-month period. The educational intervention had a significant effect on knowledge level and knowledge retention, immediately and at 1-month posttest in both experimental groups. NCWs applied what they learned to clinical practice as evidenced by an increase in the number of patients identified as being at risk for or experiencing dysphagia. Reinforcement of program content did not affect the outcomes. The study has implications for staff educators and nursing personnel who care for persons at risk for dysphagia.     

A multinational study of psychiatric nursing staffs' beliefs and concerns about work safety and patient assault

In an effort to understand beliefs and concerns about work safety and patient assault, the author describes the results of a multinational survey of 999 nursing staff members working in psychiatric facilities across the United States, Canada, United Kindgom, and South Africa. Although the majority of the sample (75%) reported being physically assaulted at least once during their careers, 62% responded that they felt safe in their work environment most of the time. Significant differences were found among the nurses with regard to beliefs about adequacy of staffing, safety of the physical environment, admission of assaultive patients, expectations about being victims of assault, overall level of safety, and taking legal action against a patient. A significant difference in attitudes was also found among nursing staff members, who reported previous assaults. They believed that assaults are expected events in their work with psychiatric patients.     

Imiquimod (Aldara cream)

The experience of intuition in a school setting contributes to a positive outcome for a young girl who suffers a playground injury. Intuition and spirituality are linked. Through the development of one's spirituality, intuitive thoughts are experienced. Centering prayer is presented as a technique to develop an awareness of the spiritual dimension. Three variations of centering prayer are described to help individuals develop their spirituality. Developing an awareness of the spiritual dimension opens the way for intuitive thoughts to enhance clinical nursing competence and all other aspects of living.     

Religion and spirituality in rehabilitation psychology.

ABSTRACT. This article surveys the current attitudes of rehabilitation specialists regarding spirituality and religiousness. The existing data on the associations of spirituality and religiousness with measures of physical and mental health and well-being in people with disabilities are described. The role of religion–spirituality in the lives of caregivers for people with disabilities is addressed, as are professionals' attitudes toward considering patients' religious and spiritual involvement in the course of rehabilitation. Finally, the potential ways to use patients' spirituality and religiousness in assessment and intervention are discussed, and directions for future research are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)