Mulbah Massaquoi Tokpah, declare honestly that this dissertation entitled "Exploring how psychiatric nurses working with psychiatric clients in EThekwini District understand the spiritual dimension of holistic psychiatric nursing practice" is my original work. The aim of this qualitative study was to explore how psychiatric nurses working with psychiatric clients in the EThekwini District understand the spiritual dimension of holistic psychiatric nursing practice.
Background to study
This chapter presents the background of the study and statement of the problem, describes the purpose of the research study and then details the research objectives and questions. Spirituality is becoming an increasingly important component of the biopsychosocial model of health in recent practice and research (Mohr, 2006; O'Reilly, 2004; Ray & McGee, 2006).
Problem statement
No local studies to this effect were found although two nursing studies located in the South African context investigated the issue of spirituality among people living with HIV/AIDS (Dolo, 2006; Mahlungulu & Uys, 2004). Local data on how nurses understand and practice spirituality in their work encounters with clients would be an important first step in improving holistic, patient-centred psychiatric nursing care in the South African context.
Purpose of the study
The integration of spiritual and psychiatric care is an important contemporary issue for psychiatric nursing if the profession is to continue to define itself as a holistic and client-centred activity and to provide socially responsive care (Greasley et al 2001; Mohr, 2006).
Objectives of the study
Research questions
Significance of the study
Summary of the chapter
Introduction
Contemporary understandings of psychiatric nursing
The nurse-patient relationship has benefits for both mental health care providers and mental health care users. Dearing (2004) reports on a study conducted on how the nurse-patient relationship affects treatment compliance of a mental health care user diagnosed with schizophrenia.
Psychiatric care in the South African context
In South Africa, the idea of integrating mental health care into primary health care for mental health consumers has made some gains and had a positive impact on the lives of people with mental illness (WHO, 2008). Understanding and appreciating the integration of mental health care with primary health care is crucial to the overall treatment strategy for people with mental illness in South Africa.
The phenomenology of spirituality and human experience
General primary care nurses provide basic mental health services in primary care clinics, and trained psychiatric nurses visit the clinics to treat severe cases and provide supervision to primary care nurses (WHO, 2008). Middleton and Uys (2009) state that approximately two-thirds of mental health care is provided to mental health patients at the clinic level in communities, while approximately one-third is provided to patients at the institutional level.
The holistic model of psychiatric nursing practice
The biological dimension
The biological dimension of the bio-psychosocial model consists of the biological theories associated with mental disorders and all biological activities associated with other health problems (Boyd, 2007). The biological dimension helps the psychiatric nurse understand how the cause of the disease is related to the functions of the body and how appropriate pharmacological agents can be administered to address the disease (Boyd, 2007; Lakhan, 2006).
The psychological dimension
The social dimension
The spiritual dimension
Introduction
Spirituality and religion
- Spirituality
- Religion
- Common religions
In South Africa, members of traditional African religions are stakeholders in the delivery of health services to the population. Members of the African traditional faith constitute 22.5% of the total population of KwaZulu-Natal province.
Differences and commonalities between spirituality and religion
- Common religious practices
Mohr (2006) reports that this froth of religious expression is practiced by all Western believers who recognize a relationship with God or a supreme being, and by some Eastern traditions (e.g. Buddhism, Hinduism, Shintoism and Taoism). Both worship and ritual sanctify people's commitment to their religious beliefs; strengthening individual devotion to God or a Supreme Being; and provide the opportunity to live peacefully with others.
The role of spirituality in health and illness
The findings of a study conducted among religious and non-religious patients, who were emotionally and physically ill, revealed that people who attended regular religious services could live longer and healthier lives (Koenig, 2005). These findings revealed that patients who attended regular religious services lived longer and healthier lives than patients who did not.
Spirituality and psychiatric nursing
Psychiatric nurses' perceptions of spirituality and its role in practice
The findings reveal that nurses consider spirituality as providing hope that strengthens them during difficult situations, such as feeding critically ill patients, death or divorce; enables them to develop a sense of relationship and faith in God or a higher being that helps them live a moral and just life with others; and it is a source of comfort that helps them to be more concerned about themselves and others through prayer.
The psychiatric nurses' dilemma: spirituality or psychiatric symptoms?
Psychiatric nursing assessment and intervention in spiritual care
This shows the difficulties that nurses have in recognizing the spiritual dimensions of patients in the patient-nurse relationship. In conclusion, the spiritual dimension of patients is of particular importance in the care relationship in the psychiatric setting.
Spiritual education curricula for psychiatric nursing
Knowledge and skills in the integration of spirituality in dealing with mental disorders in general. The authors state that ignoring patients' religious and spiritual needs can be labeled as a form of discrimination based on race, religion and ethnicity and can inhibit the psychological healing process of the patient.
Ethical cautions in integrating spirituality into psychiatric nursing practice
Knowledge and skills in dealing with ethical issues related to the provision of spiritual care. These are important caveats on which to end this exploration of spirituality in the psychiatric nursing context.
Summary of the chapter
Introduction
Philosophical assumptions of phenomenology
While both traditions focus on developing descriptions of understanding phenomena, the hermeneutic approach focuses more on the researcher's interpretations of the various meanings of the insights expressed (Silverman, 2001). The transcendental approach, on the other hand, is concerned with building clear descriptions of phenomena and excluding the researcher's interpretations as much as possible.
Phenomenological approach for this study
Steps in the descriptive phenomenological approach
- Bracketing
- Intuiting
- Analyzing and describing
In line with this principle of researcher reflexivity, section 5.3 of this report describes this process and specifically some of the difficulties the researcher encountered in applying a phenomenological method in the interview process. This step involves immersing yourself in the data and attuning to the meanings given to the phenomenon by those who have experienced it (Polit & Beck, 2008).
Selecting participants for the study
Intuiting is a form of openness; to be open to the multiple potential of meanings and to be willing to listen, see and understand with sensitivity, respect and humility for the experiences of others (Finlay, 2005). A letter was then sent to each potential participant through the class teacher thanking them for their participation pending ethics approval and again explaining the purpose of the study, detailing how privacy and confidentiality would be protected, how data would be collected, stored and administered and how the researcher would contact the person to arrange a date and time for the interview.
Procedure for collecting and recording data
We discussed the purpose of the research with each participant and obtained consent for participation. Participants also received a research study information sheet detailing the purpose of the research study, contact information for the researcher and supervisor, how privacy will be ensured, how data will be collected and stored, and how confidential it will be kept.
Colaizzi's method of data analysis and data representation
- Acquiring a sense of each transcript
- Extracting significant statements
- Formulating meanings
- Organizing formulated meanings into cluster of themes
- Exhaustively describing the investigated phenomenon
- Returning to the participants
Again, a table with the formulated meanings and their associated meaningful statements was developed to facilitate this stage of the analysis. Furthermore, the researcher managed to have cell phone preservations in three of the participants on the complete description.
Strategies for validating findings
Transferability
This is the extent to which the findings of a qualitative study can be transferred to other settings or groups (Polit & Hungler, 1999). The potential for transferability is increased if the study context from which the findings derive is richly described, if all methodological decisions are clearly outlined in the report, and if the findings are supported by narrative examples.
Dependability
The presence of these factors allows the reader to decide which insights are best applied to his/her context. The researcher also provided a detailed but simple description of the study results so that the reader can assess the applicability of these findings to other settings.
Credibility and confirmability
The researcher also discussed the data analysis process at regular intervals through peer debriefing (a structured group research supervision session led by the research supervisor and another member of the College of Health staff). Colaizzi's method of presenting and analyzing data is itself a strategy for determining and maintaining the rigor of the study.
Ethical considerations
Data management
Data dissemination
Conclusion
Introduction
Description of the participants and their work settings
Two of the female nurses have a Bachelor of Science degree in nursing as their first nursing degree.
Extracting significant statements
These significant statements and their locations in each transcript are presented in Table 4.4 in Appendix 6.
Formulating and clustering meanings
Spirituality is one of the basic needs, very important for everyone; I will definitely recommend spiritual care to my patients. Spirituality is one of the basic needs, very important for everyone” (Transcript 3, lines 784-786) and an essential element of mental health: “without spirituality you cannot have mental health, you cannot be compassionate”. Transcript 3, lines 783-784) and therefore as a dimension that must be nourished as one of the sources of human strength: "A part that must always be nourished as human beings, because that is where our strengths come from." (Transcript 2, lines 317-318).
Exhaustive description of the phenomenon
Psychiatric nurses' respect for patients' religious beliefs is considered important for the provision of spiritual care. These psychiatric nurses who provide some degree of spiritual care to their patients therefore recommend that spiritual care be included as part of the psychiatric training curriculum and continuing education if psychiatric nurses are to be successful in providing holistic care to their patients.
Conclusion
34; It will be very helpful if spirituality is included in our patient care and in our training, curriculum that will do much good.” (Transcript 4, lines 974-975).
Introduction
Discussion of the essential experience of spirituality
There is consensus agreement between the research finding and the literature on strategies and interventions that psychiatric nurses use to address the spiritual needs of people with mental illness. Nurses had more difficulty relating to the spiritual needs of patients who were actively psychotic and or aggressive.
Researcher reflexivity and limitations
An exhaustive description is defined by Sanders (2003) as the integration of all the resulting ideas (textural and structural) into a longer description of the phenomenon. All three participants agreed with the exhaustive description and felt that it represented their experiences of spirituality.
Recommendations
- Nursing practice
- Nursing education
- Nursing research
- Nursing policy makers
That an interdisciplinary team consisting of psychiatric nurses with religious knowledge and religious counselors with psychiatric knowledge be formed to increase the level of spiritual care that psychiatric patients receive. This will enable psychiatric nurses to be more grounded and in a better position to provide spiritual care to their patients.
Summary
Furthermore, they showed that spirituality and religion are interrelated in the provision of spiritual care. Finally, the fourth theme, “Holistic Nursing Practice: Educating for Spiritual Care,” revealed the importance of spiritual education to psychiatric nurses' ability to provide spiritual care to their patients.
Conclusion
Journal of Psychosocial Nursing and Mental Health Services Spirituality and Secularization: Nursing and the Sociology of Religion. Psychiatric nurses' perspectives of spirituality and spiritual needs during a merger: Journal of Psychiatric and Mental Health Nursing.
Follow-up probing questions—what, when, who, what, where, and how—may be necessary to clarify aspects of each answer. Please describe your understanding of the relationship or connection, if any, between spirituality and psychiatric nursing.
The results of this study can be used for publications in scientific journals and presentations at scientific meetings. By participating in this study you will help us gain insight into the role of spirituality in the treatment of mental illness.
Spirituality is a part of life, and it is an area that must be accommodated and included in psychiatric client care. There is a connection which is spirituality, but which does not appear at the moment, it is neglected.
34;Exploring how psychiatric nurses' work with psychiatric clients in the eThekwini District understands the spiritual dimension of holistic psychiatric nursing practice". PLEASE NOTE: Research data should be stored securely within the school/department for a period of 5 years.
446 Interviewer: What do you think can be done to integrate spiritual care into the 447 nursing curriculum. 1247 Participant: It is a right for them, according to me; they deserve spiritual care in one way 1248 from the other.
An individual's own spiritual orientation enhances his/her ability to provide spiritual care to psychiatric patients (. Transcript 2, lines 361-362). Institutional policy sometimes restricts psychiatric nurses from providing spiritual care (transcript Psychiatric Care for the Spirit: 7, lines 1452-1453).
Spirituality is unique to everyone and is based on one's faith and values. Spirituality is personal; it is a personal belief, very individual; often based on your personal needs.
