(part 3)
3. Understanding a patient’s spiritual distress:
3.1 The root meaning for ‘distress’ has to do with pressure, strain, . . . . To be distressed, therefore, is to be strained, tense, troubled, oppressed, threatened. ‘Spiritual distress’ has to do with the loss of peace, joy, hope, and resolve individuals experience (to varying degrees) when faced with unsettling life circumstances that threaten to overwhelm their core beliefs and values.
3.2 Responses to respiratory distress may range from ‘observe closely’ to ‘intensive intervention’. You are trained to think in terms of the least invasive/intrusive means (i.e., ‘do no harm’) to resolve a patient’s condition. Your response to an asthmatic patient who is wheezing should be less intensive than your response to an asthmatic patient who is listless. The intervention should match the level of concern/danger. You should have an analogous framework by which to assess a patient’s spiritual needs. Think in terms of a diagram with two paradigms – i.e., ‘spiritually centered’ and ‘spiritually distressed’ – separated by a threshold. Variations of the ‘spiritually centered’ paradigm range from ‘thriving’ to ‘holding’ as you move nearer to the threshold. Variations of the ‘spiritually distressed’ paradigm range from ‘troubled’ to ‘despairing’ as you move away from the threshold. Caregivers cross the threshold when the paradigm or framework that most fully accounts for their observations about a patient shifts from ‘spiritually centered’ to ‘spiritually distressed’.
3.3 Patients who are spiritually centered are capable of participating meaningfully in the decisions about their care and can be counted on to be diligent in fulfilling their responsibilities. Some of these patients may appear to be undisturbed by their condition. They come across as attentive, hopeful, and self-confident. They ask insightful questions, make accurate comments about their condition, and have a sense of humor. Other of these patients may be struggling to maintain their balance and focus. They show signs of being fearful, upset, disoriented, and impatient. As these dispositions strengthen, they are moving toward and may eventually cross the threshold into the ‘spiritually distressed’ paradigm.
3.4 Patients who are spiritually distressed complicate the decision-making process and the management of their care. Some of these patients are troubled for inward as well as circumstantial reasons. They are losing confidence, motivation, hope. They may appear despondent or panicky. They may deny the reality of their situation. Other of these patients are despairing. They are immobilized, depressed, apathetic, fatalistic. Their spiritual distress may surpass in urgency their injury or disease. Professionals with special training for such situations (e.g., social workers, psychologists, chaplains, ethicists, . . .) may need to be grafted into the medical team for these patients.
3.1 The root meaning for ‘distress’ has to do with pressure, strain, . . . . To be distressed, therefore, is to be strained, tense, troubled, oppressed, threatened. ‘Spiritual distress’ has to do with the loss of peace, joy, hope, and resolve individuals experience (to varying degrees) when faced with unsettling life circumstances that threaten to overwhelm their core beliefs and values.
3.2 Responses to respiratory distress may range from ‘observe closely’ to ‘intensive intervention’. You are trained to think in terms of the least invasive/intrusive means (i.e., ‘do no harm’) to resolve a patient’s condition. Your response to an asthmatic patient who is wheezing should be less intensive than your response to an asthmatic patient who is listless. The intervention should match the level of concern/danger. You should have an analogous framework by which to assess a patient’s spiritual needs. Think in terms of a diagram with two paradigms – i.e., ‘spiritually centered’ and ‘spiritually distressed’ – separated by a threshold. Variations of the ‘spiritually centered’ paradigm range from ‘thriving’ to ‘holding’ as you move nearer to the threshold. Variations of the ‘spiritually distressed’ paradigm range from ‘troubled’ to ‘despairing’ as you move away from the threshold. Caregivers cross the threshold when the paradigm or framework that most fully accounts for their observations about a patient shifts from ‘spiritually centered’ to ‘spiritually distressed’.
3.3 Patients who are spiritually centered are capable of participating meaningfully in the decisions about their care and can be counted on to be diligent in fulfilling their responsibilities. Some of these patients may appear to be undisturbed by their condition. They come across as attentive, hopeful, and self-confident. They ask insightful questions, make accurate comments about their condition, and have a sense of humor. Other of these patients may be struggling to maintain their balance and focus. They show signs of being fearful, upset, disoriented, and impatient. As these dispositions strengthen, they are moving toward and may eventually cross the threshold into the ‘spiritually distressed’ paradigm.
3.4 Patients who are spiritually distressed complicate the decision-making process and the management of their care. Some of these patients are troubled for inward as well as circumstantial reasons. They are losing confidence, motivation, hope. They may appear despondent or panicky. They may deny the reality of their situation. Other of these patients are despairing. They are immobilized, depressed, apathetic, fatalistic. Their spiritual distress may surpass in urgency their injury or disease. Professionals with special training for such situations (e.g., social workers, psychologists, chaplains, ethicists, . . .) may need to be grafted into the medical team for these patients.
