Spiritual Need Assessment

Spirituality plays a vital role in every person’s life, especially during times of sickness. Spirituality is very personal. Peoples’ faith and religious beliefs aid them in handling stressful situations. Some of the positive impacts of spirituality are better coping skills, reduced anxiety, and the alleviation of the fear of death, and the promotion of relaxation and health. Adequate knowledge of spiritual diversity, the availability of trained Chaplains, and educated, trained nurses are essential to provide holistic care to the patient during their critical time.

Spiritual assessment will help the health care providers to better support the patient; determine the patient’s spiritual needs and their hopes. ‘HOPE’ assessment tools will help the care providers to identify and collect the information regarding patients’ spiritual needs (Anandarajah,G. & Hight, E. 2001). ‘H’ stands for source of hope, ‘O’ stands for religious organization ,’P’ stands for personal practice and spirituality and ‘E’ stands for effect on health care and end of life needs.

This paper is going to describe the spiritual assessment of Mrs. Jordan who is critically ill and suffering end stage breast cancer. A questionnaire was prepared for the purpose of spiritual assessment, based on the guidelines of the joint commission and a brief summary of the spiritual assessment of Mrs. Jordan is included.

Spiritual Assessment Questions based on the ‘HOPE’ Assessment Tool

  1. Would you like to receive spiritual support at this time, and how do you experience comfort and strength during this time? Mrs. Jordan states that she would like to see a Catholic priest in order to confess and receive Holly Mass.

    She explained the real joy of Holy Mass, enabled her to experience peace and hope throughout her life. According to her these two religious elements express God’s Love for the human race. God sent His son Jesus Christ to save human beings from their sin. She also states that she believes in Jesus Christ and His healing power in her personal life.

  2. Do you wish to share your specific spiritual preference? Mrs. Jordan is a Christian Catholic. She believes in the Virgin Mary and all the Saints. She would like to receive the “Sacrament of the Sick” during this critical time of her life.
  3. What is your spiritual practice and how does it help you? At first Mrs. Jordan appears very emotional, later on in the conversation she feels more comfortable and relaxed. She emphasized the importance of family prayer, reading the Holy Bible and praying with a Rosary and their positive effects on family life .She states that Bible reading provides real comfort and hope in her life. She feels more able to handle this difficult situation. She mentioned two Bible chapters, Psalm: 23 and Psalm: 51. She relates that she is so happy in her life just because both of her boys are in good faith and active members of the church. She believes that a strong spiritual base will help her husband and boys to support her physically, emotionally and spiritually. She is resigned to her suffering, because she explains that “my God is a Loving God’, He was crucified years ago for my sins. This belief gives new meaning to her life. 4) Do you think your spiritual beliefs give meaning to your life? Yes, Mrs. Jordan replied. She states that she was born into a Catholic family and practiced the religion since birth. Her beliefs provide strength, a sense of peace and meaning to her life. She is so proud that her children; possess a strong base of faith that motivates her to look forward. 5) What is your belief about end of life or dying?

She believes in eternal life and the concept of heaven and hell. Being a catholic, she also believes in the concept of purgatory, the place of temporary punishment for sins. Death is the concept of sleep in Christ and the resurrection of the soul. On the day of final judgment all the people will be judged according to their actions. The righteous people will receive eternal life and the wicked will receive eternal death The concept of spirituality is very personal and each experience is very individual. People with terminal illnesses such as cancer; receive spiritual care as an integral part of their health care. Cancer patients are most in need of spiritual assessment, diagnosis, interventions and solutions to end of life issues. The spiritual assessment enables Mrs. Jordan to open her mind and
express her philosophy of life. Even though she was so sick, the assessment helped to promote comfort from a religious standpoint. She reveals that prayer, confession, and Holy Mass are the light in her life. Praying with a Rosary and Bible reading helps her to cope with the stressful situations during the terminal stages of her life. The ‘Sacrament of the sick’ anointed her and provides Holy peace and relaxation.

She was so thankful to God that her family was so supportive as they are very spiritual too. Family support and religious measures enable her to relax and improve her health mentally, physically and spiritually. She realizes that she is terminally sick and will die at any time, but her faith in God and the concept of resurrection alleviate her fears and worries. A few times Mrs. Jordan appeared emotional, but the conversation regarding her faith and religious concepts makes her very interested in explaining her religious practices and rites. Her culture and religion help her to make trusting relationships with the nurses and opens her mind to various aspects of religion and the end of life. She seems very comfortable and copes well with her situation. Open ended questions reduce her frustrations and reveal the concepts behind her religious beliefs. Moreover she knew that the priest would visit her and she would be able receive Holy Mass and the Sacrament of the sick, the two healing pearls in the end stages of her life. The assessment showed that she possesses strong spiritual beliefs, to overcome critical situations. To pursue the concept of ultimate holistic care, the patient needs to be physically, mentally and spiritually well. Future assessments need to focus on overcoming the barriers which limit patients in meeting their spiritual needs and experiencing peace in their life. There are some barriers which inhibit the ability to complete and reassess spiritual needs. Lack of proper timing, inadequately trained staff, and uncomfortable situations are a few of them. A patient’s permission is also needed for an assessment.. Increased nurse patient ratios, excessive workloads, and uncontrolled pain are some other factors that interfere with an assessment. Adequate staffing, management support, and the provision of adequate rest and pain control measures will help nurses overcome the barriers. A multidisciplinary approach and proper education and training of providers to promote spiritual and cultural diversity are essential in order to provide effective spiritual care to the patients. Conclusion

Religious beliefs and practices are more focused on the sacred, but spirituality gives more focus on the self (Rumbold, 2003). Regardless of their spiritual beliefs, health care providers need to respect the patient’s faith and religion. The duty of the nursing profession is to lead the way for the patients during their critical situations. Proper spiritual assessment and understanding of patients beliefs will help to fulfill the concept of holistic nursing care for the patients. Listening to the patients concerns, fears and their spiritual concepts will enable the patient to feel free to share their ideas during spiritual assessment. Spiritual care alleviates anxiety and stress and promotes healing and quality of life.

Oneself: The experience of spirituality in one’s life is very personal .In my life I will get palpitation just before either I get sick, or any of my family member get sick. Really this is an insight in my life to pray more. I’m a Catholic , so I will do Rosary, pray more and more ,stay in my room and pray loud, sometimes I will cry and do Merciful Rosary .Also I will sing devotional songs and read Bible especially Psalm :51. After all I will feel more comfortable not only in my mind but also overall well being. From my personal experience I can say that spirituality either prevent sickness or help me to cope with it and relax myself.

Ones: Patients- Whatever situation patients need freedom to practice their spirituality.. Spirituality is very critical in every body’s life. Therefore nurses needs to assess their spiritual needs and offer interventions to achieve their needs. I personally believes that spiritual interventions will help the patients to feel the sense of meaning in their life, promote healing and quality of life. If the patient more attached to their religion their recovery may be fast. They will be more optimistic and hopeful in their life that will help them to fight depression and certain disease conditions. There fore I believe that nurses needs to provide spiritual care either listening their needs and concerns, or send a referral to the pastors or Chaplains. Allow them to keep their religious things in the room, such as religious books or pictures of their God. Provide them quite environment to practice their religion.

The patient’s family: Spirituality helps the people to find meaning in their life guide them. Family is an integral part in every individual’s life. When families face stressful situations such as critical illness, or cancer , the religious beliefs and practices help them to fight that situations and get the sense of feeling of hope ,restore meaning and order to life situations and promote sense of control and well being. Allow them to practice their spiritual rituals in that stressful situation in their life. Allow their own pastoral service can visit the patient and family. Provide resources such as nearby church or temples to worship. Also stay with the family and allow them to verbalize their spiritual concerns and satisfy them.

Ones Colleagues: Ultimate aim of nursing is to provide holistic care to our patients. We are doing team work. Therefore we need to know our colleagues spiritual needs and help them to satisfy their needs. Everybody needs to respect each others religion and make sure their needs are took care .Good spiritual spirit is essential to open the healing environment and provide Radical Loving Care to the patient. Everybody needs to respect each others spiritual holidays and encourage them to practice their religion.

Health is connected not only to a single person but also to the society and the environment. Physical, spiritual, emotional, intellectual and environmental health equally important to be healthy. Coping with daily life’s problems created by a mental illness can be very stressful for everyone involved. Crisis and emergency situations are often overwhelming. It is very important to know the cause of crisis in our life .Always we need to prepare our mind to accept the situation and be positive and be flexible. Spirituality and religion plays a major role in every body’s life to cope with the crisis .Prayer, meditation, confession, worship, devotional songs and yoga are all helpful. In my personal life religion plays big role to calm be down. During the time of personal or health crisis, I would like quiet place and be calm. I like to share myself with someone, who I really trust, most of the time my parents other wise to my religious priest. My parents are not only my parents, but also they are my friends too. I have the strong belief that if my parents ‘pray’ for me in my crisis, physical, mental or spiritual, I will be relieved and will get strength to face the situation. Next step is I will try to deviate myself from that situation .I will be more engaged in other works. In a patient nurse situation we need to give much importance to spirituality and assess their needs and provide interventions. The creation of own spiritual environment help to make healing environment and patient feel comfortable. That will promote health and solve the problems and fulfill the concept of compassionate, Radical
loving care.


Anandarajah, G. & Hight, E. (2001). Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment

The Joint Commission (2012). The Joint Commission Standards FAQ Details- Spiritual Assessment.

Rumbold, B. (2003). Caring for the spirit: Lessons from working with the dying. Medical Journal of Australia, 179(6, Suppl.), S11–S13.

Skalla,K.A. & McCoy, J.P. Spiritual Assessment of Patients With Cancer: The Moral Authority, Vocational, Aesthetic, Social, and Transcendent Model, Oncology Nursing Forum VOL 33, NO 4, 2006,

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