RCN member's survey on spirituality & H2CM

Originally published - 10 March 2010
Source: http://www.rcn.org.uk/newsevents/news/article/uk/rcn_seeks_members_views_on_spirituality

The Royal College of Nursing has launched a survey to improve its understanding of nurses’ views on spirituality.

RCN members are invited to submit their thoughts on what they understand by the concepts of spirituality and spiritual care and whether they consider these to be legitimate areas of nursing practice. Specific questions will ask what level of training and support should be given to nurses to deal with spiritual issues.

RCN Executive Director of Nursing and Service Delivery Janet Davies says:

“The RCN is committed to the promotion of holistic care*, but we recognise that spirituality is a complex area. Although understood as an area of human life that applies to all, spirituality can also be subject to taboo and misunderstanding. We are committed to understanding nurses’ views on spirituality and to explore this issue further.”

The results of the survey will shape the RCN’s work in this area and will be presented at a fringe event at RCN Congress in April.

RCN members: Complete the spirituality survey by 31 March 2010.

* My emphasis.

Thoughts from Hodges' model (PJ):

Nurses most definitely need to be aware of and have due regard to care management theory and practice associated with spirituality. That is - how individuals, families, communities (and the State) express belief or non-belief concerning self, others, humanity, their environment, and their relationship with all that is, has been and will be. They need to discern when spiritual matters enter into religious affairs and the customs and rituals that exist ancient and modern. Nurses need to recognise when and where to seek guidance in how to proceed. Legislation, human rights, professional codes of conduct, local and national policies are also critical to a nurse's understanding and attainment of spiritual literacy.

This is an area were confusion can arise over terminology. What is the difference between spirituality, religion and beliefs (mine, yours)? In their training and ongoing careers students need to demonstrate an openness to spirituality in the sense of being neutral with regards to their own beliefs. In specific situations and medical procedures again professional advice may be needed.

Hodges' model is an ideal tool to support nurses in their appreciation of spiritual (and pastoral) aspects of care. The model is ethnoculturally neutral. This neutrality serves as a reservoir of deep respect, rapport and empathy and provides a foundation, a space upon which all spiritual elements of care can be written.

The spiritual is represented in h2cm as a whole.

The model's four care domains collectively represent a 5th domain - the spiritual. Strangely, as per the use of the term in technology circles, the model can be described as 'agnostic'. Not in the religious sense, but due to the fact that h2cm does not demand knowledge of, nor ascribe to any particular spiritual, religious or belief stance.

Transcultural health & Hodges model

Text by Larson et al. (2001) is presented below with a suggested placement of
Bradshaw's (1972) typology of social need on to the four care domains of Hodges' model:

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

Felt need: The needs as perceived by members of the group.	Normative need: The group fails to meet an objective, universalistic standard. Technical definitions of need such as the Australian National Mental Health Standards are examples of normative need.
Expressed need: Through their behaviour, group members have demonstrated a need, often by lengthy queues for services or failure to attend a service.	Comparative need: The group is demonstratively worse off than another group. Comparative need is usually demonstrated through routinely collected statistics, which is problematic for small ethnic groups whose identities are rarely recorded (p.336).

Bradshaw’s framework is still widely used. The important distinction is one between the ‘top-down’, professional-derived definitions of normative and comparative needs, on the one hand, and the felt and expressed needs, interpreted as the ‘bottom-up’ expression of experiences and attitudes, on the other (p.336).

See also Larson et al. discussion of 'thin' and 'thick' needs.

(The fact that this typology can be described in terms of 'top-down' - 'bottom-up' also highlights the socio-technical potential of Hodges' model.)

References:
Bradshaw, J. (1972). The concept of social need. New Society, 19(496), 640–643.
Larson, A., Frkovic, I., van Kooten-Prasad, M., Manderson, L. (2001). Mental Health Needs Assessment in Australia’s Culturally Diverse Society, Transcultural Psychiatry, 33(3), 333-347. Abstract.

The INTRAPERSONAL links page includes Psychology I & II, Mental health, Therapies...

The SOCIOLOGICAL links page includes Patients, Carers, Sociology I & II...