topic 2 spirituality(2)

8/13/2019 Topic 2 Spirituality(2)

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Topic 2: SPIRITUAL THEORIES

3NUR10 RLE 4

TY, Ralph Christian YEPES, Justin Paul ZABAT, Michelle

VITUG, Fria Franchesca YU, Justine Renelee ZAMORA, Hyacinth Elaine

WANG, Yishan YU, Tracy Ezabel ZAPANTA, Patrizia Anne

WONG, Jenina YUMENA, Marc Jusenn ZERRUDO, Ma. Rhea Dell

2.1. Fowler's Stages of Spiritual Development:

Undifferentiated Faith (infancy)

- a "prestage"

- seeds of trust, courage, hope, and love are joined to combat such issues possible

- trust or mistrust to the one providing care is developed

- the future faith of an individual lies on what kind of faith was developed on this stage

- when thought and language developed and begin to influence the child to the use of symbols

in speech and ritual play (concrete operational thinking), the child moves on to the next stage

-reality is not well-differentiated from fantasy

o the infant begins to grasp that objects continue exist outside of his or her immediate

awareness

o "pre-images are largely formed prior to language, prior to concepts and coincident

with the emergence of consciousness

o adults preaching about the negative aspects of religion - the devil and the evils of sin

- can cause great harm to a child of this age, leading him toward a very rigid, brittle

and authoritarian personality as an adult

- has particular relevance for the maternal-infant nurse concerned with issues of parental-infant

bonding

-"the quality of mutuality and the strength of trust, autonomy, hope and courage (or theiropposites) developed in this phase underlie (or threaten to undermine) all that comes later in

faith development"

Intuitive - Projective Faith (3-7 years old)

- The fantasy-filled, imitative phase in which the child can be powerfully and permanently

influenced by examples, moods, actions and stories of the visible faith of primarily related

adults.

- The gift or emergent strength of this stage is the birth of imagination, the ability to unify and

grasp the experience-world in powerful images and as presented in stories that register thechild's intuitive understandings and feelings toward the ultimate conditions of existence.

- The dangers in this stage arise from the possible "possession" of the child's imagination by

unrestrained images of terror and destructiveness, or from the witting or unwitting

exploitation of her or his imagination in the reinforcement of taboos and moral or doctrinal

expectations.

- The main factor precipitating transition to the next stage is the emergence of concrete

operational thinking.


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- Affectively, the resolution of Oedipal issues or their submersion in latency are important

accompanying factors.

- At the heart of the transition is the child's growing concern to know how things are and to

clarify for him- or herself the bases of distinctions between what is real and what only seems

to be

Mythic-Literal faith (7-12 years old)

- Is the stage in which the person begins to take on for him- or herself the stories, beliefs and

observances that symbolize belonging to his or her community.

- The rise of concrete operations leads to the curbing and ordering of the previous stage's

imaginative composing of the world.

- They can be affected deeply and powerfully by symbolic and dramatic materials and can

describe in endlessly detailed narrative what has occurred. They do not, however, step back

from the flow of stories to formulate reflective, conceptual meanings. For this stage the

meaning is both carried and "trapped" in the narrative.- The new capacity or strength in this stage is the rise of narrative and the emergence of story,

drama and myth as ways of finding and giving coherence to experience.

- This is the faith stage of the school child (though we sometimes find the structures dominant

in adolescents and in adults).

- Marked by increased accuracy in taking the perspective of other persons, those in Stage 2

compose a world based on reciprocal fairness and an imminent justice based on reciprocity.

- The actors in their cosmic stories are anthropomorphic.

- They can be affected deeply and powerfully by symbolic and dramatic materials and can

describe in endlessly detailed narrative what has occurred.

-

They do not, however, step back from the flow of stories to formulate reflective, conceptualmeanings. For this stage the meaning is both carried and "trapped" in the narrative

- The new capacity or strength in this stage is the rise of narrative and the emergence of story,

drama and myth as ways of finding and giving coherence to experience.

- The limitations of literalness and an excessive reliance upon reciprocity as a principle for

constructing an ultimate environment can result either in an over controlling, stilted

perfectionism or "works righteousness" or in their opposite, an abasing sense of badness

embraced because of mistreatment, neglect or the apparent disfavor of significant others

Synthetic-Conventional Faith(13-20 years old; middle adolescence)

- Differences in outlook are seen as differences in people

- Authority is vested in established leaders; a person can accept external authority without

question

- A conformist stage -individuals tend to have conformist acceptance of a belief with little

self-reflection on examination of these beliefs, very sensitive to other people's expectations


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- Has increased ability for abstract and hypothetical thinking makes people at this stage enables

them to form hypothetical views of how others see them, and understand that others also

envision how they can be seen by other people.

- Dependence upon significant others for confirmation and clarity about their identity and

meaning to them

-Beliefs and values are deeply felt, even though the people in this stage may not be sure why

they hold them.

- A behavior of a human leader may cast doubt on their credibility as moral authority.

- "the experience of leaving home" - transitory to the next stage; precipitates examination of

self, background, and life-guiding values.

Individuating-Reflective Faith(21-30 years old; mid-twenties to late thirties)

- The individual takes personal responsibility for his or her beliefs and feelings

- Executive ego- the person is more able to govern himself without the need for rules from the

outside.- The person may put excess confidence in the rational, conscious mind

- One begins to critically examine own beliefs and often become disillusioned with former

faith.

- This stage ends up being very non-religious and some people stay in it permanently

- This stage is marked by a double development. The self, previously sustained in its identity

and faith compositions by an interpersonal circle of significant others, now claims an identity

no longer defined by the composite of one's roles or meanings to others. To sustain that new

identity it composes a meaning frame conscious of its own boundaries and inner connections

and aware of itself as a "world view."

- This is a "demythologizing" stage. It is likely to attend minimally to unconscious factorsinfluencing its judgments and behavior.

- Loss or demytholization of the symbols can result in grief and guilt in some cases, and the

process can take up to seven years to complete. But in the place of the literal symbol, the

person gains the ability to make comparisons and whatever meanings they retain are

explicitly held and thus more authentic in that they are personal.

- The strengths of this stage lie in the capacity for critical reflection and the willingness to

face truths that may cause distancing from comfortable thought patterns.

- The weakness of this stage is that the person may put excess confidence in the rational,

conscious mind, thus ignoring unconscious forces that become more prominent in the next

stage.


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Paradoxical-Consolidative Faith (31-40 years old; A.K.A. conjunctive)

- time of opening to the voices of one's "deeper self" and the development of one's social

conscience. Nurses caring for patients in this faith stage must be sensitive to the adults more

mature spirituality, especially in relation to finding meaning in his or her illness.

-In this stage, one begins to realize that the clear boundaries of identity and worldview

constructed in Stage four overlook much of life's complexity in an effort to adapt successfully

to reality.

- Here, Fowler says the firm boundaries of the previous stage begin to become porous and

permeable

- After first calling it "paradoxical-consolidative faith," Fowler decided to use this single word,

CONJUNCTIVE, which of course implies a "joining together" -- in this case a conjoining of

all those elements into that unique combination that constitutes this or that individual person.

Accordingly, in his later book, Fowler describes this conjunctive faith:

o " ... the stage of faith that emerges with mid-life or beyond involves the integration of

elements in ourselves, in society, and in our experience of ultimate reality that havethe character of apparent contradictions, polarities, or at least paradoxical elements.

(Fowler, 1984 p. 64)

- In describing people of conjunctive faith, Fowler has, stated that these individuals are not

likely to be `true-believers, in the sense of an undialectical, single-minded, uncritical

devotion to a cause or ideology.......such people know that the line between the righteous and

the sinners goes through the heart of each of us and our communities, rather than between us

and them (Fowler:1984; p67).

- involves the integration into self and outlook of much that was suppressed or unrecognized in

the interest of Stage 4's self-certainty and conscious cognitive and affective adaptation to

reality.- People at this stage recognize the validity of others beliefs yet clearly internalize their own.

o Their own faith is clearly and consciously held together with the recognition that all

truth is Gods truth.

- A person at this stage goes beyond the clearly defined theological formulas and continues to

probe deeper, higher and broader to discover more of Gods revelation.

o They live in the tension of having accepted clearly defined truth for oneself and yet

recognizing that one has glimpsed only a small part of the ocean of Gods truth.

o There is more to be known of God than the creeds and church can teach us. We are

responsible to search more to know the God of our own faith.

- This stage is about embracing paradox and truly believing that not all things can be resolved

intellectually.

- You learn to live in the questions rather than demand answers for everything.

Universalizing Faith(40 years and above)

- a culmination of the work of all of the previous faith stage

- a time of relating to the imperatives of absolute love and justicetoward all humankind


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- Nurses need to be aware that patients may vary significantly in terms of degree of

accomplishing the imperatives of this final stage.

- Assessing approximately where the nature adult patient is, related to such faith, will help in

understanding both the patients response to an illness condition and his or her need for

external support in coping with the crisis.

2.2 Westerhoffs Four Stages of Faith

Experienced Faith

- Occurs during pre-school & early childhood

- Children observe love and faith in their interaction with adults and react to what

- they experience

- At this stage, they are too young to consciously think about faith, but they demonstrate

unwavering faith.

-at this stage are to experience trust, love, and acceptance. Little children need a few trustedand loving adults in their lives. (Example: Sometimes pets provide the love and acceptance

adults are too busy to give)

- This is what we do. This is how we act.

- It is a time of imitation (ex: a child prays the Lords Prayer without understanding the

meaning of all the words)

- First to developed in young children by observing, exploring, trusting parents

- grows by participating in the customs and rituals of our faith tradition with other Christians

- It is the lifelong foundation of our faith

- also the faith of our senses

-Young children do not fully understand the meaning behind the rituals

- by participating in them they come to believe they are meaningful and important

- The rituals point to the experience and love of God

- When children experience warm and loving feelings in church, they are more likely to value

church and, most importantly, associate God and church with love and warmth

Affiliative Faith

- Ages 7 to 11

- Child goes through the motions of the faith without fully understanding but does them

because it makes them feel like they belong

- Child develops a sense of we and wants to be a part of religious expression of their faith

through the symbols and rituals of their religions

- Known as the religion of the heart

- As one person gradually displays the beliefs, values, and practices of ones family, group, or

church, there is another ring formed

- The individual takes on the characteristics of the nurturing persons and becomes identified as

an accepted partner, one who is part of the faith tradition


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- Such participation may be formalized as in membership, a rite of baptism or confirmation, or

may simply be understood, as might be the case with regular participants who do not join a

church

- This phase of a person's growth is recognized as a time of testing

- It is a matching of the person with peer expectations. Where traditions, values, and practices

are similar, there usually is a good match and the individual merges his or her identity with

that of the body

- There is little room for personal differences dud to a strong emphasis on unity and conformity

in belief and practice

- The concerns for belonging, for security, and for a sense of power (and identity) that come

from group membership are the key drives in forming one's faith concept during this period

- This level of faith is expressed, at the earliest, during adolescent years

- Examples: child singing loudly at mass to be part of a group, child signing him/herself during

Gospel reading, Child reading along in the prayer book because it makes them feel big

Searching Faith

- Occurs at adolescence

- Is this what I believe?

- individual begins to question and doubt some aspect of their faith or religion

- marks the beginning/transition from believing in the faith of others to making faith their

own/personal

- experimentation may be part of searching faith: exploring other religious communities,

resisting common practices of roots of your faith

- assesses personal life experience against faith precepts learned through experienced and

affiliative faith development- a time of asking questionsnot blindly accepting what others have said

- adding the head to the heart of the earlier states

- Faith nurturers often have difficulties with people in this stage. Often they feel a loss of faith

for the individual. This fear is rooted in love and their desire to pass on their faith which the

nurturers consider important

- Examples: not wanting to go to Church, beginning to question about other faiths or become

intrigued with other faith expressions

Owned Faith

- Occurs at early adulthood

- This is what I believe

- Comes through the searching stage

- The strong, personal faith that one witnesses to and one is willing to die for

- Because of the serious struggle with doubt that precedes it, owned faith may appear as a great

illumination or enlightenment because of the serious struggle with doubts that precedes it

- It's now our own faith and no longer merely the faith of our parents, family, etc


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- has developed a firm set of convictions, values, and actions that direct and motivate his/her

life

- faith becomes a part of the person and impacts the decisions, choices, and actions of the

individual

- person is sure about his/her faith

-often entrace into this stage is called conversion - marks a new way of thinking, living, and

acting

- a person with newly owned faith knows that something has occurred that has made a life-

changing difference

- note: a person may have life experiences that could cause a stepping back to searching faith

for a further refining. some people never get to this stage

- amidst doubts and questions, those that remain in their own faith want to witness it by

personal and social action, and are willing and able to stand up for what they believe in as

mature disciples of Jesus Christ

- It is God's intention for everyone

-Importance of churches to provide opportunities that address the needs in each and everystage of faith development to reach their full faith potential

- Examples: commitment, making ones own faith a statement. I will go to church with my

own freewill, body, mind and spirit.

2.3 Spirituality in Nursing Theory

THEORY OF NURSING AND SPIRI TUAL I TY: JEAN WATSON

Central theme: - Human Science & Care

-Transpersonal Nursing Theory

Nursing Paradigms

Human being

- a valued person in and of him or herself to be cared for, respected, nurtured, understood and

assisted; in general a philosophical view of a person as a fully functional integrated self. He,

human is viewed as greater than and different from, the sum of his or her parts.

Health

- a high level of overall physical, mental and social functioning

- a general adaptive-maintenance level of daily functioning

- the absence of illness (or the presence of efforts that leads its absence)

Environment/society

- Caring (and nursing) has existed in every society.

- A caring attitude is not transmitted from generation to generation.

- It is transmitted by the culture of the profession as a unique way of coping


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with its environment.

Nursing

- Nursing is concerned with promoting health, preventing illness, caring for the sick and restoring

health.

-a human science of persons and human health-illness experiences that are mediated by

professional, personal, scientific, esthetic and ethical human transactions.

Transpersonal Caring Relationship

- human to human connectedness occurring in a nurse-patient encounter

- entails first and foremost a belief in the value and dignity of each human being

10 Carative Factors

1. Formation of a humanistic- altruistic system of values

2. Installation of faith-hope

3. Cultivation of sensitivity to ones self and to others4. Development of a helping-trust relationship

5. Promotion and acceptance of the expression of positive and negative feelings

6. Systematic use of the scientific problem-solving method for decision making

7. Promotion of interpersonal teaching-learning

8. Provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual

environment

9. Assistance with the gratification of human needs

10. Allowance for existential-phenomenological forces

HEALTH AS EXPANDI NG CONSCIOUSNESS THEORY: MARGARET NEWMAN

- The theory stems from Martha Rogers Theory of Unitary Human beings

- Includes the health of all persons regardless of the presence or absence of disease

- Asserts that every person in every situation, no matter how disordered and hopeless it may

seem, is part of the universal process of expanding consciousness a process of becoming

more of oneself, of finding greater meaning in life, and of reaching new dimensions of

connectedness with other people and the world

- Nurses practicing within this perspective experience joy of practicing in the expanding

process of others and find that their own lives are enhanced and transformed.

Nursing Paradigms

Health

- Health and illness are synthesized as health - the fusion on one state of being (disease) with

its opposite (non-disease) results in what can be regarded as health.

Nursing


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- Nursing is caring in the human health experience.

- Nursing is seen as apartnership between the nurse and client, with both grow in the sense of

higher levels of consciousness

Human

- The human is unitary, that is cannot be divided into parts, and is inseparable from the larger

unitary field

- Persons as individuals, and human beings as a species are identified by their patterns of

consciousness

- The person does not possess consciousness-the person is consciousness.

- Persons are centers of consciousnesswithin an overall pattern of expanding

consciousness

Environment

- Environment is described as a universe of open systems

HUMAN-TO-HUMAN RELATI ONSHI P: JOYCE TRAVELBEE

Central focus:the concept of finding meaning in an illness experience

: human-to-human relationship

Nursing Paradigms

Person

- unique, irreplaceable individual who is in a continuous process of becoming, evolving, and

changing

Health- includes the individuals perception of health and the absence of disease

Nursing

- critical work of psychiatric nursing is to help people develop a sense of self through a healing

interpersonal relationship

- Instrument for the delivery of interpersonal nursing is the therapeutic use of self

o ability to use ones personality consciously and in full awareness in an attempt to

establish relatedness and to structure nursing interventions

Nurses Role

- assisting the ill patient to experience hope as a means of coping with illness and suffering; assist

individuals and families to not just cope with illness and suffering but to find meaning in these

experiences

Illness

- spiritual, emotional, and physical experience that might be defined both subjectively and

objectively


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- "the spiritual values a person holds will determine to a great extent his perception of illness"

- one's definition of illness and suffering depended very much on the "symbolic meaning attached

to these concepts by the individual"

- "a person's attitude towards suffering ultimately determines how effectively he copes with illness"

MODELS OF PARSE (1981) AND PATERSON AND ZDERAD (1976)

- indirectly address the concept of the patient's spiritual nature in terms of phenomenological

and humanistic approaches

- Parse accepted the transcendent nature of humanity

- Nursing is unfolding in simultaneous mutual interchange with the world transcending with

greater diversity and complexity

- Paterson and Zderad viewed the human person as an incarnate being, always becoming, in

relation with men and things in a world of time and space. Humanistic nursing embraces

more than a benevolent technically competent subject-object one-way relationship guided by

a nurse in behalf of another. Rather it dictates that nursing is a responsible searching,transactional relationship whose meaning fullness demands conceptualization founded on a

nurse's existential awareness of self and of the other

5 phases:

1. Preparation of the nurse to know whats coming

Understanding own viewpoint/angle helps to make sense and aid in acquiring meaning of

experience

By identifying own views they can be withheld, so that they do not interfere with onesattempts to describe the experiences of another

Being open to new and different ideas/understandings is a necessary position in being able to

get to know the other intuitively

2. Nurse knowing the other intuitively

Moving back and forth between the impressions the nurse becomes aware of herself and the

recollected real experience of the other

Dialogue back and forth between patient and nurse allows for clearer understanding further

generalization in developing process

3. Nurse knowing the other scientifically

Implies need for objectivity in coming to know the other scientifically

Reflective practice validates patterns and themes

This is the time when the nurse mulls over, analyses, sorts out, compares, contrasts, relates,

interprets, gives names to and categorizes

4. Nurse complimentarily synthesizing known others


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The ability of the nurse to develop or see themselves as a source of knowledge, to continually

develop the nursing community through education, and increased understanding of their

owned learned experiences

5. Succession with the nurse from the many to the paradoxical one

Nurse comes up with a conception or abstraction that is inclusive of and beyond the

multiplicities and contradictions

Process that allows for reflection, correction and expansion of own angular interpretation

Implies universal understanding from the simplest to most complex dialogue and interactions

between the nurse and assimilates patient experiences

No member of this interaction or experience is the same as before

Coming together of patient and nurse

ADAPTATI ON MODEL : SISTER CALLI STA ROY

Central Theme: person in constant interaction with the changing environment

Nursing Paradigms

Health

- State of process of being of being or becoming an integrated and whole person

Person

- Human as an adaptive system

- Conceptualizes human in a holistic perspective

-

As living system, persons are in constant interaction with their environment

Nursing

- Theoretical system of knowledge that prescribes a process of analysis and actions related to the

care of the ill or potentially ill persons

Environment

- All conditions, circumstances, and influences affect the development and behavior of humans as

adaptive system

4 Adaptive Models

- Self-concept-Group Identity Mode (one of the Four Models of Adaptation) focuses on

psychological and spiritual integrity and sense of unity, meaning, and purposefulness in the

universe.

1. Physiological-physical mode

i. Physical responses and interactions with the environment

ii. Physiologic integrity


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2. Self-concept-group identity mode

i. Relates to the basic need for psychic and spiritual integrity or a need to know self with a

sense of unity

ii. Self-concept

i. Central to persons behavior

ii.

Consists of a persons beliefs or feelings about himself at any given time

3. Role function mode

i. Ste of expectations of how a person in a particular position will behave

ii. The need underlying this mode is social integrity

4. Interdependence

i. Underlying need is relational integrity or security in nurturing relationship

ii. Focuses on the giving and receiving love, respect, and value with significant others and

support system

Other Concept:

- Persons have mutual relationships with the world and God

-Human meaning is rooted in the omega point convergence of the universe.

- God is intimately revealed in the diversity of creation and is the common destiny of creation.

- Persons use human creative abilities of awareness, enlightenment, and faith.

- Persons are accountable for the processes of deriving, sustaining and transforming the

universe (Roy & Andrew, 1999, p. 35).


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