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UNIT 14VALUES BELIEF

BY NOMI WAQAS GUL (RN,POST RN BScN)

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OBJECTIVES

• Basic Terms• Concept Clearance• Importance of Pattern• History, examination, risk, Nursing diagnosis– Patient– Family – Community

• Appraisal form

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Terminology• Value is an accepted principle or standard of an

individual or group.e.g Achievement, Friendships, Physical challenge, Advancement and promotion etc

• Belief is something that is accepted as true with an emotional or spiritual sense of certainty (Belief). e.g belief in god, time of Death etc

• Attitude :Represents an individual's degree of like or dislike for an item. Attitudes are generally positive or negative views of a person, place, thing, or event (to act in certain ways)..(depend on values and Beliefs)

• Value conflicts : Arise when people give different priorities to each value. E.g. Promotion Vs Money.

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Terminology..1

• Distress: stress which causes pain, suffering, trouble, danger, etc.

• Sympathy: The ability to feel for the person; you feel sorry for them or pity (forgiveness)them, but you don’t specifically understand what they’re feeling.(E.g. when patient died you feel sorry for them by your action but not started to weep with the attendents) -Action

• Empathy: The ability.. to feel ..what others feel but also to experience that emotion yourself. (Entering into the feeling of someone).(e.g. nurse is weeping along with the attendants when his patient died.)-feelings.

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Terminology…2• Caring : lovingness: a loving feeling• Hope: Belief in a positive outcome related to events and

circumstances in one's life• Autonomy: personal independence• Mutuality : Reciprocal relationship between two or more people

or things, Having the same relationship each to the other• Spirituality :Religious feelings Or a way of living that comes from

a set of meanings, values, and beliefs (e.g Holy Book) that are important to the person. Meanings can focus on purpose in life, hope, and suffering. (E.g. Worship God, offer Pray e.t.c)

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Terminology…3

• Morality: Practice of behavior…Concern with the distinction between good and evil or right and wrong; right or good conduct.

• Faith is an inner knowing about ideas, people, and events.(E.g. strong belief in a supernatural power or powers that control human luck)

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Personal and professional values(Just Separate it….Class Activity)

• Achievement…?, Friendships…?, Physical challenge…?, Advancement and promotion, Growth, Pleasure, Adventure, Having a family, Power and authority, Affection (love and caring), Helping other people, Privacy, Arts, Helping society, Public service, Challenging problems, Honesty, Purity, Independence, Influencing others, Quality relationships, Recognition (respect from others, status), Competence, Religion, Competition, Intellectual status, Reputation, Cooperation, Involvement, Responsibility and accountability, Creativity, Knowledge Self-respect, Leadership, Position, Status, Effectiveness, Meaningful work, Supervising others, Ethical practice, Money, Truth, Work under pressure, Fast living, Personal development, Work with others, Financial gain,Freedom, Working alone ……..

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Value-Belief Pattern

• The value-belief pattern describes important characteristics of individuals, families, and communities that influence health-care delivery. Two are:

1. Ideals and behaviors that are important to the individual, family, or community.

2. Beliefs that guide decisions and provide strength and comfort.

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Why This Pattern Is Important..11. Beliefs and values influence decisions, goals, and actions.

Knowing those related to health may provide reasons the nurse can use to motivate improved disease and health management.

2. Knowing the wishes of a person or person’s family provides information if an ethical issue arises, such as surgery, treatments, or the need to use advance directives.(e.g. laser..)

3. Privacy of medical information is a value held by patients. (Grace, 2004)

4. Studies reveal that nearly two-thirds of Americans say religion is very important in their lives; 19 of 20 people say they believe in God.

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Why This Pattern Is Important..25. Individual practices may differ from book

descriptions due to diversity among and within religions.

6. Many individuals and families use prayer as a coping strategy during illness and crises

7. Spiritual values may be of even greater importance in care when an illness is prolonged, progressive, or life-threatening. (E.g. Cancer)

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Why This Pattern Is Important..38. With no pathophysiology to justify the death,

some people who are hopeless and despairing (spiritual distress) are more likely to die or die sooner than would be expected. (Harkreader and Hogan, 2004, p. 1194).

Without hope, there appears to be no will to live

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Individual Assessment

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Individual Assessment• Values and beliefs, including religious affiliations, can

influence health beliefs. In turn, health beliefs can affect:– Ideas about cause of an illness.– Dietary patterns.– Treatment options.– Postmortem care.

• The focus of individual assessment of this pattern is on:– Important values.– Plans for the future.– Spiritual or religious relationship.– Spiritual support and religious needs.

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Individuals at Risk• Life transitions, such

as maturational transitions and retirement.

• Cultural barrier to practicing religion.

• Terminal illness.(Active and progressive disease which cannot be cured)

• Uncontrolled pain or chronic pain.

• Loss of significant person, pet, job, body part, or bodily function.

• Decisional conflict, such as choice between equally risky alternatives.

• Values conflict.• Lack of social support.• Loneliness.

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HistoryGenerally get things you want out of life? Most important things in your life? If appropriate: Plans for the future?Religion important in your life? If yes: Does this help

when difficulties arise? Will being here interfere with any religious practices?

• As you are concluding the history or following the examination, ask the following:– For the patient who is hospitalized: Things that are

important to you while you are here? Maybe things we did not discuss?

– For the patient at a clinic visit: Things important to you at this visit that we did not discuss?

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Examination

• Notice signs of worship, such as a – rosary, (Taweez)– shawl, (piece of cloth used to cover the head

and shoulders)– Cross…+– Religious pictures

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Diagnostic Categories NANDA ((2007)..1

1. Moral Distress: The inability to carry out one’s chosen ethical or moral decision or action.(e.g. in operation..)

2. Spiritual Distress: Impaired ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, or a power greater than oneself.(e.g. not praying..)

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Diagnostic Categories NANDA ((2007)..2

3. Risk for Spiritual Distress: Presence of risk factors for an impaired ability to experience and integrate meaning and purpose in life through a connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself.(Allah)

4. Readiness (willingness )for Enhanced Spiritual Well-Being: Ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself(Allah).

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Diagnostic Categories NANDA ((2007)..3

5. Impaired Religiosity(mazhabi junoon): Impaired ability to rely on beliefs or participate in rituals (rasmi) of a particular faith (emaan) tradition. e.g. not going in mosque.

6. Risk for Impaired Religiosity: Presence of risk factors for impaired ability to rely on religious beliefs or participate in rituals of a particular faith tradition.

7. Readiness (willingness ) for Enhanced Religiosity: Desire and ability to increase dependence on religious beliefs or participate in rituals of a particular faith community.

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Family Assessment

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Family Assessment• Family assessment focuses on family values and

beliefs that are health related. These include:– Responsibility for passing on to children:– Cultural and moral values.– Spiritual values and beliefs.– Family traditions.– Meaning and value of relationships.– Interconnectedness of family members.– Meaning of family life.– Spiritual values that can give hope and comfort during:– Family maturational transitions or crises.– Physiological or psychological crises.– Situational crises.

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Families at Risk

• Single-parent family without extended family support.• Recent death of a family member.• Drug or alcohol abuse issues.• Poor family and neighborhood role models.• Recent retirement of family member.• Social rejection or alienation (isolation).• Terminally ill family member.• Suffering of family member.• Family member with depression.

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Assessment Items

History• Family generally gets things it wants out of life?• Important things for the future?• Family rules about behavior that everyone believes are

important?• Religion important in family? If yes: Does religion help

when difficulties arise?Examination• Notice signs of worship, such as rosary, shawl, cross, or

religious pictures.

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Community Assessment

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Community Assessment

• Providing spiritual support through parks, flowers, and concerts on the green….?

• Providing opportunities for people to get to know each other and serve as support systems for each other when necessary…?

• Supporting businesses that serve needs and support moral values of the residents…?

• Facilitating the development of churches, synagogues (yahodio ki masjid), temples, and mosques to meet the religious needs of residents.

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Communities at Risk

• Conflict over adult bookstores and lounges.(intizar gaah)

• Lack of concern for community aesthetics, such as flower gardens and clean streets.

• Lack of support for libraries, museums, and other cultural resources.

• Discriminatory practices.• Lack of support for clubs, churches, and other

community organizations.

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Assessment Items

• History (Community Representatives)– Top four things that people living in the community see as

important in their lives? (Note the health-related values and priorities.)

– Community members tend to get involved in causes or local fund-raising campaigns? (Note if any are health-related.)

– Religious groups found within the community? Places to worship available?

– People tend to tolerate differences? Tolerate behaviors not usually well accepted?

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Assessment Items

• Examination– Zoning and conservation laws.– Community government health committee

reports, including goals and priorities.– Health budget relative to total budget.– Parks, museums, and programs for the public.

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REFERENCES

Gorden M.(2008), Nursing Assessment & Diagnostic Reasoning: Assess Notes:A Davis’s Notes Book

Marjory Gordon, PhD, RN, FAANProfessor Emeritus,

Boston College School of Nursing• Multiple electronic esources….