Family Hopes Toward Role Of The Nurses In Fulfilling Spiritual Needs Of

Patients In Intensive Care Unit (ICU)

Nur Halimah1, Azizah Khoiriyati2

The Nursing Science Programme, Faculty of Medicine and Health
Sciences UMY
Email: azizahkhoiriyati@yahoo.com

ABSTRACT
Introduction: Patients were treated in the ICU generally feel fear of threats of
integrity, physical pain, and death. Patients had uncertainty about the
meaning of death so they become vulnerable to spiritual distress. One aspect
of nursing is a matter of spiritual fulfillment. The purpose of this study is to
examine family hopes toward role of nurses in fulfilling spiritual needs of the
patient in the Intensive Care Unit (ICU) room PKU Muhammadiyah Yogyakarta
Hospital. Method: Designs of this study using qualitative descriptive method.
Participants were used in this study are all closest relatives with patients in
the ICU PKU Muhammadiyah Yogyakarta Hospital as many as 5 people.
Determination of informants conducted by purposive sampling. Data were
collected around April-June 2013 through semi-structured interviews.
Analysis of the data using content analysis. Result: The results of the study
consist of 4 themes, i.e. the meaning of the spiritual needs of the patients's
families, nurses as caregivers, nurses as a motivators. Conclusion: Nurses
works in the ICU were expected able to play a role in fulfilling the spiritual
needs of patients and families.

Keywords: the role of nurses, spiritual needs, ICU

INTRODUCTION When physical condition is

One aspect of nursing is a
matter of spiritual fulfillment.
Spiritual needs is the need to
maintain or restore confidence
and fulfill religious obligations and
the need to get a excusatory or
forgiveness, loving, trusting
relationship to the God. Spiritual
needs is the need to find meaning
and purpose of life, the need to
love and be loved, and the need to
give and receive forgiveness
(Kozier, 2004).
disturbed, there is a chance of
someone having a change of
emotion. Spiritual aspects of a
person is very important to cope
with emotional changes. To fulfill
the spiritual needs of individuals
effectively, nurses must know the
beliefs and values of their religion
(Carpenito, 2009). Human as a
spiritual being having a
relationship with forces beyond
himself, relationship with his God,
and having faith in his life. The
belief that one has will influence to
his behavior (Asmadi, 2008).
Spiritual prosperity of the
individual that can affect the
health and self-care behavior is a
source of support to be able to
accept the changes experienced
(Hamid, 2008). A person who is
experiencing pain or loss as a
result of an illness, spiritual
strength can help a person
towards healing (Potter and Perry,
2005). Nursing spiritual is an
element of health care by showing
compassion to the patient to form
trusting relationship, and mutual
trust is enhanced when the care
giver appreciate and support the
spiritual well-being of the patients
(Potter and Perry, 2005).
Nurses as professional
health workers have the greatest
opportunities to provide services,
especially nursing care in a
comprehensive manner to help
fulfill the basic needs holistically.
The nurse looked at patients as
bio-psycho-socio-cultural and
spiritual beings who respond
holistically and unique to changes
in health or in a state of crisis.
Spiritual mentoring role is
one of competence of the nursing
profession (Karina et al, 2012).
Spiritual role that can be run by a
companion in carrying out the
function of spiritual mentoring is
the role of motivator, facilitator
and catalyzer (Indriswari, 2009).
Nurses working to help fulfill the
spiritual needs of the patients as
2 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
part of the overall needs of
patients, such as by facilitating the
spiritual fulfillment of patients,
although the nurse and the
patients do not have the same
spiritual or religious beliefs
(Hamid, 2008).
Results of interviews in
Nursing Department at RS PKU
Muhammadiyah Yogyakarta
showed that one provide spiritual
care to patients in the ICU is a
spiritual community development
officer. The role of the nurse in
spiritual care to the patient is still
very minimal. Results of
interviews showed that the nurse
just remind patients to pray before
meals, most of fulfillment spiritual
needs of the patients in ICU given
by spiritual unit staffs. Based on
the description above, the
researchers want to conduct a
study to determine family hopes
towards the role of nurses in
fulfilling the spiritual needs of the
patients in the ICU at RSU PKU
Muhammadiyah Yogyakarta.
METHOD
Designs in this study using a
qualitative descriptive
phenomenology. Participants were
used in this study are 5 closest
relatives of the patient in the ICU
room PKU Muhammadiyah
Yogyakarta Hospital and 1 nurse
ICU room PKU Muhammadiyah
Yogyakarta Hospital. Data source
in this study was determined by
purposive sampling. Data were
th th
Surabaya, December 6 -8 , 2016
collected in April-June, 2013. Data
analysis used content analysis,
which is making verbatim
transcripts, read the transcript
over and over again, gathering
significant statement, determining
the meaning of any statement
which is important, gather
keywords, group them into
categories and then compiled and
grouped into themes of research
results.
RESULT
This study involved 6
participants consisting of 6
participants who became the
closest person (child/husband) of
the patients treated in the ICU PKU
Muhammadiyah Yogyakarta
Hospital. The average highest
education of the participants were
high school. All the participants
came from the Javanese ethnic.
The results of this study are some
themes:
1. Meaning spiritual needs
Results of
interviews with six
participants showed that
the spiritual needs vary
among patients. The
results of interviews with
participants mentioning
the term spiritual needs
and religiosity were the
same thing. Participants
mentioned that the
spiritual needs was to
motivate, encourage
3 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
patients, corroborating the
notion, notions, pray, give
support, reminiscent of
maghdohworship. This is
supported by the following
data
"Well, spiritual needs is
mean to encouragement to
patients and their families"
(P2)
"spiritual needs reminding
of his worship which is
shalat (Islam praying),
according to the guidance.
as much as possible (P6).
Participants also
mentioned that spiritual
needs is important for
patient's recovery. It is like
the interview below:
"It is important to
accelerate healing" (P3)
2. The role of the nurse as care
provider for patients
According to interviews
with participants stating that
the nurses took the role of
services to patients by
monitoring the patient's
progress, meet the needs of
patients and deliver
information to the patient's
family. In addition, the
participants wanted the
nurse still provide the
requirements needed by the
patient such as, to pray for
the and to serve the patients.
th th
Surabaya, December 6 -8 , 2016
 This is supported by data
from participants as follows:
" As long as i know , they still
monitoring progress in the
ICU, when I asked about
patients condition, they said
patient getting better, If I
asked again about the
bleeding, they check the
patients
immediately..everytime I accompany patients during
asked they
answerfriendly"(P2)
"Though no one (the family)
isseeing patient directly..the
nurses giving attention all the
time ..provide patients
needs..and give the
information to families
outside" (P4)
"Well essentially provide the
information from the doctor
..probably doctor’s time is
limited ..so we usually asked
nurses" (P1)
"Might well continue to
provide. what is patients
needed, the nurse know
better, so must be given.
3. The role of the nurse as a
motivator for patients and
families
Results of interviews with
five participants stated that
motivating more towards to the
practical implementation of
praying during patients treated
4 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
in the ICU. Based on the
information the participants
that the motivation,
encouragement to patients and
support to run in praying
during hospitalization is needed
by the patient. This is supported
by the following data:
... ... As well as to the who
hospitalization also given
motivation and lectures
"(P1)
"I think confidence and
motivation, miss '' (P1)
"Ask for support. the need
to mental support to patient ..
"(P4)
DISCUSSION
1. Meaning spiritual needs
The results of this study
indicate that families and
nursed understand the
significance of spiritual needs
were a psychological and
religious needs. According to
participant, the spiritual needs
is providing the motivation,
confidence, encouragement,
notions, pray, give support,
while according to the spiritual
needs of the nurse is reminded
that prayer andmaghdoh
worship patient relationship
with the human being and
human beingto the God. In
addition, the perception of the
th th
Surabaya, December 6 -8 , 2016
 patient's family to spiritual
needs is important to enhance
the patient's recovery.
This is supported by the
theory of Imamul (2007) which
states that the spiritual needs
together with the spiritual
needs that are psychological,
spiritual needs include worship,
listen to religious lectures, and
listen to the advice or the advice
of noble character. In addition,
supported by theory Dwidiyanti
(2008) which states that the
spiritual dimension is an
amalgamation into a unity
between the elements of a
psychological, physiological or
physical, sociological and
spiritual.
According to research
Yousefi H & Abedi AH., (2011),
the needs of patients who are
being treated in hospitals
include the need for protection,
the need for significant others,
the need for hope, the need for
recognition, need verbal
communication, requires
sympathy and attendance,
requires relationship with God,
requires good conditions for
worship, requires knowledge of
the religious laws, and others
should remain respectful to the
beliefs of the patient.
2. Nurses as a care provider for
patients
The results of this study
indicate that the role of the
5 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
nurse is to provide information,
monitor progress, monitor,
supervise fully meet their
needs. This is supported by the
theory of health sciences (1989)
cit. Mubarak (2009), stated that
the role of the nurse is to
provide nursing care to patients
by meeting the basic needs
related to spiritual patient, the
nurse's role as an advocate in a
way nurses help patients and
families to interpret the
information, the role of nurses
as counseling by means nurses
can provide counseling, the role
of nurses as educators by
providing spiritual education,
the role of nurses as nurse
consultant can be consulted on
spiritual issues.
Dealing with such matters
nurses only exercise its role as
provider of nursing care. Nurses
have not been performing its
role as a consultant, educator,
counselor, and reformer. This is
because the ICU nurses more
focus to the patient so that the
nurses less attention to the
other one of which is the
presence of relatives of patients
who did not get the attention of
the nurses will be spiritual
needs.
The results of this study
show a difference of opinion
between the patient's family
and caregivers associated with
spiritual fulfillment to the
patient, according to
th th
Surabaya, December 6 -8 , 2016
participants absent from the
spiritual realm and nurses who
provide spiritual guidance to
patients by nurses while no
spiritual guidance given by
nurses and spiritual coaching.
According to the nurses in the
ICU, not all nurses involve
family in the fulfillment of
spiritual needs of the patient.
Nurses will involve the family if
the patient's condition
deteriorates. In addition, the
patient's family will be given the
motivation and guidance to
pray for the patient. This is
supported by the following
data:
"So we are not intensively
involve families everytime, only
if patients condition getting
worse. When patient condition
deteriorate, we’ll call patients
families and given the
motivation and guidenace to
pray for the patients .." (Nurse)
"If, for example was patient is
unconsious, he has right to get
pray so we involve spiritual
coaching to pray and whisper if
patient coma, this ia according
to the patient's condition ..."
(nurse)
Research conducted by
Warlianawati (2011) stated that
the patient's perception of the
role of nurses in the spiritual
needs are 53.4% and it is said to
6 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
be insufficient. During the study
at the time of filling the
questionnaire most respondents
answered that nurses rarely ask
patients to pray for patients,
helps to pray, and tell the
spiritual services provided in
the hospital. This contrasts with
research Ariani (2011) which
states that the spiritual needs in
the ICU and intermediate care
PKU Muhammadiyah Hospital is
sufficient, this is indicated by a
percentage of 57.7%.
Researchers assume that there’s
absence of communication
between nurses and families in
fulfilling the spiritual needs of
the patient.
Hamid (2008) stated
that nurses when practice the
principles of nursing care
activities on the spiritual aspect
should communicate or tell the
spiritual services provided in
the hospital to the family. In
addition, according to Kemp,
(1996) spiritual care in a patient
treated mainly Muslim must pay
attention to the times of prayer,
and provides a comfortable
environment for worship and
quiet prayer. A nurse should be
sensitive to the spiritual needs
of the patient.
The role of the nurse as
the service provider should be
able to do some spiritual
intervention to improve the
outcome of patients treated in
the ICU. Some spiritual
th th
Surabaya, December 6 -8 , 2016
 intervention that can be done by
nurses are to pray for the
patient and family, be an active
listener, providing therapeutic
touch and create an
environment of care that
religious nuance (Ennis E.M.,
Kazer M.W, 2013) .
Based on the function of
the nurse as an interdependent
that nurses can collaborate with
other health team (Baldacchino
D.R, 2008). Related to the
spiritual needs of patients
nurses can collaborate with
spiritual coaching to meet the
spiritual needs of the patient
such as guiding pray, pray for
the patient, providing
motivation to the family and the
patient.
3. The role of the nurse as a
motivator for patients and
families
The results also showed
that the family wants the nurses
to provide motivation and
support not only to patients but
also to the family. Based on
these results the family hopes to
nurses to meet the spiritual
needs in prayer and in terms of
giving encouragement to
patients and families have not
been as expected. That is
because a lot of the role of
nurses in the fulfillment of
spiritual needs committed by
clergy hospital. In addition, the
lack of time between the family
7 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
and caregivers to interact so
that there is some information
that is not conveyed by the
patient's family. According to
interviews with nurses, nurse
stated that nurses have offered
prayers to the patient, but it is
not communicated to the
patient's family. The provision
of prayer is devoted to patients
with worsening conditions.
According to Hamid
(2008) which stated that in
times of stress as a result of
illness, individuals will seek the
support of religious beliefs.
According to Ennis E.M., Kazer
M.W, (2013), some spiritual
intervention that can be
provided by nurses includes
providing emotional support,
providing support to the family,
facilitating visits can improve
the development and outcome
of patients.
According to the
research Warlianawati (2011)
stated that nurses sometimes
did encourage patients to try a
sincere and resilient to face the
illness. This is because nurses
have to be motivated patient
expectations and increase
patient's quality of life, but only
a few nurses who do that.
Patients and families will feel
more calm and comfortable as
the nurses provide motivation
to patients and families to be
patient with the disease he
fought, as required by the
th th
Surabaya, December 6 -8 , 2016
 patients and the families are
motivation and support so that
patients can have strength to
face their illness.
When disturbed
physical condition, there’s
possibility of someone having a
change of emotion. Under these
conditions, the spiritual
component of someone very
important to cope with the
emotional changes. To meet the
spiritual needs of individuals
effectively, nurses must know
the beliefs and values espoused
(Carpenito, 2009).
Spiritual support of a nurse is
required by the patient to see
that in the ICU is very closed so
time meeting between the
family and the patient is limited,
so only the nurses who were
diruang ICU every 24 hours. In
addition, the family also wants
the nurses to pray for a patient
even though the patient in a
coma.
CONCLUSION
Based on the results of
this study concluded that family
expectations about the role of
nurses in the ICU there are three
themes, namely the meaning of the
spiritual needs of the patient's
family, the role of nurses as care
providers, as well as the nurse's
role as a motivator for patients
and families.
SUGGESTION
8 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE
“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
For nursing services
should be more comprehensive in
providing services to patients
including the family, especially for
more attention to the spiritual
needs of the patients treated in the
ICU.
For further research needs to be
explored more in depth about the
expectations of patients admitted
to the ICU to spiritual fulfillment.
REFERENCE
Asmadi. (2008). Konsep dasar
keperawatan. Jakarta : EGC.
Carpenito,L.J. (2009). Diagnosa
keperawatan aplikasi pada praktik
klinis edisi 9. Jakarta : EGC.
Baldacchino D.R. (2006) Nursing
Competencis for Spiritual Care:
Jurnal of Clinical Nurising.
Hamid,A.Y. (2008). Asuhan
keperawatan kesehatan jiwa.
Jakarta : EGC.
Potter & perry. (2005). Buku ajar
fundamental keperawatan : konsep,
proses, praktek. Alih
Bahasa, Yasmin Asih. Edisi 4.
Jakarta : EGC.
Karina,dkk. (2012). Peran
pendampingan spiritual terhadap
motivasi kesembuhan pada
pasien lanjut usia.
Diakses 3 November 2012. Dari
cpanel.petra.ac.id/ejourna
l/index.php/stikes/article/viewFil
e/18464/18278
th th
Surabaya, December 6 -8 , 2016
Kozier, Erb, Berman dan Snyder. terhadap pemenuhan
(2010). Fundamental kebutuhan spiritual kepada
Keperawatan. Konsep, Proses & klien di ruang intensife
Praktek, Edisi 7. Jakarta:EGC. care RS PKU
Muhammadiyah
Warlianawati. (2011). Persepsi Yogyakarta. Skripsi.
pasien terhadap peran perawat Yogyakarta.
dalam pemenuhan
kebutuhan spiritual pada Ennis E.M., Kazer M.W. (2013).
pasien penyakit gagal ginjal kronik The Role of Spiritual
di unit hemodialisa RS Nursing Interventions on
PKU Muhammadiyah Improved Outcomes in
Yogyakarta. Skripsi. Yogyakarta. Older Adults With
Dementia. Holistic Nursing
Ariyani. (2011). Hubungan tingkat Practice. 106-113.
pengetahuan perawat Lippincott Williams and
tentang spiritual care Wilkins.

9 INTERNATIONAL NURSING WORKSHOP AND CONFERENCE

“Professional Nursing Practice In Free Trade Era: Threat & Challenge”
th th
Surabaya, December 6 -8 , 2016