Worksheet 9

Assessing Spirituality and Religious Practices

Case Study

Read the following case study. Then, work through the steps of analyzing the case study data.

1. First, identify the abnormal data and strengths in subjective and objective findings,
2. Assemble cue clusters,
3. Draw inferences,
4. Make possible nursing diagnoses,
5. Identify defining characteristics,
6. Confirm or rule out the diagnoses, and
7. Document your conclusions.

Use the table below to collect subjective and objective date provided to guide you. Propose nursing
diagnoses that are specific to the client in the case study. Identify collaborative problems, if any, for this
client. Finally identify data, if any, which point toward a medical problem requiring a referral.

Case Study

A 52-year-old client is in the terminal stage of leukemia. The client has been married for 25 years. He

and his wife have three children, ages 15, 18, and 22. One child is graduating from high school, and the

22 year old is graduating from college. The client and his brother are co-owners of a family hardware

business that has been in the family for 60 years. The client was diagnosed with leukemia 10 years ago

and has been receiving treatments during reoccurrences since then. He has always been optimistic, but,

for the last 2 years, the treatments have not been as successful as in the past. His symptoms have

exacerbated and return shortly after the treatments. The physician has told him that, unfortunately,

further treatments are to no avail. The client is distressed and in denial of the fact that life is short. He

has become depressed because he is concerned about what will happen to his family and his business.

The client does not want to visit family members or friends. He has always been a firm believer in God

and believes that the illness is God’s punishment for wrong deeds. While trying to reassure the client,

the nurse tells him that God does not punish.

Questions:
 a. Based on your understanding of spirituality and religion, what could the nurse have done to
reassure this client?

b. What measures should nurses take to increase their religious and spiritual competency?

NURSING INTERVIEW GUIDE TO COLLECT SUBJECTIVE DATA

QUESTIONS FINDINGS
Biographical Data
Name (use Code Name or Alyas)

Gender

Address, Phone Number

Date and Place of Birth

Nationality or Ethnicity

Marital Status

Religious or Spiritual Practices

Primary and Secondary Languages spoken,

written, and read; Birth Language
Educational Level

Occupation and Working Status

Who lives with the client? Identify significant

others
Caregivers and support people for the client

Questions Findings
Current Symptoms
1. Affect corresponding to attitude?

2. Culturally appropriate eye contact when

describing spiritual beliefs?

3. Expresses sense of hope for future and comfort

from beliefs?

4. Ease with which client divulges information?

1. Perceived stress level?

6. Presence of spiritual conflicts/struggles?

7. Display of religious articles? 8. Desire to

participate in usual religious practices?
8. Desire to participate in usual religious
practices?
Current Status
1. What do you believe has caused your illness?
Do you believe there is a spiritual cause for the
illness?
2. Would you like to be visited by your own
religious figure (pastor, priest, etc.) or someone
from pastoral care?
3. Are there any religious practices that you
would like to continue while in the hospital? (e.g.,
dietary restrictions? Daily prayer rituals?)
4. Do your spiritual beliefs give you a sense of
hope and comfort?
5. Are you aware of any spiritual conflicts at
present?
Past History
1. Has your religion helped you cope in the past?

2. Does your religion encourage you to practice

health promotion activities?
Family History
1. Do you have strong social and spiritual support
systems?

2. What religion does your family follow? Do all

members of your immediate family follow the
same religion?
Lifestyle and Health Practices
1. How often do you attend religious
service/activities?
2. Do you have a strong connection with one or
more religious groups?
3. Do you see any differences between your
beliefs and current health care treatments?
4. Are you motivated to participate in health
promotion activities?
Analysis of Data
1. Formulate nursing diagnoses (health
promotion, risk, and actual).
2. Formulate collaborative problems