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O bem-estar espiritual é um foco de atenção dos enfermeiros e uma necessidade em cuidados de enfermagem, com particular relevância nos processos de transição de saúde /doença aguda e cronica e durante a hospitalização.
Com base no modelo de bem-estar espiritual na doença de Elizabeth O‟Brien desenvolveu-se um estudo quantitativo, descritivo e correlacional, de abordagem transversal, que permitiu avaliar o nível de bem-estar espiritual da pessoa doente hospitalizada e analisar a associação das variáveis sociodemográficas, clínicas e de perceção do estado de saúde sobre o bem-estar espiritual.
Participaram no estudo 705 pessoas hospitalizadas com doença aguda e crónica. A recolha de dados foi realizada em três instituições de saúde da zona norte de Portugal. Como instrumentos de recolha de dados, foram utilizados um questionário de caracterização sociodemográfica e clinica,escala de confusão de Neecham, a Spiritual Assessment Scale e o Questionário de Estado de Saúde (SF-36v2).
Os resultados obtidos evidenciaram um nível de bem-estar espiritual e fé pessoal com sentido positivo moderado alto, e a paz espiritual e a prática religiosa revelaram valores moderados.
As variáveis sexo, idade, escolaridade e professar uma religião, demonstraram estar associadas a diferenças significativas na perceção de bem-estar espiritual, com resultados superiores para o sexo feminino, para os mais idosos, com um nível de escolaridade baixo e professar uma religião. É de realçar que os níveis globais de bem-estar espiritual aumentaram com a idade dos participantes. A maioria referiu que professava uma religião, sendo a mais apontada a religião católica apostólica romana. Professar uma religião demonstrou estar associada a um nível superior de bem-estar espiritual, fé pessoal e prática religiosa, com exceção para a subescala paz espiritual.
Os resultados obtidos da perceção do estado de saúde indicaram que as variáveis sexo, idade, escolaridade, situação laboral, coabitação, residência e proveniência, estiveram associadas a diferenças significativas, com resultados superiores para o sexo masculino, para os mais jovens, com nível de escolaridade superior, ativos profissionalmente e de proveniência urbana. Não foi possível relacionar o estado civil com a perceção do estado de saúde, contudo, os participantes que viviam integrados numa família nuclear evidenciaram perceção do estado de saúde superior.
A componente mental do SF-36v2 (vitalidade, função social, desempenho emocional e saúde mental) apresentou valores de média de ordem superiores em comparação com a componente física.
Pela análise bivariada, verificou-se uma associação significativa positiva entre fé pessoal e saúde geral e uma associação significativa com sentido negativo entre a prática religiosa, a vitalidade e o desenvolvimento emocional. A paz espiritual manifestou um padrão superior de associações com as dimensões de SF36v2 e o bem-estar espiritual apresentou uma associação significativa positiva com a saúde geral.
Com a regressão linear múltipla, obteve-se um modelo que explica 21,20% da variação média da variável bem-estar espiritual. O conjunto de variáveis que integrou o modelo está relacionado com aspetos sociodemográficos (sexo, idade e professar uma religião), clínicos (presença de sintomatologia) e do estado de saúde (saúde geral do SF-36v2). As variáveis que apresentaram maior valor preditivo em sentido decrescente, foram: professar uma religião, saúde geral, sexo, idade e presença de sintomatologia.
Relacionados com as alterações da integridade espiritual, foram identificados os seguintes diagnósticos de enfermagem: dor espiritual; alienação espiritual; ansiedade espiritual; culpa espiritual; raiva espiritual; perda espiritual e desespero espiritual.
Consideramos que a realização deste trabalho permitiu refletir sobre diversos aspetos relacionados com o bem-estar espiritual e os seus atributos: fé pessoal, prática religiosa e paz espiritual e a necessidade de compreender as necessidades espirituais durante a hospitalização, bem como os fatores que interferem com a capacidade funcional e o estado de saúde.
Spiritual well-being is a focus of attention and a need in nursing, with particular relevance in the processes of transition from health to chronic and acute disease and during hospitalization. Based on the conceptual model of spiritual well-being in illness of Elizabeth O‟Brien, a quantitative, descriptive, correlational study, transversal approach was developed, allowing us to assess the level of spiritual well-being of the sick person hospitalized and analyze associations between socio-demographic and clinical variables. A sample of 705 hospitalized patients with acute and chronic illness. Data collection was conducted in three health institutions in the north of Portugal. To collect the data, were used a socio-demographic and clinical questionnaire, the Confusion of Neecham Scale, the Spiritual Assessment Scale and the Health Status Questionnaire (SF-36v2). The results evidenced a level of spiritual well-being and personal faith with moderately high positive direction. The spiritual peace and religious practice suggested moderate values. The variables: gender, age, education and professing a religion, demonstrated to be associated with significant differences in the perception of spiritual well -being, with superior results for women, elderly , with a low level of education and professing a religion. It is noteworthy that the overall levels of spiritual well -being increased with the age. The majority of patients professed a religion, more common at Roman Catholic religion. Professing a religion was demonstrated to be associated with a higher level of spiritual well -being, personal faith and religious practice, except for the subscale spiritual peace. The results of the perception of health status indicated that the variables gender, age, education, employment situation, cohabitation , residence and origin were associated with significant differences, with superior results for men, younger , with level higher education , active professionally and urban origin. No significant relation was found between marital status and perception of health status, however, patients who lived in an integrated perception of the nuclear family indicated higher state of health. The mental component of the SF-36v2 (vitality, social function, role emotional and mental health) evidenced mean values of higher order in comparison with the physical component. In the bivariate analysis, there was a significant positive association between personal faith and general health and a significant association with negative sense of religious practice, vitality and emotional development. Spiritual peace manifested a higher standard of associations with the dimensions of SF-36v2 and spiritual well-being showed a significant positive association with general health. In multiple linear regressions was obtained a model that explains 21.20% of the mean variation of the spiritual well-being variable. The set of variables that integrated the model is associated with socio-demographic aspects (gender, age and professing a religion), clinical (presence of symptoms) and health (general health of the SF-36v2). The variables with the greatest predictive power in descending order were: to profess a religion, general health, gender, age and symptomatology. Related changes of spiritual integrity, the following nursing diagnoses were identified: spiritual pain; spiritual alienation; spiritual anxiety; spiritual guilt; spiritual anger; spiritual loss and spiritual despair. We believe that this work allowed reflecting on various aspects related to the spiritual well -being and its attributes: personal faith, religious practice and spiritual peace and the need to understand the spiritual needs during hospitalization, as well as factors that interfere with functional capacity and health status.
Spiritual well-being is a focus of attention and a need in nursing, with particular relevance in the processes of transition from health to chronic and acute disease and during hospitalization. Based on the conceptual model of spiritual well-being in illness of Elizabeth O‟Brien, a quantitative, descriptive, correlational study, transversal approach was developed, allowing us to assess the level of spiritual well-being of the sick person hospitalized and analyze associations between socio-demographic and clinical variables. A sample of 705 hospitalized patients with acute and chronic illness. Data collection was conducted in three health institutions in the north of Portugal. To collect the data, were used a socio-demographic and clinical questionnaire, the Confusion of Neecham Scale, the Spiritual Assessment Scale and the Health Status Questionnaire (SF-36v2). The results evidenced a level of spiritual well-being and personal faith with moderately high positive direction. The spiritual peace and religious practice suggested moderate values. The variables: gender, age, education and professing a religion, demonstrated to be associated with significant differences in the perception of spiritual well -being, with superior results for women, elderly , with a low level of education and professing a religion. It is noteworthy that the overall levels of spiritual well -being increased with the age. The majority of patients professed a religion, more common at Roman Catholic religion. Professing a religion was demonstrated to be associated with a higher level of spiritual well -being, personal faith and religious practice, except for the subscale spiritual peace. The results of the perception of health status indicated that the variables gender, age, education, employment situation, cohabitation , residence and origin were associated with significant differences, with superior results for men, younger , with level higher education , active professionally and urban origin. No significant relation was found between marital status and perception of health status, however, patients who lived in an integrated perception of the nuclear family indicated higher state of health. The mental component of the SF-36v2 (vitality, social function, role emotional and mental health) evidenced mean values of higher order in comparison with the physical component. In the bivariate analysis, there was a significant positive association between personal faith and general health and a significant association with negative sense of religious practice, vitality and emotional development. Spiritual peace manifested a higher standard of associations with the dimensions of SF-36v2 and spiritual well-being showed a significant positive association with general health. In multiple linear regressions was obtained a model that explains 21.20% of the mean variation of the spiritual well-being variable. The set of variables that integrated the model is associated with socio-demographic aspects (gender, age and professing a religion), clinical (presence of symptoms) and health (general health of the SF-36v2). The variables with the greatest predictive power in descending order were: to profess a religion, general health, gender, age and symptomatology. Related changes of spiritual integrity, the following nursing diagnoses were identified: spiritual pain; spiritual alienation; spiritual anxiety; spiritual guilt; spiritual anger; spiritual loss and spiritual despair. We believe that this work allowed reflecting on various aspects related to the spiritual well -being and its attributes: personal faith, religious practice and spiritual peace and the need to understand the spiritual needs during hospitalization, as well as factors that interfere with functional capacity and health status.
Description
Keywords
Espiritualidade Bem-estar espiritual Spirituality Perceção do estado de saúde Spiritual well-being Perceived health status