Gratitude & Spirituality

gratitude

state of thankfulness

state of being grateful

effect of gratutide on brain is short or long-term?

long-term

train yourself to constantly be thankful for little things in life

Acknowledging and appreciating the little things in life, can rewire the brain to deal w/ present circumstances w/ more awareness and broader perception

healthiest of all human emotions

gratitude

physiologic effects of practicing gratitude

• Decreased BP

• Decreased HR

• Decreased adrenaline

• Decreased cortisol

• Decreased C reactive protein

• Decreased BG

• Decreased anxiety, stressors

• Feeling grateful triggers "good" hormones and regulates effective functioning of the immune system

• Hormonal release (+) w/ consistent practice of gratitude - Endorphins, Dopamine

  • Oxytocin (love hormone)

mental health effects of practicing gratitude

• Best kept secret for reducing stress and anxiety

• Reduces aggression

• Builds professional commitment

• Improves health

• Practicing gratitude correlates w/ confidence, kindness, happiness, empathy

limbic system

• Consists of Thalamus, Hypothalamus, Amygdala, Hippocampus, CingulAllows us to make emotional attachments and bond w/ people

• Monitors all sensory information received and interprets it for emotional content

• Essential connection b/w mind, body, and spiritate gyrus

gratitudes effect on pain

16% of pts who kept a gratitude journal reported reduced pain sxs and were more willing to work out and cooperate w/ txt procedure

regulating level of dopamine, gratitude fills us w/ more vitality, thereby reducing subjective feelings of pain

gratitudes effect on sleep quality

• Activates hypothalamus

  • Regulates bodily mechanisms (Deeper and healthier sleep naturally everyday)

• Brain filled w/ gratitude and kindness more likely to sleep better and wake up feeling refreshed and energetic every morning

gratitudes effect on stress regulation

• McCraty - Participants felt grateful showed a marked reduction in level of cortisol

• Better cardiac functioning and more resilient to emotional setbacks and (-) experiences

• Practicing gratitude can enable individuals to handle stress better than others

gratitudes effect on anxiety and depression

• Reducing stress hormones and managing the ANS functions - Reduces sxs of depression and anxiety

• Feelings of gratitude = increase in neural modulation responsible for managing (-) emotions

• People who keep gratitude journal more empathetic and (+) minded by nature

how to cultivate gratitude

• Sig dimension of (+) Psychology - Increases optimism and improves sleep and health

• Habitual focusing on and appreciating the (+) aspects of life

• Practicing gratitude - Keep journal, Look for times to be thankful

pursuit of happiness

• Happiness encompasses living a meaningful life, utilizing your gifts and time, and living w/ thought and purpose

  • Engagement w/ family, work, or a passionate pursuit

  • Finding meaning from some higher purpose

6 dimensions of health

physical

emotional

social

intellectual

occupational

spiritual

spiritual health

• connected to religious beliefs and practices

  • Personal relationship w/ God or supernatural power force

  • Connection w/ something greater than ourselves

• Includes integrity, principle and ethics, the purpose of life

• Feeling of connection to the universe, focuses on our beliefs and values we each hold that lend meaning to life

• Awareness and appreciation that lifts oneself beyond the physical

spirituality features

• Spirit = energy and power

• Spirituality describes

  • Awareness of relationship w/ all creation

  • Appreciation of presence and purpose that includes a sense of meaning

• Discovering/using one's own unique "specialness" to become a (+) and creative person

• Discovering what brings life's significance, purpose, and direction to people's lives

• Very personal, intimate, and unique

spiritually healthy individuals

• Identify their own basic purpose in life

• Learn how to experience love, joy, peace, and fulfillment

• Help others, and themselves, achieve their full potential

• Have a sense of greater meaning in their lives

spiritual health can be key factor in

• How people cope w/ illness

• Experience healing

• Achieve sense of coherence, balance, hope, and interconnectedness

spiritual readings and practices can increase

calmness

inner strength

meaning

improve self-awareness

spiritual screening

• Assess for spiritual emergencies

  • Which needs attention of a trained chaplain right away

• Identify pts that may benefit from spiritual counseling and/or care

• FICA spiritual hx tool

FICA spiritual hx tool

• Faith and belief

  • Do you consider yourself spiritual?

  • Do you have spiritual beliefs that help you cope w/ stress or w/ what you have been going through?

• Importance

  • What importance does spirituality have in your life?

  • What role does spirituality play in health care decision making?

• Community

  • Are you a part of a spiritual or religious community?

  • Is there a group or community of people that support you?

• Address

  • How would you like me to address these issues in your healthcare?

religion

• System of beliefs and practices observed by a community

• System of symbols which act to empower motivation to followers and formulate conceptions of general order of existence

• Relies on a set of scriptures or teachings that describe the meaning and purpose of the world

• Typically offers a moral code of conduct that is agreed upon by members of the community, who also adhere

religious activity may be

• Organizational religiosity - Public, Social, Institutional

• Non-Organizational religiosity - Private, Personal, Individual

religion in USA

• 49% of adults religious

  • Previously 66% in 2015

• 69% Christian

• 21.4% non-religious

• More people "spiritual but not religious"

characteristics of religion

• Focusing on defining structures, rituals, and doctrines

• Practices carried out by those who profess a faith

• Typically organized around a prophet, teacher, or set of human generalities/rules/concepts

• Associated w/ ethical teachings of specific religious bodies and traditions

• Outward practices are in the beliefs, values, codes of conduct and rituals

• Religiosity

religiosity

• Degree of religious commitment of an individual, reflected in their beliefs, attitudes, and values

spirituality vs religion

• Spirituality

  • Fundamental element of human experience

  • Encompasses individual's search for meaning and purpose in life

  • Encompasses connections one makes w/ others, his/herself, nature, sacred realms

• Religion

  • Formal structure through which a person expresses spirituality within a community

  • Religious community then organized around common beliefs, attitudes, practices, traditions, and relationships

interfaith prayer

• Powerful to unite cultures and religions

• Binding force for people to discover common ground and feel connected

• Prayer seems to play an important role in uniting people from across cultural and religious backgrounds

faith-based medicine and practices

• Faith & religious txt methods are integral parts of health care for many cultures

• Use of charms and external articles to promote faith & healing have deep roots in many cultures

• Examples

  • Native Americans - sweat lodges

  • Hoodoo - enslaved AAs practice of root medicine

  • Voodoo - spirit medicine

how spiritualiy and religion improved med outcomes

• Active practice of prayer

• Deep spiritual belief

• Regular attendance at religious services

• (+) attitude

• Healthy lifestyle

• Physical and emotional support of a community

spirituality’s impact on health

• Prayer and meditation

  • Change the brain

  • May slow aging and decrease psych sxs

  • May increase feelings of compassion, security, and love

• Going to church - May account for an additional 2-3 yrs of life

high spirit/relig associated w/

• Improved pt QOL

• Better psych well-being

• Increased longevity

• Church attendance accounts for 2-3 yrs of additional life

• Directly related to an overall improved medical experience

health benefits among those practicing spiritual beliefs

• Sig reduced BP

• Reduced cardiac dz

• Stronger immune systems

• Fewer health problems & hospitalizations

• Shorter lengths of stay

• Stronger social support systems

• Stronger family ties

• Stronger and healthier marriages

• Stronger rates of wellbeing and acceptance

• Lower rates of depression

• Less drug & alcohol abuse

• Increases life satisfactions

• Health-promoting behaviors

health promoting behaviors

• Exercise

• Proper nutrition

• More seatbelt usage

• Smoking cessation

• Greater use of preventive services

• Greater functioning among disabled individual

• Fewer hospitalizations

• Shorter hospital stays

relationship to death

• Mortality

  • People w/ involvement live longer

    • Living and active involvement within a religious community and self-reported religiosity

• CVD

  • Decreased incidence of CVD

    • Lower BP/HTN

    • Higher med compliance

    • Less cigarette smoking

      • Decreased CLD, stroke, lung cancer, and all cancers

spirituality in med care

• Until 1990s, spiritualty was component of med care

• Return to more spiritually sensitive care could enhance experience

• Most pts engaged in some spiritual type of practice/lifestyle

• Important in all aspects of pts care

  • Palliative

  • Oncology

  • EOL

  • Chronic dz

  • Disability

• Pts of children receiving EOL care had better experience when spiritual needs met

pt’s perspective on spirituality and religion within health

• Sig coping mechanism during illness or hospitalization

• Primary way of finding meaning from illness OR find hope, forgiveness, or guilt in situation

• Pts wish to discuss spiritual or religious needs

• Attention must be give to providing holistic, pt-centered, comprehensive care

Integrating spirituality into pt care for provieders enhances

• Person-centered care

• Foster connection w/ pts

• Improve healthcare provider job satisfaction

• Reduce burnout amount inpt team members

• Facilitated awareness of the need for recognition of and response to pt spiritual needs in a timely manner

various approaches to ascertaining spirit/relig

• Many families find faith or spiritual beliefs a source of strength or comfort during a hospital stay. I’m wondering if your spirituality or religion is important to you?

• “Do you follow a particular religious tradition or spiritual path?”

• “Would you like a visit from your clergy or hospital chaplain during your stay?”

• “Would you like to include that person in the conversation when it comes time to make an important treatment decision?”

• “How does your faith influence the way that you think about this illness?”

• Are there ways that we can help you maintain your spiritual strength or routine during this stay?”

spirituality’s relationship to illness

• Illness grasps persons by the soul and the body and disturbs them both

• Illness raises Qs

• Being present to pt's suffering can change the healthcare provider - His/her own values, Priorities, Beliefs

• Healthcare is dynamic spiritual practice that impacts the development of the pt and the healthcare provider

• Medically ill pts rely on religion to cope often adapt more quickly

• Med pts more spiritual/religious less likely to develop depression - Even if develop, more likely to recover

• Lower rates of Suicide, Alcohol abuse, Drug abuse, Delinquency and criminal behavior

Dr. Harold Koenig of Duke University

• Prayer = good medicine

• Like to see all physicians assess their pt's spiritual needs and, if need be, refer to someone who can address those needs

what does/can spiritual care do?

• Enlivens or sparks

• Changes expressions

• Interacts w/ and connects

• Affects emotions

• Creates function

• Creates meaning

• Gives hope

• Reconnects w/ belief or faith

• Creates feelings of being loved and valued

what does spiritual care look like?

• Picking up a clue

• Taking a risk

• Engaging w/ person

• Creating dialogue or permission

• Acting or facilitating a religious need

• Aiding religious ritual

• "Being with..not just doing"

useful skills in delivery of spiritual care

• Adopting a caring attitude and disposition

• Recognizing and responding appropriately

• Using observation to identify cues

• Listen and attend to individual needs

• Being aware of when it is appropriate to refer to another source of support

• Looking for the best in the worst

• Being personally hope-filled

  • Believing that what 1 does and what one is, always of some value

  • Knowing that it is never too late to do good

spiritual care summary

• Not just about religious beliefs and practices

• Not about imposing our own beliefs and values on another

• About meeting people at their point of deepest need

chaplaincy care

• Spiritual, religions, pastoral, ethical, existential, emotional care that involves

  • Active and empathic depth listening

  • Respect for and nurturing of the strengths of person's own spirituality

    • Not proselytizing

  • Meeting people where they are in their lives and negotiating what they want to talk about or work on

  • Ongoing spiritual exploration/assessment and intervention

    • What person's spirituality looks like, how it works for them, what issues concern them

  • Connecting w/ local communities for faith specific needs

when to consult chaplains

• Pt or family request

• Sacramental or devotional ritual

• Pt is dying

• Sxs of spiritual distress

• Pt wants to consider med txt from a spiritual/faith perspective

• Religious or spiritual beliefs appear pathological or problematic

• Provider requests more info about religious tradition or relevance

Intimacy w/ formality (how discuss spiritual needs w/ pts)

• Follow lead of pts in discussing spiritual concerns

• Unethical to ignore spiritual concerns

• Unethical to try to address those that extend beyond one's professional expertise or comfort

• Open and honest communication

• Honor and respect individual beliefs and values

• Pts must never feel that care they deserve is dependent on meeting unstated or implied expectations of provider

• Honor professional code of ethics

• Role of clinician is facilitator

mindfulness creator

• Dr. Epstein "Mindful Practice"

  • Mindful practitioners attend in a non-judgmental way to their own physical and mental processes during ordinary, everyday tasks

• Mindfulness should be considered a characteristic of good clinical care

critical self-reflection enables physicians to

• Listen attentively to pts' distress

• Recognize their own errors

• Refine their technical skills

• Make evidence-based decisions

• Clarify their values so that they can act w/ compassion

  • Technical competence

  • Presence

  • Insight

mindfulness

• Type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, w/o interpretation or judgment

• Cognitive skill of sustaining meta-awareness of the contents of one's own mind in the present moment

• Derives from sati

  • Element of Buddhist and Hindu traditions

practicing mindfulness

• Breathing methods

• Guided imagery

• Practices to relax the body and mind and help reduce stress

4 skills in practicing mindfulness

• Being in the present

• Distress tolerance

  • Reacting less often or less intensely to distress

• Interpersonal effectiveness

  • Having more satisfying personal interactions

• Emotional regulation

  • Recognizing and controlling your emotions

  • More aware and awake to each moment

  • Being fully engaged to what is happening

    • w/ acceptance and w/o judgment

mindfulness in healing

• Survivors can create a safe space within themselves

  • Fostering resilience and promoting emotional wellbeing

• Self-compassion

  • Reinforcing the importance of nurturing oneself

    • Fundamental aspect of healing