Part I: Interview Transcript
The interview will be carried out using HOPE Questions Spirituality Assessment Tool. This assessment tool is comprised of questions focused on assisting the healthcare practitioner to apply the general concept and narrow down to specific applications. The tool is appropriate for conducting spirituality assessment since it comprises of open-ended questions covering a person’s general spiritual position and enables the follow-up using different support systems (Anandarajah & Hight, 2001). The components of the HOPE spirituality include Hope, Organized religion, Personal Spirituality and practices, and Effects on medical care and end-of-life issues.
For this interview, I will be interviewing my friend who is a military veteran. The selection of this individual was because he had recently recovered following an IED explosion, which left him confined to the ICU for over two months. Having undergone such tough ordeals makes this individual best suited for the interview on spirituality since it was clear it had been of huge impact on the patient.
Question #1: What provides you with strength and hope?
Response: As for me, I acquire my strength and hope from having faith in God. According to my spiritual belief, I am in this world with a purpose and God will allow me to live and fulfill my purpose.
Question #3: Are you part of an organized religious or spiritual community and how does that help you?
Response: I am a Christian and confess the Roman Catholic faith. Through this, I have developed my faith and belief in God. I abide by the doctrines and principles prescribed in the Bible and other church doctrines. I completely understand that God is all-powerful and I thereby rely on Him for assistance and guidance.
What elements of your spirituality and spiritual practices do you find most helpful?
Response: The spiritual practice that I consider as a great pillar in my life is the reliance on prayers. A scripture that guides me on this is Matthew 7:7 that states that “Ask and it shall be given, seek and you find, knock and it shall be opened”. I use the Holy Rosary to carry out my prayers.
Has the accident that you experienced affected the level of your spirituality?
Response: The tragic explosion that occurred to me in my line of duty has strengthened my faith and trust in God. When I look back at that accident, especially since it claimed the lives of two of my fellow soldiers, I believe that God was merciful to me. The prayers of my family and friends saw me emerge stronger after two months of using life support machines. I may be in a wheelchair today, but I am grateful to God that I am alive and can breathe on my own.
Did you have concerns with regards to conflict that arose between your beliefs and your medical situation.?
Response: Well, seeing me under a life-support machine was not easy for my family. One of the options offered to them was euthanasia. However, my parents understood my strong Christian belief and that I would not have supported such a decision. Some family members could not understand the basis of the decision and after two months, I am a living testimony of God’s mighty work.
What Went Well?
The application of HOPE spirituality assessment tool provided questions that offered a perfect opportunity to conduct an in-depth assessment of the individual’s spirituality position. The questions provided a room for the patient to express in their own words, their perception of spirituality.
Barriers and Challenges
Among the challenges that I faced while undertaking the spiritual assessment with the individual was on how to maintain neutrality during the interview and avoid the temptation of imposing my own belief systems to the interviewee or explicitly defining the term spirituality to the interviewee. Indulging in such an act would introduce prejudice to the spiritual assessment activity. This is because it would give unwarranted guidance on how the patient could answer these questions
Another challenge that I encountered while conducting this spirituality assessment was based on the fact the spirituality belief is always a delicate subject whose discussion may cause misunderstandings, especially due to the different beliefs and perspectives. During the interview, I wanted to explore more about the spiritual practice of using the rosary during prayer. However, out of my general knowledge, it dawned to me that this was a contentious issue between Catholics and other Christians. Attempts to explore more on this would appear as posing a challenge to the interviewee’s faith and possibly make him defensive and not cooperative with the assessment section.
Addressing the Challenges and Changes Necessary
To overcome the above-mentioned challenges, it is essential for the interviewer to have enough acclimatization and preparation on the spiritual assessment process in advance. Ample preparations have been known to be effective in assisting to understand fully the approach being relied upon for the assessment and predict possible challenges that could be experienced. This helps one make plans on how to overcome such problems. It is essential for the physician to conduct a spiritual assessment geared towards establishing the patients’ needs, resource, and possible outcomes on spirituality. To avoid prescribing one’s beliefs to the interviewee, it is necessary to carry out an assessment with an open mind, since it helps one maintain an open mind and can, therefore, understand the interviewee beliefs without prejudice or being judgmental.
Use of HOPE Spiritual Assessment Tool in meeting the Need of the Patient
The adoption of the HOPE Spiritual Assessment Tool for the interview enabled me to gain an understanding of the needs and perception of the interviewee, especially on the ethical and moral issue on end of life decisions. I came to understand the individual’s position that life was a sacred gift from God. This can be essential in making the care plan since it is clear no matter the health status of the individual, euthanasia was not to be part of options considered.
The Illness and Stress Amplified the Spiritual Concerns and Needs of the Interviewee
Having undergone a grisly IED attack while in the line of duty, the interviewee had almost lost his life. His two fellow soldiers were unlucky and died on the spot. However, the interviewee had survived this and endured two months in the ICU. The interviewee expressed deep belief and faith in the healing power of God. He had become a living testimony of God’s mercy and power. This helped strengthen his faith in God. He became more engaged in religious practices such as prayers. He expressed his concerns, especially on how his parents have held their ground that life was sacred and a gift from God.
Anandarajah, G., & Hight, E. (2001). Spirituality and Medical Practice: Using the HOPE Questions as a Practical Tool for Spiritual Assessment. American Family Physician, 63(1), 81-89.
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