Spirituality

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Spirituality the HIV Positive Woman

• Deborah Phillips, RN, MPH
• TX/OK AIDS Education Training Center
• Dallas, TX

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Spirit-definition

• pneuma (Greek)- breath
• Immaterial being
• Searches for relationship with God

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Caring for the whole person

• Body
• Soul
• Spirit

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Objective

• Describe 6 considerations regarding
  spirituality when caring for the HIV Positive
  Woman

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Consideration 1 Spirituality in Healthcare
Literature

• Healthcare Spirituality articles increasing in
  abundance
• 1981 1 article
• 1991 22
• 1999 57
• Western Journal of Nursing Research, 2004, 26(4),
  405-428

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Consideration 1 Spirituality in Healthcare
Literature

• Not well-defined
• Embedded in culture
• Cannot be separated as individual entity for study

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Consideration 1 Spirituality in Healthcare
Literature

• 79.5 from the U.S.
• 52.1 quantitative design
• 62.8 studies of clients or patients
• 78 adults
• Primarily r/t Cancer medical treatments

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Consideration 2Personal Beliefs

• What do I believe?
• What can I do for my patient?

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Consideration 3 Inherent Challenges of the HIV
Positive Woman

• Faces Stigma
• Race
• Gender
• Class
• Presumed HIV status

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Consideration 3 Inherent Challenges of the HIV
Positive Woman

• Stigma
• About 20 of U.S. population
• In conjunction with other stigmas
• Homosexuality, bisexuality, IDU
• More likely w/ certain religious beliefs
• More likely if less educated
• Stigma and HIV/AIDS
• A Review of the Literature, May 2003 DRAFT
  Deborah L. Brimlow, Ph.D., Jennifer S. Cook, and
  Richard Seaton, editors U.S. DHHS, HRSA, HAB

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Consideration 3 Inherent Challenges of the HIV
Positive Woman

• Faces Loss
• Body Image
• significant feelings of contamination due to
  internalization of stigma and representations, in
  addition to physical decline.
• Body image and HIV implications for support and
  care. AIDS Care. 1998 Jun10 Suppl 2S179-87.

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Consideration 3 Inherent Challenges of the HIV
Positive Woman

• Faces Loss
• Employment loss
• frequent from the first months of HIV infection
• occurs especially in women and in patients with
  adverse socioeconomic conditions, and
• severe HIV infection and/or comorbidity.
• The European Journal of Public Health 2006
  16(1)89-95 doi10.1093/eurpub/cki153

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Consideration 3 Inherent Challenges of the HIV
Positive Woman

• Depression is common
• As many as 1 in 3 HIV
• Can affect mind, mood, body behavior
• Often misinterpreted
• National Institute of Mental Health (NIMH)
  www.nimh.gov/accessed 4-28-06

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Consideration 4 Regard Her Perspective

• Psychological Spiritual Growth in HIV Positive
  Women
• 34 HIV positive pts
• 26 53 y.o.
• 1/3 knew HIV status gt 5 years
• 1/3 employed
• 1/3 in relationship with HIV partner
• Diverse ethnicities Hawaiian, Filipina, Chinese,
  Portuguese, Japanese, Hispanic, African American
• Dunbar,et al, Social Work/vol 43, no 2, March 1998

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Consideration 4Regard Her Perspective

• 82 affirmed positive outcomes
• Rebuilt relationships
• Newfound values
• New sense of meaning and purpose
• Profound self-awareness
• Self acceptance
• Discoveries of connections with nature, God
  higher powers

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Consideration 5Implications of Spiritual
Health

• 142 HIV Puerto Rican women in NYC
• High CES-D scores
• 66 above normal threshold
• A series of simultaneous multiple regression
  analyses
• Controlling for confounding variables
• Simoni JM, Ortiz MZ.Mediational models of
  spirituality and depressive symptomatology among
  HIV-positive Puerto Rican women. J Assoc Nurses
  AIDS Care. 2004 May-Jun15(3)37-46

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Consideration 5Implications of Spiritual
Health

• Most respondents (71) were Catholic
• 29 considered themselves members of a church or
  other place of worship
• and 30 reported attending religious services
  1-3 times a month.

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Consideration 5Implications of Spiritual
Health

• spirituality was high and negatively associated
  with CES-D scores
• demonstrated that both mastery and self-esteem
  scores mediated this relationship

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Consideration 5Implications of Spiritual
Health

• Morse et al., 2000
• Negative relationship between
• Attending church services and use of alcohol or
  marijuana
• Frequency of prayer and street drugs
• Journal of Religion and Health Volume 39, Number
  3 Date  September 2000 261 - 276

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Consideration 5Implications of Spiritual
Health

• Coleman, 2003
• African American men and women
• Spirituality related
• Positively to cognitive and social functioning
• Negatively to HIV symptoms

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Consideration 6Take care of YOUR health

• Kristeller, et al 1999
• 37 of oncologists 47 of oncology nurses feel
  responsible for addressing spiritual distress

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Consideration 6Take care of YOUR health

• If you have nothing left for yourself, you have
  nothing left to give

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SummaryS.P.I.R.I.T.

• Spirit-immaterial being searches for God
• Personal beliefs
• Inherent challenges
• Regard her perspective
• Implications of spiritual health
• Take care of yourself