Diminished commitment of oneself to faith-based beliefs, principles and activities

• Anxiety
• Cultural barrier to practicing religion
• Depressive symptoms
• Fear of death
• Inadequate social support
• Inadequate sociocultural interaction
• Inadequate transportation
• Ineffective caregiving
• Ineffective use of coping strategies
• Insecurity
• Pain
• Spiritual distress
• Unaddressed environmental constraints

• Depressive disorder
• Impaired health status

• Age, gender, sex
• Religious affiliation, beliefs/values
• Usual religious practices, support system

• Difficulty adhering to religious doctrines
• Difficulty adhering to religious rituals
• Difficulty reconnecting with belief patterns
• Difficulty reconnecting with religious rituals
• Discomfort with separation from faith community
• Questions religious doctrines
• Questions religious rituals

• Patient will describe conflicts with his or her religious beliefs and the effects of his or her illness on these beliefs.
• Patient will accept counsel of a person trained in spirituality.
• Patient will engage in religious practices to the extent that it is therapeutic.
• Patient will express satisfaction with ability to practice patient's religion.

Suggested NOC Outcomes

• Assess spiritual or religious beliefs; religious affiliation; importance of religion in daily life; religious involvement of family; religious dietary restrictions; importance of religion in helping with usual coping. Assessment information helps identify appropriate interventions.
• Approach patient in a nonjudgmental way when he or she is discussing religious beliefs or spiritual needs. The nurse's beliefs may differ radically, but it is a professional responsibility to assist patient in an ethically sensitive way.
• Help patient list the religious practices most important to him or her to determine what is possible to provide in the hospital.
• Acquire simple-to-obtain items, such as books, pictures, CD, cross, to provide comfort to the patient.
• Confirm that patient's spiritual needs are being satisfied so that modifications can be made in the plan.
• Involve family members in helping meet patient's spiritual needs if patient agrees. If family members have strong spiritual beliefs, they can be a help to one another in times of pain and difficulty.
• Encourage patient and family to express feelings associated with diagnosis, treatment, and recovery. Expression of feelings helps patient and family cope with treatment.
• Schedule time to spend with the family. They need time with health care providers to ask questions.
• Suggest a referral to a clergy person or faith community nurse so that the person can discuss deeper spiritual issues.

Suggested NIC Interventions

• Patient expresses understanding about how illness impacts patient's religious beliefs.
• Patient works with staff to modify plan as needed.
• Patient requests whatever resources patient thinks will help meet present needs.
• Family and clergy visit to provide support.

• Assessment of patient's perspectives on religiosity
• Practices that are meaningful to the patient
• Visits from clergy
• Modifications to the plan

• Ames, D., Erickson, Z., Youssef, N. A., Arnold, I., Adamson, C. S., Sones, A. C., … Koenig, H. G. (2019). Moral injury, religiosity, and suicide risk in U.S. veterans and active duty military with PTSD symptoms. Military Medicine, 184(3/4), e271-e278. doi:10.1093/milmed/usy148
• Bolton, C., Lane, C., Keezer, R., & Smith, J. (2018). The transformation of religiosity in individuals with cognitive impairment. Journal of Religion, Spirituality & Aging. doi:10.1080/15528030.2018.1534706
• Lin, C., Saffari, M., Koenig, H. G., & Pakpour, A. H. (2018). Effects of religiosity and religious coping on medication adherence and quality of life among people with epilepsy. Epilepsy & Behavior, 78, 45-51. doi:10.1016/j.yebeh.2017.10.008
• McClintock, C. H., Anderson, M., Svob, C., Wickramaratne, P., Neugebauer, R., Miller, L., & Weissman, M. M. (2018). Multidimensional understanding of religiosity/spirituality: Relationship to major depression and familial risk. Psychological Medicine. doi:10.1017/S0033291718003276