A ‘near‐life experience’: lived experiences of spirituality from the perspective of people who have been subject to inpatient psychiatric care

Abstract

Aims To describe lived experiences of spirituality from the perspective of people who have been subject to inpatient psychiatric care and to interpret these experiences from an understanding of health as dialectical. Methods After approval from a regional ethical board, eleven participants were recruited from two organisations for people with mental health problems. Participants were asked to narrate about spiritual experiences and occasions where such experiences had come close. The transcribed interviews were analysed by means of a phenomenological hermeneutical approach. Findings A structural analysis of the text resulted in three themes; perceiving the presence of something extra mundane, making sense of reality and struggling for acceptance. The comprehensive understanding highlights spiritual experiences as going beyond religion, even though religious experiences appear as part of it. These experiences can indeed be a resource contributing to experiences of hope, connectedness, meaning and coherence in life. However, they can also give rise to doubt, anxiety and feelings of loneliness and hopelessness. Rather than understanding spiritual experiences as being either ‘good’ or ‘bad’, we could approach spirituality as something that is always present in alternate and inter‐related forms. Metaphorically, this could be understood as a ‘near‐life experience’, summarising participants’ experiences related to their struggle with issues related to suffering and health which are simultaneously present. Conclusions If psychiatric nurses could approach this complexity and, without being judgemental, explore seemingly positive and negative experiences of spirituality as dialectically related to each other, rather than viewing them as either resources or problems, this could contribute to insiderness care and hopefully also support people who struggle with these experiences to seek help when needed.

Mental Health Staff Perspectives on Spiritual Care Competencies in Norway: A Pilot Study

“…Health care staff in mental health hospitals who are working with very ill patients have an ethical and professional duty to develop knowledge, skills, and attitudes to assess and address their patients also in the area of spirituality; this domain is an aspect of whole person patient-centered care (Saleem et al, 2014;Medås et al, 2017;Patterson et al, 2018). In discerning how to assess patients spiritually, Koslander et al's (2020) advises mental health nurses that spirituality can be both a resource and a challenge and is worth noticing, acknowledging, and discussing among the healthcare team members. In a Scandinavian context, it might also be helpful to try to determine if patients have a restful religiosity that is deeply integrated into the person and thus might provide support in times of illness, or if there is some conflict related to their belief system.…”

“…Hvidt et al (2017) ask the question if crisis religiosity has become the predominant form of religious expression in the Scandinavian population. Koslander et al (2020), also reporting from Scandinavia, found that patients who had been inpatient in psychiatric care described their experiences of spiritually as going beyond religion, even though religious experiences were part of it. Spirituality could provide resources such as hope, connectedness, meaning, and coherence in life, but also give rise to doubt, anxiety and feelings of loneliness, and hopelessness.…”

“…Spirituality could provide resources such as hope, connectedness, meaning, and coherence in life, but also give rise to doubt, anxiety and feelings of loneliness, and hopelessness. Koslander et al (2020) therefor advise mental health nurses to approach spirituality as a dialectic matter and being open to their patients, as spirituality often is in a dialectic relationship to each other as both a resource and a challenge. In one study exploring the relationship between religious and spiritual needs that are met versus unmet needs, van Nieuw Amerongen-Meeuse et al (2020) found that it is very important for nurses and other mental health practitioners to give personalized attention to religion and spirituality in their conversations with patients.…”

An integrative review of defining characteristic of the nursing diagnosis “spiritual distress”

“…These beliefs include their meaning given to life, sense of hope, and faith. Consequently, the person may experience a sense of doubt, confusion, and tension (Kord & Biadar, 2019 ; Koslander et al, 2021 ; Mrdjenovich, 2019 ). Concepts such as religious struggle, spiritual stress, and religious anguish thus found their way into health care providers' literature.…”