Faith Community Nursing: Supporting Mental Health during Life Transitions

Abstract

Faith Community Nurses consider community cultural practices an essential component in understanding how to effectively support an individual’s mental health during important life transitions. Additionally, as part of their practice, Faith Community Nurses seek to understand how religious beliefs and life transitions such as marriage, divorce, birth, death, and illness impact on spiritual and mental health care. The emotional tolls of family separations due to wars, unexpected life events, or planned transitions are pivotal time-points for the implementation of Faith Community Nursing interventions to support mental health. As we witness a worldwide declining economy, nationally high unemployment rates, a decline in health care resources, and reduced access to treatment, medication, and nutritious foods, Faith Community Nursing care will be a valuable asset to various religious communities. It is our intent to examine briefly the historical and cultural uses of Faith Community Nurses, as well as examine the concept of transitions to better understand how Faith Community Nurses can be utilized as agents to support mental health for diverse faith communities during key life events.

HISTORICAL AND CULTURAL EXAMINATION OF FAITH COMMUNITY NURSING

In the text, Nursing Today: Transition and Trends (Zerwekh & Claborn, 1997), the origin of the word nurse is said to be derived from the Latin word “nutricius,” meaning nourishing (p. 32). The authors further explain that before Greek and Roman times, ancient Egyptian physicians and nurses assembled voluminous pharmacopoeia with more than 700 remedies for numerous health problems (Zerwekh & Claborn, 1997). During this period in history, there was an aggressive political climate and numerous wars were fought, leading to extreme poverty, women being widowed, and children orphaned. Society had no means to care for the dependents of soldiers or the mentally ill. Children were abandoned without remorse and infanticide was practiced regularly as a desperate means to reduce starvation. Convents became havens to practice Christian beliefs where deaconesses, widows, and virgins ministered to the ill within the safety of the convent. Historians cite these holy wars as furthering the development of males in nursing (often referred to as Knights) and religious women as midwives, nurses, and healers. What nursing gained during this early period of history was status associated with religious faith from parishioners and the faith-based community members they served. The altruistic ideal of providing care as a service performed out of humility and love became the foundation for Faith Community Nursing (Zerwekh & Claborn, 1997)

According to the American Nurses Association (ANA), parish nursing was officially recognized as Faith Community Nursing in 2005 to reflect the full range of faiths in the United States (Dyess, Chase, & Newlin, 2010). Faith communities refer to groups of people who maintain routine fellowship to share their common history, values, and beliefs around their relationships with a higher power. In America and throughout the world, the origins of Faith Community Nursing began in places of religious worship. Depending upon the specific faith, communities of shared religious faith congregate regularly in churches, synagogues, temples, mosques, kingdom halls, and cathedrals. It is in the nature of this regular fellowship that Faith Community Nurses develop caring and trusting relationships with their congregation members.

According to the Parliament of the World’s Religions, over 50 world religions recognize the basic core values of faith nursing, which include respect for life and the promotion of service to others (Kung & Kuschel, 1993). The faith community is an ideal place to study the relationship between religion and health as it focuses on their symbiotic relationship. When compared with traditional nursing practice, Faith Community Nursing includes a more intentional use of spiritual and religious practices. Health or healing is considered within the majority of faith-based community mission statements. Faith Community Nursing differs from community-based nursing in scope and context. Community-based nursing is generally practiced throughout the community whereas faith-based nursing is practiced within the faith community; however, community-based nursing can be performed in faith-based settings. Another difference is that Faith Community Nursing incorporates spirituality and religion as basic contexts of nursing practice (Dyess, Chase, & Newlin, 2010). Both forms of nursing focus on health screening, health promotion, and disease prevention (ANA, 2005). Faith Community Nursing can have a positive impact on supporting mental health and wellness during life transitions with the provision of social support, spiritual care, health education, and the use of health and human service referrals.

EXAMINING THE CONCEPT OF TRANSITIONS

The concept of “transitions” has been defined as a passage from one state, stage, subject, or place to another (Merriam-Webster Online Dictionary, 2010). Additionally, transitions have been examined and discussed from a variety of perspectives, ranging from human development, anthropology, psychology, health care administration, gerontology, reproductive health, and within the health-illness literature. It is a concept that has been central to nursing and has been of keen interest to nurse researchers, clinicians, and theorists (Kralik, van Loon, & Visentin, 2006; Schumacher & Meleis, 1994). Within the nursing literature, transitions have been explored from a variety of contexts, ranging from near death experiences, entrance into homelessness, widowhood, entry of an elderly family member into residential care, self-identity, discharge from a hospital after an acute illness experience, and suffering and exiting an abusive relationship (Meleis, 2007). According to Schumacher and Meleis (1994), within the nursing literature, transitions are seen as universal occurrences in individuals’ life patterns and are classified as changes that occur in behaviors, abilities, identities, roles, patterns, and relationships. Factors that commonly mediate the transition process are personal interpretation of an experience, personal expectations, level of knowledge/skill, environment, level of planning, and emotional and physical well-being.

An inability to cope, adapt, or problem-solve during challenging transitions (loss of a loved one, receiving an illness diagnosis) or even positive transitions (entrance into college, marriage, birth of a child) may result in unhealthy and ineffective mental health outcomes, including depression, anxiety, posttraumatic stress disorder, and substance use or dependency. Faith Community Nurses can aid in preventing maladaptive mental health outcomes for faith community members by remaining cognizant of the spiritual needs and cultural realities of these groups while at the same time using the information garnered during private sessions with clients to aid individuals in the management of spiritual, situational, and psychological changes. Faith Community Nurses provide support to individuals experiencing transitions and, additionally, play an important role in helping clients anticipate and complete acts of transition (Meleis, 2007).

SUPPORTING MENTAL HEALTH DURING LIFE TRANSITIONS

Mental wellness or psychological well-being has been described as self-acceptance, positive relations with others, autonomy, environmental mastery, having a sense of purpose in life, and personal growth (Ryff, 1989). Specific modalities that can be utilized by the Faith Community Nurse to support maintenance of an individual’s psychological well-being during life changes include providing social support or linkages to social support networks, facilitating health education, engaging in spiritual counseling, and providing referrals. In seeking to address these domains, Faith Community Nurses support the unique physical, social, and spiritual needs of a faith community as needs arise during key life transitions.

Social support has been described as reciprocal and mutual assistance in the form of communal resources and emotional support through information, social integration, and other forms of tangible aid (Buijs & Olson, 2001). Similarly, social support networks are described as groups of individuals who include relatives, peers, professionals, or religious organizations that provide psychological, social, and tangible aid to individuals during times of distress or need (Buijs & Olson, 2001). The Faith Community Nurse can provide individual social support by offering direct services to the client during nurse-client sessions. The Faith Community Nurse also can facilitate opportunities for social support in her nursing role by creating community environments (or social support networks) where clients can meet to discuss their mutual concerns and needs. For example, a woman recently diagnosed with cancer, may find comfort and express feelings of enhanced mental wellness because she is able to talk about her diagnosis with her Faith Community Nurse. Additionally, the Faith Community Nurse may refer her to a cancer support group to assist her in coping with her current illness. The woman may find that speaking regularly with other cancer patients or survivors within a religious or spiritual context enhances her self-esteem, facilitates knowledge building, and supports a sharing of resources that can aid in promoting good mental health.

Faith community nursing also provides avenues for supporting an individual’s spiritual health. Tuck, Pullen, and Wallace (2001) found that Faith Community Nurses frequently reported praying, listening, and being present as part of the care provided to members of their faith communities. In addition, on a community level, they offered programs on healing and wholeness, healing services, newsletter articles on the relationship between health/wholeness and spirituality, and the study of sacred writing on miraculous healing to support the congregation’s emotional health and well-being. Engaging in prayer and the use of spiritual coping strategies have been linked with overall wellness and a positive effect on healing (Tuck, Pullen, & Wallace, 2001).

Within their nursing role, Faith Community Nurses act as educators and offer health education to their congregation related to health and human services, mental health services, and other educational support. Unique to faith community nursing is the inclusion of spiritual care as part of health education and health promotion. After engaging in an assessment of the faith community’s needs, the nurse can provide the congregation and congregational staff with information about appropriate primary and secondary prevention services available. These services may include health education programs, health screenings and assessments, identification of health resources, other informational tools, and development of nursing interventions.

By referring clients to health and mental health services and providing educational programs or other resources, Faith Community Nurses can aid in supporting an individual’s mental well-being. Because Faith Community Nurses are health advocates and referral agents, they maintain a consistent relationship with local community agencies to ensure that they remain current on the educational programs and resources offered in the community. Their involvement in this network allows them to discuss with individual clients the services that may be necessary to meet the holistic needs of the client. On a community level, Faith Community Nurses identify resources and services that are most appropriate for the faith community they serve; additionally, they may influence community agencies to offer services more appropriate to the needs of their faith community (Buijs & Olson, 2001). Because Faith Community Nurses engage in routine interactions with their congregations, they will have a better understanding of which services will be most readily used by their populations. For example, a nurse working within a faith community may learn that members of the congregation may be more apt to pursue counseling services if the mental health practitioner is of the same religious background. Furthermore, by having a nurse within a faith community, individual members of the faith community may feel more comfortable asking about the nature and availability of mental health services.

SUMMARY

The Faith Community Nurse can be an important agent in supporting the mental health of individuals during important life transitions by providing social support, spiritual care, referral services, and health education. Faith communities often include individuals of many generations; the young and old, newly married and recently widowed, new parents, and families whose young adults have recently left home. Nurses who provide care in these settings will likely have unique and frequent opportunities to provide mental health services and referrals to individuals experiencing transitions related to crisis, hospitalization, death, and other important life changes. Faith Community Nurses are at the frontline, aiding faith communities in supporting holistic health of the mind, body, and spirit.