HOPE for the Holidays: A Spiritual Assessment Tool

On the first Sunday of Advent, Christians light the candle of hope.

Licensed photo courtesy  Pleuntje

Licensed photo courtesy Pleuntje

Isaiah 9: 2, 4-7 (NRSV): The people who walked in darkness have seen a great light; those who lived in a land of deep darkness-on them light has shined…For the yoke of their burden, and the bar across their shoulders, the rod of their oppressor, you have broken as on the day of Midian.  For all the boots of the tramping warrior and all the garments rolled in blood shall be burned as fuel for the fire.  For a child has been born for us, a son given to us; authority rests upon his shoulders; and  he is named Wonderful Counselor, Mighty God, Everlasting Father, Prince of Peace.  His authority shall grow continually, and there shall be endless peace for the throne of David and his kingdom.  He will establish and uphold it with justice and righteousness from this time onward and forevermore.  The zeal of the Lord of hosts will do this.

The lighting of the hope candle on the first week of advent represents the hope that Christians have in Jesus.  Similarly, perhaps, our use of the HOPE spiritual assessment tool represents our hope for spiritual well-being and wholistic health of our parishioners.

Licensed photo courtesy BK

Licensed photo courtesy BK

“HOPE” is an appropriate name for a spiritual assessment tool, as spiritual care is often focused on finding hope for one’s life life that may have been lost in the midst of uncertainty, change, and ill health.  In our darkest times of suffering physically, mentally, emotionally, and spiritually, we all need hope for a brighter day.

By Patche99z (Own work) [Public domain], via Wikimedia Commons

By Patche99z (Own work) [Public domain], via Wikimedia Commons

Spirituality “is not an intellectual belief, but an actual experience.” ~Florence Nightingale, 1860 (Macrae, 2001, p.21, as cited in Hickman, 2006).

What is the HOPE spiritual assessment tool?

Developed by Anandarajah & Hight (2001), HOPE is a formal spiritual assessment tool that facilitates inclusion of spiritual assessment in a medical encounter.  The questions are open ended and do not use the words “spirituality” or “religion,” in order to avoid any language based barriers to discussion of spiritual resources and concerns.

H—sources of hope, strength, comfort, meaning, peace, love and connection;

O—the role of organized religion for the patient;

P—personal spirituality and practices;

E—effects on medical care and end-of-life decisions.

(Anandarajah & Hight, 2001)

Suggested questions to administer the HOPE assessment tool are listed in Table 4 of the original article where HOPE was first published in the American Family Physician: click here to read the article.

For a downloadable pdf of the HOPE assessment tool and some of the related questions, click here.

Hefner (2008) compares the HOPE assessment tool with “Spiritual Assessment in Aging: A Framework for Clinicians”, suggests spiritual care interventions, lists “Select Statements from the Committee on Accrediting Medical Hospitals (CAMH) and the Joint Commission on Accrediting Health Organizations(JCAHO) on Spiritual Assessment and Accreditation” that you may find helpful for promoting your practice as a faith community nurse, and provides the reader with her preferred spiritual assessment tools in the appendix (click to read Hefner’s essay), including:

  • Spiritual Assessment Scale by Gallo
  • The HOPE Approach to Spiritual Assessment by G. Anandarajah and Hight
  • Spiritual Assessment in Aging: A Framework for Clinicians by Nelson-Becker, et al.
  • Spiritual Assessment Protocol by Ortiz and Langer
  • Assessing a Patient’s Spiritual needs: A Comprehensive Instrument by Galek
photo in public domain

photo in public domain

What nursing diagnoses are related to spirituality?

Hickman (2006) lists three diagnoses approved by the North American Nursing Diagnosis Association (NANDA).  Click on the following nursing diagnoses for a definition, related Nursing Outcomes Classification (NOC), and evidence based related Nursing Interventions Classification (NIC).

  1. Spiritual distress
  2. Risk for spiritual distress
  3. Readiness for enhanced spiritual well-being. (downloadable power point slides)

Do you have a favorite spiritual assessment tool that has worked for you? Please share in the comments.

Hope is the thing with feathers  
That perches in the soul,  
And sings the tune without the words,  
And never stops at all,  
         And sweetest in the gale is heard;          
And sore must be the storm  
That could abash the little bird  
That kept so many warm.  
I’ve heard it in the chillest land,  
      And on the strangest sea;         
Yet, never, in extremity,  
It asked a crumb of me.

About courtholmes

Nurse Practitioner, Faith Community Nurse, Parish Nurse, Certified Wound Specialist, DNP Student at Quinnipiac University, Social Media Enthusiast... Passionate about integrating faith and health! CT Faith Community Nurses on Twitter @CTFCN

Posted on November 29, 2014, in Assessment, Spiritual and tagged , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

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