Background and Objectives: The aim was to translate and validate the spiritual needs questionnaire for its use in the Lithuanian context. Materials and Methods: A descriptive, cross-sectional survey design was applied. Structural individual interview method (face-to-face) was employed to collect data on spiritual needs of cancer patients. Responses were obtained from 247 patients hospitalized in nursing and supportive treatment units at public hospitals. Data were analyzed using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 22.0. To assess the psychometric properties of the scale, Cronbach’s alpha, split half test, average inter-item, and item-total correlations were calculated for internal consistency. Exploratory factor analysis was used to confirm the construct validity of the translated version of instrument. Results: Lithuanian version of The Spiritual Needs Questionnaire (27 items) had a good internal consistency (Cronbach’s alpha = 0.94). The existential and connectedness with family needs factor had the lowest Cronbach’s alpha (0.71) in relation to other factors: Religious needs (0.93), giving/generativity and forgiveness needs (0.88), and inner peace needs (0.74). Split-half test showed strong relationship between the both halves of the test. The item difficulty (1.47 (mean value)/3) was 0.49; while all values were in acceptable range from 0.20 to 0.80. Item-total correlations were inspected for the items in each of the four SpNQ-27 factors. Conclusions: The Lithuanian version of Spiritual needs questionnaire demonstrated adequate psychometric properties of the instrument. This instrument, as a screening tool and conversational model, is recommended for clinicians in health care practice to identify patients with spiritual needs.
Dvasingumas-visuotinai pripažinta, tačiau sunkiai apibrėžiama sąvoka 1. A. Narayanaswamy konkretizuoja ir išplečia dvasingumo sąvokos turinį išskirdamas šiuos požymius: asmens savastis ir gyvenimo principai, tiesos ir vertybių supratimas, gyvenimo prasmė ir tikslai, besąlygiška meilė, "manojo Aš" susietumas su "Kitu", susietumo su mistine, aukštesne galia, Dievu arba universumu prasmė ir kt. Autoriaus nuomone, įvertinti sergančiojo dvasinius poreikius padeda atsakymai į klausimus, ar paciento deklaruojamas tikėjimas yra paremtas veiksmais, ar pacientas įgyja ramybę ir vidinę stiprybę dėl dvasinių poveikių, ar pacientas turi aiškią savasties sampratą 2. Apskritai dvasingumas gali būti laikomas asmens įsipareigojimu laikytis aukštesnio principo, kuris kasdieniame gyvenime reiškiasi per etines normas arba institucionalizuotą, o kartais išeinantį ir iš / už jo ribų 3 religingumą; vis tik dvasingumas yra platesnis terminas negu religija 4. Neginčijama, kad ne kiekvienas žmogus mano esąs religingas, tačiau kiekviena žmogiška būtybė yra dvasinga 5. Dėmesys onkologinių ligonių dvasingumui ir dvasiniams poreikiams teikiant slaugos paslaugas sąlygoja aukštą priežiūros kokybę 6. Dvasingumo raišką ir dvasinius poreikius dažniausiai lemia sudėtingos žmogaus egzistencinės patirtys: gyvybei pavojingi susižeidimai, nepagydoma liga, moralinės traumos ir potrauminės būklės, dvasinė ir fizinė kančia, galiausiai-akistata su mirtimi. Lietuvoje kasmet užregistruojama iki 18 tūkst. naujų vėžio atvejų, o su šia liga kiekvieną dieną gyvena dar apie 100 tūkst. šalies gyventojų 7. Ligos diagnozė keičia žmogiškąją egzistenciją iškeldama dvasinius poreikius, kurių užtikrinimas reikšmingas onkologine liga sergančiojo savijautai ir pasitenkinimui paslaugomis, mažesnio intensyvumo intervenciniam gydymui ir gydymo kaštų mažinimui, geresnei gyvenimo kokybei ir / ar net oriai gyvenimo pabaigai. Sergantis žmogus aktyviai bando surasti prasmę to, kas atsitiko jo kūnui, ir bando suderinti tai su pakitusia gyvenimo eiga 8. Šiuolaikiniai gydymo metodai, naujausios technologijos, farmacinės galimybės daug padeda nustatant ir gydant onkologines ligas, tačiau onkologine liga sergančiojo savijauta nėra vien tik faktas, kad sergu / nesergu, yra pakitimai / nėra pakitimų, gera / bloga 1
The prominence of biomedical criteria relying on brain death reduces the impact of metaphysical, anthropological, psychosocial, cultural, religious, and legal aspects disclosing the real value and essence of human life. The aim of this literature review is to discuss metaphysical and biomedical approaches toward death and their complimentary relationship in the determination of death. A critical appraisal of theoretical and scientific evidence and legal documents supported analytical discourse. In the metaphysical discourse of death, two main questions about what human death is and how to determine the fact of death clearly separate the ontological and epistemological aspects of death. During the 20th century, various understandings of human death distinguished two different approaches toward the human: the human is a subject of activities or a subject of the human being. Extinction of the difference between the entities and the being, emphasized as rational-logical instrumentation, is not sufficient to understand death thoroughly. Biological criteria of death are associated with biological features and irreversible loss of certain cognitive capabilities. Debating on the question "Does a brain death mean death of a human being?" two approaches are considering: the body-centrist and the mind-centrist. By bridging those two alternatives human death appears not only as biomedical, but also as metaphysical phenomenon. It was summarized that a predominance of clinical criteria for determination of death in practice leads to medicalization of death and limits the holistic perspective toward individual's death. Therefore, the balance of metaphysical and biomedical approaches toward death and its determination would decrease the medicalization of the concept of death.
The process of professional education and training general education, realized in non-specialty curriculum, is oriented towards three domains: development of cognitive competence, development of personal, professional and social competence. The medical humanities include a broad spectrum of disciplines and offer great potential for enhancing professional and humanistic development in medical education. It is obvious that medical education at university first and foremost focuses on the technical, instrumental health care practice rather than on the development of practical wisdom that relates to moral efforts identifying and evaluating the situation. Lithuanian University of Health Sciences is currently in the process of taking an essential step towards the transition from the traditional concept of professional education and training towards the academic university education. Traditional approach of professional education and training stressed the person's readiness for a particular working place while the aim of universities is to provide students with universal education which embraces a broad scope of scientific knowledge and also stimulates the development of the personal and social competence.
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