Value-Belief Pattern
Moral Distress (2007)
DEFINITION
Anguish in response to the inability to carry out one’s chosen ethical/moral decision/action
DEFINING CHARACTERISTICS
Expresses anguish (e.g., powerlessness, guilt, frustration, anxiety, self-doubt, fear) over difficulty acting on one’s moral choice
ETIOLOGICAL OR RELATED FACTORS
Conflict among decision makers
Conflicting information guiding ethical decision making
Conflicting information guiding moral decision making
Cultural conflicts
End-of-life decisions
Loss of autonomy
Physical distance of decision maker
Time constraints for decision making
Treatment decisions
OUTCOME
Distress Resolution
Resolves conflicting situation
Spiritual Distress (1978, 2002)
DEFINITION
Impaired ability to experience and integrate meaning and purpose in life through a connectedness with self, others, art, music, literature, or a power greater than oneself
DEFINING CHARACTERISTICS
Connections to Self
Expresses lack of one or more of the following: hope, meaning and purpose in life, peace/serenity, acceptance, love, forgiveness of self, courage
Anger
Guilt
Poor coping
Connections with Others
Refuses interactions with spiritual leaders
Refuses interactions with friends, family
Verbalizes being separated from support system
Expresses alienation
Connection with Art, Music Literature, Nature
Inability to express previous state of creativity (e.g., singing, listening to music, writing)
No interest in nature
No interest in reading spiritual literature
Connections with Power Greater Than Self
Inability to pray
Inability to participate in religious activities
Expresses being abandoned by or having anger toward God
Inability to experience transcendence
Request to see a religious leader
Sudden changes in spiritual practices
Inability to be introspective or inward turning
Expresses being without hope, suffering
OUTCOME
Spiritual Health
Connectedness with self, others, higher power, all life, nature, and the universe that transcends and empowers the self
ETIOLOGICAL OR RELATED FACTORS
Self-alienation
Loneliness
Social alienation
Anxiety
Sociocultural deprivation
Death and dying of self or others
Pain
Life change
Chronic illness of self or others
Risk for Spiritual Distress (1998, 2004)
DEFINITION
Presence of risk factors for an impaired ability to experience and integrate meaning and purpose in life through connectedness with self, other persons, art, music, literature, nature, and/or a power greater than oneself
