Spirituality and Sexuality in Palliative Care

Spirituality and Sexuality in mitigatory heraldic bearingAnjum zahoorSignificance of eldritchity and cozyity in alleviator thrill match to WHO (2012) alleviatory sh ar is an approach that improves the quality of life of endurings and their families facing the problem associated with life-threatening illness, through the prevention and relief of pain by federal agency of early identification and impeccable assessment and treatment of pain and separate problems, physical, psychosocial and ghostly. The aim of mitigative handle is to deliver the goods comfort care and keep going system at end of life, to relieve suffering and pull off with problem associated with life changes due to illness. Literature excessively supported that alleviator care does not depend on prognosis, as the life is at end stage, or cure the disease. But it focuses primarily on anticipating, preventing, diagnosing, and treating symptoms undergo by unhurrieds with a serious or life-threatening illness and constituent patients and their families make medically important decisions.During my palliative course clinical I encountered with 80 year old male patient admitted with complain of drowsiness, hiccups and velocity GI bleed. At Aku he was treated as aspiration pneumonia. During chronicle taking patient stated that, from two days I was olf bringion weak and unable to move myself. After investigations, reports revealed that he was suffering from symmetrical brain atrophy, subdural hygromas and Pleural effusion in left lung. In Four days clinical I observed that his son took care of his father, reciting holy Quran and sprinkle holy water on his face. When I assessed patients spiritual Domain, his son verbalized that before hospitalization insurance he was real punctual in his rituals, supported prayers. referable to hospitalization he was unable to perform his rituals. During care when I asked most patients memorable day he stated that my memorable day is when me and my wife went to America to meet my daughter .we enjoyed a lot, visited the entire beautiful stance and spend good duration with my family. Suddenly patient stop dialogue and cried. I shocked for a while, elaborating further he mention that he lost his wife. I mat up very sad. The moment is very sensational, and my look are full of tears. I felt like crying. I felt the pain he was going through from which he can loll around relief after peace full death. I was very disturbing for the absence of his family members, during his last movement who can wear out at least moral support for him.As a nursing student my state is to provide holistic care to the patient and his family. During care I determine several unnatural spheres, like physical (pain in leg and stomach, drowsiness), psycho-social (death of wife), spiritual (religious), and many others. Here all domains of palliative care are interlinked to for each one other entirely I focuse on two affected domains spiri tual and informal.This paper is about issues, intervention, recommendations regarding spirituality and knowledgeableity. I would like to discuss the highlighted domain which was spirituality. Many patients envision changes in their spirituality when they are at end of life. Some patients get very closer to theology, offer their rituals and find religion as a deal mechanism to kindle their well-being. piece of music some people get confused and stack in spiritual conflicts, blaming God for illness and denied from happening as result they separate themselves from supreme-power. akin is the case with my patient, because of his illness his religious practice was greatly altered. As patient was CBR and has pain in his leg and right hand. He used to offer regular rituals prior, to his illness and now he is upset as he is unable to do. But he is very satisfied with his Gods blessing. He says that God gave me everything, satisfy my wishes, and I am very joyful with my life. But now he considers himself unkempt because of urine bag, NG tube. I encourage patient and his family to reconnect with God. Sulmasy, D. P. (2006). Stated that spirituality play a vital procedure in a persons coping style. It can to a fault provide a network of social support that promote and to maintain unrestrained and psychological wellbeing. As a nurse when I assess patients need, he verbalized that he wants to offer prayers. At that time I provide table covered with unused white clothes, so that patient put his tasbii on it and offer his prayer. Due to his physical illness he does not able to stand so, I encourage patient to offer ritual on his control and I assist him with physical limitation. I curtain patients bed provided privacy and encouraged patients family to recite holy Quran near bed side, and assist to show the direction of kiblah. During feeding his son requested me to give holy water I give. The family really appreciates me and my effect commences fruitful. It makes me so happy and proud.Other highlighted domain was sexuality. Sexuality is fundamental desire for all benignant being. According to WHO as cited in (Tierney,D.K. (2008). Sexuality is the combination of physical, emotional, intellectual, and social aspects of sexual beings in positive ways to enrich and enhance personality, communication, and love. virtually of the health care professionals are hesitant in asking about these issues. Health care provider always address physical, social, psychological domain and many times they neglect the domain of sexuality in their care. As a palliative care nurse its my responsibility to provide holistic care to patients so its important to discuss the exhaust-to doe with of their illness on sexuality. Sexuality is not only about parley or not refer to just a physical act but it means identity, gender mathematical functions and orientations, libido, pleasure, and attachment. It is experienced and may be express through thoughts and fe elings and love. It doesnt matter patient is so aged, weak or drowsy, but we have to assess patient sexual dowery. According to Julie (2004) sexuality is a lifelong natural need that is not limited by age, physical appearance, health status, or functional abilities. Referring to my patients sexual domain. No doubt patients wife is no more, he feel alone and misses his wife, he seems weak or aged but we have to assess patients sexual need, his feeling toward it. may be patient wants to meet his daughter share his feeling and emotion with her, gave any advice to them. As a nurse it is not necessary that I help patient to meet with his wife to fulfill his sexual desire, it doesnt mean that. Delivering physical care also come in sexuality. Moreover, during our palliative course theory session, one of our faculties told us that physical appearance also comes under component of sexuality. If a person is looking well, his self-esteem also improves, while if a person is unkempt, his self- esteem declines which ultimately affects patients sexuality too. I give fully attention to my patient in care, I give mouth care, bedding, encourage to change clothes. Encourage patients family to share his feeling with him.Now a day Palliative care nursing is a very new and fruitful concept. It is started in our country but on a very slow wretched and special effort is needed to build up this field. Moreover at organization level we have to work on it. Awareness session, programs are required. So we should conduct session with collaboration of other institution to come close to holistic care during last moment of live. As a student nurse it is our responsibility to assess all domain of palliative care. I would like to share a pretense that would further enhance our capabilities to understand the qualities of nurses that would help the nurses to play an effective role in palliative care. The model I am discussing isThe Nursing Role Effectiveness Model.This model focuses on the nur sing variables such as education and working experience that had a direct impact on patients effective palliative care. If a nurse is well aware and educated about the technical ways of communication with a dying patient, so she can ease his suffering in an effectual manner (Lange, Thom Kline, 2008). Furthermore, health care team should have knowledge about spirituality so that they can identify and fulfill the need of patients by providing them holistic care. It is also recommended that there should be a separate room for patient and family, where they can peace fully performed their rituals. there should a system in hospital policy that provides a spiritual leader.For sexuality it is necessary that nurse should perform a profound sexual assessment and build a therapeutic relationship. It would allow the client to good verbalize his feelings. Moreover, if his family would be there so we would encourage them to spend time with the patient, hug him, kiss him or be intimate with hi m. Hereother ways of conveyance intimacy. Legg, M. (2013).In conclusion, palliative nursing care plays a vital role in terminally ill patients and family to enhance their wellbeing. It is very important component of holistic care and we nurses also play very crucial role in improving condition of patients, providing moral support, which include social, sexual, spiritual emotional and psychological domain. By end of two week of clinical I realized that how much palliative course is important to enhanced or support for patient. In future I will tried my scoop out to help them ,provide a moral care .i used this knowledge in to practice in my community to promote this course.REFERENCEBaldacchino, D.R. (2011). Teaching On Spiritual Care The perceived impact on qualified nurses. withstand Education in practice, 11, 47-53.Julie,M. (2004). Sexuality at the end of life.American Journal of Hospice Palliative Care,21.Lange, M., Thom, B., Kline, N. (2008). Assessing Nurses Attitudes toward Death and Caring for Dying Patients in a Comprehensive cancer Center.Oncology Nursing Forum,35(6), 955-959. doi10.1188/08.onf.955-959Legg, M. (2013). What is psychosocial care and how can nurses better provide it to full-grown oncology patients.Australian Journal of Advance Nursing, 28(3), pp.1-13..Olasinde, T. A. (2012). Religious and Cultural Issues surrounding Death and ill in Nigeria.Online Journal of African Affairs,1(1), 1-3Tierney,D.K.(2008). Sexuality A Quality-of-Life Issue for crab louse Survivors.Seminars in Oncology Nursing,24(2), 71-79. doi10.1016/j.soncn.2008.02.001Sulmasy, D. P. (2006). Spiritual Issues in the Care of Dying Patients Its o.k. Between Me and God. Jama, 296(11), 1385-1392.World Health Organization. (2012). WHO definition of palliative care nursing.