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Religiosity
Frequently, throughout the hterature, spirituality is mistakenly interchanged or used synonymously with religiosity, or such psychological vanables as hope, peace,
worth, inner being and well-being Spintuahty and religiosity have been poorly differentiated in the past and it is
only recently that these terms have acquired greater specificity (Kreidler, cited m Emblen 1992, Hanmer 1990)
Religion exemplifies a particular value and belief system
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and provides an ethical-moral code, or framework, for
behaviour (Mickley et al 1992, Carson 1989), it refiects
contemporary cultural values, personal philosophies, and
IS socially constructed (Widerquist 1991, Brooke 1987,
Bumard 1987) Religion is organized, mstitubonalized,
and serves as merely one of many possible means of spiritual expression (Emblen 1992, Allport 1961)
Msiny nursing cumcula present students with an overview of particular religious doctnnes, pracbces and dietary
restrictions common to a vanety of cultures, this leads
students to assume that attenbon to a patient's religious
rituals and requirements will satisfy spintual needs
(Mansen 1993, Creen 1992, Hutchmgs 1991, Byme 1985)
Educational preparation with a greater emphasis on recognition and assessment of spintual integrity, as disbnct
from religious association, would facilitate or enhance the
provision of holisbc care (Fish & Shelly 1978)
Although the spiritucd and psychological dimensions
have been theorebcally delineated, there remains a considerable overlap m behavioural expression, this leads to
confusion and hermeneutic ambiguity Since the metaphysical nature of this phenomenon precludes direct
observation, its presence and state of integrity must be
inferred from overt behaviours or discermble moods and
emotions (Arnold 1989, Labun 1988, Brooke 1987,
Cbapman 1986), therefore, assessment of atbtudes and
bebaviours may suggest subtle clues to both dimensions,
and interpretation requires caution and sensitivity The
inability to distinguish clearly between the spiritual and
psychosociai dimensions presents a formidable challenge
to the nursing profession, careful examination reveals that
psychosocial concepts are not interchangeable witb spiritualify and tbe failure to differentiate amongst these
terms contributes to neglect, or denial, of spiritual
dimensionality
'Proprium' (logical property) and 'accidens' (logical accident) refer to attnbutes which necessanly or contingently
accompany the essence but are not part of the essence A
logical property, or proprium, is a universal that signifies
Essential predicables
an attnbute which, although not part of its quiddity, is
A 'species' expresses the completely determined essence necessanly and conceptually inseparable from its subject
of a subject and answers the question 'What is the thing (Mill 1974, Dewey 1938) The subject, therefore, cannot
(subject) essentially''' (Bachhuber 1957) It is the 'what- be conceived of sans property without contradiction
ness' of the concept Specific distinguishing attnbutes Bachhuber (1957) descnbes two types of logical properties,
which differentiate this subject from others of similar specific and genenc, both of which are necessarily connecessence are not, however, identified In the affirmative ted to the essence of the subject
A 'logical specific property' refers to an attnbute that
proposition 'spirituality is integrative energy', the species
IS 'mtegrative energy' which describes the quiddity, or results from the completely determined essence of a subessential nature, of spintuality Although there may be ject, or the species (combined genus and differentia) It is,
vanous types of mtegrative energy, the species simply therefore, demonstrable in every member of a species and
descnbes the essential, rather than the attributive, charac- IS particular only m such members A logical specific propteristics which must be present in order for mtegrative erty of spirituality would be 'capable of producing intemal
human harmony, or holism' This property necessanly
energy to be considered spintuality
Species IS a relatively narrow subdivision of a wider anses from the completely determined essence of the
class, or genus, which has been individualized by some species 'spirituality', it anses from a combination of the
specific difference The 'genus' is that portion of essence genus 'energy' and the differentia 'mtegrative' To meet this
which IS shared by other individual subclasses or species, cntenon, it must also be common to all instances of spintuit IS a umversal that expresses the mcompletely deter- ality and peculiar to spirituedity To consider spintuality
mined nature of a subject and provides only a partial without this extant property, in any culture, religion or
answer to the question 'What is a thing essentially''' (Mill individual, would result m conceptual contradiction,
1974, Bachhuber 1957) 'Energy' is the genus of 'spintu- consequently, it is a logical necessity which fiows from the
ality', and that which can be affiirmed of energy, such as subject It IS adherent to the essence of all forms of spintuits available power, activity or force, can also be affirmed ality but IS not a charactenstic of its quiddity This property
of all its vanous forms, including physical, mental, electri- does not anse solely from the genus 'energy' smce other
1995 Blackwell Science Ltd, Joumal of Advanced Nursing, 22, 808-815
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forms of energy do not necessanly mtegrate or umfy, but Table 1 Synoptic schema spintuality and the predicables*
from the species itself Therefore, to be capable of achievmg
Examples
The predicables
intemal human harmony is a necessary attnbute of all The quesUon
forms of spintuality and is particular to spmtualify
Species
A 'logical genenc properfy' refers to an attnbute that 1 What IS spintuality Integrative energy
essentially'
results from the incompletely determmed nature of the
To what immediately Energy
Genus
subject It anses from the shared consbtuent elements 2
more general class
common to all species within a broader class, or genus
of things does
Logical genenc properties wbich are attnbutable to spmtuspintuality belong'
ality, inasmuch as spmtualify is an energy, include incor- 3 What kind of energy Integrative
Differentia
poreal, vital, potential, vigorous or forceful Each of these
IS spintuality'
attnbutes is shared by spintuality and by all other species
What IS the basic
of the genus 'energy', in other words, they arise from the
note, or
genenc nature of energy
characteristic, that
distinguishes
A 'logical accident', or accidens, is an attribute wbich
spirituality from
has no conceptual connection with the subject's essence.
other energies'
It bears a purely contingent relationship to the subject of
4 What are some
Capable of
Logical specific
which it IS predicated (Dewey 1938) Although a logical
attnhutes that
producing mtemal
property
accident is compatible with the subject, its removal would
spirituality has
human harmony, or
not contradict conception of the species (Mill 1974,
specifically because holism, by
Bachbuber 1957) Transcendence and relabonal connecIt IS spintuality'
combmmg body.
tedness to others are logical accidents m relabon to the
mind and spint
essence of integrative energy The capacity for spmtualify
What are some
Incorporeal,
Logical genenc
to be metaphysically or existentially transcendent exists,
attributes that
potential, vital.
property
spirituality has that vigorous, forceful.
yet It can also be tbought of, without contradiction,
it shares vi^th other transforming.
without either of these particular attnbutes
energies'
changing
A summary of the five predicables m relation to spmtu5 What are some
Transcendent
Logical accident
ahty IS presented m Table 1 as a synopbc schema which
attnbutes that are
Relational
has been adapted from that developed by Bachhuber
compatible vnth the
(1957) An examination ofthe S3Tioptic table and refiection
essence of
upon the philosophic analysis supports acceptance of the
spirituality but do
affirmative proposition 'spirituality is mtegrabve energy'
not necessarily
as a defimbon of spmtualify
accompany it'
* Table format adapted from Bachhuber A (1957) Introduction to
Logic Appleton-Century-Crofts, New York, p 251
Tradibonally, a defimbon is based upon, and communicated by, tbe tbeory of tbe predicables, in parbcular, genus
ind differentia, which are logical distmcbons rather than
ontological disbncbons, like species and genus (Stebbmg
1961, Dewey 1938) An essenbal definibon is compnsed
of genus and differenba, it expresses the completely
detemuned quiddify of its subject and is a proposibon of
equivalence, or convertibilify
A clear, precise theorebcal definibon which is universal
and acceptable to the majonfy of nursmg pracbboners will
have significant consequences for clinical pracbce A good
defimbon requires clanfy, brevify, coextension with the
subjecbve term, and must be posibve, whenever possible
(Bachbuber 1957), it avoids tautological and metaphoncal
language for the sake of ontological precision Coextension
implies that the defimbon is applicable to all members of
a species and only to those memhers, it distmgmshes the
subject from all other subjects and is perfectly converbble
Differentia 'integrative'
hitegrabon is the process of bringing together mcorporate
parts mto an mtegral, hannomous whole In human terms.
It IS the process of umfymg the biophysical, psychosocial
and spintual dimensions to create an internal harmony
which can he demonstrated through affect and emobons
as peacefulness, contentment or tranquility O'Bnen (cited
m Lahun 1988) descnbes altered spiritual integnty as
exj>enences of spiritual pam, alienation, anxiety, guilt,
anger, loss and despair Overt behaviour or expression of
feelmgs which refiect these descnptors should alert nurses
to the need for interventions aimed at restoration of spmtual mt^^ity, such as values clanfication, empathetic
inquiry and attenbve, silent listening
Logical specific property 'capable of producmg
intemal human harmony, or holism'
Capacity in this instance describes a latent potential for
activity. It can be thought of as a resource which the mdividual can draw upon m periods of personal cnsis to mamtam or restore a sense of stability in life Cntical life events
(such as threatened health or well-bemg) or relabonships
are frequently the precipitabng antecedents of spintual
distress Recogmbon of distressmg extraquobdian situations, or spiritual turmoil, will lead the nurse to intervene
and explore areas of existenbal, metaphysical or eschatological concem with his/her patients Empathetic listening, caring, physical presence and discussion may assist
the patient to focus on the situabon and facilitate the
ascripbon of meanmg to personal suffenng or unpalatable events
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Logical accidents 'transcendent, relational'
These attnbutes are compabble with the essenbal nature
of spmtualify but do not necessanly accompany it A metaphysical or an existenbal transcendence may occur as a
function of spmtual mtegrabon or expenence but its
absence in no way dimimshes the conceptualizabon of
spmtuahfy Similarly, spmbiahfy is often manifested m
relationships to God, a diefy, or other mdividuals, it can,
however, be present solely within an individual and
removal of this relabonal attnbute does not contradict conceptualizabon of the essence of spmtualify as mtegrabve
energy
From a philosophical perspecbve, the interest and concem regarding metaphysical and eschatological issues
make this concept relevant to nursing by virtue of tbe
ascripbon of meemmg and purpose to human existence
The premise that a person's spmt is the locus of healing
requires further mvesbgabon because of its potenbal
strength and abilify to influence health status and outcomes directly through the mobilization and focusing of
intemal energy Exploration of tbe human spmtual dimension demands an approach that is fiexible, holistic and
open to metaphysical ideology A re-evaluabon of the
spintual dimension will require that methods of naturalistic inquiry be employed to increase understanding of this
phenomenon Since phenomenological research has its
epistemological origins m philosophy and searches for
commonalities, or essences, which transcend individual
expenences, it is particularly appropriate to inquiry into
spmtual dimensionalify
Nursing cumcula
Integration of spirituality into nursing cumcula and recognibon of its transcendent, universal nature will prepare
pracbtioners to recognize spmtual distress and plan for
appropnate intervention It would also facilitate mtraprofessional imderstandmg and communication
Conceptual elanfieabon and the formulabon of an accurate and acceptable theorebcal definibon of spirituality are
the mibal steps to achievmg nursing's goal m terms of
holistic nursing practice Spmtualify as mtegrabve energy
has been proposed as an essential defimbon and, if
adopted, will be mstmmental m planning intervenbons
directed towards meebng pabents' spmtual needs, ensuring holistic care, emd adding to the further development
of a body of professional nursing knowledge
References
Allport G (1961) The Individual and His Religion Macmillan,
New York
Arnold E (1989) Bumout as a spintual issue rediscovenng meaning in nursing practice In Spintual Dimensions of Nursing
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