Spiritual background and its association with the medical decision of, DNR at terminal life stages.

In recent years personal and clinical dilemmas relating to terminally ill patient-care medical, decisions have increased significantly. Although understanding the patient's medical, nursing and, social background is important, a comprehensive appraisal essential for treating the "whole patient" is, incomplete without a spirituality assessment. Religious beliefs and practices affect medical and health, care decisions and require recognition as a dynamic in coping with suffering, loss, life, and death. Taking a spiritual background obtains information that is meaningful to the patient's life and may, influence the medical decision-making relating to health. A study was undertaken to determine, whether assessing the spiritual background influences medical decisions-making regarding the use of, DNR. The target population was 46 family-member caregivers of non-communicative patients in the Herzog, Hospital Skilled Nursing ward located in Jerusalem. The spiritual assessment questionnaire was the, acronym FICA (faith, importance, community and addressing). Two-thirds of the families were opposed to a determination utilizing do not resuscitate (DNR). Multivariate, analysis of the findings found that only religious affiliation was statistically significant (p=0.003). The doctors recommend DNR in 67% of the cases while the family caregiver accepted this decision in, only 33% of the cases. The hypothesis was verified. People who are perceived as being religious or as being greatly influenced, by faith/spirituality opposed the recommendation implementing DNR. Obtaining a spiritual background assists the physician to understand the patient or family spirituality, facilitates sensitivity to value frameworks and preferences in making medical and health-related, decisions.

From hope to despair, and back: being the wife of a patient in a persistent vegetative state.

In this study we examined the meaning of being the wife of a vegetative patient over time. The research was based on semistructured interviews with 12 wives of husbands who were diagnosed with persistent vegetative state between 1 year 2 months and 10 years prior to the interview. We found that there were two contradicting forces common to all of the wives across time. First, there was a process of finding significance in the situation based on acceptance of the husband's condition and focusing on positive emotions and values such as love, commitment, and loyalty. Second, the wives described an increase in negative emotions such as sadness, pain, loneliness, loss, and grief. These findings are discussed in the context of research and theoretical literature about coping processes and the meaning of caring for patients in a persistent vegetative state.