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Mental health
Fortinash: Psychiatric Mental Health Nursing, 5th Edition

Chapter 08: Culture, Ethnicity and Spirituality

Case Studies - Critical Thinking Answer Guidelines

CASE STUDY: HOLISTIC ASSESSMENT
The patient is a 66-year-old woman who has been hospitalized for an extensive period (approximately 6 weeks). The initial problems were major depression, anxiety, and a degenerative spinal condition that required several surgeries. The spinal condition is treatable, but the process will leave her with some permanent restrictions in movement and some possible residual pain. The patient currently has significant chronic leg and lower back spasms and states that medication gives her little relief. Both the pain and the restrictions resulting from surgery have exacerbated her depression and anxiety.

The patient has been divorced for almost 40 years. Immediately after her divorce, she and her four children moved 1500 miles away from her family and friends so that she could seek employment in a manufacturing environment. Although two of her children live close by, only one child is in regular contact with the patient. The patient has a Lutheran background, but she has no local connection to a congregation and has not attended church regularly since leaving her hometown. Both the patient and her physician are extremely interested in her having regular visits for spiritual care, and both have stated that the visits provide the patient with significant help and support.

The Patient’s Belief and Meaning
Being independent, strong, and self-sufficient are important goals in life, which are to be valued and pursued.

The Patient’s Vocations and Obligations
The patient’s goal was to support, raise, and care for herself and her children without being dependent on others. She still seeks to care for her adult daughter—asking the spiritual caregiver to meet with her daughter to talk about performing a marriage ceremony.

The Patient’s Experience and Emotion
The patient

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