Counseling and Spiritual Assistance to Chemotherapy Patients: A Reflection in the Light of Jean Watson's Theory

Mendonça, Angelo Braga; Pereira, Eliane Ramos; Barreto, Bruna Maiara Ferreira; Silva, Rose Mary Costa Rosa Andrade

doi:10.1590/2177-9465-EAN-2018-0081

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REFLECTION • Esc. Anna Nery 22 (4) • 2018 • https://doi.org/10.1590/2177-9465-EAN-2018-0081 copy

Counseling and Spiritual Assistance to Chemotherapy Patients: A Reflection in the Light of Jean Watson's Theory

Orientación y asistencia espiritual a pacientes en quimioterapia: una reflexión a la luz de la Teoría de Jean Watson

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Aim:

To reflect on the use of spiritual interventions and methods of psychological, theological and psychotherapeutic counseling applicable to nursing.

Method:

Theoretical reflection article, used to identify approximations and distances of counseling methods and spiritual interventions with Jean Watson's Theory of Human Care.

Results:

The critical analysis of methods of psychological, theological and psychotherapeutic counseling indicates approximations with the Theory of Human Care, promoting the improvement of spiritual interventions directed to patients in chemotherapy.

Conclusion:

From Jean Watson's Theory emerged a creative, original and unique advice in nursing.

Implications for practice:

Understanding counseling methods and spiritual interventions are important tools for the practice of oncological nursing, as well as enhancing the resources available to integrate spirituality and health.

Keywords:
Counseling; Spirituality; Neoplasms; Nursing

Qualities/requirements for counseling	Methods and spiritual counseling interventions	Caritas Processes
Empathy; spiritual self-care; compassion		Formation of a system of altruistic-humanistic values: practice of love/kindness, equity for oneself and for the other.
- need to recognize the impact of cultural and religious differences between therapist and client on counseling¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... 14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^-¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... - multicultural competences¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... - authenticity¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...	- reading of biblical and/or religious texts¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... 14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^-¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... - prayer¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... ^,¹⁷17 Sharma V, Marin DB, Sosunov E, Ozbay F, Goldstein R, Handzo GF. The Differential Effects of Chaplain Interventions on Patient Satisfaction. J Health Care Chaplain [Internet]. 2016; [cited 2018 Mar 1]; 22(3):85-101. Available from: http://dx.doi.org/10.1080/08854726.2015.1133203 http://dx.doi.org/10.1080/08854726.2015.... 18 Brown O, Elkonin D, Naicker S. The use of religion and spirituality in psychotherapy: enablers and barriers. J Relig Health [Internet]. 2013 Dec; 52(4):1131-46. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=The+Use+of+Religion+and+Spirituality+in+Psychotherapy%3A+Enablers+and+Barriers.+J+Relig+Health.+2013%3B52(4)%3A1131-46 https://www.ncbi.nlm.nih.gov/pubmed/?ter... ^-¹⁹19 Memaryan N, Ghaempanah Z, Saeedi MM, Aryankhesal A, Ansarinejad N, Seddigh R. Content of Spiritual Counselling for Cancer Patients Undergoing Chemotherapy in Iran: A Qualitative Content Analysis. Asian Pac J Cancer Prev [Internet]. 2017 Jul; [cited 2018 Mar 1]; 18(7):1791-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28749107 http://www.ncbi.nlm.nih.gov/pubmed/28749... - application of elements of ethno-psychological advice¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr... - application of elements of multicultural counseling¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... - therapy of hope²⁰20 Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL. Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol [Internet]. 2014 Dec; [cited 2018 Mar 3]; 82(6):1087-100. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0036959 http://doi.apa.org/getdoi.cfm?doi=10.103...	Instillation of faith and hope: to be authentically present; enable, sustain and deeply honor the belief system of self and other.
- active clinical listening - practical experience and training - awareness of one's limitations	- centralization techniques to establish spiritual connections with counseling¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/...	Cultivation of the sensibility of self and of the other: cultivation of one's own spiritual practice and a transpersonal "Self" that goes beyond one's own ego.
- congruence¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...	- strategic counseling²¹21 Manjón González J. La Autoayuda y el Consejo como Procedimientos Psicoterapéuticos. Rev Asoc Esp Neuropsiq [Internet]. 2014 Apr/Jun;34(122):283-300. Available from: http://dx.doi.org/10.4321/S0211-57352014000200004 http://dx.doi.org/10.4321/S0211-57352014... - non-directive procedures²¹12 Watson J. Watson's theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice. Texto Context Enferm [Internet]. 2007 Jan/Mar; [cited 2018 Mar 1]; 16(1):129-35. Available from: http://dx.doi.org/10.1590/S0104-07072007000100016 http://dx.doi.org/10.1590/S0104-07072007...	Development of a relationship of help and confidence: development and permanence of an authentic relationship of care.
	- meditation¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... ^,¹⁷17 Sharma V, Marin DB, Sosunov E, Ozbay F, Goldstein R, Handzo GF. The Differential Effects of Chaplain Interventions on Patient Satisfaction. J Health Care Chaplain [Internet]. 2016; [cited 2018 Mar 1]; 22(3):85-101. Available from: http://dx.doi.org/10.1080/08854726.2015.1133203 http://dx.doi.org/10.1080/08854726.2015.... - mindfulness²⁰20 Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL. Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol [Internet]. 2014 Dec; [cited 2018 Mar 3]; 82(6):1087-100. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0036959 http://doi.apa.org/getdoi.cfm?doi=10.103... - use of transference and countertransference as therapeutic elements in counseling²²22 Jang JE. The Interactive Play and a Persuasive God: A Psychoanalytic Approach to Re-envisioning Pastoral Care and Counseling. J Pastor Care Couns [Internet]. 2016; [cited 2018 Mar 3]; 70(2):136-42. Available from: http://dx.doi.org/10.1177/1542305016643057 http://dx.doi.org/10.1177/15423050166430...	Promoting acceptance of negative and positive feelings: being present to support the manifestation of positive and negative feelings as a means of deep connection with yourself and with individuals for care.
- know cultures and religious practices¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,¹⁴14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...		Systematic use of the scientific method of problem solving for decision making: use of the Self and all other knowledge recognized as part of the process of caring for engagement in a health recovery process through art.
- specialization in mental health - masters in the area of spiritual care		Promoting an interpersonal teaching-learning process: engage truly in teaching-learning experiences within the context of caring; assist another person fully and in the subjective sense of experience.
		Provision of a supportive, protective and/or corrective mental, physical, sociocultural and spiritual environment: creation of a healthy environment at all levels, both physical and non-physical, conscientious and energetically refined, whereby totality, beauty, comfort, dignity and peace are strengthened.
		Assistance from the gratification of human needs: with reverence and respect, meet basic human needs; maintain the consciential intentionality of care by touching and dealing with the embodied spirit of the other, honoring the connection of the being; allow spiritual connection.
	- application of strategies proposed by Gestalt-Therapy¹⁴14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,²³23 Henning-Geronasso MC, More CLOO. Influência da Religiosidade/Espiritualidade no Contexto Psicoterapêutico. Psicol Cienc Prof [Internet]. 2015;35(3):711-25. Available from: http://www.scielo.br/scielo.php?pid=S1414-98932015000300711&script=sci_abstract&tlng=pt http://www.scielo.br/scielo.php?pid=S141...	Recognition of existential phenomenological forces: openness and attention to the spiritual, mysterious, unknown and existential dimension inherent in life, death and suffering.

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[1] Corresponding author: Angelo Braga Mendonça. E-mail: angeloprimax@gmail.com