Academic journal article Communication Studies

The Dilemmas of Spirituality in the Caring Professions: Care-Provider Spiritual Orientation and the Communication of Care

Academic journal article Communication Studies

The Dilemmas of Spirituality in the Caring Professions: Care-Provider Spiritual Orientation and the Communication of Care

Article excerpt

In the last decade, communication scholars have begun exploring the problems of care in our society and relationships between care and communication (Miller & Considine, in press; Wood, 1994). Care giving, once a private task, is increasingly moving to the public arena (Wood, 1994). Professional care providers, such as social workers, daycare providers, ministers, and medical assistants, play a crucial role in many organizations. Jobs in health care and social assistance already account for 10.4% of all employment in the United States, and jobs in these sectors are projected to increase almost 32% by 2012 (U.S. Department of Labor, 2005).

Although this institutionalization of care may be necessary, the shift of care from the private realm to the public arena is not without significant challenges. Past research exploring the tensions between the private and the public world in professional care provision has focused primarily on issues related to the role of emotion in professional care (Karabanow, 1999; Mumby & Putnam, 1992). Emotion, however, is not the only issue of contention as care transitions from the private world to the public arena.

Recent scholarship suggests that spirituality also plays an important role in care (Parrott, 2004). The vast majority of this research has focused on care recipients' needs and lay understandings of spiritual care (Bullis, 1996; Canda & Furman, 1999; Ellor, Netting, & Thibault, 1999; Koenig, 2002). To date, little research has focused on care providers' needs and professional understandings of spirituality. Hence, this study explores care providers' understanding of spirituality and the care relationship and examines how care providers' communication reflects these understandings.

Spirituality and Communication in the Caring Relationship

This article is based upon the assumption that all human beings are inherently spiritual (Rodriguez, 2001). Definitions of spirituality have been vague and contradictory in much of the academic literature with much of the confusion stemming from a conflation of religion and spirituality (Giacolone & Jurkiewicz, 2003). Spirituality can be understood as the search for the sacred, the transcendent, and a desire for a greater sense of meaning and connection (Koenig, 2002). For some, though not all, individuals, the experience and expression of spirituality comes largely within a particular religious context.

Historically, spiritual beliefs played an important role in caring (Canda & Furman, 1999). The connection between spirituality and healing practices remained strong up to the Enlightenment (Koenig, 2002). However the scientific revolution shifted the focus of care away from a holistic, spiritual approach toward a more technological and biomedical model of care that largely neglects spiritual issues (McGrath, 1997). The institutionalization of caring created further challenges as care providers were forced to manage organizational, societal, and legal restrictions on the incorporation of spiritual care into their work.

Yet, the last decade has seen a rising trend of resistance to the marginalization of spiritual care. Surveys show that as many as 77% of patients report that primary-care physicians should "consider" patients' religious needs (King & Bushwick, 1994). Derezotes and Evans (1995) found that 91% of social workers reported client-initiated spiritual discussions. In their review of the medical literature, Koenig, McCullough, and Larson (2001) found more than twelve hundred studies examining the relationship between religion and patient health with most finding a significant positive association. In our discipline, a recent special issue of Health Communication explored the connection between spirituality and health (Parrott, 2004).

Despite the fact that many scholars, practitioners, and care recipients support a more central role for spirituality in care (Bullis, 1996; Canda & Furman, 1999; Ellor, Netting, & Thibault, 1999; Koenig, 2002), communication about spirituality and religion is not a common practice for most care providers. …

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