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The LOVE Spiritual Care Model: A Chaplain's Tool in

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 Asia-Africa Journal of Mission and Ministry
Vol. 21, pp. 3–29, Feb. 28, 2020
ⓒ 2020 Mission and Society Research Institute
https://doi.org/10.21806/aamm.2020.21.01

The LOVE Spiritual Care Model:

A Chaplain’s Tool in Clinical Practice

1
Sikhumbuzo Dube

ABSTRACT—Providing spiritual care in a clinical setting may require a

scientific approach for it to be relevant both to the care seekers and the
healthcare team. The methodology that the clergy serving in such a
situation utilise should enable other members of the team to realise the
importance of chaplaincy. This article’s principal focus is to introduce
the LOVE spiritual care model and show its use as a tool or a working
template for healthcare clerics in delivering spiritual care. Furthermore,
it emphasises how the application of the model can present the chaplains’
professional etiquette in a good light. While the call to chaplaincy is
spiritual, the intent to show that as being spirit-led does not mean
neglecting the essentials that make up being an expert in providing the
needed nourishment. A few biblical examples from the Gospels are used
to illustrate the methodology Jesus used in His healing ministry. A
psycho-socio-spiritual wellness triadic support system is developed to
demonstrate the collaborative effort needed in the provision of total
healing. By following the sequence that the model suggests, chaplains are
thus equipped with skills that will not only help them to “link-up” with
their care seekers but also empower them to walk out of their pain
without having to depend on caregivers. A pseudo clinical vignette is
used to illustrate this.
Keywords: The LOVE Care Model, Spiritual Care, Chaplaincy,
Healthcare Chaplaincy

Manuscript received Nov. 8, 2019; revised Jan. 19, 2020; accepted Feb. 10, 2020.
Sikhumbuzo Dube ([email protected]) is with Mpilo Central Hospital,
in the West Zimbabwe Conference territory. He is a Zimbabwean by nationality.

AAMM, Vol. 21, 3

 I. Introduction

The spiritual care provided by the clergy must be motivated by the

unction of the Holy Spirit. Their individual private devotional life sets the
tone of their operation (Dube, 2019c, p. 89). While this is important, it is
equally necessary to embrace a scientific approach that does not negate
the working of the Holy Spirit but elevates the chaplain to the level of
other professionals in the healthcare team. Spiritual care is the
nourishment of the soul that demands a Spirit-led, methodical,
premeditated plan. It is not haphazard but follows precise calculated steps.
In her definition of spiritual care, Puchalski included the physical aspect.
She explained that it encompasses ministering to the whole person—that
is the physiological, the affective, sociological, and spiritual facets (2001,
p. 352). This may not be possible when the caregiver is not scientific in
his/her approach. Speaking about this, Puchalski (2000) stressed the
importance of tracing the spiritual history of the patients in order to
understand them completely. She developed the FICA acronym that can
be used by clinicians to assess their care seekers’ spirituality—which
entails faith or beliefs (F), importance and influence (I), community (C),
and address of the issue (A) (Puchalski and Romer, 2000, p. 131).
A spiritual caregiver needs to carry out assessments and document the
findings about his/her care seekers. While it must not be a mechanical
process, it should transcend just being emotionally and physically present
but walk the one needing attention out of the uncomfortable zone. Other
non-chaplaincy clinicians like medical doctors follow a systematic
approach in curing diseases. For instance, Donovan (2012) pointed out
that doctors are educated to:

Listen to the stories of their patients to identify the relevant

history and current concerns. Observe patients for signs of
other symptoms, which the patient may not mention or may not
even be aware of. Evaluate the data they gather to determine
the exact nature of the current concerns. Determine what
interventions can be used to help the patient return to health
and wholeness (pp. 42–43).

Christ, the chaplain par excellence, was systematic in His approach of

spiritual care provision. Commenting on how He did His work, White
(1905, p. 143) observed that He associated with people just like an
individual who sought their good. He extended sympathy to them and
satisfied their felt needs. He only called them to follow Him after gaining

4 Sikhumbuzo Dube
their confidence. She further added that there is a need to connect with
the people in diverse ways. This is the basis for the development of the
LOVE spiritual care model. It finds its motivation from the way Jesus did
His healthcare ministry. It is a systemic approach in which L stands for
“linking-up” (connecting), O for observation, V for verifying, and E for
empowerment. Its focus is the care for the whole person and those who
are connected to him/her (Dube, 2018, pp. 22–23).
In this article, an interrogation of the ways chaplains may link up with
their care seekers is made. The roadblocks to connecting with them are
briefly discussed. Using a question format, the crucial elements of
observation are deliberated upon. The process of verification is broken
down into simple steps that can be followed by the one providing care.
The final section deals with providing enablement for the care seeker and
those connected to him/her. Figure 1 (Dube, 2019b, p. 89) and Table 1
(Dube, 2018, p. 22–24) below show the sequence and questions of the
LOVE spiritual care model.

Figure 1. The LOVE Spiritual Care Model

Empowerment
Enablement for the care-seeker and
all connected to his/her condition.

Verifying
This will reduce
making
assumptions
when providing

Observing
Paying attention to all important symptoms
(besides the physical) in a patient. Observing
how the patient interprets the diagnosis given to
him/her. How is he/she feeling about his/her
condition?

Linking-up
Connecting the care seeker with
healthcare provider, his/her family, the
divine and the community.

AAMM, Vol. 21, 5

Table 1. LOVE Spiritual Care Model Questions

Linking-up

•How is the chaplain linking up with the care seeker? (and vice
versa)
•How is the chaplain linking up with the care seeker’s family?
•How is the chaplain linking up with his/her personal narrative?
•How is the care seeker linking up with members of his/her
family?
•How is the care seeker linking up with self?
•How is the care seeker linking up with the divine?

Observation

•What does the care seeker understand about the medical facts
given?
•How does the care seeker interpret the diagnosis given to
him/her?
•What symptoms of emotional, sociological and spiritual
turmoil are observed?

Verifying

•What feelings does the care seeker have towards his/her

condition?
•What is the intensity of these feelings?
•How deleterious are they?
•What are the care seekers’ non-verbal cues communicating?
•What elements in the present situation connect with past grief?
•What spiritual beliefs interfere with the program of care?

6 Sikhumbuzo Dube
 Empowerment

• What support system does the care seeker have in his/her

community?
• What spiritual rituals empower the care seeker in his/her
challenge?
• What empowerment does the family provide the care seeker?
• What is the appropriate intervention resource for the care
seeker?
• What previous coping mechanisms are applicable to the
presenting crisis?
• What tool can help the care seeker to be independent from the
chaplain?

II. Thabo’s Case of Clinical Depression

Chaplains are sometimes presented with cases they are not trained to
address. They need other clinicians to work with in completing the cycle
of whole person care. Below is a pseudo clinical vignette that will be
used throughout the article to illustrate the application of the LOVE
spiritual care model and how it can enhance the coordination of the
chaplain with other clinicians in the healthcare team.

Thabo Nxunge is a boy raised in a strong African Traditional

Religious home. He has been missing classes for the past two and
half weeks. He is admitted into the paediatric section of the hospital
where you are serving as a chaplain. The nurses have indicated that
the teen needs chaplaincy services. The principal of his school also
calls you to give counsel. Upon enquiring you discover that Thabo
has lost interest in school. Nothing seems to excite him anymore. His
outgoing extroverted personality has disappeared. Although he is a
promising student with a good report card, he sees no hope for the
future and thinks it is better to die than to live. His friends tell you
that before his admission he went to bed early and did not want to
wake up. For the past four weeks he has lost his appetite and feels
exhausted. He is irritable and isolates himself from friends. He

AAMM, Vol. 21, 7

 complains about body aches and headaches. He is in conflict with
his father Thando Nxunge. As you do your first visitation, you find
his father by the bedside.

The above vignette shows signs of clinical depression. While the role
of the chaplain in this case is not to be a diagnostician (Meller & Albers,
2012, p. 20), his/her work must have measurable outcomes that are
informed by his/her professional acumen and ethical astuteness
(Donovan, 2012, p. 43). His/her care provision must go beyond dealing
with the symptoms to facilitate the setting of goals that will help in
triaging issues (Paget & McCormack, 2006, p. 106). He/she must
develop a plan of intervention that will fit into the larger hospital care
strategy (Roberts, Donovan & Handzo, 2012, p. 66). However, before all
this happens no effective spiritual care may occur in the absence of
connecting with the patient. “Linking-up” with those in need of care
means that they willingly invite the caregiver into a personal sacred space
because of the trust that has been built. The chaplain must find what
Epperly called, “a sacred space-time” (2014, p. 100). This will serve as a
joining link “within which one experiences one’s life as organized,
perhaps with some details attended to by others, but within which there
also remains an appropriate degree of privacy” (Burton, 2003, p. 444).

III. “Linking-up”: Building Bridges with Care-seekers

Jesus was methodical in His approach to the provision of total healing.

His starting point was building bridges through creatively looking for
ways to connect with His care-seekers. When He approached the woman
at the well, He did not begin by condemning her, but chose to use water
as a connecting factor. When He said, “Give Me a drink” (John 4:7), He
was inviting Himself into the care seeker’s sacred space. While this
woman did not have a pathological challenge, she was probably
emotionally wounded as a result of being socially maligned by her people.
It is also likely that she was spiritually disconnected. Jesus engaged in
what Patterson, Grenny, McMillan and Switzler (2012) called a crucial
conversation—one in which something vital can potentially be lost, there
are differing viewpoints, and emotions are high (p. 3). Another instance is
when Jesus built a bridge by joining the troubled disciples on the road to
Emmaus after His crucifixion (Luke 24:13–31). He made His observation
by asking what the narrative was about. As He followed the storying of
the pain, He verified its intensity by further probing them to share the

8 Sikhumbuzo Dube
events that led to their sadness. This assessment led to the receipt of
relevant empowerment (Dube, 2018, p. 24). In the two instances cited
above, Jesus used a narrative approach to effectively link-up with His
care seekers. He acted as a competent caregiver that was equipped with
good listening skills—the best gift that can be offered to patients as they
relate their stories. He exhibited the qualities presented in Doehring’s
descriptor of a caregiver, that is, a “respectful guest who steps into the
lived and intentional theologies of the care seeker’s stories” (2015, p. 5).

A. Linking-up Catalysts

Utilising the narrative approach is the heart of the LOVE spiritual

care model. Using this methodology honours the mystery that enshrouds
the history of the one in need of nourishment. An adept caregiver will
pay attention to the divergent emerging issues, their affective
undercurrents, and the resultant lived theologies (Doehring, 2015, p. 117).
When a care seeker freely shares his/her story it enhances and maintains
connectivity. The extent of the patient’s willingness to do so may be
incumbent upon the connection made in his/her initial contact with the
chaplain. While James-Tannariello argued that care seekers are receptive
to spiritual things during their time of hospitalisation, she warned the
clerics that they should exercise caution in their approach (2013, p. 3, 4)
as this could either hinder or aid the linking-up process. Catalysing it
calls for respecting the invitation into the care receiver’s sacred space and
the shared narrative.
The clinical vignette presented above calls for the chaplain’s linking-
up skills. This step not only needs to be taken at the beginning of the visit
but should be maintained throughout the pastoral clinical encounter. Trust
is the primary catalyst that is needed before care seekers will be free to
share their stories and their “undigested emotional reiterations of trauma”
(Doehring, 2015, p. xv). The process of building trust demands being
empathetically present and a commitment to the happiness of the care
seeker (Appleby, Swinton & Wilson, 2018, Balboni, 2011, Best, Butow,
& Olver., 2016, Vermandere, 2011). The need for confidentiality not only
enhances linking-up but also improves trust (Cramer, Tenzek & Allen,
2015, p. 140). This calls for patience on the part of the caregiver.
Sometimes it may not happen quickly or as soon as the chaplain gets into
the sick room. Some care receivers are slow to accept strangers into their
private space. It is only trust that will make the connectivity possible.
Chovan (2016, p. 208) explained that it is a virtue that takes a long time

AAMM, Vol. 21, 9

to establish, yet is easily undone. This means that once it is founded it
must be maintained.
The creation of trust is through the way the chaplain presents
him/herself to the patient. James-Tannariello (2013, p. 6) used the visitor
and friend metaphors to illustrate the dressing and the deportment of the
cleric respectively as he/she provides care. In a pastoral clinical
encounter, the way the minister is dressed and the way he/she relates with
people may ameliorate or mitigate the linking-up process. To the patients,
the chaplain is the representative of a higher power that they subscribe to.
One study showed that these clerics considered themselves as channels
between patients and the divine (Cramer, Tenzek & Allen, 2015, p. 140).
The manner of dress and speech should thus communicate the same to
both the chaplain and the patient. The body language can also mar the
presentation and impede connectivity. Ihewulezi (2011, p. 30, 31) urged
the chaplains to greet the patients and introduce themselves to them in
each initial interaction, maintaining a good eye contact that
communicates warmth. He also encouraged a smile which shows being
appreciative of the patient and friendliness. Concerning a handshake, he
pointed out that cultural competence is important. In some settings, men
should not extend their hands to greet a female.
A systemic view of the patient is another important driver to linking
up. When he/she steps into the room where Thabo is, a systemic
connectivity is imperative not only because of Thando’s presence, but
because in an African setting, the sickness of one person is considered as
a communal challenge. Human beings are not viewed individually, but as
making up a relational and symbiotic community (Turaki, 2012, p. 36).
Second, such an approach would help in locating the identified patient(s)
present or absent from the sick room. Third, the way Thabo is connecting
to the the chaplain, his family and/or friends, himself, the divine,
transcendental or higher power (Dube 2018, p. 22–24), communicates his
sociological, emotional and psychological, and spiritual conditions. From
the onset, the chaplain must look for cues that show these links. Fourth, if
the empowerment must be wholistic, the plan of intervention must
address all the issues and people connected with Thabo. Donovan (2012)
argued that:

Many of our faith traditions suggest that we were created to be

in relationship with both the Divine and one another . . . An
early and accurate assessment of a person’s key relationships
and his or her sense of connectivity to others, including who or

10 Sikhumbuzo Dube
 what the person understands to be sacred, is the essential first
step in providing care as a pastoral professional (p. 46).

When the chaplain is accepted into the patient’s sacred space,

sociocultural competence is the highest attaching link that will maintain
the systemic connectivity. There are a few such issues that he/she should
be careful about. First, while Thabo may be having relational challenges
with his father, the cleric must keep in mind that in an African setting he
is more cherished than a girl child (Tabong & Adongo, 2013, p. 4,
Hjelmerud, 2015, Fuseini & Kalule-Sabiti, 2016). His father may want to
see a pastor that honours this. Second, males generally do not want to
express their feelings. One study revealed that they avoided showing
affective aspects that indicated depression. The participants removed
themselves from their own narratives and experiences (Žilinská &
Smitková, 2017, p. 93). A research carried out among South African
young men who attempted suicide revealed that they preferred to keep to
themselves rather than share their problems with others (Meissner &
Bantjes, 2017, pp. 788–790). Third, depending on the age, there is need
for sensitivity in using the first name of the patient or family member in
addressing him. Unlike in other civilisations where 99% of the elderly
care seekers preferred an informal salutation (Parsons, et. al., 2016), in an
African setting, using the first name may not be palatable. It may
communicate disrespect. For instance, in a study carried out in Nigerian
businesses which had adopted a first name culture, it was found that the
higher the discomfort felt by the employees, the more dysfunctional was
their conduct (Ugwuzor, 2016). Speaking about a United States hospital
setting, Ihewulezi (2011, p. 31) argued that in the initial contact it is
important to be a bit formal. While the chaplain may use the first name
salutation for Thabo, such should be avoided when speaking to his father.

B. Linking-up Roadblocks

It is imperative for spiritual care providers to be able to help those in

need of care to narrate their stories in order to manage their trauma
(Wimberly, 2011). This is only possible as the carer is meaningfully
connecting to his/her personal narrative without projecting its unresolved
elements to the patient. It calls for dealing with past hurts so that they do
not impede the effort to spiritually nourish care receivers. Depending on
the extent of the carer’s unhealed woundedness, there is likely to be an
explosive internal chatter (Dube, 2019a, p. 56) that may result in over-
functioning—where the caregiver’s internal rant and meaning-making is

AAMM, Vol. 21, 11

so absorbing that he/she fails to compassionately listen (Doerhing, 2015,
p. 65). While the background information given by the nurses, the school
principal and the friends in the clinical vignette is valuable, it has the
potential of causing over-functioning, thus creating a roadblock to
effective linking-up.
Mismatching the feelings of the patient will communicate callousness.
While having a happy demeanour is a great tool, it may not yield the best
results if the cleric chooses to continue smiling when the one in need of
care has a gloomy countenance. This also speaks to paying attention to
the responses that the patients give. If the greeting was loud and the
response was low, there is need for the pastor to match the tone
(Ihewulezi, pp. 31, 32). This is an incarnational ministry that clears all
the roadblocks to linking-up. It not only communicates that the cleric has
accepted the invitation into the patient’s sacred space but is also showing
empathetic presence and understanding.
It is important for the chaplain to read the facial non-verbal cues.
Understanding them and responding to them accordingly will enhance
and maintain connectivity. Ekman and Friesen (2003, pp. 10–12)
described the face as a “multisignal, multimessage system” that conveys
a variety of communications. They mentioned three types of facial
signals, namely, static, slow and rapid. The static is the permanent
physiognomy such as the skin tone. The slow includes those features that
occur with the progress of time like wrinkles. The rapid is produced by
the involuntary movement of the facial muscles in response to certain
internal or external stimuli. Attention needs to be paid to these rapid
signals as they reveal the condition of the patient. Failure to understand
what each facial expression means becomes a roadblock to effective
linking-up.

IV. Observation of their Condition

Each time Jesus saw His patients, He was moved to minister to them.
There are many recorded instances when He took a keen interest on His
care seekers’ welfare. “Seeing the people, He felt compassion for them,
because they were distressed and dispirited like sheep without a
shepherd” (Matt 9:36). In the case of the man at the pool at Bethesda,
“Jesus saw him lying there, and knew that he had already been a long
time in that condition” (John 5:6). He could only draw these conclusions
after keenly observing his condition. The looking of Jesus transcended
merely taking a glance on the one in need of care. It was an explorative

12 Sikhumbuzo Dube
and contemplative exercise that revealed the condition of those in need of
restoration to wholeness. He examined the trajectory of the illness in
order to deal with its roots and its after-effects.
Observation is not merely giving attention to the care seekers but
investigating the patient’s understanding of their medical condition and
its implications. When they brought the epileptic boy to Jesus, the
Saviour did this by asking “How long has this been happening to him?”
(Mark 9:21). It calls for comprehending the exhibited affective, social,
and transcendental turmoil (Dube, 2018, p. 22, 23). When Jesus made
this enquiry, He not only traced the boy’s spiritual history but also
assessed how the father interpreted the presenting situation. The question
was not more inclined to the time but to the existence of such a condition
and its systemic impact. The family must have been suffering from the
stigma that comes with demon possession. Furthermore, any illness was
spiritually interpreted (Dube, 2019c, pp. 82, 83). In certain societies, all
or some of the diseases have a shame that is attached to them. For
instance, studies indicate that families with people that have mental
illnesses live under stress and stigma (Moses, 2010; Henderson, Evans-
Lacko & Thornicroft, 2013, Muralidharan, et. al., 2016). It must have
been hard for the father of the epileptic boy to have his son integrated
into the society.
The observation step is a collaborative exercise that calls for the input
of other clinicians. In the medical vignette presented, the chaplain visits
Thabo because of the examination done by other professionals whose
role is not primarily spiritual caregiving. The nurses and the school
principal used their best knowledge to understand that the child may need
spiritual care. While the former are being trained to do spiritual screening,
the latter still need this education. One study revealed that 67.9% of the
nurses discovered the spiritual need of their patients mostly through
paying attention to and observing them (Mulyono & Chen, 2019). In
another study, while 86% of participants recognised the spiritual needs,
only 13% were able to meet them (Austin, et. al., 2016). This creates the
need to collaborate with the chaplains who are not only trained to do
spiritual assessment (Roberts, Donovan and Handzo, 2012, p. 65), but
also to provide the needed nourishment. As a means of enhancing this
concerted practice, Nightingale’s proposition is essential:

The most important practical lesson that can be given to nurses

is to teach them what to observe—how to observe—what
symptoms indicate improvement . . . which are of

AAMM, Vol. 21, 13

 importance—which are of none—which are the evidence of
neglect—and of what kind of neglect (2003, p. 88).

In the case of Thabo, the chaplain needs to work with the nurses that
might have done spiritual screening. Before he/she asks him/herself the
questions below, he needs to get the results of what they got from their
observation. The guiding internal enquiries will be:

Question 1: What is the understanding that Thabo and his father

have about the given medical opinion? The chaplain must help Thabo to
restate the facts given by the doctor concerning his condition. At this
stage, the intent is to get an overview of what he understands about his
medical state. Being a case of clinical depression, the patient must not be
put under pressure to relate his ordeal. Another good source of
information is Thando who is in the room. He can tell the chaplain what
he thinks about the particular medical opinion. Given the African
Traditional Religious background that Thabo is raised in, it is highly
likely that both may attribute the aetiology to being bewitched (Chirisa,
2017). The belief in the malevolent spirit world will inform the decision
that Thabo’s father is going to take in dealing with mental illness
(Mutambirwa, 1989). Considering that all illnesses have got social,
transcendental, and cognitive matters that must be investigated and some
perceived triggers (Machinga, 2011, p. 4), an understanding of the care
seeker’s conceptualisation of the given medical facts will help in building
up the plan of care.
Question 2: How do Thabo and his father process the diagnosis
given? The diagnosis given to Thabo can be interpreted to mean anything
that crosses his mind. He may be wondering, “Am I not better dead than
alive?”, “What is the purpose of life?”, “After such a medical opinion,
what is my reason for existence?” His father may be saying, “What
wrong have we done to the spirits?”, “Should we brew beer and appease
the ancestors?” and so on. These questions may bother a Christian
chaplain if he/she fails to assume an incarnational ministry. It is
important to remember that when one is suffering, espoused theologies
do not always match lived theologies. Doehring (2015) proposed that
caregivers should engage “theological empathy . . . to stand in the shoes
of those theologically different from them and appreciate how their lived
theology can be home for them in troubled times” (p. 101).
Question 3: In both Thabo and Thando, what affective, social,
emotional unrest symptoms exist? The third question leads to the phase
of verifying the felt needs. This is where the chaplain assesses the patient

14 Sikhumbuzo Dube
wholistically—noting every observable symptom of unrest. What
emotional issues affect Thabo? Is he able to manage them? How is
Thando’s affective wellbeing? How are the two fairing sociologically?
What is the relational problem they are having? Does either of them have
irreconcilable differences that hinder care? If so, what are they? What is
troubling both spiritually?
Understanding these issues will help in the continuing process of
assessment. While the chaplain must ask his/her patient some questions
as a way of observation, the intent is to be conversational and not
interrogative (Ihewulezi, 2011, p. 33). Furthermore, open-ended
questions are preferred as they allow the care seeker to freely share in a
narrative style that facilitates the conceptualisation of what is going on
(Doehring, 2015, p. 63). Listening is key at this stage. Justes (2001, p.
21) warned that the tendency is to add personal stories to what the care
seeker is saying, thus creating a roadblock to effective linking-up. The
three questions are meant to guide the caregiver to effectively make
enquiries. They are meant to enhance observation through listening.
Conclusions drawn at this stage are not final as the chaplain must verify
them in the subsequent step. It is important to note that observation-like
assessment is an ongoing process that informs empowerment.

V. Verifying the Observed Elements

Jesus never empowered without verifying the felt needs and the faith
of His care seekers (Matt. 9:2, 22, 29; 15:28; Mark 2:5; 5:34; 10:52;
Luke 7:9, 50; 8:48). In the case of the father of the epileptic boy (Mark
9:18–26), Jesus could have exorcised the demon without substantiating
his faith. However, His consensus was necessary for the receipt of
relevant empowerment. When Jesus asked the blind men, “What do you
want Me to do for you?” (Matt. 20:32, Mark 10:51, Luke 18:41), He was
doing a needs analysis (Dube, 2018, p. 23). While He saw that blindness
was plaguing His patients, enquiring helped the care seekers to look into
their situation and walk out of them through the empowerment of the
Saviour. To the sufferer at the pool of Bethesda, when He asked the
question, “Do you wish to get well?” (John 5:6), it was not because He
did not know what he needed but He was verifying the depth of the felt
need. His answer could have been a “yes” or “no”, however, the man
began to narrate his ordeal. Jesus knew how to ask the right question that
served not only as a connecting link but also as a verification tool. In
every healing encounter, Jesus not only sought to gain the attention of

AAMM, Vol. 21, 15

His patient but also his/her willingness to participate in the restoration to
wholeness (Johnson, 1999, p. 86). This serves as the basis for the
verification of the care seeker’s felt needs.
It is highly likely that both Thabo and Thando may exhibit some
symptoms that the chaplain will detect. Although they may sometimes be
unverbalized by the care seekers, a careful spiritual caregiver will
skilfully find a way to notice “the observable signs of emotional torment,
spiritual relapses, and sociological disconnectedness.” When these are
identified they must “be verified. There is more assessment in this stage
because it should provide the basis for empowerment” (Dube 2019c, p.
101). The evaluation done by nurses is called screening. It precedes the
chaplain’s assessment. Its intent is to measure the impact of religion on
the coping of the patient. The progress of this exercise is incumbent upon
the capability and readiness of non-chaplaincy clinicians to do it (Handzo,
2012, p. 35). This process involves, but is not limited to, taking a spiritual
history. Such an enquiry has a high likelihood of adding value to the care
seekers’ spiritual care in a medical centre. Furthermore, it may promote
referrals to the chaplain (Blanchard, Dunlap & Fitchett, 2012, Vlasblom,
et. al., 2015, Drury & Hunter, 2016). Collaboration is a requisite if
wholistic patient care is to be achieved. Nurses play a vital role in this
regard. The Nursing and Midwifery Council (2018) pointed out that

Registered nurses prioritise the needs of people when assessing

and reviewing their mental, physical … and spiritual needs.
They use information obtained during assessments … to
develop person-centred care plans … that take account of their
… preferences (p. 13).

In the observation stage, there is a look at the feelings that the care
seeker has about his/her condition. In the subsequent phase of the model,
these are further verified, and their intensity and lethality is assessed.
This takes a continuation of careful observation (Dube, 2018, p. 23). Post
et al., (2014, p. 876) observed that the affective elements in a patient can
be informative to the clinicians in their empathic and compassionate
patient care provision. In a discussion about doctor-patient relationship in
mental health, Lakdawala (2015) pointed out that wholesome empathy
and a desire to comprehend the feelings of the patient is very vital in
providing therapy. He further intimated that the carer’s feelings towards
the patient has some psychodynamic issues that may either positively or
negatively impact the healing process. In another qualitative study of 23
HIV patients, concern for their feelings was considered as one of the

16 Sikhumbuzo Dube
contributory factors to adherence. When care providers showed that they
respected their feelings, care seekers’ faithfulness in taking medication
was increased. These foregoing researches are indicative of the need of
paying attention to the feelings of patients—which is a foundation for
verifying the observable emotional torment. This calls for understanding
the meaning of non-verbal cues (Dube, 2018, p. 23). The art of attention
calling is appropriate as it will reveal disregarded actions or feedbacks. A
case in point is when a patient is crying, the caregiver may politely ask,
“‘I see tears and wonder what they are saying’” (Kidd, 2012, p. 101).
One qualitative research revealed that nursing students that were
competent and sensitive to the patients’ non-verbal cues managed to
satisfy their needs (Zenobia and Chan, 2013).
An identification of what elements in the presenting situation are
linked with past grief is very vital (Dube, 2018, p. 23). There are three
reasons for this proposition. First, unprocessed grief may manifest itself
in new ways. The chaplain should assess whether Thando has unhealed
grief which has the likelihood of exhibiting itself in Thabo as depression.
Bearse (2013) pointed out that if it emanates from traumatic events, it
may not easily be eradicated. She argued that it can be inherited. In such
a case it will be called intergenerational or historical trauma. Second,
previous neurotic baggage may hinder the work of care. There is a need
to assess its existence. Third, it helps the caregiver to utilise the previous
coping skills that the patient employed in dealing with pain. Individuals
facing difficult times have internal coping tools that a chaplain can utilise
to provide care. Roberts (2000) pointed out that they are buoyant

and having untapped resources or latent inner coping skills

from which to draw upon . . . . Integrating strengths and
solution-focused approaches involves jogging clients’
memories so they recall the last time everything seemed to be
going on well, and they were in a good mood rather than
depressed and/or successfully dealt with a previous crisis in
their lives (p. 19).

Thando and Thabo’s spirituality is key in the provision of care. It is

not essentially associated to the faith tradition of an individual, but
his/her intrapersonal, interpersonal and transpersonal connection. It also
includes self-consciousness and meaning making (Royal College of
Nursing, 2011). However, it is informed by one’s espoused theology. The
storying of the existing pain serves as a tool for assessing the spiritual
condition of the patient. Doehring explained that this narrative approach

AAMM, Vol. 21, 17

seeks to discover the meaning developed in the unfavourable presenting
situation. It facilitates the assessment of the meanings that the care
seekers are attaching to their espoused beliefs (2015, p. xv). In
challenging moments, the uprightness of God may be questioned (Wright,
2011, p. 205), and there could be venting up of anger against Him (Dube,
2019a, p. 54). When the espoused theology is affected by perplexities of
life, Doehring explained that “a compassionate and respectful care
relationship can provide a trustworthy space for exploring new
meanings”. In some situations, with good intentions, clergy in haste
deductively apply their own endeared theological themes to the care
seekers’ narratives. Utilising an inductive method facilitates the
emergence of theological matters from the personal stories (Doehring,
2015, p. xv).
Another important element that needs to be verified is who the
identified patient (IP) is. This is a member of the family whose pain has
caused all the members to seek for healing. In most instances, youngsters
are the IPs. Family therapists utilise the notion of IP to prevent the family
members from blaming the IP or employing him/her as a means to evade
challenges in the entire family structure. (“Family Therapy,” n.d., para 5).
When the IP is identified, the chaplain must be wholistic in his/her
approach. As stated earlier, Thabo’s illness is a communal challenge in
the African setting (Turaki, 2012, p. 36). Thus, such an intervention,
would facilitate healing. In his argument about health seeking behaviours
in non-western societies, Helman (2007, pp. 85, 87) intimated that
because of their holistic approach to challenges care seekers face, folk
healers are preferred to doctors. Their systemic methodology facilitates
the participation of the family in the creation of the solution. In this case,
the one that the family is using as a scapegoat for unresolved issues does
not carry the burden alone, but it is shared with others in the household
system.
In their discussion of the assessment that is done by a chaplain, Paget
and McCormack (2006, p. 106) describe the process as facilitating the
prioritisation of care seekers’ desires, deciding the order of interventions,
and goal setting for the spiritual care program. Fitchett and Canada
(2010) saw the roots of chaplaincy assessment as the caregiver-care
seeker relationship that not only yields voluntary sharing of personal
broken narratives by the patient, but also provides a basis for developing
a spiritual care plan that other clinicians will benefit from. Roberts,
Donovan and Handzo (2012, pp. 61–80) presented a guide that can help
chaplains to develop and implement an informed spiritual care plan.

18 Sikhumbuzo Dube
Figure two below shows how the LOVE spiritual care model
incorporates the discussed chaplaincy competences.

Figure 2. The LOVE Spiritual Care Model as a Cycle

The LOVE spiritual care model should be treated as a cycle involving

spiritual screening that is done by non-chaplain clinicians, an assessment
by the chaplain, identification and verification of spiritual distress. This
becomes the basis of the formulation of goals and plans of care which
“must be fully and completely incorporated into the larger care plan”
(Roberts, Donovan & Handzo, 2012, p. 66). It is after these phases that
evidence-based enablement will be implemented. Interventions and
empowerment do not become the end of the process but provide an
opportunity for spiritual screening which will inform the caregiver of the
effectiveness of the program of care.

VI. Empowerment of the Care Seeker

In the narrative of the epileptic boy, enablement was a systemic

approach. Jesus did not empower the sufferer only, but also the father of
the boy. Furthermore, the nine disciples, the onlooking multitude (Dube,

AAMM, Vol. 21, 19

2018, p. 23), and His critics had their needs met. In His ministry, Jesus
recognised the spirituality of His care seekers. He considered the faith of
the patients as a tool for restoration to wholeness (Matt 9:22, Mark 5:34,
10:52, 8:48, 18:42). This is the case with most illnesses in this day. For
instance, spirituality has been found to be a tool that enables patients with
chronic heart failure to cope (Sira, et al., 2014, Ginting, et al., 2015,
Shahrbabaki, et al., 2017). Some studies among HIV/AIDS patients
indicated that management of emotional pain and acceptance was
contingent on the response to religious beliefs and/or spirituality (Lee,
Nezu & Nezu, 2014, Kremer, et al., 2015, Arrey, et al., 2016, Ironson, et
al., 2016). Individuals dealing with depression indicated similar results to
those cited above (Sun & Hodge, 2012, Breland-Noble, et al., 2015,
Rahnama, et al., 2015). For the purposes of empowerment, an adept
spiritual caregiver will make use of the client’s spirituality, as it is an
internal coping resource that he/she possesses.
Thabo’s case needs a psycho-socio-spiritual wellness triadic support
system as an empowerment tool. This is a human resource support
mechanism where the chaplain, the mental health specialist and the
family collaboratively work at providing a sustainable healing solution.
The depression that he is suffering from needs psychiatric attention. The
ruined relationship with his father needs the significant others in Thabo’s
family to intervene. The discovered spiritual challenges must be met by
the cleric that is trained to provide a caring ministry.
The three human resources are indispensable for Thabo’s restoration
to wholeness. Each plays a pivotal role in his empowerment. The
professional chasm that may exist between the non-chaplaincy clinicians
and the healthcare cleric needs to be reduced if this wellness triadic
support system is to respond to the LOVE spiritual care model’s goal of
empowerment. Since chaplains “are not usually equipped to do
psychological triage and diagnosis” (Yeagley, 2002, p. 10), they must not
assume the role of psychiatric specialists. However, an appreciation of
some diagnostic criteria is essential. Mental health professionals that
assist Thabo must do spiritual screening to discover any counter-healing
issues. On this note, McCullough and Larson (1998, p. 96) intimated that
a referral to a chaplain is imperative when the one in need of care is
showing signs of spiritual distress that are worsening his/her depression.
This calls for the family’s sociological support to enrich care provision.
The involvement of Thando is demanded as he may be one of the reasons
for having Thabo as the identified patient. Usually children and
adolescents are used as scapegoats for failing to solve problems (“Family
Therapy,” n.d., para. 5).

20 Sikhumbuzo Dube
 The chaplain is the leader in the spiritual care program that Thabo will
be in. His/her focus will be on spirituality—assessing maladaptive
spiritual practices that might hinder the work of care and exploring those
that can be useful to the care seeker. While this “is a dimension that
appears overlooked or marginalized by certain approaches to and
assumptions about mental health care” (Swinton, 2003, p. 131), nurses
that not only utilise it but understand their own are more compassionate
in care provision (Labrague et al., 2016, p. 608). Using the LOVE
spiritual care model as a tool in clinical practice, the chaplain can be able
to assist both Thando and his son to be healed. This will bring relief to
Thabo’s friends, family, and the school authorities that are concerned
about his wellbeing. Figure 3 below shows the developed model of
empowerment.

Figure 3. A Psycho-Socio-Spiritual Wellness Triadic Support System

Empowerment for the patient and all individuals linked to his/her

situation is not conceivable if the preceding phases are overlooked (Dube,
2019c, p. 101). For instance, the attitude of the clinicians is among the
imperative forecasters of the care seeker’s enablement (Entwistle, 2010).
This is a phase where the chaplain through an empathetic and courteous

AAMM, Vol. 21, 21

care-bond facilitates the creation of a sacred space in which new
meanings are explored (Doehring, 2015, p. xv). It is a final step where
the chaplain gives the patient tools of thriving without a caregiver. The
identification of these implements is done through the observation and
verification stages. They inform the carer on the kind of latent inner
coping skills, the maladaptive spiritual practices that hinder care,
previous surviving mechanisms and lethality of exhibited symptoms.

VII. Conclusion

The development of the LOVE spiritual care model is informed by the

methodology of Jesus in His healing ministry. Although He was
empowered by the Holy Ghost, this did not remove the need for being
systematic in approaching a patient. Being Spirit-led does not mean being
indiscriminate in providing care. It calls for a more thorough and careful
methodology in healthcare provision because God is not the originator of
confusion (1 Cor 14:33). Clergy who claim to be under the unction of the
third person of the Godhead need to learn the art of care from the Spirit-
endowed Being who fasted for forty days and forty nights before
beginning His divine mission. He sought to link-up with His care seekers
by looking for something that would draw their attention. Having done
that, a careful observation led to His verification of their faith. This
became the basis of the empowerment. He would say, “Your faith (an
evidence of the verified spirituality) has made you whole (the needed
wholistic empowerment).”
While providing spiritual care may not always follow the steps shown
in this article, the intent of the plan is to present indispensable elements
that must not be left out in each encounter with the patient. Each
component is important as it addresses patients’ felt needs. Linking up
with them communicates that the chaplain is caring. Observing and
verifying exhibited symptoms responds to the quest for meaning which
will be co-created in the presenting situation. Empowerment is indicative
of the carer’s desire to provide wholeness to the care seeker. While
observing without verifying amounts to presumption, empowerment
without linking up communicates treating the patient like a machine that
responds by giving commands. It negates the fact that a human being is
not only a biological organism, but a psychological, sociological, and
spiritual being. The LOVE spiritual care model takes this into account.
The model presented in this article is not only linear but also circular.
It assumes that empowerment is not always the end. As the chaplain

22 Sikhumbuzo Dube
connects with his/her care seekers, he/she does assessment during the
observation and verification stages. This will help him in identifying
existing spiritual distresses caused by the illness and become a basis for
the plans and goals of care and the empowerment program to be given.
Before a patient is released, there is need for non-chaplaincy clinicians to
do spiritual screening which will inform the chaplain of the effectiveness
of the program. Furthermore, while the psycho-socio-spiritual wellness
triadic support system as an empowerment tool suggests that the care
seeker needs a sustenance structure that he/she can depend on, the goal of
care is giving independence to the care seeker. This is the reason why the
climactic stage of the LOVE spiritual care model is empowerment.

References

Appleby, A., Swinton, J., and Wilson, P. (2018). What GPs Mean by
“Spirituality” and How they Apply this Concept with Patients: A
Qualitative Study. BJGP Open, 2(2), 836–847.
Arrey, A. E., Bilsen, J., Lacor, P., and Deschepper, R. (2016).
Spirituality/Religiosity: A Cultural and Psychological Resource
among Sub-Saharan African Migrant Women with HIV/AIDS in
Belgium. PLoS ONE, 11(7), 1–22.
Austin, P. D. Macleod, M. Siddall, J. P., McSherry W., and Richard E.
(2016). The Ability of Hospital Staff to Recognise and Meet
Patients’ Spiritual Needs: A Pilot Study. Journal for the Study of
Spirituality, 6(1), 20–37.
Balboni M. J., Babar A., Dillinger J., Babar, A., Dillinger, J., Phelps, A.
C., George, E., Susan D. Block, S. D., Kachnic, L., Hunt, J.,
Peteet, J., Prigerson, H. G., VanderWeele, T. J., and Tracy A.
Balboni, T. A. (2011). “It Depends”: Viewpoints of Patients,
Physicians, And Nurses on Patient-Practitioner Prayer in the
Setting of Advanced Cancer. Journal of Pain Symptom and
Management, 41(5), 836–847.
Best M., Butow P., and Olver I. (2016). Doctors Discussing Religion
and Spirituality: A Systematic Literature Review. Palliative
Medicine, 30(4), 327–337.
Blanchard, J. H., Dunlap, D. A., and Fitchett, G. (2012). Screening for
Spiritual Distress in the Oncology Inpatient: A Quality
Improvement Pilot Project Between Nurses and Chaplains.
Journal of Nursing Management, 20(8), 1076–1084.

AAMM, Vol. 21, 23

Breland-Noble, A. M., Wong, M. J., Childers, T., Hankerson, S., and
Sotomayor, J. (2015). Spirituality and Religious Coping in
African-American Youth with Depressive Illness. Mental Health,
Religion and Culture, 18(5), 330–341, DOI:
10.1080/13674676.2015.1056120
Burton, Rod. (2003). Spiritual Pain: A Brief Overview and an Initial
Response within the Christian Tradition. The Journal of Pastoral
Care and Counseling, 57(4), 437–446.
Chirisa, S. (2017, March 2). Spiritual Beliefs and Mental Health. The
Herald. Retrieved from https://www.herald.co.zw/spiritual-
beliefs-and-mental-health/
Chovan, John D. (2016). Homeless, Mentally Ill and Drug Addicted
Patients. In E. Wittenberg, B. R. Ferrell, T. Smith, S. L. Ragan, G.
Handzo (Eds.), Textbook of Palliative Care Communication (pp.
205–213). New York: Oxford University Press.
Cramer, Emily M., Tenzek, Kelly E. & Allen, Mike. (2015).
Recognizing Success in the Chaplain Profession: Connecting
Perceptions with Practice. Journal of Health Care Chaplaincy,
21(4), 131–150.
Doehring, Carrie. (2015). The Practice of Pastoral Care: A Postmodern
Approach. Louisville, KY: Westminster John Knox Press.
Donovan, D. W. (2012). Assessments. In S. B. Roberts (Ed.),
Professional Spiritual and Pastoral Care: A Practical Clergy and
Chaplain’s Handbook (pp. 42–60). Woodstock: Skylight Paths
Publishing.
Drury, Connie and Hunter, Jennifer. (2016) The Hole in Holistic Patient
Care. Open Journal of Nursing, 6, 776–792.
Dube, Sikhumbuzo. (2018). Jesus and Eli: Antithetical Portraits of
Spiritual Care Models. Ministry: International Journal for
Pastors, 90(7), 22–25.
_____ (2019a). Therapeutic Silence in Spiritual Care: Lessons from Eli
and Job’s Friends. Asia-Africa Journal of Mission and
Ministry, 19, 43–62.
_____ (2019b). A Wholistic Intervention Approach to Involuntarily
Childless Patients’ Care in Bulawayo Hospitals,
Zimbabwe (Unpublished Master’s Project). Adventist University
of Africa, Nairobi, Kenya.
_____ (2019c). “The Spirit of the Lord is Upon Me” (Luke 4:18): The
Place of the Holy Spirit in Spiritual Care. Asia-Africa Journal of
Mission and Ministry, 20, 74–95.
Ekman, Paul and Friesen, Wallace V. (2003). Unmasking the Face: A
Guide to Recognising Emotions from Facial Expressions. Los
Altos: Malor Books.

24 Sikhumbuzo Dube
Entwistle, Vikki A. (2010). Enabling Consultations: The Facilitative
Significance of Relational Aspects of Interpersonal
Communication. Health Expect, 13(1),1–3.
Epperly, Bruce G. (2014). A Center in the Cyclone: Twenty-first
Century Clergy Self-care. Lanham: Rowman and Littlefield
Publishers.
Family Therapy. (n.d.). Retrieved from
http://www.healthofchildren.com/E-F/Family-Therapy.html
Fitchett, G. and Canada, A. L. (2010). The Role of Religion/Spirituality
in Coping with Cancer: Evidence, Assessment and Intervention.
In J. Holland, W. Breitbath, P. Jacobsen, M. Lederberg, M.
Loscalzo and R. McCorkle (Eds.), Psycho-oncology (2nd ed.)
(pp. 440–446). New York: Oxford University Press.
Fuseini, Kamil and Kalule-Sabiti, Ishmael. (2016). Lineage and
Women’s Autonomy in Household Decision-making in Ghana.
Journal of Human Ecology, 53(1), 29–38.
Ginting, H., Näring, G., Kwakkenbos, L., and Becker, E. S. (2015).
Spirituality and Negative Emotions in Individuals with Coronary
Heart Disease. Journal of Cardiovascular Nursing, 30(6), 537–
545.
Handzo, George. (2012). Creating and Implementing a
Spiritual/Pastoral Care: A General Theory for Providing
Spiritual/Pastoral Care Using Palliative Care as a Paradigm. In S.
B. Roberts (Ed.), Professional Spiritual and Pastoral Care: A
Practical Clergy and Chaplain’s Handbook (pp. 61–80).
Woodstock: Skylight Paths Publishing.
Helman, Cecil G. (2007). Culture, Health and Illness, 5th Edition. Boca
Raton: Francis and Taylor.
Henderson, C., Evans-Lacko, S., and Thornicroft, G. (2013). Mental
Illness Stigma, Help Seeking, and Public Health Programs.
American Journal of Public Health, 103(5), 777–780.
Hjelmerud, Ingrid. (2015). Caught in a Quandary: A Study of
Contraceptive Non-Use Among Women in Addis Ababa,
Ethiopia (Unpublished Master’s Thesis). University of Oslo,
Norway.
Ihewulezi, Cajetan N. (2011). Hospital Preaching as Informed by
Bedside Listening: A Homiletical Guide for Preachers, Pastors,
and Chaplains in Hospital, Hospice, Prison, and Nursing Home
Ministries. Lanham: University Press of America.
Ironson, G., Kremer, H., and Lucette, A. (2016). Relationship Between
Spiritual Coping and Survival in Patients with HIV. Journal of
General Internal Medicine, 31(9), 1068–1076.

AAMM, Vol. 21, 25

James-Tannariello, Derry. (2013). Heaven Touches Earth through
Hospital Ministry. Minneapolis: Mill City Press.
Johnson, B. W. (1999). The New Testament Commentary, vol. 3. Oak
Harbor: Logos Research Systems.
Justes, Emma, J. (2006). Hearing Beyond the Words: How to Become a
Listening Pastor. Nashville, TN: Abingdon Press.
Kidd, Robert A. (2012). Foundational Listening Skills. In S. B. Roberts
(Ed.), Professional Spiritual and Pastoral Care: A Practical
Clergy and Chaplain’s Handbook (pp. 92–105). Woodstock:
Skylight Paths Publishing.
Kremer, H., Ironson, G., Kaplan, L., Stuetzele, R., Baker, N., and
Fletcher, M. A. (2015). Spiritual Coping Predicts CD4-Cell
Preservation and Undetectable Viral Load Over Four Years.
Psychological and Socio-medical Aspects of AIDS/HIV, 27(1),
71–79.
Labrague, L. J., McEnroe-Petitte, D. M., Achaso, R. H. Jr., Cachero, G.
S., and Mohammad, M. R. A. (2016). Filipino Nurses’
Spirituality and Provision of Spiritual Nursing Care. Clinical
Nursing Research, 25(6), 607–625.
Lakdawala Paresh D. (2015). Doctor-Patient Relationship in Psychiatry.
Mens Sana Monographs, 13(1), 82–90. doi:10.4103/0973-
1229.153308
Lee, M., Nezu, A. M., and Nezu, C. M. (2014). Positive and Negative
Religious Coping, Depressive Symptoms, and Quality of Life in
People with HIV. Journal of Behavioural Medicine, 37, 921–930.
McCullough, M. E., and Larson, D. B. (1998). Future Directions in
Research. In H. G. Koenig (Ed.), Handbook of Religion and
Mental Health (pp. 96–111). San Diego: Academic Press.
Meissner, Birte Linda and Bantjes, Jason. (2017). Disconnection,
Reconnection and Autonomy: Four Young South African Men’s
Experience of Attempting Suicide. Journal of Youth Studies,
20(7), 781–797.
Moses, Tally. (2010). Being Treated Differently: Stigma Experiences
with Family, Peers, and School Staff among Adolescents with
Mental Health Disorders. Social Science and Medicine, 70(7),
985–999.
Mulyono, Wastu A. and Chen, Chung-Hey. (2019). Nurses’ Perceptions
of Spirituality and Spiritual Care and the Challenges of Learning
Spirituality. Jurnal Keperawatan Soedirman, 14(2), 103–113.
Muralidharan, A., Lucksted, A., Medoff, D., Fang, L. J., Dixon, L.
(2016). Stigma: A Unique Source of Distress for Family
Members of Individuals with Mental Illness. Journal of
Behavioral Health Services and Research, 43(3), 484–493.

26 Sikhumbuzo Dube
Mutambirwa, J. (1989). Health Problems in Rural Communities,
Zimbabwe. Social Science and Medicine, 29, 927–932.
Nightingale, Florence. (2003). Notes on Nursing: What It Is and What It
is Not. Sudbury: Jones and Bartlett Publishers.
Nursing and Midwifery Council. (2015). The Code: Professional
Standards of Practice and Behaviour for Nurses and Midwives.
London: Nursing and Midwifery Council.
Paget, Naomi, K. and McCormack, Janet, R. (2006). The Work of the
Chaplain. Valley Forge: Judson Press.
Parsons, Shaun R., Hughes, Andrew J., and Friedman, N Deborah.
(2016). “Please Don’t Call Me Mister”: Patient Preferences of
How they are Addressed and their Knowledge of their Treating
Medical Team in an Australian Hospital. BMJ Open, 6, 1–4.
Patterson, Kerry, Grenny, Joseph, McMillan, Ron and Switzler, Al.
(2012). Crucial Conversations: Tools for Talking When Stakes
are High. New York: McGraw-Hill.
Post, S. G., Ng, L. E., Fischel, J. E., Bennett, M., Bily, L., Chandran, L.,
Joyce, J., Locicero, B., McGovern, K., McKeefrey, R. L.,
Rodriguez, J. V., Roess, M. W. (2014). Routine, Empathic and
Compassionate Patient Care: Definitions, Development,
Obstacles, Education and Beneficiaries. Journal of Evaluation in
Clinical Practice, 20(6), 872–880.
Puchalski, Christina M. (2001). The Role of Spirituality in Health Care.
Baylor University Medical Center Proceedings, 14(4), 352–357.
Puchalski, Christina M. & Romer, Anna, L. (2000). Taking Spiritual
History Allows Clinicians to Understand Patients More Fully.
Journal of Palliative Medicine, 3(1), 129–137.
Rahnama, P., Javidan, A., Saberi, H., Montazeri, A., Tavakkoli, S.,
Pakpour A. H., and Hajiaghababae, M. (2015). Does Religious
Coping and Spirituality Have A Moderating Role on Depression
and Anxiety in Patients with Spinal Cord Injury? A Study from
Iran. Spinal Cord, 53, 870–874 doi:10.1038/sc.2015.102
Roberts, S. B., Donovan, D. W., & Handzo, G. (2012). Creating and
Implementing a Spiritual/Pastoral Care Plan. In S. B. Roberts
(Ed.), Professional Spiritual and Pastoral Care: A Practical
Clergy and Chaplain’s Handbook (pp. 61–80). Woodstock:
Skylight Paths Publishing.
Royal College of Nursing, 2011. RCN Spirituality Survey 2010.
Retrieved from: https://www.rcn.org.uk/professional-
development/publications/pub-003861

AAMM, Vol. 21, 27

Shahrbabaki M. P., Nouhi, E., Kazemi, M., Ahmadi, F. (2017).
Spirituality: A Panacea for Patients Coping with Heart Failure.
International Journal Community Based Nursing and Midwifery,
5(1), 38–48.
Sira, N., Desai, P. P., Sullivan, K. J., & Hannon, D. W. (2014). Coping
Strategies in Mothers of Children with Heart Defects: A Closer
Look into Spirituality and Internet Utilization. Journal of Social
Service Research, 40(5), 606–622, DOI:
10.1080/01488376.2014.908808
Sun, Fei and Hodge, David R. (2014). Latino Alzheimer’s Disease
Caregivers and Depression: Using the Stress Coping Model to
Examine the Effects of Spirituality and Religion. Journal of
Applied Gerontology, 33(3), 291–231.
Swinton, J. (2003). Spirituality and Mental Health Care: Rediscovering
A ‘Forgotten’ Dimension. London: Jessica Kingsley Publishers.
Tabong, Philip Teg-Nefaah and Adongo, Philip Baba. (2013).
Understanding the Social Meaning of Infertility and
Childbearing: A Qualitative Study of the Perception of
Childbearing and Childlessness in Northern Ghana. PLoS ONE,
8(1), 1–9.
Turaki, Yusufu. (2012). Foundations of African Traditional Religion
and Worldview. Nairobi, Kenya: WorldAlive Publishers Limited.
Ugwuzor, Miebi. (2016). First Name Office Culture and Employee
Behavior in Work Places. International Journal of Management
Excellence, 7(1), 736–742.
Vlasblom, Jan P., van der Steen, Jenny T., Walton, Martin N.,
Jochemsen, H. (2015). Holistic Nursing Practice, 29(6), 346–356.
Vermandere M., De Lepeleire J., Smeets L, Hannes K, Van Mechelen W,
Aertgeerts B., Hannes, K., Mechelen W. V., Warmenhoven, F.,
van Rijswijk, E. and Aertgeerts, B. (2011) Spirituality in General
Practice: A Qualitative Evidence Synthesis. British Journal of
General Practice, 61(592), e749–e760.
White, Ellen G. (1905). Ministry of Healing. Mountain View: Pacific
Press Publishing Association.
Wimberly, Edward P. (2011). Story Telling and Managing Trauma:
Health and Spirituality at Work. Journal of Health Care for the
Poor and Underserved, 22(3), 48–57.
Wright, H. Norman. (2011). The Complete Guide to Crisis and Trauma
Counseling. Grand Rapids, MI: Bethany House Publishers.
Yeagley, L. (2002). Pastoral Counseling: The Art of Referral. Ministry:
International Journal for Pastors, 74(9), 10–13.

28 Sikhumbuzo Dube
 Žilinská, Miroslava and Smitková, Hana. (2017). Boys Don’t Cry: Male
Depression through Gender Lens. Psychologie a Její Kontexty,
8(1), 87–97.
Zenobia, C. Y. and Chan, M. A. (2013). A Qualitative Study on
Non‐Verbal Sensitivity in Nursing Students. Journal of Clinical
Nursing, 22(13–14), 1941–1950.

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