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Faith
Faith is often perceived to have religious overtones; however,
theorists such as Fowler (1981) believed that faith is a universal
phenomenon characterized by a sense of coherence, relationships with
others, and meaning and purpose (O”Brien, 1999). For Fowler, faith
is a developmental process.
Benson (1997) related faith to the relaxation response. He
defines faith as beliefs and expectancies about life, illness,
spiritual concerns and so forth. The relaxation response has
positive health benefits and is enhanced by a person’s religious
beliefs or life philosophy.
Koenig (1999), Pargament (1997), and Levin (1994) reviewed the
research documenting the influence of religious practice on healing.
Benefits of Positive Faith:
- Hope
- An avenue for giving and receiving prayer
- Connectedness
- Social support
- Peacefulness
- Self-confidence
- A sense of purpose
- Altruism
- Accessing a source of energy
Faith Issues for Patients with Cancer:
- Negative spiritual role models (Example: Abusive
relationships)
- Guilt (Something I did caused my cancer; God is punishing me)
- Spiritual Distress (God abandoned me; God doesn’t care about
me anymore)
- Suffering (How can a loving God allow this to happen?)
- Anger at God
Case Study
Assessment is the key to unlocking Diane's needs at each point in
her disease trajectory. It is important for the nurse to discover
Diane's faith and possible issues such as guilt, anger, or others
listed above. Also important is assessment of the importance of
Diane's faith throughout her life and her stage of faith
development. The nurse may then tailor interventions to Diane's
needs. For example, in disease recurrence, Diane may be helped to
find hope through prayer, social support of her faith community (if
any), and a sense of connectedness. Difficult issues, such as a
history of abusive relationships, may require referral to a
religious professional.
Stages of Faith Development (Fowler, 1981)
Fowler believed that faith develops sequentially much as Piaget
and Erikson described cognitive and social development. For Fowler,
faith develops in community rather than in isolation. Thus, healthy
faith develops in loving, caring contexts. The stages of Fowler’s
developmental theory are:
| Age |
Stage |
Characteristics |
Nursing Responsibilities |
| Infant |
Primal Faith |
Trust is a basis for faith development |
Consistent, loving, respectful responses from
caregivers |
| Early Childhood |
Intuitive-Projective Faith |
Impulsive, unconscious acceptance of what others tell them
about faith |
Telling faith based stories, modeling prayer, religious
activities, simple repetitive songs |
| Childhood and Beyond* |
Mythic-Literal Faith |
Realistic, factual, black and white, no grey areas |
Support participation in ritual; reading stories of faith;
faith-based music |
| Adolescence and Beyond* |
Synthetic-Conventional Faith |
Commonly accepted beliefs, view of God as a friend, but
also begin to have doubts about God or spirituality |
Calm acceptance of questions; listening; support
participation in ritual |
| Young Adulthood and Beyond* |
Individuative-Reflective |
Unique, thoughtful, spiritual analysis leads to personal,
self-directed faith |
Acceptance of faith struggles; listening; support
ritual |
| Early Midlife and Beyond |
Conjunctive Faith |
Connected; realizes that faith is personal and within but
also transcendent; acceptance of mystical nature of faith |
Teach contemplative prayer or meditation; Discuss
ecumenism; Support ritual |
| Midlife and Beyond |
Universalizing Faith |
Holistic; faith becomes part of identity; consider actions
in light of their values; faith drives actions rather than
self |
Allow time and privacy to practice contemplative prayer;
few reach this stage—Mother Teresa, Ghandi, Billy
Graham |
Note: Based on information from Halstead & Nilssen, in press;
Mauk & Schmidt, 2004; O’Brien, 1999; Taylor, 2002.
Halstead, M. (2005)
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