Assessing Values and Beliefs

ASSESSING VALUES AND BELIEFS

Introductory Overview

Values and beliefs represent two aspects of a person's attitudes and moral outlook that guide behavior and life goals. More formal definitions of values and beliefs have been provided by writers in the field, such as Steel and Harmon, who define these terms as follows: "A value is an effective disposition towards a person, object or idea." Beliefs are "a special class of attitudes in which the cognitive component is based more on faith than fact. They represent a personal confidence in the validity of some idea, person, or object." (Steel & Harmon, 1979)

Values and beliefs guide and influence people in forming goals, opinions, and decisions every day. Values can influence health related decision, health practices and priorities, and behavior in life-threatening situations. Such beliefs may explain why a person values certain objects and practices.

A value and belief system is the basis of a person's philosophy of life, whether conscious or unconscious, religious or secular. Such a philosophy is intimately connected with spirituality. Spirituality is an abstract concept; each person's spirituality is highly variable, individualistic, and ever-changing.

The pattern of a person's values and belief is closely related to his or her self-concept, coping abilities, stress tolerance, and role-relationship behaviors. Values and beliefs must be considered in the assessment process in order to provide a basis for holistic care, and an understanding of the reasons for certain health-related decisions. They also suggest coping strategies that support the person's values and beliefs.

Assessment Focus

An essential component in assessing values and beliefs is to determine if the person's values and beliefs agree with his or her life philosophy and culture.

The purposes for assessing values and beliefs are to

 Identify the person's cultural and ethnic background

 Determine health practices that might be influenced by culture and beliefs.

 Identify the person's belief about life, death, and spirituality.

 Recognize any evidence of spiritual distress.

The methods for collecting this information are described in Table 16-1.

Table 16-1. Assessment Focus for Values and Beliefs

Assessment Goal Data Collection Methods

1. Identify the person's cultural and ethnic background to promote the development of a realistic treatment plan

Interview:

✈ Ethnic Background

✈ Affiliation with a particular cultural group

Observe:

✈ Note cues to culture in appearance, belongings, and interaction patterns

2. Identify health practices that might be influenced by a person's culture and beliefs

Interview:

✈ Validate health practices that might be influenced by culture and belief systems

✈ Determine cultural influences on diet

3. Identify the person's beliefs concerning life, death and spirituality.

Interview and Observe:

✈ Philosophy of Life

✈ Spiritual beliefs and values

✈ Use of symbols and rituals

4. Recognize states of spiritual distress.

Interview and Observe:

✈ Note especially any conflicts with beliefs and values associated with traditional Western Health Care.

✈ Self -concept

Nursing Diagnoses

The main nursing diagnoses related to values and beliefs are as follows:

 Spiritual distress (distress of the human spirit)

 Decisional conflict

KNOWLEDGE BASE FOR ASSESSMENT

Culture, spirituality, values, and beliefs are closely interrelated and must be considered together during the assessment process. It is important to know how such variable affect health.

Culture

Every person's definition of health, optimal health, and illness are influenced to some extent by cultural background. Culture is socially inherited and represents the values, beliefs, customs, rituals, and norms shared by a group of people. Although cultures are always evolving, changes are often slow. Even though a person may not internalize all aspects of the culture, the influence of culture on a person's behaviors and the interpretation of the behaviors of others is usually discernable.

Cultural Sensitivity

Being aware of a person's cultural background is important in assessing values and beliefs, and in determining a plan of care. Avoiding cultural blindness, ethnocentrism, cultural imposition, and stereotyping is crucial in providing effective care.

Because nurses frequently encounter many ethnic groups, it is essential that they be sensitive to persons from different cultures to deliver effective care and avoid misunderstandings. Clark (1984) states that practicing cultural sensitivity includes (1) using nursing interventions based on the client's culture rather that on stereotypes; (2) understanding implications of culturally specific health beliefs and attitudes; (3) incorporating folk health practices when possible; and (4) acting as an advocate for a person of another culture who has been denied quality care.

Cultures share similar components in the shaping of values and beliefs. Kluckholn (1961) identified the following five dimensions of orientation basic to all cultures.

Nature of Humans. Some cultures view people as basically good; others view people as basically evil, or as a combination of good and evil. In the United States, the dominant view is that humans are both good