Spiritual Qualitative Analysis

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Background and purpose
Healthcare is changing. We are shifting from treating disease towards managing daily functioning and disease in light of patients’ values, choices and decisions (1,2). This requires not only a different therapy approach, but also a new method to assess the impact of the disease and treatment on a person’s life. To date, physical therapists can use patient-reported outcome measures (PROMs) to determine the impact of a disease (and its treatment) on their life (3). However, these instruments are often very generic and often lack information regarding the ICF component personal factors. In a new conceptualization of health -- the ability to adapt and self-manage in the face of social, physical and emotional challenges (4)
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Therefore, a spiritual qualitative analysis could help us to assess the personal impact of a disease, values and meaning in a person’s life. Speelman developed a narrative spiritual method in order to find values and meaning within the personal daily stories of people (10–12). The method is looking in stories for the motivation to perform actions, the values that are important and the competences that are needed or lacking. The use of such a qualitative method has been used before (13–17) and succeeded to retrieve relevant information regarding meaning, values and illness, in people with serious illness.
The purpose of this study is to get insight in personal preferences and spiritual dimensions of a patient involved in an intensive physical therapy intervention. To do so, we describe the diagnostic preoperative process of a patient with osteoarthritis of the hip who opted for total hip arthroplasty (THA). The descriptive layer will be complemented with a reflective and deepened spiritual analysis of the story of, primary, the patient, and secondary, her closest family (daughter) and the physical therapist (PT) involved in the
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The patient was interviewed (with the same question) because she found it difficult to write a story. Her interview was written literally from the tape recording and all stories were translated by a native speaker. The stories were analyzed with the narrative spiritual method developed by Speelman (10–12) by EO and WS in order to find guiding forces (destinators), human actions, reality changed by those actions and values realized. First the stories were read several times attentively. Secondly the stories were considered, interpreted and analyzed framed by the so-called narrative scheme. The narrative program of the stories were described as a sequence of four phases (table 2.): 1. Motivation (or destinator (Dr.) in the original method), 2. Competences, 3. Performance and 4. Judgment or evaluation (table 2.). The grammatical roles are nothing but tools to describe the narrative process. The analysis was discussed several times between EO and

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