This is all about Learning Theories Related to health.

1. LEARNING
THEORIES
RELATED TO
HEALTH CARE
PRACTICES

2. OUTLINE
KEY TOPICS DISCUSSED
IN THIS PRESENTATION
• MAIN TOPIC: PRINCIPLES AND THEORIES IN
TEACHING AND LEARNING
SUB TOPICS:
• BEHAVIORIST THEORY
• COGNITIVE THEORY
• SOCIAL THEORY
• MOTIVATION AND NEEDS THEORY
• MORAL AND SPIRITUAL

3. BEHAVIORIST THEORY
John B. Watson is the proponent of
behaviorist theory which emphasizes
the importance of observable behavior
in the study of human beings.
He defined behavior as muscle
movement and it came to be associated
with the Stimulus-Response
psychology.
He postulated that behavior results
from a series of conditioned reflexes
and that all emotions and thoughts
are a product of behavior learned
through conditioning. (de Young,
2003).

4. BEHAVIORIST THEORY
 Learning, then is a result of the conditions
or stimuli (S) in the environment and the
learner’s response (R) that follow. This is
known as the S-R model of learning or the
stimulus-response theory.
 Behavioral scientists usually observe the
responses and then manipulate the environment
to bring about the desired change. (Hilgard
and Bower, 1996; Bigge and Shermis, 1992; Hill
1990).
 To bring about the intended change in the
attitudes and responses of the subject, some
stimuli in the environment are altered or the
effects or consequences of a response is
changed.

5. BEHAVIORIST THEORY
 Motivation to change is brought about by the
desire to reduce some drive or DRIVE-
REDUCTION.
Consequence:
Satisfied, complacent or satiated individuals
have little motivation to change and learn.
 For this behavior to be applied or transferred
from the initial learning situation to other
settings or circumstances is possible through
practice or formation of habits.

6. Behaviorism started as a reaction against introspective psychology in the 19th century, which relied
heavily on first-person accounts. J.J. Watson and B.F. Skinner rejected introspective methods as
being subjective and unquantifiable. These psychologists wanted to focus on observable,
quantifiable events and behaviors. They said that science should take into account only observable
indicators. They helped bring psychology into higher relevance by showing that it could be
accurately measured and understood, and wasn’t just based off opinions.
HISTORY

7. Watson and Skinner believed that if they were given a group of infants, the way they
were raised and the environment they put them in would be the ultimate determining
factor for how they acted, not their parents or their genetics.
Behaviorism focuses on the idea that all behaviors are learned through interaction
with the environment. This learning theory states that behaviors are learned from the
environment, and says that innate or inherited factors have very little influence on
behavior.
HISTORY

8. The most famous example of classical conditioning was Ivan Pavlov’s
experiment with dogs, who salivated in response to a bell tone. Pavlov showed
that when a bell was sounded each time the dog was fed, the dog learned to
associate the sound with the presentation of the food.

9. Pavlov’s Dogs
Then, he
presented them
with food,
they
salivated. The
food was an
unconditioned
stimulus and
salivation was
an
unconditioned
response
(innate
response)
He first
presented the
dogs with the
sound of a
bell; they did
not salivate so
this was a
neutral
stimulus.
He then
repeatedly
presented the
dogs with the
sound of the
bell first
and then the
food
(pairing).
After a few
repetitions,
the dogs
salivated when
they heard the
sound of the
bell.
The bell had
become the
conditioned
stimulus and
salivation
had become
the
conditioned
response.
1 2 3 4 5

10. This is exactly what behaviorism argues- that the things we experience and our
environment are the drivers of how we act.
The stimulus-response sequence is a key element of understanding behaviorism. A
stimulus is given, for example a bell rings, and the response is what happens next, a
dog salivates or a pellet of food is given. Behavioral learning theory argues that even
complex actions can be broken down into the stimulus-response.

11. Behavioral learning is based on
respondent conditioning and
operant conditioning procedures.

12. 1. Classical or Pavlovian Conditioning:
-a process which influences the acquisition of new responses
to environmental stimuli.
A.1 RESPONDENT CONDITIONING

13. -a neutral stimulus (NS) elicits an unconditional response (UCR) through repeated pairings with
an unconditioned stimulus (UCS).Aneutral stimulus (NS) is a stimulus that has no particular
value, significance or meaning to the learner. When the NS is repeatedly paired with the
unconditioned stimulus (UCS), there comes a time when the NS , even without the UCS, elicits
the same UCR.
A.1 RESPONDENT CONDITIONING

14. Principles of
Classical
Conditioning
Neutral Stimulus (NS)
Is a stimulus that initially does
not evoke a response until it is
paired with the unconditioned
stimulus. For example, in Pavlov’s
experiment, the bell was the
neutral stimulus, and only produced
a response when it was paired with
food.
Unconditioned Stimulus
Is a feature of the environment
that causes a natural and automatic
unconditioned response. In Pavlov’s
study the unconditioned stimulus
was food.

15. Principles of
Classical
Conditioning
Unconditioned Response
Is an unlearned response that
occurs automatically when the
unconditioned stimulus is
presented. Pavlov showed the
existence of the unconditioned
response by presenting a dog with a
bowl of food and measuring its
salivary secretions.
Conditioned Stimulus
Is a substitute stimulus that
triggers the same response in an
organism as an unconditioned
stimulus. Simply put, a conditioned
stimulus makes an organism react to
something because it is associated
with something else. For example,
Pavlov’s dogs learned to salivate
at the sound of the bell.

16. Principles of
Classical
Conditioning
Conditioned Response
Is the learned response to the
previously neutral stimulus. In
Ivan Pavlov’s experiment in
classical conditioning, the dog’s
salivation was the conditioned
response to the sound of a bell.
Discrimination
Is a process through which
individuals learn to differentiate
among similar stimuli and respond
appropriately to each one.
For example, eventually Pavlov’s
dogs learn the difference between
the sound of the two bells and no
longer salivates at the sound of
the non-food bell.

17. Cecilia Belle, a pretty and lively three year old, accidentally touched the flame (NS) of the candle.
She felt intense pain (UCS) and quickly withdrew her hand (UCR). Two days later, the same
experience happened and part of her finger was burned. Consequently, the flame of the candle
(NS) came to be associated with the pain (UCS) that, even in its absence, just the sight of the
flame makes her withdraw her hand. Hence, the neutral stimulus (NS), which is the flame, has now
become the conditioned stimulus (CS) and the automatic withdrawal of her hand has become the
learned response.
SITUATIONAL ILLUSTRATION

18. Principles of respondent conditioning may also be
used to extinguish a previously learned response:
Learned responses may eventually be unlearned if
the occurrence of a CS is not accompanied by the
UCS for a long period of time or interval.

19. 2. Systematic desensitization:
-is another technique based on respondent conditioning which
is widely used in psychology and even in medicine to reduce
fear and anxiety in the patient (Wolpe, 1982).
A.1 RESPONDENT CONDITIONING

20. -this is based on the principle that repeated and gradual
exposure to fear-inducing stimulus under relaxed and
non-threatening circumstances will give the patient that
sense of security that no harm will come so that he or she
no longer fears the stimulus.
A.1 RESPONDENT CONDITIONING

21. -this is also a stress-reducing strategy that is adapted to
help pre-operative patients, rehabilitating drug addicts and
tension headaches and phobias, among others (Bastable,
2003)
A.1 RESPONDENT CONDITIONING

22. GOAL:
-the goal of systematic desensitization is to become
gradually desensitized to the triggers that are causing
your distress.
A.1 RESPONDENT CONDITIONING

23. -Systematic desensitization begins with imaginary
exposure to feared situations. You can use your anxiety
hierarchy to breakdown the feared situation into
manageable components.
A.1 RESPONDENT CONDITIONING

24. SITUATIONAL ILLUSTRATION
For example:
Let’s say you fear to go into large stores. You may have the least
anxiety walking into the store and your anxiety likely intensifies as
you get further from the exit doors. Standing in the checkout line
represents your highest fear response. In this case, you would start
the process by focusing on the action that causes the least amount
of distress and then work your way up. The result is that you will
gradually, or systematically, become desensitized to shopping in
large stores.

25. 3. Stimulus Generalization
-occurs when a previously unassociated or new stimulus that
has similar characteristics to the previously associated
stimulus elicits a response that is the same or similar to the
previously associated response. In short, similar stimuli trigger
similar responses when stimulus generalization is at work.
A.1 RESPONDENT CONDITIONING

26. -Discrimination learning develops later when varied
experiences eventually enable the individual to differentiate
among similar stimuli.
-Discrimination learning is often involved in professional
education and clinical practice
A.1 RESPONDENT CONDITIONING

27. SITUATIONAL ILLUSTRATION
Fear is one of the most common classically conditioned responses
experienced by humans. We will use the fear of snakes to illustrate how
stimulus generalization works in classical conditioning.
Imagine that a four-year-old child who is watching Nature show on TV
sees a 20-feet long green tree python devour a cute little brown mouse.
While this experience is perfectly natural in the jungles of South America,
the child (who has a pet mouse) immediately imagines a snake coming
into her bedroom and doing the same thing to her mouse! The thought of
such a thing elicits a strong fear response, including increased heart rate,
pupil dilation, and anxiety, which quickly becomes associated with the
snake.

28. SITUATIONAL ILLUSTRATION
So what happens when the child goes outside to play and sees a harmless
18-inch long brown snake in the backyard? The conditioned fear response
kicks in, and even though it is not a 20-feet long green tree python, the
reaction is quite similar. This is stimulus generalization.
The person who is afraid of snakes did not have to experience a snake of
every size, shape, and color in the world. Associating the key
characteristics of the snake, like long and skinny, slithery, rapid tongue
protrusions form the mouth, and two eyes on the sides of the head, with
the fear response is enough to learn that anything that possesses those
characteristics is likely a snake.

29. 4. Spontaneous Recovery
-is usually applied in relapse prevention programs (rpp) and may explain why it is quite difficult to
completely eliminate “unhealthy habits and addictive behaviors” (alcoholism, drug abuse, smoking)
which one may claim having successfully “kicked the habit” or extinguished it only to find out that it
may recover or reappear any time, even years later. Spontaneous recovery is the re-emergence of
a response that had been previously conditioned.
A.1 RESPONDENT CONDITIONING

30. SITUATIONAL ILLUSTRATION
Every day a dog is fed, his food bowl bangs against the ground. The bang
makes the dog excited about food. For several weeks, the food bowl is
banged against the ground with no food. The dog stops getting excited to be
fed. A few weeks later when a food bowl is banged on the ground, the dog
gets excited again.
When a child hears the music of the ice cream truck, they run to the door
because their parent usually buys them ice cream. After a few weeks of not
getting ice cream, the child stops running to the door. A month later, they
hear the ice cream truck jingle and run to the door.
A student immediately stops talking during instruction when his teacher
purses her lips and shakes her head. However, the student changes this
behavior by not responding to the teacher’s expression. Then, weeks later,
he begins to respond once again.

31. Technology is an
effective tool that
can make education
more meaningful and
engaging for teachers
and students alike.

32. “Operant Conditioning”
By Burrhus Frederic Skinner
B.F. Skinner was an American psychologist,
behaviorist, author, inventor, and social
philosopher. He was a professor of
psychology at Harvard University from
1958 until his retirement in 1974. Skinner
referred to his own philosophy as 'radical
behaviorism' and suggested that the
concept of free will was simply an illusion.
All human action, he instead believed, was
the direct result of conditioning.

33. Operant Conditioning in Health Care
Practices
- Developed by B.F. Skinner which focuses on the behavior of
the organism and the reinforcement that follows after the
response (Alberto & Troutman, 1990). His theory was heavily
influenced by the work of psychologist Edward Thorndike,
who had proposed what he called the law of effect.
Reinforcement- are events that strengthen responses. It is one of
the most powerful tools or procedures used in teaching and is a
major condition for the most learning to take place. A reinforcer
is a stimulus or event that is given, applied or elicited after a
response to strengthen or reinforce the possibility that the
response will be repeated.

34. Skinner Box

35. Positive reinforcers – any consequence of behavior that leads
to an increase that leads to an increase in the probability of its
occurrence.
Ways of Employing Positive Reinforcement:
 Verbal ways
 Non-verbal ways
 Citing in class or Publishing

36. Classification of Educational Reinforcers (Tosti and
Addison 1979):
1. Recognition
2. Tangible rewards
3. Learning activities
4. School responsibilities
5. Status indicators
6. Incentive feedback
7. Personal activities

37. “The Law of Effect”
By Edward Thorndike
Edward Lee Thorndike was an American
psychologist who spent nearly his entire career
at Teachers College, Columbia University. His
work on comparative psychology and the
learning process led to the theory of
connectionism and helped lay the scientific
foundation for educational psychology.

38. The Law of Effect
 The law of effect principle developed by Edward
Thorndike stated that those behavioral responses (R) that
were most closely followed by a satisfactory result were
most likely to become established patterns and to
reoccur in response to the same stimulus (S). Conversely,
if the situation is followed by discomfort, the
connections to the situation will become weaker, and the
behavior of response is less likely to occur when the
situation is repeated.
Thorndike’s Puzzle Box

39. There are two key aspects of the law of effect:
1. Behaviors immediately followed by favorable consequences
are more likely to occur again.
2. Behaviors followed by unfavorable consequences are less
likely to occur again.

40. Cognitive Theories of learning
 More than knowledge acquisition.
 It stresses that mental processes or cognition
occurs between the stimulus (S) and the response
(R).
 It stresses the importance of “what goes on inside
the learner” which involves the individuals cognitive
processes of perception, thinking skills, memory
and ways of processing and structuring
information.

41. I. Gestalt- the configuration or patterned organization of cognitive
elements reflecting the maxim that the “whole is greater than the
sum of its parts.”
Gestalt perspective emphasizes the importance of perception in
learning which focuses on the configuration or organization of a pattern
or stimulus.
Perspectives of the cognitive learning theory

42. Some principles of gestalt which are
related to healthcare:
1. Psychological organization is directed toward simplicity,
equilibrium and regularity.
2. Perception is selective which means that no one can attend or
pay attention to all the surrounding stimuli at the same time.
3. What individuals pay attention to or what they ignore may be
affected by factors like needs, personal motives, past
experiences and the particular structure of the stimulus or
situation.

43. Implication to healthcare
 Knowledge of this gestalt principle will help the health educator on how
he/she approaches any learning situation with an individual or group
II. Information-processing is a cognitive perspective that emphasizes the
thinking processes like:
a. Thought c. The way information is encountered and stored
b. Reasoning d. Memory functioning

44. Stages in the memory process:
1st Stage: Paying attention to the environmental
stimuli;
Attention is the key to learning.
2nd Stage: Information is processed by the senses.
3rd Stage: Information is transformed and incorporated
or encoded briefly into short-term memory.
4th Stage: Involves the action or response that the
individual makes on the basis of how the information
was processed and stored

45. Jean Piaget
 Born August 9, 1896, Neuchâtel,
Switzerland—died September 16, 1980,
Geneva), Swiss psychologist who was
the first to make a systematic study of
the acquisition of understanding in
children. He is thought by many to have
been the major figure in 20th-
century developmental psychology.

46. III. Cognitive Development is a third
perspective that focuses on qualitative
changes in perceiving, thinking and
reasoning as individuals mature and grow.
Jean Piaget
 A Cognitive Development Theorist.
 He found out that children’s perception
at different ages.
 He identified four sequential stages of
cognitive development.

47. Piaget’s four major periods of cognitive or
intellectual development
1. Sensorimotor Stage (Birth-2 yrs.)
*Actual perception of the senses and the external or
physical factors.
2. Abstract Thinking
*Represents reality using symbols that can be
manipulated mentally.

48. 3. In Formal Operations (“Perspective thought” or
Relativism)
*New perspective of other people possessing varied
thinking on the same stimulus or situation.
4. Assimilation or Accommodation
* Characterized by hypothesis testing before making
conclusions, things must be tested with logical pieces
of evidence in search for truth.

49. “Multiple Intelligence”
By Howard Gardner
An American cognitive psychologist
and author, best known for his theory
of multiple intelligences.

50. Theory of Multiple Intelligences
- States that there are various types of talent or seven forms
of intelligence. About three to four types may be possessed
or developed by an individual or child and all learners have
all the seven kinds of intelligence but in different proportion.

51. 8 Intelligences

52. 1. Visual-Spatial Intelligence
-People who are strong in visual-spatial intelligence are good at
visualizing things. These individuals are often good with directions as
well as maps, charts, videos, and pictures.
Strengths
Visual and spatial judgment
Characteristics
People with visual-spatial intelligence:
• Read and write for enjoyment
• Are good at putting puzzles together
• Interpret pictures, graphs, and charts well
• Enjoy drawing, painting, and the visual arts
• Recognize patterns easily

53. 2. Linguistic-Verbal Intelligence
-People who are strong in linguistic-verbal intelligence are able to use words
well, both when writing and speaking. These individuals are typically very good
at writing stories, memorizing information, and reading.
Strengths
Words, language, and writing
Characteristics
People with linguistic-verbal intelligence:
• Remember written and spoken information
• Enjoy reading and writing
• Debate or give persuasive speeches
• Are able to explain things well
• Use humor when telling stories

54. 3. Logical-Mathematical Intelligence
-People who are strong in logical-mathematical intelligence are good at reasoning,
recognizing patterns, and logically analyzing problems. These individuals tend to
think conceptually about numbers, relationships, and patterns.
Strengths
Analyzing problems and mathematical operations
Characteristics
People with logical-mathematical intelligence:
• Have excellent problem-solving skills
• Enjoy thinking about abstract ideas
• Like conducting scientific experiments
• Can solve complex computations

55. 4. Bodily-Kinesthetic Intelligence
-Those who have high bodily-kinesthetic intelligence are said to be good at
body movement, performing actions, and physical control. People who are
strong in this area tend to have excellent hand-eye coordination and dexterity.
Strengths
Physical movement, motor control
Characteristics
People with bodily-kinesthetic intelligence:
• Are skilled at dancing and sports
• Enjoy creating things with his or her hands
• Have excellent physical coordination
• Remember by doing, rather than hearing or seeing

56. 5. Musical Intelligence
People who have strong musical intelligence are good at thinking in patterns,
rhythms, and sounds. They have a strong appreciation for music and are often
good at musical composition and performance.5
Strengths
Rhythm and music
Characteristics
People with musical intelligence:
• Enjoy singing and playing musical instruments
• Recognize musical patterns and tones easily
• Remember songs and melodies
• Have a rich understanding of musical structure, rhythm, and notes

57. 6. Interpersonal Intelligence
-Those who have strong interpersonal intelligence are good at understanding and
interacting with other people. These individuals are skilled at assessing the emotions,
motivations, desires, and intentions of those around them.5
Strengths
Understanding and relating to other people
Characteristics
People with interpersonal intelligence:
• Communicate well verbally
• Are skilled at nonverbal communication
• See situations from different perspectives
• Create positive relationships with others
• Resolve conflicts in group settings

58. 7. Intrapersonal Intelligence
Individuals who are strong in intrapersonal intelligence are good at being aware
of their own emotional states, feelings, and motivations. They tend to enjoy self-
reflection and analysis, including daydreaming, exploring relationships with
others, and assessing their personal strengths.
Strengths
Introspection and self-reflection
Characteristics
People with intrapersonal intelligence:
• Analyze their strengths and weaknesses well
• Enjoy analyzing theories and ideas
• Have excellent self-awareness
• Understand the basis for his or her own motivations and feelings

59. Naturalistic Intelligence
Naturalistic is another facet of intelligence and the most recent addition to
Gardner’s theory and has been met with more resistance than his original
seven intelligences. It refers to flora and fauna, has green thumb, enjoys pets,
enjoys nature or classifies species, discriminates among plants and animal.
Strengths
Finding patterns and relationships to nature
Characteristics
People with naturalistic intelligence:
• Are interested in subjects such as botany, biology, and zoology
• Categorize and catalog information easily
• Enjoy camping, gardening, hiking, and exploring the outdoors
• Dislikes learning unfamiliar topics that have no connection to nature

60. “Social Learning
Theory”
By Albert Bandura
Albert Bandura is an influential social cognitive
psychologist who is perhaps best known for his
social learning theory, the concept of self-
efficacy, and his famous Bobo doll experiments

61. Social Learning Theory
• Emphasize the importance of environment or situational
determinants of behavior and their continuing intersection.
Reciprocal Determinism by Albert Bandura states that
“environmental conditions, shape behavior through learning
and the person’s behavior, in return, shapes the
environment.”
Modeling or observational learning occurs vicariously,
even in infants, where the individual learns of the
consequences of a behavior by observing another person
undergoing the experience.

62. 4 Operations involve in Modeling are:
1. Attentional processes - determine what a person can do and what he or
she can attend to.
2. Retentional processes - determine hoe experiences is encoded or
retained in memory.
3. Motor reproduction processes - determine what a behavior can be
performed.
4. Motivational & reinforcement processes – determine the circumstances
under which learning is translated into performance.

63. HOW BEHAVIOR OCCURS
There are 3 interrelated determinants of behavior which are
antecedents, consequences, and cognitive factors. Behavior is
based on the past (antecedents) as we have seen it, but it is also
influence by its results (consequence) and how we are
motivated (cognitive factor).
Bandura assumes that all actual behavior patterns must be
learned through traditional learning (by reinforcement) and
observational learning (by modeling). Behavior is shaped by
people’s expectation.

64. The social learning theory approach to personality focuses
directly on a person’s behavior (what did he do?) and not on his
motives. A relatively enduring quality or characteristic is called a
trait. Instead of trait, Walker Mischel (1993) dealt with cognitive
variables:
a. Competencies – which refer to various skills like intellectual
abilities, social and physical skills and other special abilities.
b. Encoding strategies and personal constructs - experience that
are retained and categorized by the individual.
c. Subjected values – what a person considers as worth having or
accomplishing.
d. Self-regulating systems or plans – people have different
standards and rules for regulating their behavior

65. MASLOW’S HIERARCHY OF NEEDS

66. Abraham Maslow
 Abraham Harold Maslow,
also called Abraham H.
Maslow, (born April 1, 1908,
New York, U.S.—died June 8,
1970, Menlo Park,
California), American
psychologist and philosopher
best known for his self-
actualization theory
of psychology, which argued
that the primary goal
of psychotherapy should be
the integration of the self.

67. Maslow’s Theory of Motivation and Needs
This theory was proposed by Abraham Maslow (1943), people
are motivated based on a variety of needs which he categorized
into five basic groups:
1. Physiologic needs- are the lowest level of Maslow's
hierarchy of needs. They are the most essential things a person
needs to survive. These includes the biological basic needs.
2. Safety needs-hierarchy refer to the need for security and
protection.

68. 3. Social needs- refer to the need to have
relationships with others once the physiological and
safety needs have been fulfilled.
4. Esteem needs- refer to people's desires to have a
stable and realistically positive evaluation of
themselves.
5. Self-actualization needs- represented as one of
the key stages in achieving contentedness or self-
actualization.

69. Criteria for Prioritizing Learning Needs
(Healthcare Education Assoc, 1985):
 Mandatory- learning needs that must be
immediately met since they are life threatening or
are need for survival.
 Desirable- learning needs that must be met to
promote well-being and are not life-dependent.
 Possible- “nice to know”, learning needs which are
not directly related to daily activities

70. Methods in Assessing Learning Needs
(Bastable, 2003)
 A. Informal Conversations or Interview
 B. Structured Interviews
 C. Written pretest
 D. Observation of health behaviors over a period of
different times

71. Importance of Motivation in Learning
 It is important to get the learner into a state of
readiness to learn for it increases alertness, vigor,
and wholeheartedness of learning.
 Continuous motivation is needed to help learners
concentrate on the lessons to be learned.

72. Moral/ Spiritual

73. Nursing as an ethical practice requires courage to be moral, taking tough
stands for what is right, and living by one’s moral values. Nurses need moral
courage in all areas and at all levels of nursing. Along with new interest in
virtue ethics in healthcare, interest in moral courage as a virtue and a
valued element of human morality has increased. Nevertheless, what the
concept of moral courage means in nursing context remains ambiguous.

74. 1. True Presence
2. Moral Integrity
3. Responsibility
4. Honesty
5. Advocacy
6. Commitment and Perseverance
7. Personal Risk
7 Core Attributes of Moral Courage:

75. Antecedents were ethical sensitivity, conscience, and
experience.
Consequences includes personal and professional
development and empowerment.

76. • Spirituality may be a dynamic in the patient's understanding of the disease.
• Religious convictions may affect health care decision making
• Spirituality may be a patient need and may be important in patient coping.
• An understanding of the patient's spirituality is integral to whole patient care.
Advantages of Becoming Familiar
with Patient’s Spirituality

77. • Practicing compassionate presence—i.e., being fully present and attentive to their patients and being
supportive to them in all of their suffering: physical, emotional, and spiritual
• Listening to patients' fears, hopes, pain, and dreams
• Obtaining a spiritual history
• Being attentive to all dimensions of patients and their families: body, mind, and spirit
• Incorporating spiritual practices as appropriate
ASPECTS OF SPIRITUAL CARE