Gardner Fiona
Social Work, La Trobe Rural Health School, La Trobe University, Edwards Road, Bendigo, VIC 3552, Australia.
Palliat Care Soc Pract. 2024 Sep 30;18:26323524241282683. doi: 10.1177/26323524241282683. eCollection 2024.
This article outlines how a framework for critical spirituality incorporated into a social work perspective, can contribute to work in end-of-life care. This is based on my experience of working in interdisciplinary teams, including pastoral care workers or chaplains, nurses, doctors, a range of carers and other allied health professionals. Traditionally, social workers have focused on the holistic well-being of the dying person and their families but tended not to actively include the spiritual. However, there is increased recognition in social work of the value of integrating critical spirituality: understanding the person's own sense of meaning and the social assumptions that might influence how this can be expressed. This might mean working with individuals and families on understanding how societal expectations of the dying process are undermining the person's desire to die in a particular way. To do this, workers must themselves recognise their own internalised societal assumptions and be willing to challenge these. The article explores the potential value of how such a social work approach can integrate critical, postmodern, green and relational theories as well as indigenous worldviews with key qualities of practice such as humility, deep listening and waiting, and the ability to be critically reflective. Key ideas are used to help focus practice and the inclusion of critical spirituality. These include (1) exploring the influence of the person's history and social context; (2) the value of particular relationships and networks, including community and environmental connections and activities and processes that are an intrinsic aspect of the person's well-being; (3) challenging workers to be critically and reflectively aware of their own assumptions and values to ensure the dying person can truly express their preferences related to death and dying. Examples from my experience are used to illuminate how such perspectives can be actively included in practice across professional boundaries to shift perceptions of 'how things are done here' to what can be more life enhancing for those in palliative care.
本文概述了将批判性灵性框架融入社会工作视角如何能为临终关怀工作做出贡献。这是基于我在跨学科团队中的工作经验，这些团队包括神职护理人员或牧师、护士、医生、各类护理人员以及其他相关健康专业人员。传统上，社会工作者关注临终者及其家人的整体福祉，但往往没有积极纳入灵性层面。然而，社会工作中越来越认识到整合批判性灵性的价值：理解个人自身的意义感以及可能影响其表达的社会假设。这可能意味着与个人和家庭合作，以理解社会对临终过程的期望是如何破坏个人以特定方式离世的愿望。要做到这一点，工作者自身必须认识到自己内化的社会假设，并愿意挑战这些假设。本文探讨了这种社会工作方法如何将批判性、后现代、绿色和关系理论以及本土世界观与诸如谦逊、深度倾听和等待以及批判性反思能力等关键实践品质相结合的潜在价值。关键理念用于帮助聚焦实践并纳入批判性灵性。这些理念包括：（1）探索个人历史和社会背景的影响；（2）特定关系和网络的价值，包括社区和环境联系以及对个人福祉至关重要的活动和过程；（3）促使工作者批判性和反思性地意识到自己的假设和价值观，以确保临终者能够真正表达与死亡和临终相关的偏好。我经验中的例子用于说明如何能将这些视角积极纳入跨专业界限的实践中，将“这里的做事方式”的观念转变为对姑息治疗患者更具生命提升意义的方式。
