Chronic Obstructive Pulmonary Disease (COPD) is a group of progressive pulmonary disorders characterized by airflow limitation in the respiratory tract. Globally, COPD represents a major health burden, accounting for more than 3 million deaths annually, and is projected to become the third leading cause of death worldwide by 2020. This study aims to implement nursing care for a palliative COPD patient experiencing spiritual distress in the Dahlia Ward of Wates Regional Hospital. This research utilized an observational case study design with a cross-sectional approach. The subject of this case study was a 53-year-old male patient, Mr. S, hospitalized at Wates Regional Hospital. The patient's palliative care screening score was 6, indicating the need for referral to palliative services. The Edmonton Symptom Assessment System (ESAS) revealed that the most prominent issue was spiritual distress, rated at a level of 7. The patient's Karnofsky Performance Status score was 50%, indicating frequent need for assistance and regular medical care. The Spiritual Well-Being Scale (SWBS) yielded a total score of 41, suggesting a moderate level of spiritual well-being. Spiritual assessment indicated that the patient refrained from performing prayers during illness, believing that illness justified this decision. Based on the assessment, Mr. S was identified as experiencing spiritual distress associated with his medical diagnosis of COPD. The primary nursing diagnosis was spiritual distress related to lifestyle changes, based on the Indonesian Nursing Diagnosis Standard (SDKI). The expected nursing outcomes, according to the Indonesian Nursing Outcomes Standard (SLKI), were improvements in spiritual status, particularly the ability to engage in worship and enhanced coping abilities. Interventions were provided based on the Indonesian Nursing Intervention Standard (SIKI), focusing on supporting the patient's ability to perform religious practices.
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