Spirituality or psychosis?--An exploration of the criteria that nurses use to evaluate spiritual-type experiences reported by patients.

Spiritual experiences and psychotic symptoms have many aspects of form and content in common. Despite this, clinicians make judgements about the pathology of these experiences and base care-plans on these judgements. Semi-structured interviews incorporating vignettes of spiritual-type experiences were given to 14 UK mental health nurses. This revealed that the nurses employed a complex and inter-relating set of criteria when evaluating spiritual-type experiences. The nature of the experience was considered, but the outcome of the experience (positive or negative) was an important evaluative factor, together with the personal and cultural context in which the experience occurred. The nurses demonstrated a tolerance of ambiguity and the need for awareness of their own subjectivity. They emphasised the importance of close-engagement with patients to achieve a rounded and holistic view of the patient's experience. They also emphasised the importance of team working in reducing idiosyncratic decision making.