Aging; Religious aspects; Older people; Religious life; Spirituality; Hong Kong
摘要
The life expectancy of Chinese people in Hong Kong is increasing and is amongst the longest in the world. However, many people, especially older persons may experience chronic ill-health and, less detectable, many may also be experiencing alienation, loneliness, meaninglessness and fear of death. Spirituality and spiritual care, which focus on the healing of the soul and quest for meaning, are important to many people as they age and face the prospect of death, and therefore they may have existential anxieties. A holistic healthcare approach, which views humans as bio-psycho-social-spiritual beings, stresses the importance of spirituality to people’s health and the well-being. However, there is a lack of consensus on the definition/conceptualisation of spirituality in the social gerontology literature. Further, many concepts such as spirituality and religiosity (one important channel of spiritual experiences) may be unclear or ambiguous. Relatively few international studies focus on ageing, spirituality and religiosity in gerontology and very few have been conducted in Hong Kong. This study therefore investigates the concept of spirituality in Hong Kong, in a Chinese context, and explores spiritual experiences and histories among older persons. It attempts to examine how religiosity may inspire spirituality. This research was based on triangulation of various data sources including a wide review of the academic and professional literature, interviews with key informants (social work, academic and religious experts), and the collection and analysis of qualitative data. The qualitative data are drawn from three focus group discussions involving three categories, the San Jiao triad, Christianity, and a non-religious group, with a total of sixteen participants; and three individual interviews. The focus group respondents were recruited from a Christian church and a Buddhist elderly home. This research yielded a number of findings. The focus group discussions corroborate suggestions in the literature that spirituality is interpreted differently by individuals, and it does not only apply to religious persons but to every individual. Spirituality can be related to religion, selfless service, the quality of personhood and the universe; For older persons, a “fractured” relationship with their family and others is often a core factor causing spiritual distress that the individual is unable to invest life with meaning; and religiosity (belief in a god, prayer, reciting religious scriptures, etc.) may inspire different dimensions of spirituality among older persons. The main conclusions drawn from this research were that spirituality is important to older persons regardless of their religious affiliations; it could cater to spiritual needs and experiences among older persons who can help to address spiritual distress throughout the spiritual history. Further, spiritual assessment is central to addressing spiritual needs and spiritual tasks associated with ageing, hence contributing to the need for spiritual care and spiritual narrative to older persons. This dissertation recommends that the World Health Organization’s (WHO) definition of health should emphasize the spiritual dimension. Finally, the dissertation highlights the spiritual concerns in elderly services and recommends caregivers recognize spirituality and provide spiritual care to older persons.
目次
Contents i List of Tables vi List of Figures vii Abbreviation viii Acknowledgements ix Chapter One: Introduction 1 1.1 Background 1 1.1.1 Ageing: a Global Trend 1 1.1.2 Ageing: in Hong Kong 2 1.1.3 The Emergence of Chronic Conditions and Disabilities 4 1.2 The Research Focus 5 1.3 Overall Aim of the Research and Research Objectives 9 Chapter Two: The Review of the Literature 12 2.1 Introduction 12 2.2 Social Significance of the Topic 14 2.3 The Concept of Spirituality 16 2.3.1 Models and Theories Related to Spirituality 17 2.3.1.1 Frankl's Logotherapy 17 2.3.1.2 Erikson's Psychosocial Theory of Personality Development and Maslow's Hierarchy of Needs 19 2.3.2 The Definitions of Spirituality in Various Studies 23 2.3.2.1 The Origin of the Word 'Spirit' 24 2.3.2.2 The Nature of Spirituality 25 2.3.2.3 Spirituality: Broad Concepts 30 2.3.2.4 Spirituality: Narrow Definitions 33 2.3.2.5 Interim Conclusion: Spirituality 35 2.3.3 Other Terms Related to Spirituality 35 2.3.3.1 The Spiritual Dimension 36 2.3.3.2 Spirituality Growth 37 2.3.3.3 Spiritual Well-being 37 2.3.3.4 Spiritual Needs 38 2.3.3.5 Boundary Situations 40 2.3.3.6 Spiritual Distress 41 2.3.3.7 Spiritual Capital 42 2.3.3.8 The Medium of Spirituality 42 2.4 Spirituality and Religiosity 43 2.4.1 A Review of the Literature Related to Religion and Gerontology 43 2.4.2 Religion, Religiosity and Religiousness 46 2.4.3 The Relationship between Spirituality and Religiosity 51 2.5 The Conceptual Frameworks of Spirituality 55 2.5.1 Stoll's Two-Dimensional Model of Spirituality 56 2.5.2 White's 'Dimensions of Spirituality' 57 2.5.3 McSherry's the Analogy of Spirituality 59 2.5.4 MacKinlay's Generic Model of Spiritual Tasks and Process of Ageing 60 2.6 Guidelines and Tools to Assess Spirituality 62 2.6.1 Stoll's Spiritual History Guide 63 2.6.2 Anandarajah and Hight‟s Acronym HOPE 63 2.6.3 Kivnik's Life Strength Interview Guide 64 2.6.4 White‟s Suggested Questions for Spiritual Assessment 64 2.7 Emerging Issues and the Need for Empirical Research 66 Chapter 3: A Case Study of Religions and Religious Characteristics in Hong Kong 69 3.1 The Importance of Studying Religions and the Older Persons in HK 69 3.2 Religions in Hong Kong: a Statistical View 70 3.2.1 Religions Among the Older Persons in Hong Kong 71 3.3 Different Religions and Religious Characteristics in Hong Kong 72 3.3.1 Traditional Chinese Religions 72 3.3.1.1 Buddhism 73 3.3.1.2 Taoism 74 3.3.1.3 Confucianism 75 3.3.2 Western Religions: Christianity 77 3.3.3 Other Religions 78 Chapter Four: Research Design and Methodology 79 4.1 Introduction to Research Design and Methodology 79 4.2 Research Design 81 4.3 Data Collection: Site and Sample Selection 82 4.4 Data Collection Techniques 86 4.4.1 Focus groups 86 4.4.2 Individual Interviews 89 4.4.3 Researcher Interview Guide 89 4.5 Data Collection Procedures 90 4.6 Data Analysis 94 4.6.1 Data Processing and Open Coding 94 4.6.2 Data Quality and Triangulation 98 Chapter Five: Results From Qualitative Data 100 5.1 Introduction 100 5.2 Research Question 1: “What is spirituality?” 100 5.2.1 The Quality of Personhood 105 5.2.2 Selfl
