Background: Chronic pain is a complex, multidimensional experience. Spirituality is hypothesized to impact pain experience in various ways. Nevertheless, the role that spirituality plays in multimodal pain therapy remains controversial and, to date, quantitative data on whether and for which patients spiritual aspects should be considered in the treatment of chronic pain is lacking. The aim of this study was thus to investigate the proportion and characteristics of patients with chronic pain who wish spiritual aspects to be integrated in their treatment.Methods: Two hundred nine patients with chronic pain were recruited from five inpatient departments and outpatient clinics in the German-speaking part of Switzerland. Patients filled out validated questionnaires, such as the Hospital Anxiety and Depression Scale (HADS), the Resilience Scale (RS-11), the Spiritual and Religious Attitudes in Dealing with Illness (SpREUK), and the 12-item Spiritual Well-Being Scale (FACIT-Sp-12).Results: More than 60% (CI95%: 55.5–67.9%) of the patients wanted to address spiritual aspects in their treatment. These patients were significantly younger, had higher levels of education, and suffered from more frequent and more severe pain than patients who did not wish to address spiritual aspects. Furthermore, there were high correlations with existing spiritual resources and higher scores of spirituality.Conclusions: These results confirm that the majority of chronic pain patients wish spiritual aspects to be considered in their treatment. Additionally, the finding that these patients had more spiritual resources underlines the importance of integrating spiritual aspects in a resource-oriented, patient-centered care approach for this condition.

Context. Valid instruments for assessing spiritual resources and distress in pain therapy are scarce. The Spiritual Distress and Resources Questionnaire (SDRQ) was developed to fill this gap.Goals. The objective of this study was to investigate the SDRQ's psychometric properties. Methods. We presented the SDRQ to 219 patients with chronic pain conditions and examined its measurement properties, namely reliability and structural, convergent and discriminant validity. To investigate test−retest reliability, the SDRQ was presented a second time to a subsample of 58 randomly selected participants.Results. Factor analysis required a grouping of the 22 SDRQ items into four subscales: spiritual distress, spiritual coping, immanence and transcendence, the latter two representing spiritual resources. Cronbach's alpha was high for spiritual distress (0.93), transcendence (0.85), and immanence (0.81) while it was somewhat lower but still satisfactory for spiritual coping (0.70). The construct validity of the SDRQ was shown by correlations with established measures in the field. Higher levels of spiritual distress were associated with signs of more severe illness, such as emotional distress and pain intensity.Conclusion. The results from this study suggest that the SDRQ is an easy-to-use, reliable and valid screening instrument for assessing spiritual distress, spiritual resources and spiritual coping in patients with chronic pain. The SDRQ has the potential to be used with patients suffering from other chronic diseases and to disseminate the palliative approach to pain treatment to other areas of medicine.

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Zusammenfassung Spiritual Care etabliert sich im klinischen Kontext zunehmend als interprofessionelle Aufgabe, was einer angemessenen Form der Ausbildung bedarf. Dieser Artikel beleuchtet das an der Universität Zürich seit 2016 angebotene Wahlpflichtmodul „Spiritual Care“ für Medizin- und Theologiestudierende, welches informative, formative und transformative Bildungsdimensionen berücksichtigt. Präsentiert werden die quantitativen Ergebnisse einer Studie, die die Einstellungen und die Lernprozesse der beteiligten Studierenden befragte. Untersucht wurden die Einstellungen der Studierenden zu Spiritualität und Religiosität, Hinderungsgründe für Gespräche über spirituelle Aspekte und Veränderung dieser Einschätzungen während des Moduls. Dazu wurden die Daten von insgesamt 72 Teilnehmenden aus 5 Kohorten (Herbstsemester 2016 bis Herbstsemester 2018) ausgewertet. Die Studierenden füllten zu Beginn und am Ende des Moduls einen Fragebogen aus, der in Anlehnung an die deutsche Version des NERSH-Fragebogens gestaltet wurde und vorwiegend Antwortmöglichkeiten auf einer Likert-Skala enthält. Der Lernprozess führte dazu, dass die Studierenden sich am Ende des Moduls als kompetenter einschätzten, spirituelle Themen in Gesprächen mit Patienten und Patientinnen anzusprechen. Zudem befürchteten die Studierenden weniger, sich selber emotional in solchen Gesprächen zu überfordern oder die Balance zwischen professioneller Distanz und zwischenmenschlicher Nähe nicht halten zu können.

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