The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

Abstract

BackgroundAlthough spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients.MethodsA three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT): 1) Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model) to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2) Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT) investigating needs related to each of the defined dimensions; 3) Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains.ResultsFour dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity) and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups.ConclusionsThe SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

Instruments to Assess Depressive Symptoms and Spiritual Distress Investigate Different Dimensions

“…Spiritual distress was assessed using the SDAT, a validated tool to assess spiritual distress in elderly hospitalized patients (Monod, Rochat, Büla, Jobin, et al, 2010;Monod et al, 2012). In the SDAT construct, spirituality is conceptualized as "the particular coherence expressed when describing one's meaning of life, referring to one's transcendence, and explaining one's values" .…”

“…The chaplain investigated in a semi-structured format the various spiritual needs which were scored on a 4-point Likert scale (0 to 3), resulting in a total SDAT score that ranged from 0 (no distress) to 15 (severe distress). Spiritual distress is defined as a score ≥ 5 because this cut-off corresponds to a range of situations with unmet needs considered as significant either in terms of severity (e.g., one severe unmet spiritual need [score = 3] combined with some other slightly unmet spiritual need) or in terms of extent (e.g., unmet spiritual need in all dimensions) (Monod, Rochat, Büla, Jobin, et al, 2010;Monod et al, 2012).…”

“…To further explore this potential overlap between spirituality and depression constructs, we decided to adopt a different approach and to use an instrument specifically designed to assess spiritual distress (the Spiritual Distress Assessment Tool, SDAT) (Monod, Rochat, Büla, Jobin, et al, 2010;Monod, Martin, Spencer, Rochat, & Büla, 2012) instead of using an instrument with a spiritual well-being construct (Figure 1). This original approach uses definitions of psychological and spiritual states oriented toward the same direction.…”

Measuring Spirituality and Religiosity in Clinical Settings: A Scoping Review of Available Instruments

“…The BENEFIT Through spirituality/religiosity scale (chronic diseases and spinal cord injury) (Bussing and Koenig 2008;Xue et al 2016 (Monod et al 2010(Monod et al , 2012a • The Advance Cancer Patients' Distress Scale (Fischbeck et al 2013 Very recently, just before the application of our search protocols, two spirituality/religiosity measures gained validation, both in cancer care. First the QRFPC25, a measure of religiosity and spirituality was validated and shown to be reliable in 156 people with neoplastic disease (Kouloulias et al 2017).…”

The Interdisciplinary Spiritual Care Model – A holistic Approach to Patient Care

“…Supporting religious and spiritual coping is an important aspect in total patient care. Of equal importance is the assessment of spiritual struggles and spiritual distress (MONOD et al, 2010), often interfering with the recovery process.…”