title: The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons.
abstract: BACKGROUND
  Although 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Four 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Medical Center (CHUV), Lausanne, Switzerland. stefanie.monod-zorzi@chuv.ch
authors.forename: Stefanie M
authors.initials: SM
authors.lastname: Monod
authors.forename: Etienne
authors.initials: E
authors.lastname: Rochat
authors.forename: Christophe J
authors.initials: CJ
authors.lastname: Büla
authors.forename: Guy
authors.initials: G
authors.lastname: Jobin
authors.forename: Estelle
authors.initials: E
authors.lastname: Martin
authors.forename: Brenda
authors.initials: B
authors.lastname: Spencer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D011594:Psychometrics / Q000295:instrumentation*; D012069:Religion and Psychology; D029181:Spirituality; D013315:Stress, Psychological / Q000175:diagnosis*