title: Spiritual distress-proposing a new definition and defining characteristics.
abstract: OBJECTIVE
  To identify the definition and defining characteristics (DCs) of spiritual distress (00066).
  
  
  METHODS
  Integrative literature review.
  
  
  RESULTS
  Thirty-seven articles and 35 DCs were identified. Spiritual distress as a response to health problems in the context of nursing care is different from an impaired ability to experience and integrate meaning in life.
  
  
  CONCLUSIONS
  The diagnosis misses some DCs that emerged from the literature review and lacks comprehensiveness. The domain and the class are reductionist toward its meaning. The taxonomy lacks a spiritual domain to include this and other diagnoses currently dispersed in other domains.
  
  
  CONCLUSIONS
  Further content and clinical validation is needed, as well as an assessment, to determine the diagnosis' class and domain.
authors: The Catholic University of Portugal, Lisbon, Portugal.
authors: Sílvia
authors: S
authors: Caldeira
authors: University of São Paulo, Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil.
authors: Emília Campos
authors: EC
authors: Carvalho
authors: Institute of Health Sciences, The Catholic University of Portugal, Porto, Portugal.
authors: Margarida
authors: M
authors: Vieira
mesh_terms: D006801:Humans; D009732:Nursing Care; D029181:Spirituality; D013315:Stress, Psychological