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Open Access Highly Accessed Research article

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

Stefanie M Monod1*, Etienne Rochat12, Christophe J Büla1, Guy Jobin3, Estelle Martin1 and Brenda Spencer4

Author Affiliations

1 Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Medical Center (CHUV), 1011 Lausanne, Switzerland

2 Chaplaincy Service, University of Lausanne Medical Center (CHUV), 1011 Lausanne, Switzerland

3 Faculty of Theology and Religious Sciences, University of Laval, QC G1V 0A6 Quebec, Canada

4 Institute of Social and Preventive Medicine (IUMSP), University Hospital Center and University of Lausanne, Bugnon 17, 1005 Lausanne, Switzerland

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BMC Geriatrics 2010, 10:88  doi:10.1186/1471-2318-10-88

Published: 13 December 2010



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.


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.


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.


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.