Spiritual Distress Within Inpatient Settings-A Scoping Review of Patients' and Families' Experiences

Amanda L Roze des Ordons; Tasnim Sinuff; Henry T Stelfox; Jane Kondejewski; Shane Sinclair

doi:10.1016/j.jpainsymman.2018.03.009

Spiritual Distress Within Inpatient Settings-A Scoping Review of Patients' and Families' Experiences

J Pain Symptom Manage. 2018 Jul;56(1):122-145. doi: 10.1016/j.jpainsymman.2018.03.009. Epub 2018 Mar 14.

Authors

Amanda L Roze des Ordons¹, Tasnim Sinuff², Henry T Stelfox³, Jane Kondejewski⁴, Shane Sinclair⁴

Affiliations

¹ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Anesthesiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: amanda.rozedesordons@ucalgary.ca.
² Interdepartmental Division of Critical Care, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.
³ Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁴ Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.

PMID: 29548894
DOI: 10.1016/j.jpainsymman.2018.03.009

Abstract

Context: Spiritual distress contributes to patients' and families' experiences of care.

Objectives: To map the literature on how seriously ill patients and their family members experience spiritual distress within inpatient settings.

Methods: Our scoping review included four databases using search terms "existential" or "spiritual" combined with "angst," "anxiety," "distress," "stress," or "anguish." We included original research describing experiences of spiritual distress among adult patients or family members within inpatient settings and instrument validation studies. Each study was screened in duplicate for inclusion, and the data from included articles were extracted. Themes were identified, and data were synthesized.

Results: Within the 37 articles meeting inclusion criteria, we identified six themes: conceptualizing spiritual distress (n = 2), diagnosis and prevalence (n = 7), assessment instrument development (n = 5), experiences (n = 12), associated variables (n = 12), and barriers and facilitators to clinical support (n = 5). The majority of studies focused on patients; two studies focused on family caregivers. The most common clinical settings were oncology (n = 19) and advanced disease (n = 19). Terminology to describe spiritual distress varied among studies. The prevalence of at least moderate spiritual distress in patients was 10%-63%. Spiritual distress was experienced in relation to self and others. Associated variables included demographic, physical, cognitive, and psychological factors. Barriers and facilitators were described.

Conclusion: Patients' and families' experiences of spiritual distress in the inpatient setting are multifaceted. Important gaps in the literature include a narrow spectrum of populations, limited consideration of family caregivers, and inconsistent terminology. Research addressing these gaps may improve conceptual clarity and help clinicians better identify spiritual distress.

Keywords: Spirituality; family members; patients; review; spiritual distress.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Family / psychology*
Humans
Inpatients / psychology*
Spirituality*
Stress, Psychological* / etiology