The Spiritual Needs Model: Spirituality Assessment in the Geriatric Hospital Setting

Journal of Religion Spirituality & Aging 10/2010; Spirituality & Aging(4):271-282. DOI: 10.1080/15528030.2010.509987


Clinicians increasingly agree that it is important to assess patients' spirituality and to incorporate this dimension into the care of elderly persons, in order to enhance patient-centered care. However, models of integrative care that take into account the spiritual dimension of the patient are needed in order to promote a holistic approach to care. This research defines a concept of spirituality in the hospitalized elderly person and develops a model on which to base spirituality assessment in the hospital setting. The article presents in detail the different stages in the conceptualization of The Spiritual Needs Model.

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    • "Within this conceptual framework, the SDAT was developed in three stages. First, a conceptual model of spirituality, the Spiritual Needs Model, was defined [22]. In this model, spirituality in hospitalized elderly persons is defined as a multidimensional concept that includes four dimensions: Meaning, Transcendence, Values and Psycho-social Identity. "
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    ABSTRACT: The Spiritual Distress Assessment Tool (SDAT) is a 5-item instrument developed to assess unmet spiritual needs in hospitalized elderly patients and to determine the presence of spiritual distress. The objective of this study was to investigate the SDAT psychometric properties. This cross-sectional study was performed in a Geriatric Rehabilitation Unit. Patients (N = 203), aged 65 years and over with Mini Mental State Exam score ≥ 20, were consecutively enrolled over a 6-month period. Data on health, functional, cognitive, affective and spiritual status were collected upon admission. Interviews using the SDAT (score from 0 to 15, higher scores indicating higher distress) were conducted by a trained chaplain. Factor analysis, measures of internal consistency (inter-item and item-to-total correlations, Cronbach α), and reliability (intra-rater and inter-rater) were performed. Criterion-related validity was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) and the question "Are you at peace?" as criterion-standard. Concurrent and predictive validity were assessed using the Geriatric Depression Scale (GDS), occurrence of a family meeting, hospital length of stay (LOS) and destination at discharge. SDAT scores ranged from 1 to 11 (mean 5.6 ± 2.4). Overall, 65.0% (132/203) of the patients reported some spiritual distress on SDAT total score and 22.2% (45/203) reported at least one severe unmet spiritual need. A two-factor solution explained 60% of the variance. Inter-item correlations ranged from 0.11 to 0.41 (eight out of ten with P < 0.05). Item-to-total correlations ranged from 0.57 to 0.66 (all P < 0.001). Cronbach α was acceptable (0.60). Intra-rater and inter-rater reliabilities were high (Intraclass Correlation Coefficients ranging from 0.87 to 0.96). SDAT correlated significantly with the FACIT-Sp, "Are you at peace?", GDS (Rho -0.45, -0.33, and 0.43, respectively, all P < .001), and LOS (Rho 0.15, P = .03). Compared with patients showing no severely unmet spiritual need, patients with at least one severe unmet spiritual need had higher odds of occurrence of a family meeting (adjOR 4.7, 95%CI 1.4-16.3, P = .02) and were more often discharged to a nursing home (13.3% vs 3.8%; P = .027). SDAT has acceptable psychometrics properties and appears to be a valid and reliable instrument to assess spiritual distress in elderly hospitalized patients.
    Full-text · Article · Mar 2012 · BMC Geriatrics
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    • "As both roles have yet to be accepted fully as professions within elite soccer, there also remains a need among both sets of practitioners to demonstrate their occupational worth. There is evidence from research completed within the health industry that the psychologist and chaplain have become increasingly accepted, professionalized and accountable within this context by working cooperatively to improve healthcare (see Flannelly, Weaver, Smith, & Handzo, 2003; Monod, Rochat, Bula, & Spencer, 2010). Therefore, the theoretical argument that the sport psychologist and sport chaplain should work together within professional soccer appears to have foundation. "
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    ABSTRACT: Despite an increased focus on spirituality and athlete well-being in sport (Watson, 2011), there is limited research regarding those who provide support to the athlete in these areas. The aim of this study was to explore the practice of sport psychologists and sport chaplains within professional soccer, and identify potential for working partnerships. By interviewing three psychologists and four chaplains who are employed currently within English Premiership soccer, it was revealed that significant overlap in their roles existed. The psychologists and chaplains identified barriers that restricted support offered to players, which may be addressed by working cooperatively in the future.
    Full-text · Article · Jan 2012 · Journal of Applied Sport Psychology
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    • "The overall concept was defined as The Spiritual Needs Model [33]. "
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    ABSTRACT: 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.
    Full-text · Article · Dec 2010 · BMC Geriatrics