Identification of Patients' Spiritual Needs Using a Spiritual Health Assessment Tool

Purpose: The purpose of this study was to determine whether nurses were able to recognize patients’ spiritual crises and with this awareness, conduct a spiritual health assessment. Timely referral to a hospital chaplain would then be more likely to occur. The author created two spiritual assessment tools; one that used spiritual terminology and the other, more neutral content not specific to a faith nor belief system. Each tool, upon review, received expert validation from Rabbi Jeffery M. Silberman, Dmin, DD, Director of Spiritual Care and Education at Bridgeport Hospital in Bridgeport, Connecticut.

Methods: There are presently no standardized spiritual health assessments being used consistently, by health care facilities. Ease of use of spiritual assessment tools and comfort level by nurses and patients with the tools, may facilitate identification of spiritual crisis in the health care setting and immediate referrals to chaplains. Nurses and patients were provided education (nurses a PowerPoint with a patient case study and patients, verbal instructions) on the topic of spiritual health after signing consent forms. Two spiritual assessment tools were administered to patients and nursing staff on a clinical unit providing medical and palliative care. The site was Gaylord Specialty Healthcare, a rehabilitation healthcare facility in Wallingford, Connecticut. The research was both qualitative and quantitative. Participants included 30 nurses and 12 patients.

Results: Comparison between Nurses and Patients for Each Item of Tools Tool 1 There is no significant difference between groups on any of the 5 questions from tool 1. All p-values are greater than .05.
Tool 2 For tool 2 the groups differed on question 1 (p=.031, talking to God for support) and question 4 (p=.050, peace and hope in life related to belief in God). The difference was due to patients giving higher scores (more likely to agree) than nurses on questions 1 and 4.

Total Score For Tool 1 the total mean score between nurses and patients is similar (18.07 vs 19.73) and the difference is not significant (p=.242). For Tool 2 there is over a 3 point difference (14.43 vs 17.83) and the difference is near significant (p=.053).

Comparison between Tool 1 Total Score and Tool2 Total Score by Group For nurses the total score was higher on Tool 1 (18.07) compared to Tool 2 (14.43) and the difference was significant (p=.000). For patients the Total scores for Tool 1 (18.56) was similar to Tool 2 (17.22) and did not differ (p=.134).

Conclusion: Based upon study results, regardless whether the spiritual health assessment tool includes overtly spiritual terminologies or does not, patients can benefit from the use of these assessment tools. Spiritual health assessment tools can aid in the facilitation of discussion between nurses and patients, as to how patient perceive their illness and potential health outcomes. With this information, nurses can make referrals for chaplain support.