A growing body of research documents the harmful effects of religious or spiritual struggle among patients with a wide variety of diagnoses. We developed a brief screening protocol for use in identifying patients who may be experiencing religious/spiritual struggle, as well as patients who would like a visit from a chaplain. We describe the results of a pilot study in which non-chaplain healthcare colleagues administered the screening protocol to patients admitted to an acute medical rehabilitation unit. The protocol identified 7% of the patients as possibly experiencing religious/spiritual struggle. Follow up spiritual assessments by the chaplain confirmed religious/spiritual struggle in all but one of these patients and also identified additional cases of religious/spiritual struggled not identified by the protocol. In addition to areas for future research, the authors describe how using a protocol to screen patients for religious/spiritual can make important contributions to spiritual care.
Get full access to this article
View all access options for this article.
References
1.
AnoG. G., & VascolcellesE. B. (2005). Religious coping and psychological adjustment to stress: A meta-analysis. Journal of Clinical Psychology, 61, 461–480.
2.
BergG. E. (1994). The use of the computer as a tool for assessment and research in pastoral care. Journal of Health Care Chaplaincy, 6, 11–25.
3.
BergG. E. (1999). A statement on clinical assessment for pastoral care. Chaplaincy Today, 14, 42–50.
4.
BergG. E.FonssN.ReedA. J., & VandeCreekL. (1995). The impact of religious faith and practice on patients' suffering from a major affective disorder: A cost analysis. The Journal of Pastoral Care, 49, 359–363.
5.
BoscagliaN.ClarkeD. M.JoblingT. W., & QuinnM. A. (2005). The contribution of spirituality and spiritual coping to anxiety and depression in women with a recent diagnosis of gynecological cancer. International Journal of Gynecological Cancer, 15, 755–761.
6.
BradshawA., & FitchettG. (2003). “God, why did this happen to me?”: Three perspectives on theodicy. The Journal of Pastoral Care and Counseling, 57, 179–189.
7.
BurkerE. J.EvonD. M.SedwayJ. A. & EganT. (2005). Religious and non-religious coping in lung transplant patients: Does adding God to the picture tell us more?Journal of Behavioral Medicine, 28, 513–526.
8.
DerricksonP. E. (1994–1995). Screening patients for pastoral care: A preliminary report. The Caregiver Journal, 11, 14–18.
9.
EllisM. R.VinsonD. C., & EwigmanB. (1999). Addressing spiritual concerns of patients: Family physicians' attitudes and practices. Journal of Family Practice, 48, 105–9.
10.
ExlineJ. J.YaliA. M., & LobelM. (1999). When God disappoints: Difficulty forgiving God and its role in negative emotion. Journal of Health Psychology, 4, 365–279.
11.
ExlineJ. J.YaliA. M., & SandersonW. C. (2000). Guilt, discord, and alienation: The role of religious strain in depression and suicidality. Journal of Clinical Psychology, 56, 1481–1496.
12.
FitchettG. (1999A). Screening for spiritual risk. Chaplaincy Today, 15, 2–12.
13.
FitchettG. (1999B). Selected resources for screening for spiritual risk. Chaplaincy Today, 15, 13–26.
14.
FitchettG.MeyerP., & BurtonL. A. (2000). Spiritual care: Who requests it? Who needs it?The Journal of Pastoral Care, 54, 173–186.
15.
FitchettG.MurphyP. E.KimJ.GibbonsJ. L.CameronJ. R., & DavisJ. A. (2004). Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. International Journal of Psychiatry in Medicine, 34, 179–196.
16.
FitchettG.RybarczykB. D.DeMarcoG. A., & NicholasJ. J. (1999). The role of religion in medical rehabilitation outcomes: A longitudinal study. Rehabilitation Psychology, 44, 333–353.
17.
HandzoG. F. (1998). An integrated system for the assessment and treatment of psychological, social, and spiritual distress. Chaplaincy Today, 14, 30–37.
18.
HodgesS. (1999). Spiritual screening: The starting place for intentional pastoral care. Chaplaincy Today, 15, 30–40.
19.
IdlerE. L. (1987). Religious involvement and the health of the elderly: Some hypotheses and an initial test. Social Forces, 66, 226–238
20.
KoenigH. G.PargamentK. I., & NielsenJ. (1998). Religious coping and health status in medically ill hospitalized older adults. Journal of Nervous and Mental Disease, 186, 513–521.
21.
KristellerJ. L.RhodesM.CripeL. D., & SheetsV. (2005). Oncologist Assisted Spiritual Intervention Study (OASIS): Patient acceptability and initial evidence of effects. International Journal of Psychiatry in Medicine, 35, 329–347.
22.
Manning-WalshJ. (2005). Spiritual struggle: Effect on quality of life and life satisfaction in women with breast cancer. Journal of Holistic Nursing, 23, 120–140.
23.
MasseyK.FitchettG., & RobertsP. A. (2004). Assessment and diagnosis in spiritual care. In MaukK. L., & SchmidtN. K. (Eds.), Spiritual care in nursing practice(pp. 209–242). Philadelphia, PA: Lippincott, Williams and Wilkin.
24.
McConnellK. M.PargamentK. I.EllisonC. G., & FlannellyK.J. (2006). Examining the links between spiritual struggles and symptoms of psychopathology in a national sample. Journal of Clinical Psychology, 62, 1469–1484.
25.
MontonyeM. (1994–1995). Patient-centered caring: Identifying religious needs. The Caregiver Journal, 11, 33–37.
26.
O'ConnorT. S.MeakesE.O'NeillK.PennerC.Van StaalduinenG., & DavisK. (2005). Not well known, used little and needed: Canadian chaplains' experiences of published spiritual assessment tools. The Journal of Pastoral Care and Counseling, 59, 97–107.
27.
PargamentK. I. (1997). The psychology of religion and coping: Theory, research, practice. New York: The Guilford Press.
28.
PargamentK. I.KoenigH. G.TarakeshwarN., & HahnJ. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A two-year longitudinal study. Archives of Internal Medicine, 161, 1881–1885.
29.
PargamentK. I.KoenigH. G.TarakeshwarN., & HahnJ. (2004). Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: A two-year longitudinal study. Journal of Health Psychology, 9, 713–730.
30.
PargamentK. I.SmithB. W.KoenigH. G., & PerezL. (1998). Patterns of positive and negative religious coping with major life stressors. Journal for the Scientific Study of Religion, 37, 710–724.
31.
ParkesC.M. (2001). A historical overview of the scientific study of bereavement. In StroebeM. S.HanssonR. O.StroebeW., & SchutH. (Eds.), Handbook of bereavement research: Consequences, coping, and care (pp. 25–45). Washington, D.C.: American Psychological Association.
32.
PetermanA. H.FitchettG.BradyM. J.HernandezL. & CellaD. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy — Spiritual Well-Being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58.
33.
RippentropE. A.AltmaierE. M.ChenJ. J.FoundE. M., & KeffalaV. J. (2005). The relationship between religion/spirituality and physical health, mental health, and pain in a chronic pain population. Pain, 116, 311–321.
34.
ShermanA. C.SimontonS.LatifU.SpohnR., & TricotG. (2005). Religious struggle and religious comfort in response to illness: Health outcomes among stem cell transplant patients. Journal of Behavioral Medicine, 28, 359–67
35.
StoddardG. A. (1993). Chaplaincy by referral: An effective model for evaluating staffing needs. The Caregiver Journal, 10, 37–52.
36.
TaylorE. J. (2002). Spiritual care: Nursing theory, research, and practice. Upper Saddle River, NJ: Pearson Education, Inc.
37.
TaylorE. J.OutlawF. H.BernardoT. R., & RoyA. (1999). Spiritual conflicts associated with praying about cancer. Psycho-Oncology, 8, 386–394.
38.
WakefieldJ. L.CoxR. D., & ForrestJ. S. (1999). Seeds of change: The development of a spiritual assessment model. Chaplaincy Today, 15, 41–50.
