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Validation of the Spiritual Distress Assessment Tool in older hospitalized patients.

Monod S, Martin E, Spencer B, Rochat E, Büla C - BMC Geriatr (2012)

Bottom Line: 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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Medical Center (CHUV), 1011 Lausanne, Switzerland. Stefanie.monod-zorzi@chuv.ch

ABSTRACT

Background: 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.

Methods: 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.

Results: 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).

Conclusions: SDAT has acceptable psychometrics properties and appears to be a valid and reliable instrument to assess spiritual distress in elderly hospitalized patients.

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SDAT administration and scoring process.
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Figure 1: SDAT administration and scoring process.

Mentions: The Spiritual Distress Assessment Tool (SDAT) was developed to address the need for a valid instrument specifically designed to assess spiritual distress in hospitalized elderly patients. The hypothesis was made that spiritual distress arises from unmet spiritual needs. The greater the degree to which a spiritual need remains unmet, the greater the disturbance in spiritual state and the greater the level of spiritual distress experienced by the patient. 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. Related spiritual needs were systematically defined for each dimension. The dimensions and their related needs are presented in Table 1. Second, the SDAT instrument was developed on the basis of this model [23]. A standardised set of questions to be used in a semi-structured interview performed by a chaplain has been specifically defined. Moreover, a structured assessment procedure to identify unmet spiritual needs and score the degree to which spiritual needs remain unmet was successively developed. The overall process for SDAT administration and scoring is presented in Figure 1 and an example of SDAT scoring is provided in Table 2. Finally, face validity and acceptability of the SDAT instrument were evaluated in chaplains experienced in hospital pastoral care. Results confirmed very good face validity and showed high acceptability of the SDAT [23].


Validation of the Spiritual Distress Assessment Tool in older hospitalized patients.

Monod S, Martin E, Spencer B, Rochat E, Büla C - BMC Geriatr (2012)

SDAT administration and scoring process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3368768&req=5

Figure 1: SDAT administration and scoring process.
Mentions: The Spiritual Distress Assessment Tool (SDAT) was developed to address the need for a valid instrument specifically designed to assess spiritual distress in hospitalized elderly patients. The hypothesis was made that spiritual distress arises from unmet spiritual needs. The greater the degree to which a spiritual need remains unmet, the greater the disturbance in spiritual state and the greater the level of spiritual distress experienced by the patient. 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. Related spiritual needs were systematically defined for each dimension. The dimensions and their related needs are presented in Table 1. Second, the SDAT instrument was developed on the basis of this model [23]. A standardised set of questions to be used in a semi-structured interview performed by a chaplain has been specifically defined. Moreover, a structured assessment procedure to identify unmet spiritual needs and score the degree to which spiritual needs remain unmet was successively developed. The overall process for SDAT administration and scoring is presented in Figure 1 and an example of SDAT scoring is provided in Table 2. Finally, face validity and acceptability of the SDAT instrument were evaluated in chaplains experienced in hospital pastoral care. Results confirmed very good face validity and showed high acceptability of the SDAT [23].

Bottom Line: 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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Medical Center (CHUV), 1011 Lausanne, Switzerland. Stefanie.monod-zorzi@chuv.ch

ABSTRACT

Background: 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.

Methods: 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.

Results: 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).

Conclusions: SDAT has acceptable psychometrics properties and appears to be a valid and reliable instrument to assess spiritual distress in elderly hospitalized patients.

Show MeSH
Related in: MedlinePlus