Clinical Spiritual Assessment Instrument Spiritual Assessment

Developing a Spiritual Assessment Instrument for Clinical Use

Developing a Spiritual Assessment Instrument for Clinical Use

The Joint Commission (2005) requires all healthcare organizations seeking accreditation to implement a patient spiritual needs assessment policy and recommends spiritual assessment training for all medical staff. The design and content of the spiritual assessment is left up to the organization, but an effective assessment strategy would be both respectful of the patient's perspectives and beliefs, while ascertaining how the healthcare organization can facilitate their religious and/or spiritual practices (The Joint Commission, 2008). The overall goal would be to improve patient outcomes.

Aside from meeting accreditation requirements, attending to the spiritual needs of patients is increasingly viewed as an ethical obligation for clinicians (Vermandere et al., 2011). For example, the American Nurses Association (ANA, 2014) considers the spiritual needs of patients an important component of professional nursing practice. For many patients, their spiritual and religious beliefs help them to make sense of their illness, thereby reducing the amount of stress they may be experiencing. Other important consideration are faith-based dietary choices and attending to religious practices when feasible.

Among the many benefits that spiritual and religious practices can provide patients, probably the most important from a clinical perspective is attributing meaning to a patient's illness and reframing their suffering as an opportunity for spiritual growth (Nadarajah, Berger, & Thomas, 2013). Relevantly, meaning-making interventions increased perceived self-esteem, self-efficacy, and optimism in breast cancer patients undergoing chemotherapy (Casellas-Grau, Font, & Vives, 2014). Aside from improved mental health, another obvious benefit of this intervention would be improved treatment adherence. Breast cancer patients exposed to psychospiritual interventions experienced increased hope, happiness, life satisfaction, energy, sense of control, posttraumatic growth, and quality of social relationships (Casellas-Grau, Font, & Vives, 2014). These interventions reveal that helping...

The instrument will be designed so that patients can complete the questionnaire when alone or surrounded by family members, thereby encouraging patients to be honest about their spiritual and religious practices. The answers provided will then serve as points of discussion to better help clinicians understand the spiritual needs of patients.
CSAT Evaluation

To evaluate the outcome of a single CSAT administration I asked a friend (Bev) to fill out the questionnaire (Appendix) in the privacy of her own home and return it to me the next day. The total CSAT score was 18, out of a total score of 50. Based on this overall score, faith, spirituality, and/or religion are only modestly important to Bev. From our conversation the next day it was apparent that completing the CSAT took less than five minutes and was not perceived to be imposition. The brevity of the instrument actually encouraged Bev to take more time to think about her answers. In addition, Bev appreciated being able to complete the instrument in a private location, because if a clinician, social worker, or chaplain was waiting for her responses she would have felt rushed and unlikely to provide well-considered answers. From Bev's perspective, a person's faith and spiritual practices is often one of the most personal and intimate aspects of their life and spending time considering the answers to the CSAT questions would be no exception.

Overall, the CSAT was well-received and provided valuable information about the spiritual needs of Bev; however, the use of the instrument on a larger patient sample might reveal weaknesses and other problems that limit its efficacy. Despite this possibility, the scores for the individual questions provided invaluable insight into the spiritual needs of Bev. What I discovered is that completing the instrument in privacy is an important component of the assessment approach, but the post-completion discussion with Bev was equally valuable because it provided further elaboration on why Bev answered the way she did. In other…