Overview of what is important to include in a spiritual
In order to assess spirituality, it is important for the
clinician to have some self-awareness of their own spirituality, to
be able to care for their own spiritual needs, to establish a good
relationship with the patient, and to time the discussion
appropriately (Highfield, 2000). One author goes so far as to state
that assessment of spiritual pain depends, “as much upon the
spirituality of the caregiver, and upon their capacity for
contemplation, for close listening, to narrative, for intuition, and
for discernment, as it will upon the results of any neatly developed
questionnaire" (Bartel, 2004). Many providers may recognize
this kind of pain intuitively, however lack a clinically usable tool
to elicit discussion that helps to validate the patients’
experience. It is important to find a tool that works for you- that
you are comfortable using. The main areas to focus on are: source of
hope/meaning (transcendence), sense of community/social resources,
vocation, what the patient derives pleasure from (creativity), their
sense of moral authority/direction, and what resources they have (or
don’t) for discussion and/or reflection of spiritual matters.
Here are my top ones…
- What things do you enjoy doing? Are you doing them now?
- Where does your sense of what to do come from?
- Do you have someone you talk to for [spiritual/religious]
- What gives your life meaning?
- What sustains you during difficult times?
- What do you hope for?
- Are you part of a religious or spiritual community? Is it a
source of support? In what ways?
- What aspects of your religion/spirituality would you like me
to keep in mind as I care for you?
- Does your religious or spiritual beliefs influence the way you
look at your disease and the way you think about your health?
- As we plan for your care, how does your faith impact on your
For Diane Brady, careful assessment at each phase of the cancer
trajectory will ensure that interventions are tailored to the needs
of the individual. Research demonstrates that spiritual needs vary
as the individual seeks to make sense of the diagnosis, treatment,
learning to live with as a survivor, recurrence of disease, and
end-of-life (Halstead & Hull, 2001; Taylor, 2000).
Are there any resources about spiritual assessment that you
- Anandarajah, G. & Hight, E. (2001). Spirituality and
medical practice: Using the HOPE questions as a practical tool
for spiritual assessment. [see comment]. American Family
Physician, 63, 81-89.
- Bartel, M. (2004). What is spiritual? What is spiritual
suffering? Journal of Pastoral Care & Counseling, 58,
- Bregman, J. (2004). Editorial: Defining spirituality: Multiple
uses and murky meanings of an incredibly popular term. Journal
of Pastoral Care and Counseling, 58, 157-167.
- Gordon,T. (2004). A competency model for the assessment and
delivery of spiritual care. Palliative Medicine,18,
- Highfield, M.E. (2000). Providing spiritual care to patients
with cancer. Clinical Journal of Oncology Nursing, 4,115-120.
- Hodge, D.R. (2001). Spiritual assessment: a review of major
qualitative methods and a new framework for assessing
spirituality. [see comment]. Social Work, 46, 203-214.
- Puchalski, C., Dorff, E., & Hendi, Y. (2004).
Spirituality, religion, and healing in palliative care. Clinics
in Geriatric Medicine, 20, 689-714.
- Puchalski, C., & Romer, A.L. (2000). Taking a spiritual
history allows clinicians to understand patients more fully. Journal
of Palliative Medicine, 3,129-138.
- Vandenbrink, R.A. (2001). Spiritual assessment: Comparing the
tools. Journal of Christian Nursing, 18, 24-27.
How about on-line links to articles or web sites that could be