SPIRITUAL SUFFERING SCALE: 

          TEACHING TOOL

 

Spiritual pain is defined here as emotional distress due to spiritual and religious issues. 

Spiritual issues that may result in emotional distress include:

·         theological and belief issues, such as:

-          inability to participate in usual religious practices

-          a belief that God is punitive

-          incongruence between experience and beliefs

-          troubling beliefs about dying, death, or afterlife

·         existential and meaning issues, such as:

-          loss of a sense of meaning, loss of role which gave meaning

-          loss of a sense of hope; letting go, and grief, and anger

-          loss of a sense of dignity, or loneliness

·         relationship issues, such as:

-          difficulties in relationship with God, or sense of God’s absence or failure, or sense of a need for forgiveness

-          difficulties in relationship with loved one, or broken relationships, or sense of need to forgive or be forgiven, or need to let go of expectations

-          negative sense of self-value, or feelings of guilt or regret in life lived

 

SPIRITUAL SUFFERING LEVELS

 

0.      No end-of-life issues causing spiritual distress.  This is for patient who has no life regrets and no family issues and is ready for death. 

1.      Patient puts little focus on life events which are possible sources of minimal spiritual distress during end-of-life, and most focus on issues of well-being.  No recent losses; no regrets.

2.      Patient puts some focus on spiritual/religious issues in their lives which cause distress, but does not acknowledge distress; puts focus on drawing from sources of spiritual well-being and coping. 

3.      Patient expresses minimal spiritual distress from life issues, but more focus on issues of well-being.

4.      Moderate distress from issues noted.  Patient acknowledges the distress, but continues to also focus on sources of well-being.

5.      Moderate distress from issues noted, with less focus on sources of well-being.

6.      Moderate suffering from issues noted, dominating the patient’s focus.  Patient either unable to draw from sources of spiritual well-being or has not identified sources.

7.      Severe suffering from issues noted.  Patient still able to draw from sources of well-being.

8.      Severe suffering from one or more issues noted.  Patient having difficulty drawing from sources of well-being.

9.      Severe suffering from one or more issues noted.  Patient unable to find relief through humor or distraction, with little or no ability to draw from sources of well-being.

10.  Severe, unbearable suffering from one or more issues noted.  Loss of hope; utter despair.