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Determining best methods to screen for religious/spiritual distress

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Abstract

Purpose

This study sought to validate for the first time a brief screening measure for religious/spiritual (R/S) distress given the Commission on Cancer’s mandated screening for psychosocial distress including spiritual distress.

Methods

Data were collected in conjunction with an annual survey of adult hematopoietic cell transplantation (HCT) survivors. Six R/S distress screeners were compared to the Brief RCOPE, Negative Religious Coping subscale as the reference standard. We pre-specified validity as a sensitivity score of at least 85 %. As no individual measure attained this, two post hoc analyses were conducted: analysis of participants within 2 years of transplantation and of a simultaneous pairing of items. Data were analyzed from 1449 respondents whose time since HCT was 6 months to 40 years.

Results

For the various single-item screening protocols, sensitivity ranged from 27 (spiritual/religious concerns) to 60 % (meaning/joy) in the full sample and 25 (spiritual/religious concerns) to 65 % (meaning/joy) in a subsample of those within 2 years of HCT. The paired items of low meaning/joy and self-described R/S struggle attained a net sensitivity of 82 % in the full sample and of 87 % in those within 2 years of HCT but with low net specificities.

Conclusions

While no single-item screener was acceptable using our pre-specified sensitivity value of 85 %, the simultaneous use of meaning/joy and self-described struggle items among cancer survivors is currently the best choice to briefly screen for R/S distress. Future research should validate this and other approaches in active treatment cancer patients and survivors and determine the best times to screen.

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Acknowledgments

We express great appreciation to Dr. Paul Martin for his support for the conduct of the survey that produced the data for this study and for his helpful comments regarding this paper. We also express appreciation to those within the Long-Term Follow Up program at Fred Hutchinson Cancer Research Center, including Peggy Adams Myers, Kathleen Meeth, Kevin Bray, and Carey Fudurich. The collection of the survey data for this project was supported by the ALC grant CA018029.

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Authors and Affiliations

  1. Chaplaincy, Child Life, & Clinical Patient Navigators, Seattle Cancer Care Alliance, PO Box 19023, K1-104, Seattle, WA, 98109, USA

    Stephen D. W. King

  2. Department of Religion, Health & Human Values, Rush University Medical Center, Chicago, IL, 60612, USA

    George Fitchett & Patricia E. Murphy

  3. Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA

    Kenneth I. Pargament

  4. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, 98195, USA

    David A. Harrison

  5. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA

    Elizabeth Trice Loggers

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  1. Stephen D. W. King
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  2. George Fitchett
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  3. Patricia E. Murphy
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  4. Kenneth I. Pargament
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Correspondence to Stephen D. W. King.

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Ethical approach

All procedures in this study were in accordance with the ethical standards of the institutional review committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare no conflict of interest. We do not have full control of all the primary data.

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The views expressed in the submitted article are the authors’ and not an official position of their respective institutions.

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King, S.D.W., Fitchett, G., Murphy, P.E. et al. Determining best methods to screen for religious/spiritual distress. Support Care Cancer 25, 471–479 (2017). https://doi.org/10.1007/s00520-016-3425-6

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  • DOI: https://doi.org/10.1007/s00520-016-3425-6

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