Supportive Care in Cancer

, Volume 26, Issue 9, pp 3187–3193 | Cite as

The cultural expression of spiritual distress in Israel

  • Michael Schultz
  • Tehilah Meged-Book
  • Tanya Mashiach
  • Gil Bar-Sela
Original Article



Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel.


We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care.


Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress.


Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.


Spiritual distress Spiritual care Chaplaincy Cultural match Cultural variance 



We gratefully thank for its permission to use the Facit-Sp-12 and Chaplain Gary Berg for his permission to use the SIS. Thank you to the UJA/Federation of New York for their ongoing support of the spiritual care service and research efforts at Rambam Health Care Campus. Thank you to Professor George Fitchett of Rush University for our consultations in designing this study.

Compliance with ethical standards

The corresponding author has full control of all primary data and agrees to allow the journal to review the data if requested.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of OncologyRambam Health Care CampusHaifaIsrael
  2. 2.Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael
  3. 3.Statistical DepartmentRambam Health Care CampusHaifaIsrael
  4. 4.Integrated Oncology and Palliative Care UnitRambam Health Care CampusHaifaIsrael

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