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The accuracy of measures in screening adults for spiritual suffering in health care settings: a systematic review

  • Sayna Bahraini (a1), Wendy Gifford (a1), Ian D Graham (a2), Liquaa Wazni (a1), Suzette Brémault-Phillips (a3), Rebekah Hackbusch (a4), Catrine Demers (a5) and Mary Egan (a5)...



Guidelines for palliative and spiritual care emphasize the importance of screening patients for spiritual suffering. The aim of this review was to synthesize the research evidence of the accuracy of measures used to screen adults for spiritual suffering.


A systematic review of the literature. We searched five scientific databases to identify relevant articles. Two independent reviewers screened, extracted data, and assessed study methodological quality.


We identified five articles that yielded information on 24 spiritual screening measures. Among all identified measures, the two-item Meaning/Joy & Self-Described Struggle has the highest sensitivity (82–87%), and the revised Rush protocol had the highest specificity (81–90%). The methodological quality of all included studies was low.

Significance of Results

While most of the identified spiritual screening measures are brief (comprised 1 to 12 items), few had sufficient accuracy to effectively screen patients for spiritual suffering. We advise clinicians to use their critical appraisal skills and clinical judgment when selecting and using any of the identified measures to screen for spiritual suffering.


Corresponding author

Address correspondence: Sayna Bahraini, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Ottawa, Canada. E-mail:


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