Instruments Measuring Spirituality in Clinical Research: A Systematic Review

ABSTRACT: INTRODUCTION: Numerous instruments have been developed to assess spirituality and measure its association with health outcomes. This study's aims were to identify instruments used in clinical research that measure spirituality; to propose a classification of these instruments; and to identify those instruments that could provide information on the need for spiritual intervention. METHODS: A systematic literature search in MEDLINE, CINHAL, PsycINFO, ATLA, and EMBASE databases, using the terms "spirituality" and "adult$," and limited to journal articles was performed to identify clinical studies that used a spiritual assessment instrument. For each instrument identified, measured constructs, intended goals, and data on psychometric properties were retrieved. A conceptual and a functional classification of instruments were developed. RESULTS: Thirty-five instruments were retrieved and classified into measures of general spirituality (N = 22), spiritual well-being (N = 5), spiritual coping (N = 4), and spiritual needs (N = 4) according to the conceptual classification. Instruments most frequently used in clinical research were the FACIT-Sp and the Spiritual Well-Being Scale. Data on psychometric properties were mostly limited to content validity and inter-item reliability. According to the functional classification, 16 instruments were identified that included at least one item measuring a current spiritual state, but only three of those appeared suitable to address the need for spiritual intervention. CONCLUSIONS: Instruments identified in this systematic review assess multiple dimensions of spirituality, and the proposed classifications should help clinical researchers interested in investigating the complex relationship between spirituality and health. Findings underscore the scarcity of instruments specifically designed to measure a patient's current spiritual state. Moreover, the relatively limited data available on psychometric properties of these instruments highlight the need for additional research to determine whether they are suitable in identifying the need for spiritual intervention

The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

BACKGROUND: Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. METHODS: A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT): 1) Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model) to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2) Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT) investigating needs related to each of the defined dimensions; 3) Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. RESULTS: Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity) and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. CONCLUSIONS: The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care

120 km single-photon Brillouin optical time domain reflectometry

We present a novel distributed Brillouin optical time domain reflectometer (BOTDR) using standard telecommunication fibers based on single-photon avalanche diodes (SPADs) in gated mode, hd-BOTDR, with a range of 120 km and 10 m spatial resolution. We experimentally demonstrate the ability to perform a distributed temperature measurement, by detecting a hot spot at 100 km. Instead of using a frequency scan like conventional BOTDR, we use a frequency discriminator based on the slope of a fiber Bragg grating (FBG) to convert the count rate of the SPAD into a frequency shift. A procedure to take into account the FBG drift during the acquisition and perform sensitive and reliable distributed measurements is described. We also present the possibility to differentiate strain and temperature

Chicory increases acetate turnover, but not propionate and butyrate peripheral turnovers in rats

Chicory roots are rich in inulin that is degraded into SCFA in the caecum and colon. Whole-body SCFA metabolism was investigated in rats during food deprivation and postprandial states. After 22h of food deprivation, sixteen rats received an IV injection of radioactive 14C-labelled SCFA. The volume of distribution and the fractional clearance rate of SCFA were 0·25-0·27 litres/kg and 5·4-5·9%/min, respectively. The half-life in the first extracellular rapidly decaying compartment was between 0·9 and 1·4min. After 22h of food deprivation, another seventeen rats received a primed continuous IV infusion of 13C-labelled SCFA for 2h. Isotope enrichment (13C) of SCFA was determined in peripheral arterial blood by MS. Peripheral acetate, propionate and butyrate turnover rates were 29, 4 and 0·3μmol/kg per min respectively. Following 4 weeks of treatment with chicory root or control diets, eighteen fed rats received a primed continuous IV infusion of 13C-labelled SCFA for 2h. Intestinal degradation of dietary chicory lowered caecal pH, enhanced caecal and colonic weights, caecal SCFA concentrations and breath H2.The diet with chicory supplementation enhanced peripheral acetate turnover by 25% (P=0·017) concomitant with an increase in plasma acetate concentration. There were no changes in propionate or butyrate turnovers. In conclusion, by setting up a multi-tracer approach to simultaneously assess the turnovers of acetate, propionate and butyrate it was demonstrated that a chronic chicory-rich diet significantly increases peripheral acetate turnover but not that of propionate or butyrate in rat

Extending the sensing range of Brillouin optical time-domain analysis up to 325 km combining four optical repeaters

A novel scheme is proposed to extend the sensing range of Brillouin optical time-domain analyzers (BOTDA). Specially-designed erbium doped fiber amplifier (EDFA) repeaters are located every 65km fiber along the sensing cable to achieve a total sensing length of 325km, corresponding to a 650km loop. At the end of the sensing fibre, we experimentally demonstrated a measurement repeatability of 2°C (2σ) using a three meters spatial resolution

Optical Sensor for the Detection of OH- Contamination during Optical Fibre Manufacturing

Sub-ppm (HCl) and (H2O) monitoring using photoacoustic spectroscopy is reported in optical fibre manufacturing for the production of low-water-peak fibres. Contamination sources of the carrier gas used for fibre preforms manufacturing were identified and discussed

Extending the Real Remoteness of Long-Range Brillouin Optical Time-Domain Fiber Analyzers

The real remoteness of a distributed optical fiber sensor based on Brillouin optical time-domain analysis is considerably extended in this paper using seeded second-order Raman amplification and optical pulse coding. The presented analysis and the experimental results demonstrate that a proper optimization of both methods combined with a well-equalized two-sideband probe wave provide a suitable solution to enhance the signal-to-noise ratio of the measurements when an ultra-long sensing fiber is used. In particular, the implemented system is based on an extended optical fiber length, in which half of the fiber is used for sensing purposes, and the other half is used to carry the optical signals to the most distant sensing point, providing also a long fiber for distributed Raman amplification. Power levels of all signals launched into the fiber are properly optimized in order to avoid nonlinear effects, pump depletion, and especially any power imbalance between the two sidebands of the probe wave. This last issue turns out to be extremely important in ultra-long Brillouin sensing to provide strong robustness of the system against pump depletion. This way, by employing a 240 km-long optical fiber-loop, sensing from the interrogation unit up to a 120 km remote position (i.e., corresponding to the real sensing distance away from the sensor unit) is experimentally demonstrated with a spatial resolution of 5 m. Furthermore, this implementation requires no powered element in the whole 240 km fiber loop, providing considerable advantages in situations where the sensing cable crosses large unmanned areas

Validation of the spiritual distress assessment tool in older hospitalized patients

ABSTRACT:¦BACKGROUND: The Spiritual Distress Assessment Tool (SDAT) is a 5-item instrument developed to assess unmet spiritual needs in hospitalized elderly patients and to determine the presence of spiritual distress. The objective of this study was to investigate the SDAT psychometric properties.¦METHODS: This cross-sectional study was performed in a Geriatric Rehabilitation Unit. Patients (N = 203), aged 65 years and over with Mini Mental State Exam score ≥ 20, were consecutively enrolled over a 6-month period. Data on health, functional, cognitive, affective and spiritual status were collected upon admission. Interviews using the SDAT (score from 0 to 15, higher scores indicating higher distress) were conducted by a trained chaplain. Factor analysis, measures of internal consistency (inter-item and item-to-total correlations, Cronbach α), and reliability (intra-rater and inter-rater) were performed. Criterion-related validity was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual well-being (FACIT-Sp) and the question "Are you at peace?" as criterion-standard. Concurrent and predictive validity were assessed using the Geriatric Depression Scale (GDS), occurrence of a family meeting, hospital length of stay (LOS) and destination at discharge.¦RESULTS: SDAT scores ranged from 1 to 11 (mean 5.6 ± 2.4). Overall, 65.0% (132/203) of the patients reported some spiritual distress on SDAT total score and 22.2% (45/203) reported at least one severe unmet spiritual need. A two-factor solution explained 60% of the variance. Inter-item correlations ranged from 0.11 to 0.41 (eight out of ten with P < 0.05). Item-to-total correlations ranged from 0.57 to 0.66 (all P < 0.001). Cronbach α was acceptable (0.60). Intra-rater and inter-rater reliabilities were high (Intraclass Correlation Coefficients ranging from 0.87 to 0.96). SDAT correlated significantly with the FACIT-Sp, "Are you at peace?", GDS (Rho -0.45, -0.33, and 0.43, respectively, all P < .001), and LOS (Rho 0.15, P = .03). Compared with patients showing no severely unmet spiritual need, patients with at least one severe unmet spiritual need had higher odds of occurrence of a family meeting (adjOR 4.7, 95%CI 1.4-16.3, P = .02) and were more often discharged to a nursing home (13.3% vs 3.8%; P = .027).¦CONCLUSIONS: SDAT has acceptable psychometrics properties and appears to be a valid and reliable instrument to assess spiritual distress in elderly hospitalized patients