Prevalence and correlates of spiritual distress in adult patients facing elective surgery: A cross-sectional analysis.

Résumé

BACKGROUND: Patients with terminal disease, leading to existential concerns, commonly experience spiritual distress. Despite the uniqueness of the surgical encounter, which evokes major life disruption, the prevalence of spiritual distress in patients undergoing elective surgery remains unknown.METHODS: We surveyed patients ≥18 years of age scheduled within 4 weeks for elective surgery requiring overnight admission. Scores 52 on the Religious and Spiritual Struggles scale indicated spiritual distress. Pearson χ, Welch 2-sample t tests, and logistic regression were used to evaluate associations.RESULTS: Of 140 patients (response rate 31%), 49 were spiritually distressed (35%; mean [standard deviation] Functional Assessment of Chronic Illness Therapy-Spiritual Well-being 12: 37 [9], median [interquartile range] Religious and Spiritual Struggles: 5 [13]). Those with distress had significantly lower intrinsic religiosity scores (P < .001) and lower levels of organizational and nonorganizational religious activity (P < .001 for both) than those without distress. Depression (P < .001), anxiety (P < .001), being unmarried (P < .001), frequent financial worry (P < .001), fair/poor health (P < .001), and no identified religion (P < .001) were associated with spiritual distress. On adjusted analysis, intrinsic religiosity (odds ratio, 0.71; 95% confidence interval, 0.53-0.92, P = .013), identified religion (odds ratio, 0.04; 95% confidence interval, 0.00-0.57; P = .038), and good/excellent health (odds ratio, 0.09; 95% confidence interval, 0.01-0.39; P = .003) were associated with lower odds of spiritual distress.CONCLUSION: More than one-third of patients experienced spiritual distress preoperatively, suggesting an unmet need to facilitate spiritual care in the preoperative period. Although the surgical encounter is an isolated event, patients with surgical disease navigate serious concerns related to health, meaning, and purpose.