Concept Analysis of Spiritual Distress in Cancer Patients Using a Hybrid Model

Abstract

Purpose: This study was intended to clarify the concept of spiritual distress in cancer patients using the hybrid model of Schwarz-Barcott and Kim. Methods: The hybrid model was used to clarify the dimension, attributes, and definition of spiritual distress. In the theoretical phase, a systemic literature review of nursing and other disciplines was conducted. In the fieldwork phase, individual in-depth interviews were held with six cancer patients. In the final analytic phase, the results of the theoretical and fieldwork phases were integrated after comparing and reviewing. Results: The concept of spiritual distress was analyzed in three domains: a changed relationship with God, a changed relationship with the self, and a changed relationship with others. Also, 10 attributes were clarified. The changed relationship with God domain had two attributes: “low connectedness in relationship with God” and a “feeling of guilt”. The changed relationship with the self domain had five attributes: “loss of self-identity”, “changed meaning of life”, “loss of inner peace”, “dwelling on the cause of unsloved suffering”, and “avoidance of confronting death”. The changed relationship with others domain had three attributes: “shrunk relationships”, “the feeling of being unloved and unforgivable”, and “burden on family”. Conclusion: The concept of spiritual distress in patients with cancer encompasses multidimensional domains and 10 attributes. To assess spiritual distress in patients with cancer based on the findings of this study, it is necessary to develop a suitable spiritual distress assessment scale.