Dilemmas of spiritual assessment: considerations for nursing practice

Background. Interest in the spiritual dimension of nursing has resulted in a proliferation of published research internationally that is very prescriptive, suggesting that nurses should be providing spiritual care. However, little research has been published that provides nurses with a potential framework for the assessment and subsequent delivery of spiritual care. It would appear that there is a consensus of opinion that nurses can and should be able to undertake an assessment of their patients' spiritual needs. However, such assumptions may be unfounded, inaccurate, misguided and potentially detrimental to patient care. Aim. This article explores the area of spiritual assessment, drawing on the international literature, highlighting potential dilemmas in conducting a spiritual assessment. A review of some of the currently available spiritual assessment tools is also undertaken. Design. A debate is presented based on the authors' experiences and opinions with regard to this aspect of care. The debate is informed by a review of the literature specifically addressing spiritual assessment. The authors use United Kingdom policy to illustrate drivers and provide a context for the debate. However the dilemmas presented and issues raised are of significance to a wider international audience. Conclusion. It is argued that the area of spiritual assessment needs careful consideration, both nationally and internationally, by those professionals involved in the provision of spiritual care so that potential dilemmas can be identified and reviewed. Such consideration may prevent the construction and subsequent use of inappropriate assessment tools within practice. The article incorporates some considerations for practice.