Testing the Validity of a Protocol to Screen for Spiritual Struggle among Parents of Children with Cystic Fibrosis

Abstract

Spirituality is important to many Americans and is used to cope with adverse events. Some forms of spiritual coping are maladaptive or troubling, and are known as negative spiritual coping or spiritual struggle. These forms of spirituality are often associated with poorer physical and mental health outcomes. Thus, in clinical contexts there is a need to identify persons who may be experiencing spiritual struggle and, if indicated, offer spiritual care that may address that struggle. Twenty-two parents of children with cystic fibrosis (CF) completed semi-structured interviews and questionnaires exploring spirituality’s role in their child’s illness. Interviews included oral administration of a protocol to screen for spiritual struggle. The parents also completed the negative religious coping subscale of the Brief RCOPE, a commonly used measure of spiritual struggle. Descriptive statistics were obtained. The screening protocol identified 18% of the parents as potentially having spiritual struggle. Thirty-two percent had negative religious coping scores suggestive of spiritual struggle. Comparison of results with both measures found the screening protocol had good specificity (87%) but relatively low sensitivity (29%). Using either measure, indications of spiritual struggle were associated with higher levels of depressive symptoms. The screener’s administration was acceptable and feasible. The low sensitivity may be due in part to differences between the focus of the screener and that of the negative religious coping subscale, which focuses on struggle with the Divine. Further work is needed to establish the best approach to screening for spiritual struggle.

Anxiety and Avoidance in Adults and Childhood Trauma Are Associated with Negative Religious Coping

“…As a robust predictor of poor health-related outcomes, NRC has been separately assessed in some studies [ 9 , 30 , 31 ]. According to these studies, the prevalence of NRC varies from 7 to 50% in various populations [ 30 ].…”

“…As a robust predictor of poor health-related outcomes, NRC has been separately assessed in some studies [ 9 , 30 , 31 ]. According to these studies, the prevalence of NRC varies from 7 to 50% in various populations [ 30 ]. This variation might be explained by the variability of criteria employed to determine the presence of NRC [ 32 , 33 , 34 ].…”

Spiritual Struggle in Parents of Children with Cystic Fibrosis Increases Odds of Depression

“…Spiritual Struggle . SS is commonly operationalized as using negative spiritual coping styles as measured by the Brief R-COPE [ 18 , 19 ]. The exposure of interest, SS, was defined based on previous studies [ 8 , 19 ] as follows.…”

“…SS is commonly operationalized as using negative spiritual coping styles as measured by the Brief R-COPE [ 18 , 19 ]. The exposure of interest, SS, was defined based on previous studies [ 8 , 19 ] as follows. The following Fitchett and colleagues [ 20 ], responses to the R-COPE items were used to classify SS observed for each participant and time point into one of three levels corresponding to the frequency of negative spiritual coping: “None,” “Mild,” or “Moderate/Severe.” The first category corresponded to a participant not using any form of negative spiritual coping; the second category was for a participant who used all forms of negative spiritual coping only as often as “somewhat”; finally, the last category was for a participant who used any form of negative spiritual coping “quite a bit” or “a great deal.”…”

Chaplaincy and Narrative Theory: A Response to Risk's Case Study

“…It is not clear if the Rush Protocol Chaplain Risk used was the original version or the revised version described in that original publication. As described, it appears that Bob referred himself through the Protocol’s question, “Would you like to talk with a chaplain?” This question is included in the protocol to identify persons who may or may not be experiencing spiritual struggle and for whom a chaplain’s visit might or might not be important—and yet whose satisfaction will be lower if they do not receive one (Grossoehme & Fitchett, in Press). Having a sense of what lay behind Bob’s self-referral might (or might not) have influenced Chaplain Risk’s initial meeting or his future care.…”