Spiritual Needs Assessment in Palliative Care
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ScribdTranslationsGES QUESTIONNAIRE
Assessment of resources and needs
spiritual
Version 5 - GUIDE FOR THE APPLICATION OF THE GES QUESTIONNAIRE
Assessment of spiritual resources and needs and facilitation of intervention
with palliative care patients
Spirituality Group SECPAL (GES)
This tool1of evaluation of spiritual resources and needs and facilitation of
accompaniment or intervention is based on the anthropological model of spirituality developed
by the GES and validated2The GES recommends that its use be limited to professionals with
experience that know the GES model and have established an empathetic relationship and
trust with the patient. To be interviewed, the patient must meet a minimum of
conditions that are:
a. Adult patients who give their consent to be evaluated in this.
dimension.
b. Presence of advanced-terminal disease according to the WHO/SECPAL criteria in
palliative care subject.
c. To have the ability to understand subjective measures (calculated with the Spanish version of
SPMSQ3-Pffeifer normal).
Be aware of your diagnosis and prognostic situation and/or have expressed at least
occasionally his intuition of the possibility of dying (scores equal to or higher than
3 according to the Ellershaw scale.4
The questionnaire has a primarily evaluative purpose of the spiritual dimension.
knowing that self-assessment is a privileged facilitator of that support
spiritual that begins with the evaluation.
Instructions for use
The questionnaire aims to create a framework and a methodology that allows for exploration in a way
ordered and systematic the possible sources of spiritual satisfaction or need. The attitude
the clinician's should be one of deeply attentive listening, welcoming, respectful, and affable.
1. Benito E, Oliver Galiana A, L, BarretoP, Pascual A, Gomis C, Barbero J. Development and Validation of a New Tool for the Assessment and
2. Note: it is a scale with factorial validity and clear evidence of reliability (alpha = 0.72) and that is coherently related to other measures of spirituality, depression, anxiety
and resilience.
3. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. JAm Geriatr Soc 1975; 23(10): 433--41. H Martínez de la
Iglesia J, Dueñas R, Onis MC, Aguado C, Albert C, Luque R. Adaptation and validation of the Pfeiffer questionnaire (SPMSQ) into Spanish to detect the existence of cognitive impairment.
in people over 65 years old. Med Clin 2001; 117(4): 129--‐134.
4. Ellershaw JE, Peat SJ, Boys LC. Assessing the effectiveness of a hospital palliative care team. Palliat Med 1995; 9(2): 145--‐52.
No. 6 • NOVEMBER 2014 281
SPIRITUALITY IN CLINIC
A proposal for evaluation and spiritual accompaniment in Palliative Care
If a sufficiently close and/or therapeutic bond has not yet been created, it is suggested to use
the initial open questions that facilitate a space of intimacy and a climate of serenity,
that allow exploring their inner world in a guided way. The questions can be formulated
in that order and at the pace that the patient needs to formulate the answers.
They try to assess the needs while at the same time the experience and resources of the
person, both in the intrapersonal, interpersonal, and transpersonal domains,
recognizing and validating what the patient brings, precisely because it is their experience.
It is important to remind the patient that there are no right or wrong answers and that there
they explore concerns and abilities that can affect any human being throughout
our life and what we usually face. The important thing is that the response is true to what he
same experiment.
When presenting the questionnaire of 8 statements, we ask you to evaluate to what extent you
I feel identified with each one of them and to what degree, from least to most.
It is also clarified that the objective is not so much to seek a category for each response,
but by stimulating dialogue, the patient can explore, reflect, and find a
intuitive response that can be a gateway to the resource or to the spiritual need
of each person, which can at the same time be accompanied, accepted, reconciled,
transcended, etc.
Initial open-ended questions to facilitate the atmosphere (optional)
At this moment, in your current situation...
What worries you the most?
What bothers you the most?
3. What helps you the most?
4. What or who do you rely on in times of crisis?
5. What makes you feel safe, secure?
6. What do your people value most about you?
282 SECPAL MONOGRAPHS
GES QUESTIONNAIRE
Assessment of resources and spiritual needs
Questionnaire on spirituality
When responding to the following group of questions, it is advisable to remember that practically
All people, in one way or another, have or have had to a greater or lesser extent
different concerns or anxieties or similar capabilities to those that will be raised, that
they matter to us and that we address throughout life. We ask you to evaluate to what extent
Do you feel identified with the following statements (Not at all, a little, quite a lot, or a lot):
1. Reviewing my life, I feel satisfied with what I have lived and with myself.
I have done in my life what I felt I had to do.
I find meaning in my life.
I feel loved by the people who matter to me.
I feel at peace and reconciled with others.
I believe I have been able to contribute something valuable to life or to others.
7. Despite my illness, I maintain hope that positive things will happen.
I feel connected to a higher reality (nature, God,...).
OPEN COMMENTS ON THE SHARED EXPERIENCE
Spanish Society of Palliative Care
No. 6 • NOVEMBER 2014 283
Common questions
Powered by AIThe GES Questionnaire can identify and support the spiritual needs of patients aware of their mortality by facilitating a candid exploration of their thoughts, fears, and hopes related to their finite time. It offers a platform for expressing existential concerns, such as finding meaning in their life and contributions, through which clinicians can offer targeted spiritual care and support. Recognizing and addressing these needs can help patients achieve a sense of peace and completion, contributing to their overall well-being in their final stages of life .
The GES Questionnaire uses open-ended questions at the start to initiate discussions, such as asking what worries the patient most at the moment, what helps them, and who they rely on during crises. These questions are crucial as they establish an environment of security and sincerity, allowing patients to express personal fears and desires honestly. These initial questions help set the tone for a meaningful and secure exchange, enabling deeper exploration of spiritual concerns .
The GES Questionnaire ensures reliability and validity by incorporating a scale with factorial validity and an alpha reliability coefficient of 0.72. The tool is designed to be coherently related to other well-established measures of spirituality, such as depression, anxiety, and resilience. This structured approach, combined with the questionnaire's links to validated spiritual assessment tools, ensures that it can reliably and validly assess the spiritual dimension of palliative care patients .
The GES Questionnaire supports clinicians in establishing an empathetic relationship by encouraging a framework of attentive listening and response to the patient's experiences and concerns. The recommended use of open-ended questions at the beginning of the assessment process creates a space of intimacy and serenity, allowing patients to express their inner worlds securely. Such a method respects patients' experiences and validates their feelings, promoting trust and empathy, which are crucial components of effective palliative care .
Self-assessment in the GES Questionnaire process plays a crucial role as it is considered a privileged facilitator of spiritual support, which begins with evaluation. By engaging patients in self-evaluation, it encourages them to reflect on their spiritual needs and resources, consider their life's meaning, and identify areas of satisfaction or need. This self-reflection can lead to greater personal insight and facilitate a deeper understanding of their spiritual condition, potentially aiding in spiritual resource realization and support .
Maintaining a welcoming and attentive attitude during the GES Questionnaire application is critical because it fosters a supportive climate where patients feel comfortable sharing personal and potentially vulnerable aspects of their spirituality. Such a demeanor helps build trust, allowing patients to openly communicate their spiritual concerns and needs. This empathetic approach is essential for accurately assessing spiritual resources and aligning care efforts with the patient's personal values and beliefs .
The GES model of spirituality contributes to palliative care by providing a structured approach to understanding and addressing the spiritual dimensions of patients with advanced illnesses. It emphasizes the identification of spiritual needs as an integral component of patient care and supports clinicians in promoting spiritual well-being through empathetic engagement. This model recognizes the uniqueness of each patient's spiritual journey and facilitates meaningful dialogue, enhancing overall care quality by addressing emotional and existential concerns alongside physical symptoms .
The prerequisites for a patient to be evaluated using the GES Questionnaire in palliative care include being an adult patient who consents to the evaluation, having an advanced or terminal disease per WHO/SECPAL criteria, possessing the ability to understand subjective measures (as determined by the Spanish version of SPMSQ), and being aware of their diagnosis and prognosis, or having expressed an understanding of their potential for death. These criteria ensure that the patient is able to participate meaningfully in the assessment process .
The GES Questionnaire addresses the transpersonal domain by encouraging patients to explore their connection with a higher reality, such as nature or a divine presence, through introspective questions. This capacity is significant because it acknowledges the broader existential aspects of spirituality, which can be vital for patients facing terminal illnesses. By exploring beyond the personal to the universal, the questionnaire can help patients find solace and meaning, supporting emotional resilience and a sense of peace, which are crucial during palliative care .
The GES Questionnaire facilitates the evaluation of spiritual needs and resources by creating a structured framework that guides the exploration of a patient's spiritual dimension in a systematic way. It enables clinicians to assess spiritual needs through open-ended questions that encourage patients to reflect on personal concerns, resources, and experiences. The evaluative purpose is to identify areas of spiritual satisfaction or needs, promoting a dialogue that can lead to understanding and addressing the individual's spiritual resources or needs .