{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T01:17:17Z","timestamp":1771031837797,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T00:00:00Z","timestamp":1572220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Religions"],"abstract":"<jats:p>Spiritual distress may ascend from unmet spiritual needs. The use of instruments to measure spiritual distress seems to facilitate the approach to spirituality, such as the Spiritual Distress Scale (SDS) that has been used worldwide. No instrument to assess spiritual distress in cancer patients is currently available in Portugal. This study aims to conduct the translation, adaptation and validation of the SDS in Portuguese cancer patients undergoing chemotherapy. Methodological study based on Sousa and Rojjanasrirat (2011), a seven-step approach, started with the linguistic translation to the psychometric tests. The main participants (55.4%) were older than 60 years; about 64.7% were females, married (68.0%), and 86.7% were Catholic. Moderate spiritual distress was experienced by 49.3% of the participants. Linguistic and conceptual equivalences were obtained. The SDS European Portuguese version has an overall Cronbach\u2019s alpha of 0.91, and the subscales were as follows: \u201crelationship with self\u201d (0.92), \u201crelationship with others\u201d (0.63), \u201crelationship with God\u201d (0.64) and \u201cfacing death\u201d (0.85). Four factors emerged after Varimax rotation. Overall, these results indicate that the SDS European Portuguese version has good psychometric characteristics and can used in assessing spiritual distress in cancer patients.<\/jats:p>","DOI":"10.3390\/rel10110599","type":"journal-article","created":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T11:26:13Z","timestamp":1572261973000},"page":"599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Validation of the Spiritual Distress Scale in Portuguese Cancer Patients Undergoing Chemotherapy: A Methodological Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5804-7934","authenticated-orcid":false,"given":"Helga","family":"Martins","sequence":"first","affiliation":[{"name":"Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Cat\u00f3lica Portuguesa, Palma de Cima, 1649-023 Lisbon, Portugal"}]},{"given":"S\u00edlvia","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Cat\u00f3lica Portuguesa, Palma de Cima, 1649-023 Lisbon, Portugal"}]},{"given":"Tiago","family":"Dias Domingues","sequence":"additional","affiliation":[{"name":"Centre of Statistics and Its Applications Universidade de Lisboa, 1649-004 Lisbon, Portugal"}]},{"given":"Margarida","family":"Vieira","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Cat\u00f3lica Portuguesa, Rua de Diogo Botelho 1327, 4169-005 Oporto, Portugal"}]},{"given":"Ya-Lie","family":"Ku","sequence":"additional","affiliation":[{"name":"College of Nursing, Fooyin University, Kaohsiung City 83102, Taiwan"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"The accuracy of measures in screening adults for spiritual suffering in health care settings: A systematic review","volume":"7","author":"Bahraini","year":"2019","journal-title":"Palliative and Supportive Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1017\/S1478951514001217","article-title":"Assessment of Spiritual Suffering in the Cancer Context: A Systematic Literature Review","volume":"13","author":"Best","year":"2015","journal-title":"Palliative and Supportive Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/07317115.2015.1120255","article-title":"Instruments to Assess Depressive Symptoms and Spiritual Distress Investigate Different Dimensions","volume":"39","author":"Bornet","year":"2016","journal-title":"Clinical Gerontologist"},{"key":"ref_4","first-page":"246797","article-title":"Spiritual Dryness as a Measure of a Specific Spiritual Crisis in Catholic Priests: Associations with Symptoms of Burnout and Distress","volume":"2013","author":"Baumann","year":"2013","journal-title":"Evidence-Based Complementary and Alternative Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"B\u00fcssing, Arndt, Recchia, Daniela Rodrigues, Harold, Koenig, Baumann, Klaus, and Frick, Eckhard (2018). Factor Structure of the Spiritual Needs Questionnaire (SpNQ) in Persons with Chronic Diseases, Elderly and Healthy Individuals. Religions, 9.","DOI":"10.3390\/rel9010013"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.2047-3095.2013.01234.x","article-title":"Spiritual Distress-Proposing a New Definition and Defining Characteristics","volume":"24","author":"Caldeira","year":"2013","journal-title":"International Journal of Nursing Knowledge"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1007\/s10943-017-0390-4","article-title":"Spiritual Well-Being and Spiritual Distress in Cancer Patients Undergoing Chemotherapy: Utilizing the SWBQ as Component of Holistic Nursing Diagnosis","volume":"56","author":"Caldeira","year":"2017","journal-title":"Journal of Religion & Health"},{"key":"ref_8","unstructured":"Timmins, Fiona, and Caldeira, S\u00edlvia (2019). The Role of the Nurse in Providing Spiritual Care: A Case Study Approach to Exploring Specific Care Provision by Healthcare Workers in the Context of an Interdisciplinary Healthcare Team. Spirituality in Healthcare: Perspectives for Innovative Practice, Springer."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1111\/jonm.12005","article-title":"An Integrative Review of Spiritual Assessment: Implications for Nursing Management","volume":"20","author":"Draper","year":"2012","journal-title":"Journal of Nursing Management"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1016\/S0191-8869(03)00045-X","article-title":"Domains of Spiritual Well-Being and Development and Validation of the Spiritual Well-Being Questionnaire","volume":"35","author":"Gomez","year":"2003","journal-title":"Personality and Individual Differences"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.paid.2004.07.009","article-title":"Item Response Theory Analysis of the Spiritual Well-Being Questionnaire","volume":"38","author":"Gomez","year":"2005a","journal-title":"Personality and Individual Differences"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1016\/j.paid.2005.03.023","article-title":"The Spiritual Well -Being Questionnaire: Testing for Model Applicability, Measurement and Structural Equivalencies, and Latent Mean Differences Across Gender","volume":"39","author":"Gomez","year":"2005b","journal-title":"Personality and Individual Differences"},{"key":"ref_13","first-page":"285","article-title":"Vers\u00e3o Portuguesa do Question\u00e1rio de Bem-Estar Espiritual (SWBQ): An\u00e1lise Confirmat\u00f3ria da sua Estrutura Factorial","volume":"10","author":"Gouveia","year":"2009","journal-title":"Psicologia, Sa\u00fade & Doen\u00e7as"},{"key":"ref_14","unstructured":"Gray, Jennifer R., Grove, Susan K., and Sutherland, Suzanne (2017). Burns and Grove\u2019s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence, Elsevier. [8th ed.]. First published 1987."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF02289162","article-title":"Some Necessary Conditions for Common Factor Analysis","volume":"19","author":"Guttman","year":"1954","journal-title":"Psychometrika"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1136\/eb-2015-102129","article-title":"Validity and Reliability in Quantitative Research","volume":"18","author":"Heale","year":"2015","journal-title":"Evidence-Based Nursing"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Herdman, Heather T., and Kamitsuru, Shigemi (2018). NANDA: NANDA International Nursing Diagnoses: Definitions and Classification 2018\u20132020, Wiley-Blackwell. [11th ed.]. First published 1994.","DOI":"10.1055\/b-006-161179"},{"key":"ref_18","first-page":"1","article-title":"A Note on Guttman\u2019s Lower Bound for the Number of Common Factors","volume":"14","author":"Kaiser","year":"1961","journal-title":"British Journal of Psychology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s11089-014-0633-1","article-title":"Using a Spiritual Distress Scale to Assess Suicide Risk in Veterans: An Exploratory Study","volume":"64","author":"Kopacz","year":"2015","journal-title":"Pastoral Psychology"},{"key":"ref_20","first-page":"221","article-title":"Spiritual Distress Experienced by Cancer Patients-Develop a Spiritual Care for Cancer Patients","volume":"10","author":"Ku","year":"2005","journal-title":"Taiwan Journal of Hospice Palliative Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"133","DOI":"10.12968\/ijpn.2010.16.3.47325","article-title":"Establishing the Validity of a Spiritual Distress Scale for Cancer Patients Hospitalized in Southern Taiwan","volume":"16","author":"Ku","year":"2010","journal-title":"International Journal of Palliative Nursing"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"155","DOI":"10.24198\/jnc.v1i2.16514","article-title":"Spiritual Distress in Breast Cancer Patients","volume":"1","author":"Lestari","year":"2018","journal-title":"Journal of Nursing Care"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Martins, Helga, and Caldeira, S\u00edlvia (2018). Spiritual Distress in Cancer Patients: A Synthesis of Qualitative Studies. Religions, 9.","DOI":"10.3390\/rel9100285"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"89","DOI":"10.12707\/RIII13129","article-title":"Translation and Adaptation of the Spirituality and Spiritual Care Rating Scale in Portuguese Palliative Care Nurses","volume":"4","author":"Martins","year":"2015","journal-title":"Revista de Enfermagem Refer\u00eancia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/s11606-011-1769-7","article-title":"Instruments Measuring Spirituality in Clinical Research: A Systematic Review","volume":"26","author":"Monod","year":"2011","journal-title":"Journal of General Internal Medicine"},{"key":"ref_26","unstructured":"Munro, Barbara Hazard (2005). Statistical Methods for Health Care Research, Lippincott Williams & Wilkins. [5th ed.]. First published 1986."},{"key":"ref_27","first-page":"e4011","article-title":"Questionnaires Measuring Patients\u2019 Spiritual Needs: A Narrative Literature Review","volume":"10","author":"Seddigh","year":"2016","journal-title":"Iranian Journal of Psychiatry and Behavioral Sciences"},{"key":"ref_28","first-page":"231","article-title":"Cultural Adaptation and Analysis of the Psychometric Properties of the Brazilian Version of the Spiritual Distress Scale","volume":"25","author":"Chaves","year":"2015","journal-title":"Journal of Clinical Nursing"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1365-2753.2010.01434.x","article-title":"Translation, Adaptation and Validation of Instruments or Scales for use in Cross-Cultural Health Care Research: A Clear and User-Friendly Guideline","volume":"17","author":"Sousa","year":"2011","journal-title":"Journal of Evaluation in Clinical Practice"},{"key":"ref_30","unstructured":"Tabachnick, Barbara G., and Fidell, Linda S. (2013). Using Multivariate Statistics, Pearson Education Limited Harlow. [6th ed.]. First published 1983."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/HNP.0b013e318294e50a","article-title":"Nurse Responses to Patient Expressions of Spiritual Distress","volume":"27","author":"Taylor","year":"2013","journal-title":"Holistic Nursing Practice"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Velosa, Teresa, Caldeira, S\u00edlvia, and Capelas, Manuel Lu\u00eds (2017). Depression and Spiritual Distress in Adult Palliative Patients: A Cross-Sectional Study. Religions, 8.","DOI":"10.3390\/rel8080156"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Waltz, Carolyn, Strickland, Ora Lea, and Lenz, Elizabeth (2016). Measurement in Nursing and Health Research, Springer. [5th ed.]. First published 1991.","DOI":"10.1891\/9780826170620"}],"container-title":["Religions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-1444\/10\/11\/599\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:30:00Z","timestamp":1760189400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-1444\/10\/11\/599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,28]]},"references-count":33,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11]]}},"alternative-id":["rel10110599"],"URL":"https:\/\/doi.org\/10.3390\/rel10110599","relation":{},"ISSN":["2077-1444"],"issn-type":[{"value":"2077-1444","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,28]]}}}