Survey of Spiritual Needs (Short Version)
The Survey of Spiritual Needs is a seven-question survey to assess for spiritual distress, depression and patient needs and wishes related to these issues. This survey can be completed in two to five minutes. It is intended for adult and older teen populations with abstract reasoning skills.
Screening for spiritual needs can be conducted by any healthcare personnel including patient care technicians and certified nursing assistants. The SOSN is a brief survey that will enable any healthcare professional to assess for spiritual distress and disruptions in spiritual engagement thoroughly yet quickly. It will also enable the examiner to identify solutions to help their patient re-engage with this occupation and begin to resolve present distress. It will enable the examiner to connect the patient with other appropriate resources and determine if further screening is necessary. No prior training is required.
Some users of the original SOSN have requested a shortened version. This alternate version is provided to make the tool more efficient. The user may determine which version is suited to their needs. If a user finds that one question from the survey is sufficient to the conversation at hand, then foregoing the rest of the survey permissible. The survey is intended as a guide rather than as a formal questionnaire with ridged guidelines. So, users are free to change the order of questions, skip questions or use this short version as needed.
Survey of Spiritual Needs (Short)
Name_____________________________ Date____________ Patient Number __________
State: “You seem stressed. Would it be ok if I asked you some questions about that?” If they are agreeable, proceed to ask the following questions. If not, let them know you are willing to listen if they change their mind.
1) Are you at peace?
2) Are there any ways we (the staff) can support you better?
3) Would you like help connecting with someone important to you?
4) Would you like to talk to a chaplain or a mental health professional?
Closing: Thank them for their honesty and courage in sharing with you.
Further steps:
It may be beneficial to share the results of this survey with the patient’s case manager and the treatment team. Refer them to a chaplain or mental health professional as indicated.
Screening for spiritual needs can be conducted by any healthcare personnel including patient care technicians and certified nursing assistants. The SOSN is a brief survey that will enable any healthcare professional to assess for spiritual distress and disruptions in spiritual engagement thoroughly yet quickly. It will also enable the examiner to identify solutions to help their patient re-engage with this occupation and begin to resolve present distress. It will enable the examiner to connect the patient with other appropriate resources and determine if further screening is necessary. No prior training is required.
Some users of the original SOSN have requested a shortened version. This alternate version is provided to make the tool more efficient. The user may determine which version is suited to their needs. If a user finds that one question from the survey is sufficient to the conversation at hand, then foregoing the rest of the survey permissible. The survey is intended as a guide rather than as a formal questionnaire with ridged guidelines. So, users are free to change the order of questions, skip questions or use this short version as needed.
Survey of Spiritual Needs (Short)
Name_____________________________ Date____________ Patient Number __________
State: “You seem stressed. Would it be ok if I asked you some questions about that?” If they are agreeable, proceed to ask the following questions. If not, let them know you are willing to listen if they change their mind.
1) Are you at peace?
2) Are there any ways we (the staff) can support you better?
3) Would you like help connecting with someone important to you?
4) Would you like to talk to a chaplain or a mental health professional?
Closing: Thank them for their honesty and courage in sharing with you.
Further steps:
It may be beneficial to share the results of this survey with the patient’s case manager and the treatment team. Refer them to a chaplain or mental health professional as indicated.
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