The Spiritual Comfort Index (SCI): A Pilot Study Toward Establishing a Spiritual Vital Sign in the United States

The provision of spiritual care in USA-based healthcare has historically relied on narrative and anecdotal feedback to characterize treatment outcomes. This approach has demonstrated a relative inability to accurately determine whether spiritual care interventions have a measurable impact on treating patient spiritual lack or distress, despite the recent increase in the use of spiritual care measurement scales. The Spiritual Comfort Index (SCI) is a quantitative, results-oriented screening system, intervention methodology, and healthcare statistical tool that assesses patient spiritual distress to inform the administration of spiritual care. The purpose of this prospective pilot study was to measure the impact of healthcare chaplain visitation for patients scoring positive for spiritual distress on clinical outcomes and to assess nurse perceptions of the SCI's ease of use and confidence in implementation. The SCI was administered to 34 patients at a public regional healthcare system to measure the impact of spiritual care on reducing patient spiritual distress and improving health outcomes. Additionally, 25 nurses completed the System Usability Scale (SUS) to evaluate the ease of use and confidence in administering the SCI. Patient spiritual distress decreased significantly from admission to discharge when a spiritual care intervention was provided by a chaplain (median change in SCI = 0.31 (IQR 0.09, 0.75), p < .001). Additionally, nurses reported high ease of use of the SCI as part of their clinical workflow and felt confident about administering the index to screen patients for spiritual distress at intake and discharge (median SUS ease score = 5.0, (IQR 4.0, 5.0)).