using the dses to improve patient care

Using the Daily Spiritual Experience Scale to Improve Patient Care. Psychiatry Conference: Sympozion National al ARSP cu Participare Internationala. Lynn Underwood. Sponsored invitation to speak. Targu Mures, Romania. 31 May – 3 June, 2012.


Spiritual and religious issues and values can influence how people cope with disease, make decisions, and behave in ways that affect their health. Spiritual and religious attitudes help to shape how people view the world and what they consider important. They can provide resources for patients to draw on. These may be particularly salient for them in the midst of mental illness, chronic disease, addiction, times of medical crisis, and at end-of-life.  It is often challenging to communicate with patients about religious and spiritual values and issues without running headlong into beliefs that may polarize conversation and empathic understanding, and limit the caregiver’s capacity to attend to patient needs and desires.

The Daily Spiritual Experiences Scale (DSES) is a 16-item psychometrically validated scale that measures the frequency of ordinary experiences such as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life ( ).  The DSES was constructed based on extensive qualitative research in multiple cultures, religions and secular settings.  It has been used in over 100 published studies, answered by many thousands of people, put on longitudinal health studies, and translated into over 20 languages.  It is linked to outcomes such as less addictive behaviors, better mood, improved relationships, decreased hospital stays, positive health behaviors, and diminished burnout.  It has been used extensively in medicine, psychiatry, psychology and social work research.   It functions well for people from various major religious backgrounds as well as for those who call themselves spiritual but not religious.  It does not reduce the spiritual to vague positive features, rather it allows for the kinds of experiences that encompass religious and spiritual depth. It is not only a potential mediating variable but also a measure of a significant component of quality of life for many.

This presentation will discuss ways in which the scale can be used in health-care settings to enhance the caregivers’ capacity to communicate with the patient and to help those who are ill to mobilize their own spiritual and religious resources to better cope with illness.  Another use of the scale is as a self-exploration tool for caregivers themselves using a structured method to enhance self-understanding and their ability to communicate with others different from themselves.  Scores have predicted less burnout in a large hospital system in Hong Kong, as well as in a study of those in the US working in palliative care.

In addition to describing its use in research, and how spiritual experience interacts with biology, this presentation will describe how this psychometrically validated set of 16 questions can be used as a clinical tool to improve patient care.

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