"Spiritual distress (00060)" in patients under fertility treatment: clinical validation study

Joana Romeiro*, Sílvia Caldeira, Marcos Venicios Lopes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose This study aimed to clinically validate the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in people under assisted reproductive technologies, and to determine the sensitivity, specificity, and predictive value of the defining characteristics. Methods Cross-sectional study that was conducted between September 2019 and June 2020. Recruitment happened by invitation posted in fertility-related websites. Those who accepted to participate were asked to fill the consent form and the online questionnaire. Statistical analysis was based on Rasch's model. The study was approved by the Ethics Committee. Findings The sample comprised 104 Portuguese individuals undergoing assisted reproductive techniques. The "Spiritual distress (00066)" was validated and 22 defining characteristics were confirmed as representative. No item showed differential item functioning. "Perceived suffering" was the most sensitive defining characteristic and had the highest negative predictive value. "Insufficient courage" had the highest positive predictive value, and "Anger toward power greater than self" was the most specific. Conclusions Results validated the presence of the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in a sample going through assisted reproductive technologies, improving accuracy of this nursing diagnosis in such population. Implications for nursing practice This is a crucial step to raise the level of evidence of such nursing diagnosis and to increase the level of evidence on NANDA-I terminology. Furthermore, this study has contributed to raising the quality of nurse's critical judgement and clinical reasoning and allow an early spiritual and a more holistic and personalized patient-centered intervention in the reproductive field.
Original languageEnglish
JournalInternational journal of nursing knowledge
Publication statusAccepted/In press - 6 Jul 2022


  • Assisted reproductive techniques
  • Infertility
  • Nursing diagnosis
  • Spirituality
  • Validation studies


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