Spiritual Suffering

Spiritual Suffering

Introduction to NANDA Nursing Diagnosis: Spiritual Suffering

NANDA nursing diagnosis is a comprehensive taxonomy of recognized nursing diagnoses, which are defined clinical judgments about individual, family, or community responses to actual or potential health problems/life processes. NANDA-I nursing diagnoses categories include impaired comfort, ineffective coping, insomnia, risk for infection, and risk for spiritual distress. The spiritual suffering nursing diagnosis from the list of NANDA-I diagnoses was categorized under Risk for Reduced Resilience.

NANDA Nursing Diagnosis Definition

The NANDA-I definition for Spiritual Suffering nursing diagnosis reads:

  • Risk for Reduced Resilience – At risk for diminished capacity to adapt and cope with aversive events.

Defining Characteristics (Subjective)

  • Spiritual discomfort
  • Struggle to find meaning in life
  • Questions own worth and values
  • Anger at God/higher power
  • Difficulty to find serenity and peace
  • Lack of joy
  • Feelings of sadness
  • Discord between beliefs and practices
  • Loss of hope
  • Fear of death/dying

Defining Characteristics (Objective)

  • Loss of interest in activities once found meaningful
  • Limited interaction with others
  • Unresponsive to comfort and joy
  • Crying spells
  • Withdrawal from family and friends
  • Verbal expression of hopelessness or helplessness
  • Lack of optimism
  • Social isolation
  • Engagement in behaviors once held sacred
  • Altered level of consciousness (for example, preoccupation)

Related Factors

  • Inability to adapt to significant life changes: Changes in personal life, death/loss of loved one, relocation, loss of employment, physical illness/infirmity, financial stress.
  • Interpersonal/cultural conflict: Lack of support/accommodation from interpersonal relationships, difficulty understanding conflicting religious/cultural beliefs, loss of sense of purpose.
  • Lack of spiritual coping mechanisms: Few individuals/institutions to rely on, inadequate knowledge of spiritual coping strategies.

Risk Populations

  • People in hospital/health care settings
  • People with chronic illnesses
  • Elders
  • Terminally ill
  • People living with mental illness
  • People who identify as LGBTQ+
  • People facing end-of-life decisions

Associated Problems

Individuals experiencing spiritual suffering may exhibit the following associated problems, such as:

  • Depression
  • Anxiety
  • Insomnia
  • Social isolation
  • Anger
  • Lack of motivation/purpose in life
  • Self-destructive behaviors
  • Poor job performance

Suggestions of Use

Spiritual suffering nursing diagnosis can be suggested for use in any setting (clinic, hospital, hospice, etc.) whenever a client’s spiritual needs are not being met adequately. Nurses should assess for signs and symptoms of spiritual distress by asking questions about the client’s religious/spiritual beliefs and cultural values and/or refer them to appropriate services/resources.

Suggested Alternative NANDA Diagnoses

Other related diagnoses may include:

  • Ineffective Coping
  • Ineffective Spirituality
  • Readiness for Enhanced Spiritual Wellbeing

Usage Tips

  • Assess for spiritual suffering in every client.
  • Encourage clients to engage in spiritual activities and offer referrals to appropriate resources.
  • Regularly monitor the client’s spiritual health.
  • Assess spiritual needs of the family and refer to relevant support services.

NOC Results

The nursing interventions may lead to the following positive outcomes, as measured by the NOC measure:

  • Spiritual Well-Being: An individual’s satisfaction derived from awareness of participating in meaningful activities, communities, and relationships with self, others, and environment.
  • Social Support Network: Availability of people with whom to share feelings, hopes, and concerns.
  • Coping Self-Efficacy: Beliefs about one’s ability to successfully handle an adverse situation.
  • Hope: Perception that the desired outcome will be achieved.
  • Resilience: Ability to adjust to change and/or cope with adversity.

NIC Interventions

In line with the NANDA-I nursing diagnoses, a variety of nursing interventions may be implemented, including but not limited to the following:

  • Spiritual Assessment: Evaluate the client’s spiritual history, interests, and needs; assess spiritual distress and refer to appropriate services.
  • Counseling on Spiritual Issues: Provide spiritual counseling and support to clients experiencing spiritual distress.
  • Referral: Refer to appropriate resources and support services that can help meet the individual’s spiritual/emotional needs.
  • Foster Spiritual Practices: Assist the client in establishing/maintaining spiritual practices such as meditation, prayer, and/or journaling.
  • Assist in Development of Meaningful Goals: Encourages clients to set meaningful goals as part of developing a sense of purpose in life.
  • Provide Emotional Support: Provide emotional support to clients and families experiencing spiritual distress.


In conclusion, the spiritual suffering NANDA nursing diagnosis from the list of NANDA-I nursing diagnoses can provide an effective tool for nursing professionals to recognize and assess for spiritual distress. Through early recognition and assessment, nurses can intervene effectively and provide appropriate services/resources that can help individuals experiencing spiritual distress.


Q: How do I assess for spiritual suffering?

A: Assessing for spiritual suffering should include conducting a spiritual assessment to evaluate the individual’s spiritual history, interests, and needs. Additionally, intervening through spiritual counseling, emotional support, and referral to appropriate resources can also help meet the individual’s spiritual/emotional needs.

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