Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 Assessing Spiritual Distress in Post-Operative Orthopedic Patients:
A Descriptive Study at dr.
Soebandi Regional Hospital.
Jember Mulia Hakam1* .
Lula Apriliya Puteri Bintari2.
Jon Hafan Sutawardana1 Department of medical and surgical nursing.
Faculty of nursing.
University of Jember.
Indonesia Faculty of nursing.
University of Jember.
Indonesia Article History Submitted: 28-06-2025 Revised: 29-09-2025 Accepted: 06-12-2025 org/10.
58545/jkki.
Copyright .
2025 Mulia Hakam This is an open-access article under the CC-BY-SA License.
Abstract Background: Spiritual distress is a problem with the patient's response to health.
Spiritual distress is a disturbance in the meaning of life about oneself, others, and God.
Spiritual distress occurs due to spiritual needs not being met.
Purpose: This study aims to determine spiritual distress in post-operative orthopedic patients in the surgical room at dr.
Soebandi Regional Hospital Jember.
Methods: This study employed a descriptive, consecutive sampling method involving 150 respondents from both major and minor post-operative orthopedic patients in 2023.
Results: The majority of respondents in this study were men with varying ages and types of surgery, 80.
7% experienced major surgery, and 3% underwent minor surgery.
Data collection was conducted using the Spiritual Distress Scale questionnaire, and the results showed a median value of 74.
00, with a minimum value of 33 and a maximum value This indicates that the resulting value is close to the maximum value of the questionnaire, suggesting a high level of spiritual distress.
This can be caused by the high value placed on self-relationship, which encompasses the strengths that exist within a person, including knowledge and attitudes about oneself.
This high value can occur due to a lack of knowledge about oneself and a lack of confidence in the future, leading to a loss of peace of mind.
Conclusion: This research provides additional data and knowledge regarding spiritual distress in postoperative orthopedic patients.
Patients with spiritual distress require maintenance of spiritual well-being, which helps them find meaning in life and experience a sense of peace.
The results of this research make it possible for nurses to develop and understand the importance of spiritual care for patients Keywords: Spiritual distress.
Post-operation.
Orthopedic.
Spiritual distress scale Correspondence Mulia Hakam.
Faculty of Nursing.
University of Jember Jl.
Kalimantan No.
Sumbersari.
Jember.
East Java 68121 Indonesia Email: muliahakam81@gmail.
How to cite:
Hakam.
Bintari.
, & Sutawardana.
Assessing Spiritual Distress in Post-Operative Orthopedic Patients:
A Descriptive Study at dr.
Soebandi Regional Hospital.
Jember.
Jurnal Kesehatan Komunitas Indonesia, 5.
, 290-301.
https://doi.
org/10.
58545/jkki.
BACKGROUND
life about oneself, others, and God.
Spiritual distress is a problem with Spiritual distress arises when spiritual the patient's response to health.
Spiritual needs are not met (Martins & Caldeira, distress is a disturbance in the meaning of Individuals are strengthened by Assessing Spiritual Distress in Post-Operative Orthopedic Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 "spirit," which has a profound impact on and dying .
(Roze des Ordons et their overall well-being and health.
The , 2.
influence of spirituality is significant.
Patients not only need medical especially during times of illness (Clark et services but also need spiritual help , 1.
Inpatients not only suffer from (Talindong & M, 2.
According to physical illnesses but also experience Darwis & and Syaipuddin .
, the mental and spiritual disorders ranging greater the degree of unmet spiritual needs, from severe to mild (Priyanto, 2.
the greater the level of spiritual distress.
Patients experience anxiety, fear, and This is because individuals with emotional sadness if it is not being treated stress tend to experience spiritual health immediately, resulting in despair and problems (Fitria Wahyuni et al.
, 2.
frustration, especially in patients who are This emotional pressure arises as a result of about to face or have had surgery (Majid et anxiety and fear.
This feeling arises because , 2.
Spiritual problems that can occur of fear of the pain of a surgical wound, fear in patients after surgery are spiritual of anesthesia, fear of the unknown or other distress (Potter et al.
, 2.
Qualitative threats that can cause anxiety, fear of a failed operation, and fear of death (Darma .
Rosmaharani.
, and Nahariani, treatment of a bimalleolar fracture at risk of Emotional stress affects both experiencing spiritual distress (Mundle.
Research by Rangki et al.
activating the sympathetic autonomic showed that post-colostomy patients nerves and increasing heart rate and experienced spiritual distress due to changes in religious behavior patterns and reducing the patientAos energy (Potter & conflicting beliefs.
Apart from that.
Perry, 2.
When energy levels decrease.
Mundle the patient's spirituality is affected, and quantitative research studies are needed to they are unable to carry out the worship demonstrate that problems exist in the activities/rituals spiritual dimension during illness.
A gap in performed (Clark et al.
, 1.
Then, a research on spiritual distress was found, disturbance arose in his beliefs (Rangki et most of which was only carried out on , 2.
, and his spiritual needs were not patients with cancer, advanced disease, met (Hutagulung, 2.
82-year-old Hakam et al.
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 The results of this research enable respondents per day.
Priority in sampling nurses to develop a deeper understanding was given to respondents who had of the importance of spiritual care for undergone surgery for an extended period In spiritual matters, specific of time.
The sample in this study consisted points or indicators play a significant role, of 150 respondents, with calculations performed using the principal component others, and God, as well as attitudes analysis formula.
Data collection was toward death.
The success of spiritual care conducted from October 2023 to December can be seen from awareness, intervention 2023 in the Seruni room at dr.
Soebandi .
, and the direct presence of Regional Hospital Jember.
A total of 150 This research can also serve as a basis for policies that support patient welfare, such as enhancing therapeutic relationships between nurses and patients.
Patients with spiritual distress require maintenance of spiritual well-being, which helps them find meaning in life and experience a sense of METHODS This study employed a consecutive sampling technique with a descriptive analysis design to investigate the spiritual distress of post-operative patients.
The population of this study consisted of all post-operative minor and major orthopedic patients in the Seruni ward at dr.
Soebandi Regional Hospital Jember.
The population in this study consisted of 389 patients from January to May 2023, with an average of 4 respondents in hospitals by researchers.
this research, two questionnaires were questionnaire and the Spiritual Distress Scale (SDS).
The questionnaire contains the respondent's Meanwhile, the Spiritual Distress Scale consists of 30 questions with 4 relationship between oneself and other people, the relationship between oneself and God, and attitudes toward death.
The final results of this questionnaire indicate that a higher score corresponds to greater spiritual distress.
This questionnaire uses a 1-4 Likert scale.
Value 1: never.
sometimes: 3.
quite often.
4: often, with a minimum score = of 30 and a maximum score of 120.
This questionnaire has never been used in Indonesia.
Hence, researchers need to conduct a content validity test Assessing Spiritual Distress in Post-Operative Orthopedic Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 (CVI) to improve each measuring item in the instrument, ensuring it is relevant to the researcher's objectives.
The results of educational history, and type of operation, the CVI test on the Spiritual Distress Scale as shown in Table 1.
Based on Table 1, the questionnaire showed that the CVI was data indicate that the age of most This result is considered valid because respondents falls within the 18-40 years old the I-CVI value is 0.
reater than 0.
In the adult group, there are 76 The reliability of this questionnaire has respondents .
7%) who adhere to the been tested by the owner, yielding a largest religion, namely Islam, with 144 Cronbach's alpha of 0.
95, which indicates respondents .
%).
The largest gender is that the 30 questions are reliable.
male, with 103 respondents .
7%).
The majority of respondents in this study had at RESULTS least a high school education, with 129 Respondents Demography respondents .
%), and the majority In this study, there were 150 respondents from post-major and minor performed major surgical procedures, with 121 respondents .
7%).
orthopedic surgery patients.
The data Table 1.
Distribution of Respondents Based on Age.
Religions.
Gender.
Education,Type of Operation Demographic Data Frequecy Percentage (%) Age 18 Ae 40 years (Matur.
41 Ae 65 years (Elderl.
>65 years (Senior.
Religions Moslem Christian Bludldha Hiindul Others Gender Male Female Education Uneducated Elementary school Junior high school Senior high school College Type of Operation Minor Major Hakam et al.
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 indicators of self-relating to other people, it Description of Spiritual Distress was found that the median value was 7.
presented in Table 2, the spiritual distress with a mean value .
value has been calculated using the (A1.
, a minimum value of 5, and a Spiritual Distress Scale (SDS).
The median maximum value of 13.
The indicator of self- score is 74.
00, with a mean value .
verage relationship with God shows a median valu.
72 (A13.
, a minimum value value of 20, with a mean .
value of of 33, and a maximum value of 103.
In Table 13 (A4.
and a minimum value of 7, 3, the indicator value of self-relationship is and a maximum value of 24.
The attitude The median value of respondents indicator towards death shows a median 00, with a mean .
value of value of 14, with a mean value of 12.
16 (A5.
and a minimum value of 14 (A3.
, a minimum value of 4, and a and a maximum value of 50.
Regarding maximum value of 16.
Based Table 2.
Descriptive Analysis of Respondents' Spiritual Distress Variable Spiritual Distress MeanASD 72A13.
Median 74,00 Min-Max Tabel 3.
Descriptive Analysis of Indicator Spiritual Distress Category Self-relationship with self Relationship with others Personal relationship withGod Attitudes towards death MeanASD 16A5.
10A1.
13A4.
33A3.
Median Min-Max
Meanwhile, research conducted on 332
DISCUSSION
The results of research related to respondents with breast cancer obtained a post-operative mean of 56.
60 (A13.
with a minimum orthopedic patients in the Seruni Room, dr.
value of 31 and a maximum value of 98.
Soebandi Regional Hospital.
Jember was Overall, 9.
6% of respondents had a high assessed using a questionnaire the Spiritual level of spiritual distress (Martins, 2.
Distress Scale (SDS) has a mean .
From this research, it is evident that the value of 74.
00 with a mean .
value mean value in studies on postoperative 72 (A13.
, a minimum value of 33 orthopedic patients is also high.
and a maximum value of 103, this shows Research conducted on breast cancer that the resulting value is close to the patients showed that most respondents maximum value of the questionnaire.
were not religious, so 9.
6% experienced Assessing Spiritual Distress in Post-Operative Orthopedic Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 high spiritual distress (Martins, 2.
minimum value of 1 to a maximum value of Similar things were also found in research on post-operative patients, 100% of whom relationship between oneself and oneself in were religious, but the majority did not post-operative orthopedic patients is high show any attitudes or behavior in the .
edian value .
because it is close to the respondents that reflected their religious maximum value.
These Therefore, the individual's Indicators of self-relationship are a ability to understand or recognize religious crucial characteristic in fulfilling the spiritual needs of individuals experiencing principles in their attitudes and behavior spiritual distress.
Because the relationship does not exist.
This is due to suffering, between oneself and oneself is a strength which makes it challenging to find meaning that exists within a person, including in life, especially during difficult times knowledge and attitudes about oneself, (Wahyuni, 2.
The author assumes that this knowledge can strengthen their beliefs the high median value, which is close to the about themselves and what they will do in maximum value of the questionnaire, is due the future (Putri, 2.
A person's self- to respondents struggling to find meaning attitude is related to confidence or trust in in life during difficult times.
oneself, a belief in the future, and a sense of and apply them Spiritual distress in post-operative inner peace and well-being.
At a young age, orthopedic patients was measured using they are generally in the search stage the Spiritual Distress Scale (SDS), which .
piritual has 4 indicators, namely (Ku et al.
, 2.
individuals are still questioning themselves regarding various matters related to Self-Relationship with Self The research results indicate that principles and beliefs (Sejati, 2.
This finding aligns with research on post- respondents have a median score of 33, ranging from a minimum score of 14 to a indicating that the majority of respondents maximum score of 50.
The univariate test were adults .
-40 years ol.
and that results of the question items on indicators young patients tended to still be in the of self-relationship show that the highest stage of spiritual development.
frequency is for question item number 1, "I Based on the results of research on feel shocked/hit by the current situation," post-operative with a median value of 4, ranging from a concluded that the age characteristics of Hakam et al.
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 the respondents partly influenced the high through social media and act individually.
level of self-relationship.
Slowly the young age group will experience spiritual decline and feel that spirituality is not important (Putra & Firmanto, 2.
Relationship with Others This finding aligns with research on post- indicators of self-other relationships show operative patients, which revealed that the a median value of 7 out of a minimum score majority of respondents were young adults of 5, with a maximum score of 13.
The .
-40 year.
who were individualistic and univariate test results for question items on preferred to communicate via social media indicators of self-relationship with others rather than in person.
The show that the highest frequency is in Based on the research results, the researcher concluded that the respondents' disappointed when interacting with other age characteristics can influence their low people," with a median value .
iddle self-perception valu.
of 2, ranging from a minimum value of 1 to a maximum value of 3.
This indicates that the self-relationship with other people Personal Relationship with God in post-operative orthopedic patients is The research results regarding the low .
edian value .
, as it is close to the indicator of the relationship between minimum value.
oneself and God show that the mean Self-relationships with others are .
score of respondents is 20, out of formed due to the need for justice, a minimum score of 7 and a maximum score kindness, respect, and care for them.
The The univariate test results of domain of self-relationship with other question items on the indicator of the people is a domain that can indicate relationship between oneself and God show that the item has the highest problems, as it is a necessity for someone Question number 7, "I cannot who is religious (Yani, 2.
At a young attend religious activities," has a median age, awareness of spirituality is still very value of 4, with a minimum value of 1 and a Young age groups tend to prefer maximum value of 4.
This indicates that social groups that share the same hobbies the relationship between oneself and God and activities.
However, currently, young in post-operative orthopedic patients is people prefer to interact with others Assessing Spiritual Distress in Post-Operative Orthopedic Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 high .
edian value .
, as it is close to the maximum value.
Based on the research results, the researchers concluded that sociocultural.
Indicators of one's relationship with God can reveal that an individual is sociocultural relationships with God.
experiencing spiritual issues, as a religious person is expected to have a meaningful Attitudes towards death relationship with God (Yani, 2.
The research results related to the Individuals, as religious creatures, are indicator of attitudes toward death have a encouraged to seek a strength that can mean .
value of 14 out of a protect and guide them in times of minimum score of 4, with a maximum score Spiritual The univariate analysis of question emptiness or religious feelings will give rise items on the attitude indicator for facing to psychosocial problems in a person's life.
death reveals that the highest frequency is Individuals who believe in and feel a bond associated with question item number 1, "I with God will experience feelings of feel shocked/devastated by the current calmness and stability (Nazri et al.
, 2.
situation," with a median value of 4.
However, each individual with a religious ranging from a minimum value of 1 to a background has a different level of religious maximum value of 4.
This indicates that respondents have a generally positive understand and recognize religious values attitude towards death .
edian value .
, and apply them in their attitudes and as it is close to the maximum value.
behavior is a characteristic of religious Therefore, serve as a form of assessment and understanding of what a death event behaviors that demonstrate obedience to entails (Yuwono, 2.
Someone who has one's religion (Wahyuni, 2.
This theory difficulty understanding attitudes toward aligns with the findings of research on death will be vulnerable to experiencing post-operative patients, specifically that spiritual distress (Rohman, 2.
the majority of respondents reported religious beings, individuals are driven to adhering to a religion 100%.
However, their seek a force that can protect and guide attitudes and behaviors did not reflect this them during times of difficulty.
A spiritual or religious void can lead to psychosocial Indicators of attitudes toward death problems in a person's life.
Individuals who Hakam et al.
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 believe in and feel a bond with God will awareness, intervention .
, and experience a sense of calm and stability the direct presence of nurses on spiritual (Nazri et al.
, 2.
However, each This research can also serve as a individual with a religious affiliation has a varying level of religious maturity.
implement policies that support patient individual's ability to understand and welfare, such as enhancing therapeutic recognize religious values and incorporate relationships between nurses and patients.
these values into their attitudes and Patients with spiritual distress require behavior is a hallmark of religious maturity.
maintenance of spiritual well-being, which Therefore, religious beliefs are reflected in helps them find meaning in life and experience a sense of peace.
demonstrate devotion to one's religion (Wahyuni, 2.
This theory aligns with the results of a study on postoperative AUTHOR CONTRIBUTIONS The patients, which found that the majority of conceptualization, data collection and respondents .
%) identified with a analysis Mulia Hakam.
Lula Apriliya Puteri particular religion.
However, in practice.
Bintari.
Jon Hafan Sutawardana.
Writing their attitudes and behavior did not reflect and manuscript revisions: Mulia Hakam a devotion to their religion.
Based on the research results.
ACKNOWLEDGMENT researchers concluded that sociocultural.
The author want to thank you for the religious, or beliefs influence high levels of the Seruni Room of dr.
Soebandi Regional death attitudes.
Hospital of Jember that facilatatedthis CONCLUSION Spiritual distress in post-operative orthopedic patients obtained a mean score 00 with a minimum score of 33 and a CONFLICT OF INTEREST The authors declare that there are no conflicts of interest in this research.
maximum score of 103.
The results of this research enable nurses to develop a deeper
DATA AVAILABILITY STATEMENT
understanding of the importance of The data are available from the spiritual care for patients.
The success of corresponding author upon reasonable Assessing Spiritual Distress in Post-Operative Orthopedic Patients Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 5 Issue 3.
December 2025, pp 290-301 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435
REFERENCES