ORIGINAL ARTICLE Cultural adaptation and analysis of the psychometric properties of the Brazilian version of the Spiritual Distress Scale Talita Prado Sim~ ao, Erika de C assia Lopes Chaves, Em  ılia Campos de Carvalho, Denismar Alves Nogueira, Camila Csizmar Carvalho, Ya-Li Ku and Denise Hollanda Iunes Aims and objectives. To culturally adapt and test the psychometric properties of the Brazilian version of the Spiritual Distress Scale. Background. In Brazil, there is currently a lack of validated instruments that assess the spiritual dimension, which includes the spiritual distress phenomenon that can be experienced at different moments in a person’s life. This can include times when a person is affected by a disease such as cancer, which occurs sud- denly and causes significant life changes. Design. Methodological and cross-sectional study. Methods. Cultural adaptation of the Spiritual Distress Scale was performed using translation and back-translation stages, evaluation of cultural equivalence, com- mittee review and pretesting. An interview using the Brazilian version of the scale was conducted with 170 patients in a cancer treatment unit of a charitable gen- eral hospital (not state funded). The following psychometric properties were eval- uated: construct validity (divergence and factor analysis) and internal consistency/ reliability (Cronbach’s a and Kappa). Results. Reliability analysis in the intra- and inter-rater phase showed that more than half of the items had Kappa values > 0Á75. A correlation between the Spiri- tual Well-Being Scale and the Spiritual Distress Scale was found. Overall, the Spiritual Distress Scale showed a Cronbach’s a of 0Á87, with three of its four domains showing significant parameters. Conclusion. The Brazilian version of the Spiritual Distress Scale proved to be a reliable, valid and efficient instrument that is capable of assessing spiritual dis- tress. The Brazilian Spiritual Distress Scale presented reliability and validity parameters that correspond to the original English version of the scale. Relevance to clinical practice. The existence of an internationally validated instru- ment that assesses spiritual distress will assist healthcare professionals and researchers in recognising this phenomenon in clinical practice. What does this paper contribute to the wider global clinical community? • The spiritual distress scale will enable professionals to identify and evaluate the degree of spiri- tual distress displayed by patients in clinical practice. • Professionals can include evalua- tions of patients’ spirituality in their clinical practice. Authors: Talita Prado Sim~ ao, RN, Student of the Nursing Doctoral Program at University of S~ ao Paulo at Ribeir~ ao Preto College of Nursing – EERP-USP, Brazil; Erika de C assia Lopes Chaves, PhD, RN Adjunct Professor II at School of Nursing, Federal University of Alfenas – UNIFAL-MG, Brazil; Em  ılia Campos de Carvalho, PhD, RN, Senior Professor at University of S~ ao Paulo at Ribeir~ ao Preto College of Nursing – EERP-USP, Brazil; Denismar Alves Nogueira, PhD, Professor at the Institute of Exact Sciences, Fed- eral University of Alfenas – UNIFAL-MG, Brazil; Camila Csizmar Carvalho, RN, Master of Nursing, Federal University of Alfenas – UNIFAL-MG, Brazil; Ya-Li Ku, PhD, Assistant Professor at School of Nursing, Fooyin University; Denise Hollanda Iunes, PhD, Adjunct Professor II at School of Nursing, Federal University of Alfenas – UNIFAL-MG, Brazil Correspondence: Talita Prado Sim~ ao, RN, Student of the Nursing Doctoral Program at University of S~ ao Paulo at Ribeir~ ao Preto College of Nursing – EERPP-USP, Brazil. 3900 Bandeirantes Av. –Monte Alegre, Ribeir~ a Preto –ZIP 14040902. S~ ao Paulo, Brazil. Telephone: +55 (16) 3315 3475. E-mail: tapsimao@usp.br © 2015 John Wiley & Sons Ltd Journal of Clinical Nursing, 25, 231–239, doi: 10.1111/jocn.13060 231