This study aims to identify concepts and clinical indicators that evidence spiritual distress in patients. Integrative review was the method adopted for the development of the study. In the initial stage, 82 studies were found in the following databases PUBMED, COCHRANE, CINAHL, LILACS and North American Nursing Diagnosis Association Conference Proceedings and 18 were selected. The descriptors used were spirituality and nursing diagnosis in addition to the term spiritual distress. Literature review (38.9%) and articles with level of evidence IV (27.8%) were the predominant types of study. The analysis of the articles revealed that the identified concepts of spiritual distress presented common and related elements to the human being subjective and individual response to life experiences, which harm the human spiritual dimension. Defining spiritual distress is a complex task since it depends on the perspective of those evaluating it, limiting in this way, its generalization. However, knowledge regarding the constructs that guide the understanding of human spirituality can base the nursing care in its spiritual dimension, thus providing theoretical support for the diagnosis.