Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-27T00:53:27.072Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychometric testing of the Spiritual Well-Being Scale–Mandarin version in Taiwanese cancer patients

Published online by Cambridge University Press:  04 November 2016

Woung-Ru Tang  and
Chen-Yi Kao
Woung-Ru Tang*
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
Chen-Yi Kao
Affiliation:
Department of Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
*
Address correspondence and reprint requests to Woung-Ru Tang, School of Nursing, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, Taiwan, Republic of China. E-mail: wtang@mail.cgu.edu.tw.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan.

Method:

The present cross-sectional study validated the Spiritual Well-Being Scale–Mandarin version (SWBS–M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing. Patients' spiritual well-being and quality of life were assessed using the SWBS–M and the McGill Quality of Life Questionnaire (MQoL), respectively.

Results:

Overall, the SWBS–M had an internal consistency/reliability of 0.89. Exploratory factor analysis showed that the SWBS–M had an underlying two-factor structure, explaining 46.94% of the variance. SWBS–M scores correlated moderately with MQoL scores (r = 0.48, p < 0.01). Terminally ill cancer patients' spiritual well-being was inversely related to their average pain level during the previous 24 hours (r = –0.183, p = 0.006). Cancer patients' spiritual well-being also differed significantly with their experience of pain (t = –3.67, p < 0.001); terminally ill cancer patients with pain during the previous 24 hours had a lower sense of spiritual well-being than those without pain.

Significance of results:

Our findings support a two-factor model for the SWBS–M in terminally ill Taiwanese cancer patients. We recommend testing the psychometric properties of the SWBS–M in different patient populations to verify its factorial structure in other Asian countries.

Keywords

Terminally ill patientCancerSpiritual well-beingPainPsychometric testing
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 3 , June 2017 , pp. 336 - 347
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Ando, M., Tsuda, A. & Morita, T. (2007). Life review interviews on the spiritual well-being of terminally ill cancer patients. Supportive Care in Cancer, 15(2), 225–231. Epub ahead of print Sep 12, 2006.Google Scholar
Bentur, N. & Resnizky, S. (2005). Validation of the McGill Quality of Life Questionnaire in home hospice settings in Israel. Palliative Medicine, 19(7), 538–544.Google Scholar
Bufford, R.K., Paloutzian, R.F. & Ellison, C.W. (1991). Norms for the Spiritual Well-Being Scale. Journal of Psychology & Theology, 19(1), 56–70. Available from https://www.researchgate.net/publication/304581515_Norms_for_the_Spiritual_Well-being_Scale.Google Scholar
Cheng, K.K.F. & Lee, D.T.F. (2011). Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer. Critical Reviews in Oncology/Hematology, 78(2), 127–137. Epub ahead of print Apr 18, 2010. Available from http://www.croh-online.com/article/S1040-8428(10)00059-4/pdf.Google Scholar
Coakes, S.J. (2013). SPSS version 20.0 for windows: Analysis without anguish. Milton, Queensland: John Wiley & Sons Australia.Google Scholar
Cohen, S.R., Mount, B.M., Tomas, J.J., et al. (1996). Existential well-being is an important determinant of quality of life: Evidence from the McGill Quality of Life Questionnaire. Cancer, 77(3), 576–586. Available from http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1097-0142(19960201)77:3%3C576::AID-CNCR22%3E3.0.CO;2-0/pdf.Google Scholar
Comrey, A.L. & Lee, H.B. (2016). A first course in factor analysis. London: Psychology Press.Google Scholar
Costello, A.B. & Osborne, J.W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation, 10(7), 1–9. Available from http://pareonline.net/pdf/v10n7.pdf.Google Scholar
Daaleman, T.P. & VandeCreek, L. (2000). Placing religion and spirituality in end-of-life care. The Journal of the American Medical Association, 284(19), 2514–2517.Google Scholar
Delgado-Guay, M.O., Hui, D., Parsons, H.A., et al. (2011). Spirituality, religiosity, and spiritual pain in advanced cancer patients. Journal of Pain and Symptom Management, 41(6), 986–994. Epub ahead of print Mar 12.CrossRefGoogle ScholarPubMed
Ellison, C.W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology & Theology, 11(4), 330–340.Google Scholar
Eslami, A.A., Rabiei, L., Khayri, F., et al. (2014). Sleep quality and spiritual well-being in hemodialysis patients. Iranian Red Crescent Medical Journal, 16(7), e17155. Epub ahead of print Jul 5. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166099/.Google Scholar
Exline, J.J., Park, C.L., Smyth, J.M., et al. (2011). Anger toward God: Social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer. Journal of Personality and Social Psychology, 100(1), 129–148.Google Scholar
Fehring, R.J., Miller, J.F. & Shaw, C. (1997). Spiritual well-being, religiosity, hope, depression, and other mood states in elderly people coping with cancer. Oncology Nursing Forum, 24(4), 663–671.Google ScholarPubMed
Field, A. (2009). Discovering statistics using SPSS. London: Sage Publications.Google Scholar
Finocchiaro, D.N., Roth, P.A. & Connelly, C.D. (2014). Spiritual well-being as predictor of quality of life for adults with paraplegia. Rehabilitation Nursing, 39(6), 285–293. Epub ahead of print May 19. Available from http://onlinelibrary.wiley.com/doi/10.1002/rnj.161/full.CrossRefGoogle ScholarPubMed
Fisch, M.J., Titzer, M.L., Kristeller, J.L., et al. (2003). Assessment of quality of life in outpatients with advanced cancer: The accuracy of clinician estimations and the relevance of spiritual well-being. A Hoosier Oncology Group study. Journal of Clinical Oncology, 21(14), 2754–2759.Google Scholar
Genia, V. (2001). Evaluation of the Spiritual Well-Being Scale in a sample of college students. The International Journal for the Psychology of Religion, 11(1), 25–33.CrossRefGoogle Scholar
Gow, A.J., Watson, R., Whiteman, M, et al. (2011). A stairway to heaven? Structure of the religious involvement inventory and Spiritual Well-Being Scale. Journal of Religion and Health, 50(1), 5–19.Google Scholar
Green, S.B & Salkind, N.J. (2013). Factor analysis. In Using SPSS for Windows and Macintosh, 7th ed. London:: Pearson.Google Scholar
Hu, W.Y., Dai, Y.T., Berry, D, et al. (2003). Psychometric testing of the translated McGill Quality of Life Questionnaire–Taiwan version in patients with terminal cancer. Journal of the Formosan Medical Association, 102(2), 97–104.Google Scholar
Kaasa, S. & Håvard Loge, J. (2015). Quality of life in palliative care: Principles and practice. In Oxford textbook of palliative medicine, 5th ed. Cherny, N. et al. (eds.), pp. 1198–1209. New York: Oxford University Press.Google Scholar
Kandasamy, A., Chaturvedi, S.K. & Desai, G. (2011). Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer. Indian Journal of Cancer, 48(1), 55–59. Available from http://www.indianjcancer.com/article.asp?issn=0019-509X;year=2011;volume=48;issue=1;spage=55;epage=59;aulast=Kandasamy.Google Scholar
Koenig, H.G. (2002). A commentary: The role of religion and spirituality at the end of life. The Gerontologist, 42(3), 20–23. Available from http://gerontologist.oxfordjournals.org/content/42/suppl_3/20.long.Google Scholar
Kuuppelomaki, M. (2001). Spiritual support for terminally ill patients: Nursing staff assessments. Journal of Clinical Nursing, 10(5), 660–670.Google Scholar
Ledbetter, M.F., Smith, L.A., Fischer, J.D, et al. (1991). An evaluation of the construct validity of the Spiritual Well-Being Scale: A confirmatory factor analytic approach. Journal of Psychology & Theology, 19, 94–102.Google Scholar
Li, C.C., Rew, L. & Hwang, S.L. (2012). The relationship between spiritual well-being and psychosocial adjustment in Taiwanese patients with colorectal cancer and a colostomy. Journal of Wound, Ostomy, and Continence Nursing, 39(2), 161–169; quiz 170–171.Google Scholar
Lua, P.L., Salek, S., Finlay, I., et al. (2005). The feasibility, reliability and validity of the McGill Quality of Life Questionnaire–Cardiff Short Form (MQoL–CSF) in palliative care population. Quality of Life Research, 14(7), 1669–1681.Google Scholar
McClain-Jacobson, C., Rosenfeld, B., Kosinski, A., et al. (2004). Belief in an afterlife, spiritual well-being and end-of-life despair in patients with advanced cancer. General Hospital Psychiatry, 26(6), 484–486.CrossRefGoogle Scholar
McNeill, J.A., Sherwood, G.D., Starck, P.L, et al. (1998). Assessing clinical outcomes: Patient satisfaction with pain management. Journal of Pain and Symptom Management, 16(1), 29–40.Google Scholar
Mickley, J.R., Soeken, K. & Belcher, A. (1992). Spiritual well-being, religiousness and hope among women with breast cancer. Image: The Journal of Nursing Scholarship, 24(4), 267–272.Google Scholar
Miller, G., Fleming, W. & Brown-Anderson, F. (1998). Spiritual Well-Being Scale ethnic differences between Caucasians and African Americans. Journal of Psychology & Theology, 26, 358–364. Available from http://files.eric.ed.gov/fulltext/ED467831.pdf.Google Scholar
Miller, G., Gridley, B. & Fleming, W. (2001). Spiritual Well-Being Scale ethnic differences between Caucasians and African Americans: Follow up analyses. Paper presented at the 109th Annual Meeting of the American Psychological Association, San Francisco, August 24–28, 2001. Available from http://files.eric.ed.gov/fulltext/ED467831.pdf.Google Scholar
Miller, L.J. (2012). The Oxford handbook of psychology and spirituality. New York: Oxford University Press.CrossRefGoogle Scholar
Ministry of Health and Welfare, Republic of China (2014). Respecting end-of-life. National Health Insurance Bimonthly, 111, 10–15.Google Scholar
Murray, S., Line, D., Pellerey, M, et al. (2015 a). 2015 Quality of Death Index: Ranking palliative care across the world. A report by The Economist Intelligence Unit and commissioned by the Lien Foundation. Available from http://www.eiuperspectives.economist.com/healthcare/2015-quality-death-index.Google Scholar
Murray, A.L., Johnson, W., Gow, A.J., et al. (2015 b). Disentangling wording and substantive factors in the Spiritual Well-Being Scale. Psychology of Religion and Spirituality, 7(2), 120–129. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563774/pdf/rel_7_2_120.pdf,Google Scholar
Musa, A.S. (2016). Factor structure of the Spiritual Well-Being Scale cross-cultural comparisons between Jordanian Arab and Malaysian Muslim university students in Jordan. Journal of Transcultural Nursing, 27(2), 117–125. Epub ahead of print May 27, 2014.Google Scholar
Musa, A.S. & Pevalin, D.J. (2012). An Arabic version of the Spiritual Well-Being Scale. The International Journal for the Psychology of Religion, 22(2), 119–134.Google Scholar
National Health Research Institutes, Republic of China (2007). Cancer pain management guideline [in Mandarin]. Available from http://www.nhri.org.tw/NHRI_ADM/userfiles/file/tcog/pain.pdf.Google Scholar
National Hospice and Palliative Care Organization (2012). NHPCO's facts and figures hospice care in America. Alexandria, VA: National Hospice and Palliative Care Organization. Available from http://www.nhpco.org/sites/default/files/public/Statistics_Research/2014_Facts_Figures.pdf.Google Scholar
Nelson, C.J., Rosenfeld, B., Breitbart, W., et al. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43(3), 213–220.Google Scholar
Paloutzian, R.F. & Ellison, C.W. (1982). Loneliness, spiritual well-being and the quality of life. In Loneliness: A sourcebook of current theory, research and therapy. Peplau, L.A. & Perlman, D. (eds.), pp. 224–237. New York: Wiley Interscience.Google Scholar
Paloutzian, R.F., Bufford, R.K. & Wildman, A.J. (2012). Spiritual well-being scale: Mental and physical health relationships. In Oxford textbook of spirituality in healthcare. Cobb, M. et al. (eds.), pp. 353–358. Oxford: Oxford University Press.Google Scholar
Patil, V.H., Singh, S.N., Mishra, S., et al. (2008). Efficient theory development and factor retention criteria: Abandon the “eigenvalue greater than one” criterion. Journal of Business Research, 61(2), 162–170. Available from https://www.researchgate.net/publication/223726896_Efficient_theory_development_and_factor_retention_criteria_Abandon_the_'eigenvalue_greater_than_one'_criterion.Google Scholar
Pearce, M., Coan, A., Herndon, J, et al. (2012). Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients. Supportive Care in Cancer, 20(10), 2269–2276. Epub ahead of print Nov 29, 2011.Google Scholar
Phelps, A.C., Maciejewski, P.K., Nilsson, M., et al. (2009). Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. The Journal of the American Medical Association, 301(11), 1140–1147. Available from http://jama.jamanetwork.com/article.aspx?articleid=183578.CrossRefGoogle ScholarPubMed
Riley, B.B., Perna, R., Tate, D.G., et al. (1998). Types of spiritual well-being among persons with chronic illness: Their relation to various forms of quality of life. Archives of Physical Medicine and Rehabilitation, 79(3), 258–264.Google Scholar
Schnoll, R.A., Harlow, L.L. & Brower, L. (2000). Spirituality, demographic and disease factors, and adjustment to cancer. Cancer Practice, 8(6), 298–304.Google Scholar
Scott, E.L., Agresti, A.A. & Fitchett, G. (1998). Factor analysis of the “Spiritual Well-Being Scale” and its clinical utility with psychiatric inpatients. Journal for the Scientific Study of Religion, 37(2), 314–321.Google Scholar
Steinhauser, K.E., Voils, C.I., Clipp, E.C., et al. (2006). “Are you at peace?”: One item to probe spiritual concerns at the end of life. Archives of Internal Medicine, 166(1), 101–105. Available from http://archinte.jamanetwork.com/article.aspx?articleid=409431.Google Scholar
Stewart, A.L., Teno, J., Patrick, D.L., et al. (1999). The concept of quality of life of dying persons in the context of health care. Journal of Pain and Symptom Management, 17(2), 93–108.Google Scholar
Su, S.F. (2002). Psychometric assessment of the Spiritual Well-Being Scale in Chinese. Master's thesis. Taoyuan, Taiwan: Chang Gung University.Google Scholar
Tabachnick, B.G. & Fidell, L.S. (2013). Using multivariate statistics. Boston: Pearson.Google Scholar
Tang, W.R., Lo, W.P., Kuo, H.C., et al. (2004 a). Quality of life and its related factors for terminal and non-terminal patients with gastrointestinal cancer. The Journal of Oncology Nursing, 4(2), 1–13.Google Scholar
Tang, W.R., Aaronson, L.S. & Forbes, S.A. (2004 b). Quality of life in hospice patients with terminal illness. Western Journal of Nursing Research, 26(1), 113–128.Google Scholar
Tang, W.R., Tang, S.T. & Kao, C.Y. (2009). Psychometric testing of the Caregiver Quality of Life Index–Cancer on a Taiwanese family caregiver sample. Cancer Nursing, 32(3), 220–229.Google Scholar
True, G., Phipps, E.J., Braitman, L.E., et al. (2005). Treatment preferences and advance care planning at end of life: The role of ethnicity and spiritual coping in cancer patients. Annals of Behavioral Medicine, 30(2), 174–179.Google Scholar
Tsuneto, S. (2013). Past, present, and future of palliative care in Japan. Japanese Journal of Clinical Oncology, 43(1), 17–21. Epub ahead of print Nov 19, 2012. Available from http://jjco.oxfordjournals.org/content/43/1/17.long.Google Scholar
Utsey, S.O., Lee, A., Bolden, M.A., et al. (2005). A confirmatory test of the factor validity of scores on the Spiritual Well-Being Scale in a community sample of African Americans. Journal of Psychology & Theology, 33(4), 251–257.Google Scholar
Vallurupalli, M., Lauderdale, K., Balboni, M.J., et al. (2012). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology, 10(2), 81–87. Epub ahead of print Nov 16, 2011. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3391969/.Google Scholar
Watson, R. & Thompson, D.R. (2006). Use of factor analysis in the Journal of Advanced Nursing: Literature review. Journal of Advanced Nursing, 55(3), 330–341.Google Scholar
You, S. & Yoo, J.E. (2015). Evaluation of the Spiritual Well-Being Scale in a sample of Korean adults. Journal of Religion and Health, 55(4), 1289–1299.Google Scholar
Zhao, N. (2008). The minimum sample size in factor analysis. Available from https://www.encorewiki.org/plugins/servlet/mobile#content/view/25657.Google Scholar
Zimmermann, C., Burman, D., Swami, N., et al. (2011). Determinants of quality of life in patients with advanced cancer. Supportive Care in Cancer, 19(5), 621–629. Epub ahead of print Mar 30, 2010. Available from http://link.springer.com/article/10.1007%2Fs00520-010-0866-1.Google Scholar