Development and validation of a spiritual assessment scale for cancer patients in Hong Kong

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Development and validation of a spiritual assessment scale for cancer patients in Hong Kong

 

Author: Li, Ching Man Lucia
Title: Development and validation of a spiritual assessment scale for cancer patients in Hong Kong
Degree: D.H.Sc.
Year: 2012
Subject: Cancer -- Patients -- China -- Hong Kong -- Psychology.
Spiritual care (Medical care)
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xiii, 237 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2551431
URI: http://theses.lib.polyu.edu.hk/handle/200/6838
Abstract: Background: Nowadays, health care professionals tend to pay more attention to spirituality rather than focusing solely on physical or psychosocial needs especially on chronic debilitated cancer patients. By development and validation of a local psychometric assessment tool, the Spiritual Assessment Scale Cancer Perspective in Chinese (SAS CC), the domains and levels of spirituality that influencing patients' coping strategy could be assessed and measured. Conceptual Framework: The Holistic Flow Model of Spiritual Wellness with the themes of identified attributes of spirituality including transcendence, connectedness, faith, movement towards compassion and making meaning to life and death was adopted to provide guidance for the development of this spiritual assessment scale. Study design: This study was divided into two stages: the development of instrument and the psychometric evaluation in the main study. In stage one, the open-ended item-generation interviews and discussions from 11 participants were conducted to elicit the viewpoint of cancer patients. Through the content validation following the semantic analysis of the participants' cancer metaphors in the developmental stage, a set of deliberate concerns were established. A subsequent pilot study was performed to ensure the practicability and content validity of the instrument for the main study. In stage two, a convenience sample of 174 adults between the ages of 31 to 84 years suffering from cancer, with the experience of receiving at least once cancer-related treatment were invited to participate in the study. They were recruited from the hospital, social organization, and church. All responses were voluntary and anonymous.
Results: The data collected were analyzed using principle component factor analysis, Cronbach's alpha and Pearson product moment correlations. The findings resulted in a final instrument of 25 items. The oblique rotation of principle component factor analysis yielded four factors with four or more items loading at 0.5 or above. This findings of factor analysis supported 4 of 5 attributes of spirituality that were proposed early during the content validation of the study. The alpha coefficient for the 25-item total instrument was 0.7057 which indicated adequate consistency reliability. Alpha coefficients for the four components were: 'Joy and Peace', 0.9186; 'Connectedness with Higher Power', 0.9777; 'Let Nature take its Cause', 0.7233 & 'Positive Attitude towards Life', 0.7943. All of the item-total correlations ranged from 0.4 or above. Pearson's correlation coefficient demonstrated a good reliability coefficient 0.937, signified its stability and reliability over a period of time. External validity of this study was also assessed through the theoretically predicted relationships between the developed SAS CC and selected variables. It resulted in the rejections of the proposed hypotheses of significant positive correlation between SAS CC and FACT G (r = 0.375), and significant negative correlation between SAS CC and BDI (r = -0.335). For the hypothesis postulated on the significant positive correlation between SAS CC and religiousness, the Spearman's rho correlation coefficient (rs) reported rs = 0.544 which supported the hypothesis. Conclusion: A comprehensive spiritual assessment scale demonstrated foremost importance for the health care providers to be more attuned in dealing with cancer patients. The findings of this study provided an initial support for the developed SAS CC as a reliable and valid measure of spirituality for cancer patients. It is a useful instrument for data collection and research regarding spirituality for the Chinese cancer patients. Furthermore, it can be used by the health care professionals in exploring and determining the possible relationships between spirituality and one's response to health and health-related issues which could have significant impact for the cancer patients and future nursing practice.

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