Development and psychometrics of a ‘spiritual needs assessment scale of patients with cancer’: A mixed exploratory study

Abstract

Background: The diagnosis of cancer can cause great spiritual crises in persons and affect various aspects of their lives. Objectives: This study was conducted to design a psychometric spiritual needs assessment scale of patients with cancer in Iran. Methods: This methodological research was conducted in 2 parts: qualitative and quantitative. Interviews were conducted with 18 patients with cancerwhowere referred toImamKhomeini Hospital in Tehran with themaximumdiversity of the patients occurring in the qualitative stage for explaining the spiritual needs of patients. The purposive sampling method was applied to this study. The interviews were analysed with the content analysis method, and eventually classes related to patients’ spiritual needs were conducted. Also, the terms of the scale were designed in thisway. In the quantitative stage, content validity, formal validity, structure validity (exploratory factor analysis), and convergent validity were evaluated with internal consistency and retests of the scale. Results: The 4 themes, Connection, Search for Peace, Find Meaning and Purpose, and Achieve Transcendence were extracted from the codes obtained. The intended scale was, then, designed. The content validity index and validity ratio of tools of content validity were determined. Content validity was applied during the assessment of face validity assessment of written comments of experts. In addition, 10 patients were examined on the scale. An exploratory factor analysis indicated the 5 factors of the designed scale. Finally, a scale was obtained with 38 terms in 5 subscales and its scoring was determined in a 6-episode Likert. Cronbach’s alpha for the total scale was estimated 0.81; for the religious dimension, this was 0.88, for meaning and purpose 0.77, for peace 0.70, for connection 0.74, and for support and nationalism 0.67, respectively. The result of the retest was also estimated ICC = 0.89. Conclusions: The spiritual needs scale in patients with cancer can measure different aspects of spiritual needs and is reliable and valid. It is suggested that the spiritual needs assessment scale of patients with cancer be used in different populations of patients with cancer separated on the basis of sex, age, type of cancer, and stage of the cancer and the spiritual needs of these patients be determined. Also, the designed scale is validated in other places and with different cultural conditions.