Spiritual quality of life and spiritual coping: evidence for a two-factor structure of the WHOQOL spirituality, religiousness, and personal beliefs module

Health and Quality of Life Outcomes

Penny Pei Minn Chai¹  Marcus A Henning²  D Rex Billington¹  Christian U Krägeloh¹ 

[1] Department of Psychology, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand;University of Auckland, Auckland, New Zealand

关键词: Confirmatory factor analysis;    Spiritual wellbeing;    Coping;    WHOQOL-SRPB;    Quality of life;   

Others  :  1133797
DOI  :  10.1186/s12955-015-0212-x

 received in 2014-07-15, accepted in 2015-01-21,  发布年份 2015

【 摘 要 】

Background

The WHOQOL-SRPB has been a useful module to measure aspects of QOL related to spirituality, religiousness, and personal beliefs, but recent research has pointed to potential problems with its proposed factor structure. Three of the eight facets of the WHOQOL-SRPB have been identified as potentially different from the others, and to date only a limited number of factor analyses of the instrument have been published.

Methods

Analyses were conducted using data from a sample of 679 university students who had completed the WHOQOL-BREF quality of life questionnaire, the WHOQOL-SRPB module, the Perceived Stress scale, and the Brief COPE coping strategies questionnaire. Informed by these analyses, confirmatory factor analyses suitable for ordinal-level data explored the potential for a two-factor solution as opposed to the originally proposed one-factor solution.

Results

The facets WHOQOL-SRPB facets connected, strength, and faith were highly correlated with each other as well as with the religious coping sub-scale of the Brief COPE. Combining these three facets to one factor in a two-factor solution for the WHOQOL-SRPB yielded superior goodness-of-fit indices compared to the original one-factor solution.

Conclusions

A two-factor solution for the WHOQOL-SRPB is more tenable, in which three of the eight WHOQOL-SRPB facets group together as a spiritual coping factor and the remaining facets form a factor of spiritual quality of life. While discarding the facets connectedness, strength, and faith without additional research would be premature, users of the scale need to be aware of this alternative two-factor structure, and may wish to analyze scores using this structure.

【 授权许可】

   
2015 Krageloh et al.; licensee BioMed Central.

【 图 表 】

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【 参考文献 】

• [1]Katerndahl D, Oyiriaru D: Assessing the biopsychosociospiritual model in primary care: development of the biopsychosociospiritual inventory (BioPSSI). Int J Psychiatry Med 2007, 37:393-414.
• [2]O’Connell KA, Skevington SM: The relevance of spirituality, religion and personal beliefs to health-related quality of life: Themes from focus groups in Britain. Br J Health Psychol 2005, 10:379-398.
• [3]Vivat B: Measures of spiritual issues for palliative care patients: a literature review. Palliat Med 2008, 22:859-868.
• [4]Ellison CW: Spiritual well-being: Conceptualization and measurement. J Psychol Theol 1983, 11:330-340.
• [5]Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D: Measuring spiritual well-being in people with cancer: the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med 2002, 24:49-58.
• [6]Büssing A, Ostermann T, Matthiessen PF: Role of religion and spirituality in medical patients: Confirmatory results of the SpREUK questionnaire. Health Qual Life Outcomes 2005, 3:10. BioMed Central Full Text
• [7]Monod S, Brennan M, Rochat E, Martin E, Rochat S, Büla CJ: Instruments measuring spirituality in clinical research: a systematic review. J Gen Intern Med 2011, 26:1345-1357.
• [8]O’Connell KA, Skevington SM: To measure of not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life. Chronic Illn 2007, 3:77-87.
• [9]Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ: Routine use of patient reported outcome measures in healthcare settings. BMJ 2010, 340:464-467.
• [10]Greenhalgh J, Long AF, Flynn R: The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory? Soc Sci Med 2005, 60:833-843.
• [11]WHOQOL Group: The World Health Organization Quality of Life assessment (WHOQOL): Development and general psychometric properties Soc Sci Med 1998, 46:1569-1585.
• [12]WHOQOL Group: The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization Soc Sci Med 1995, 41:1403-1409.
• [13]WHOQOL Group: Development of the World Health Organization WHOQOL-BREF quality of life assessment Psychol Med 1998, 28:551-558.
• [14]WHOQOL SRPB Group: A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life Soc Sci Med 2006, 62:1486-1497.
• [15]Mandhouj O, Etter J-F, Courvoisier D, Aubin H-J: French-language version of the World Health Organization quality of life spirituality, religiousness and personal beliefs instrument. Health Qual Life Outcomes 2012, 10:39. BioMed Central Full Text
• [16]Moreira-Almeida A, Koenig HG: Retaining the meaning of the words religiousness and spirituality: A commentary on the WHOQOL SRPB group’s “A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life” (62: 6, 2005, 1486--1497). Soc Sci Med 2006, 63:843-845.
• [17]Krägeloh C, Henning MA, Billington R, Hawken SJ. The relationship between quality of life and spirituality, religiousness, and personal beliefs of medical students. Acad Psychiatry, in press.
• [18]O’Connell KA, Skevington SM: Spiritual, religious, and personal beliefs are important and distinctive to assessing quality of life in health: a comparison of theoretical models. Br J Health Psychol 2010, 15:729-748.
• [19]Skevington SM, Gunson KS, O’Connell KA: Introducing the WHOQOL-SRPB BREF: developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Qual Life Res 2013, 22:1073-1083.
• [20]Chai PPM, Krägeloh CU, Shepherd D, Billington R: Stress and quality of life in international and domestic university students: cultural differences in the use of religious coping. Mental Health Relig Cult 2012, 15:265-277.
• [21]Carver CS: You want to measure coping but your protocol’s too long: Consider the Brief COPE. Int J Beh Med 1997, 4:92-100.
• [22]Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress. J Health Soc Behav 1983, 24:385-396.
• [23]Krägeloh CU, Kersten P, Billington DR, Hsu PH-C, Shepherd D, Landon J, et al.: Validation of the WHOQOL-BREF quality of life questionnaire for general use in New Zealand: Confirmatory factor analysis and Rasch analysis. Qual Life Res 2013, 22:1451-1457.
• [24]Krägeloh CU, Henning MA, Hawken SJ, Zhao Y, Shepherd D, Billington R: Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students. Educ Health 2011, 24:1-5.
• [25]Krägeloh CU: A systematic review of studies using the Brief COPE: Religious coping in factor analyses. Religions 2011, 2:216-246.
• [26]Jöreskog KG: New developments in LISREL: Analysis of ordinal variables using polychoric correlations and weighted least squares. Qual Quant 1990, 24:387-404.
• [27]Flora DB, Curran PJ: An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods 2004, 9:466-491.
• [28]Marsh HW, Balla JR, McDonald RP: Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size. Psychol Bull 1988, 103:391-410.
• [29]Hu L, Bentler PM: Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods 1998, 3:424-453.
• [30]de Jager Meezenbroek E, Garssen B, van den Berg M, van Dierendonck D, Visser A, Schaufeli WB: Measuring spirituality as a universal human experience: a review of spirituality questionnaires. J Relig Health 2012, 51:336-54.
• [31]Gardner TM, Krägeloh CU, Henning MA: Religious coping, stress, and quality of life of Muslim university students in New Zealand. Mental Health Relig Cult 2014, 17:327-338.
• [32]Li K, Kay NS, Nokkaew N: The performance of the World Healthy Organization’s WHOQOL-BREF in assessing the quality of life of Thai college students. Soc Indic Res 2009, 90:489-501.