Nurse Spiritual Therapeutics Scale: Psychometric evaluation among cancer patients

Instruments for assessing the spiritual needs of cancer patients: A systematic review of psychometric properties

AIMS AND OBJECTIVES

To identify available instruments for assessing cancer patients' spiritual needs and to examine their psychometric properties using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology.

BACKGROUND

Cancer patients frequently have significant spiritual needs. The nurse plays an integral role in assessing the patient's spiritual needs as part of providing holistic care. It is crucial to assess these needs using appropriate and reliable instruments.

DESIGN

A systematic review based on COSMIN methodology.

METHODS

Seven electronic databases (PubMed, EMBASE, CINAHL, Web of Science, ProQuest, CNKI and WANFANG) were systematically searched from inception until 14 February 2023. Two authors independently screened eligible literature, extracted data and evaluated methodological and psychometric quality. This systematic review was conducted following the PRISMA checklist.

RESULTS

Sixteen studies have reported 16 different versions of the instruments. None of the instruments were properly assessed for all psychometric properties, nor were measurement error, responsiveness and cross-cultural validity/measurement invariance reported. All of the instruments failed to meet the COSMIN quality criteria for content validity. The quality of evidence for structural validity and/or internal consistency in five instruments did not meet the COSMIN criteria. Eventually, five instruments were not recommended, and 11 were only weakly recommended.

CONCLUSION

Instruments to assess spiritual needs exhibited limited reliability and validity. The Spiritual Care Needs Scale is provisionally recommended for research and clinical settings, but its limitations regarding content validity and cross-cultural application must be considered in practice. Future research should further revise the content of available instruments and comprehensively and correctly test their psychometric properties.

RELEVANCE TO CLINICAL PRACTICE

The review findings will provide evidence for healthcare professionals to select instruments for recognising spiritual needs in cancer patients.

NO PATIENT OR PUBLIC CONTRIBUTION

This study is a systematic review with no patient or public participation.

Psychometric Properties of the Turkish Version of the Nurse Spiritual Therapeutic Scale for Oncology Patients and Caregivers

This study evaluated the Turkish version of the Nurse Spiritual Therapeutic Scale for assessing oncology patients' and caregivers' needs. It involved 200 participants from July 2022 to May 2023. The scale demonstrated high validity (content validity index = 0.97) and good internal consistency (Cronbach's alpha = 0.879). Factor analysis revealed a 20-item single-factor structure with satisfactory representation (factor loadings: 0.29-0.89). Item-total score correlations indicated moderate to strong relationships (0.236-0.761). The model showed a good fit (goodness-of-fit indices > 0.90). The Turkish version of the scale is valid and reliable for assessing oncology patients' and caregivers' spiritual care needs.

The concept of spirituality in the context of Chinese patients with cancer: A scoping review

AIM

To elucidate how the concept of spirituality has been addressed in studies with Chinese people with cancer.

DESIGN

A scoping review.

METHODS

Patterns in conceptual definitions of spirituality and indicators for measuring spirituality were analysed.

DATA SOURCES (INCLUDE SEARCH DATES)

Literature published from inception to August 2022 was searched in five electronic databases (CINAHL, PubMed, Web of Science, PsycINFO and a Chinese database).

RESULTS

Using data from 10 qualitative studies, a new taxonomy of concepts of spirituality among Chinese people with cancer was derived, consisting of four categories: Creation of meaning, Connection, Transcendence and Existence. A total of 12 instruments developed outside of Chinese contexts and used to measure dimensions of spirituality across 27 quantitative studies were compared to the taxonomy developed in this review, and patterns were identified according to the dimensions of spirituality. Several instruments required modifications or additional explanations in questions regarding God/Higher Power and religion.

CONCLUSION

The four categories of spirituality classified in the current review are considered universal across all cultural contexts. Spirituality is multidimensional and functional concept, and the components of the instruments differed depending on which dimension of spirituality was being measured.

IMPACT

The findings of this study suggest that for measuring spirituality in research and clinical settings with Chinese people with cancer, it is important to use culturally appropriate scales that are consistent with the dimensions of spirituality being measured.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Even instruments developed outside of the Chinese context could be used for Chinese people with cancer if appropriately selected for their intended use.

REPORTING METHOD

This paper adheres to the EQUATOR guidelines and has no direct patient or public contribution.

Psychometric properties of the Chinese version of the preoperative assessment of readiness tool among surgical patients

Background

The evaluation of the surgical readiness of patients plays an important role in clinical care. Preoperative readiness assessment is needed to identify the inadequacy among surgical patients, which provides guide for interventions to improve patients’ preoperative readiness. However, there is a paucity of high-level, quality tool that evaluate surgical readiness of patients in China. The purpose of this study is to translate the Preoperative Assessment of Readiness Tool (PART) into Chinese and determine the reliability and validity of the Chinese version in the population of surgical patients.

Methods

Using a standard translation-backward method, the original English version of PART was translated into Chinese. A convenient sampling of 210 surgical patients was recruited from 6 hospitals in Zhejiang Province to test the psychometric properties of this scale including internal consistency, split-half reliability, content validity, structure validity, and floor/ceiling effect.

Results

A total of 194 patients (92%) completed questionnaires. The Chinese version of PART achieved Cronbach’s alphas 0.948 and McDonald’s omega coefficient 0.947, respectively, for the full scale. The estimated odd-even split-half reliability was 0.959. The scale-level content validity index was 0.867, and the items content validity index ranged from 0.83 to 1.0.The output of confirmatory factor analysis (CFA) revealed a two-factor model (χ2 = 510.96; df = 86; p < 0.001; root mean square error approximation = 0.08) with no floor/ceiling effect.

Conclusion

The Chinese version of PART demonstrated acceptable reliability and validity among surgical patients. It can be used to evaluate patients’ preoperative preparation and help health professionals provide proper preoperative support.

Influence of Spirituality and Religiosity of Cancer Patients on Their Quality of Life

Taking into account the spiritual and religious dimensions is important when it comes to taking care of patients with cancer and their quality of life. The study aimed to show the degree of dependence between the level of spirituality/religiosity of people who have just been diagnosed with cancer or have been diagnosed with cancer in the past and their quality of life. The Daily Spiritual Experience Scale (DSES), the EORTC QLQ-C30 quality of life and EORTC QLQ-FA12 fatigue-related quality of life questionnaire were used. One hundred one respondents of the Catholic faith obtained 65.22 points in DSES; 49.84 points on the QLQ-C30 functioning scale, 58.75 points on the physical scale, 60.73 points on the social scale, 50.17 points on the emotional scale, 64.69 points on the cognitive scale, 55.45 points in fulfilling one’s role and 28.38 points in financial impact. In the QLQ-FA12, respondents obtained 45.94 points on the physical scale, 47.53 points on the emotional scale and 30.69 points on the cognitive scale. In the respondents’ opinion, fatigue was the disease that reduced their quality of life the most—on average, 51.27 points. The oncological patients were characterized by a high level of spirituality/religiosity and an average level of quality of life. Spirituality/religiosity had a positive relationship with physical, emotional and social functioning. On the other hand, it was negatively associated with disease symptoms, such as pain or emotional and physical fatigue. Future research is needed in the context of the quality of life, focused on the spiritual and religious sphere of functioning of cancer patients, conducted in various cultural, ethnic and religious circles, which can serve to improve the education of nurses and develop their spiritual competences.

Validation of the Nurse Spiritual Care Therapeutics Scale in Portuguese palliative care settings: a methodological study

BACKGROUND

Spirituality is a critical dimension in palliative care, but difficulties have been described in literature concerning the effective implementation and measuring of spiritual care.

AIM

To translate, adapt and validate the Nurse Spiritual Care Therapeutics Scale (NSCTS) in Portuguese palliative care settings.

METHODS

A methodological study was conducted. A final version of the questionnaire included the scale and was submitted to full psychometric testing using nurses working in Portuguese palliative care settings.

FINDINGS

A total of 88 nurses participated. The average age of the sample was 36.1 ± 8.93 years (range 23-60 years), and 92.0% were women. A Cronbach alpha value of 0.88; Kaiser-Meyer-Olkin measure of sampling adequacy 0.80; and Bartlett's Test of Sphericity were adequate. An exploratory factor analysis was conducted using principal axis factoring with an oblimin rotation that resulted in a three-factors solution.

CONCLUSION

The European Portuguese NSCTS questionnaire is a valid and reliable tool to assess the frequency of nurses' activities concerning spirituality in palliative care.

Spiritual Care: A Description of Family Members’ Preferences of Spiritual Care Nursing Practices in Intensive Care Units in a Private Hospital in Kwa-Zulu Natal, South Africa

Background: Spiritual care is a part of the holistic care that enables family members in intensive care units to find meaning in their life events and simultaneously bolsters their resilience and coping tools. Objective: To determine family members’ preferences of spiritual care practices that they require from nurses working in intensive care units. Methods: A quantitative, descriptive, cross-sectional study was conducted in the intensive care units of a private hospital in the province of KwaZulu-Natal. Data, using the Nurse Spiritual Therapeutic Scale, were collected from a purposive sample of family members (n = 47). Data were analyzed using descriptive statistics. Results: The mean overall Nurse Spiritual Therapeutic Scale was 58.4 (20–80). The most preferred and least preferred spiritual care practices by family members were “to be helped to have quiet time and space”, (M = 3.32, SD = 0.59) and “to arrange for a chaplain to visit them” (M = 2.70, SD= 0.91), respectively. Conclusion: The mean overall NSTS score indicated that there was a strong preference among family members for nurses to provide them with spiritual care in the intensive care units. However, due to the diversity of family members’ preferences it remains important that family members guide intensive care nurses in their spiritual care.

Quality of life in cancer patients with different preferences for nurse spiritual therapeutics: The role of psychological capital

AIM

To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics.

DESIGN

A cross-sectional survey was used.

METHODS

Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST.

RESULTS

Compared with patients having high PNST, patients with mild-moderate PNST experienced lower self-efficacy, hope, optimism, PsyCap and social/family well-being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well-being of patients with high PNST.

CONCLUSION

The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild-moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild-moderate PNST.

IMPACT

It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL.