Development and Testing of the Spiritual Needs Inventory for Patients Near the End of Life

Carla P. Hermann

ONF 2006, 33(4), 737-744. DOI: 10.1188/06.ONF.737-744

Purpose/Objectives: To develop and test an instrument to measure the spiritual needs of patients near the end of life.

Design: Instrumentation methodology.

Setting: One inpatient and five outpatient hospices.

Sample: 62 female and 38 male hospice patients with a mean age of 67 years; most were Caucasian, Protestant, and dying of cancer.

Methods: Items for the Spiritual Needs Inventory (SNI) were developed from a qualitative study of spiritual needs of dying patients. Data were analyzed for internal consistency using Cronbach's alpha and item-to-total correlations and for content and construct validity using factor analysis.

Main Research Variables: Spiritual needs and life satisfaction.

Findings: The total scale alpha of the 27-item SNI was 0.81. Item-to-total correlations ranged from 0.07-0.65, resulting in seven items being eliminated. A principal component factor analysis with a promax oblique rotation was used to estimate content and construct validity. A total of 17 items comprised the five-factor solution. Cronbach's alpha for the revised SNI was 0.85.

Conclusions: The SNI is a valid and reliable measurement of spiritual needs of patients near the end of life. Further psychometric testing of this newly developed instrument is warranted.

Implications for Nursing: Nurses must recognize the spiritual needs of all patients, particularly those near the end of life. The SNI may be useful in the clinical setting as well as in future studies of spiritual needs of patients.

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    References

    American Association of Colleges of Nursing. (1997). Peaceful death: Recommended competencies and curricular guidelines for end-of-life nursing care. Report from the Robert Wood Johnson End-of-Life Roundtable. Washington, DC: Author.

    Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press.

    Carson, V.B., & Green, H. (1992). Spiritual well-being: A predictor of hardiness in patients with acquired immunodeficiency syndrome. Journal of Professional Nursing, 8, 209-220.

    Doka, K.J. (1993). The spiritual needs of the dying. In K.J. Doka & J.D. Morgan (Eds.), Death and spirituality (pp. 143-150). Amityville, NY: Baywood.

    Dossey, B.M. (1998). Holistic modalities and healing moments. American Journal of Nursing, 98(6), 44-47.

    Ellerhorst-Ryan, J.M. (1997). Instruments to measure aspects of spirituality. In M. Frank-Stromberg & S.J. Olsen (Eds.), Instruments for clinical health-care research (2nd ed., pp. 202-212). Boston: Jones and Barlett.

    Ellison, C.W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11, 330-340.

    Fernsler, J.I., Klemm, P., & Miller, M.A. (1999). Spiritual well-being and demands of illness in people with colorectal cancer. Cancer Nursing, 22, 134-140.

    Flannelly, L.T., Flannelly, K.J., & Weaver, A.J. (2002). Religious and spiritual variables in three major oncology nursing journals: 1990-1999. Oncology Nursing Forum, 29, 679-685.

    Green, L.W., & Lewis, F.M. (1986). Measurement and evaluation in health education and health promotion. Palo Alto, CA: Mayfield.

    Hermann, C.P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28, 67-72.

    Hess, J.S. (1983). Spiritual needs survey. In S. Fish & J.A. Shelly (Eds.), Spiritual care: The nurse's role (pp.157-159). Downer's Grove, IL: Intervarsity Press.

    Highfield, M.F. (1992). Spiritual health of oncology patients: Nurse and patient perspectives. Cancer Nursing, 15, 1-8.

    Jenkins, R.A., & Pargament, K.I. (1995). Religion and spirituality as resources for coping with cancer. Journal of Psychosocial Oncology, 13, 51-74.

    Kaczorowski, J.M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer. Hospice Journal, 5(3/4), 105-116.

    Kirschling, J.M., & Pittman, J.F. (1989). Measurement of spiritual well-being: A hospice caregiver sample. Hospice Journal, 5(2), 1-11.

    Knapp, T.R., & Brown, J.K. (1995). Ten measurement commandments that often should be broken. Research in Nursing and Health, 18, 465-469.

    Laborde, J.B., & Powers, M.J. (1980). Satisfaction with life for patients undergoing hemodialysis and patients suffering from osteoarthritis. Research in Nursing and Health, 3, 19-24.

    Lemmer, C. (2002). Teaching the spiritual dimension of nursing care: A survey of U.S. baccalaureate nursing programs. Journal of Nursing Education, 41, 482-490.

    Maslow, A.H. (1970). Motivation and personality (2nd ed.). New York: Harper and Row.

    Maugans, T.A. (1996). The SPIRITual History. Archives of Family Medicine, 5, 11-16.

    Mickley, J.R., Soeken, K., & Belcher, A. (1992). Spiritual well-being, religiousness, and hope among women with breast cancer. Image: Journal of Nursing Scholarship, 24, 267-272.

    Miller, J.F. (1985). Assessment of loneliness and spiritual well-being in chronically ill and healthy adults. Journal of Professional Nursing, 1, 79-85.

    Munro, B.H. (1997). Statistical methods for health care research (3rd ed.). Philadelphia: Lippincott.

    Narayanasamy, A. (1993). Nurses' awareness and educational preparation in meeting their patients' spiritual needs. Nurse Education Today, 13, 196-201.

    Narayanasamy, A., & Owens, J. (2001). A critical incident study of nurses' responses to the spiritual needs of their patients. Journal of Advanced Nursing, 33, 446-455.

    Nunnally, J.C., & Bernstein, I.H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.

    Paloutzian, R., & Ellison, C. (1982). Loneliness, spiritual well-being and the quality of life. In L. Peplau & D. Perlman (Eds.), Loneliness: A source book of current theory, research, and therapy (pp. 224-237). New York: John Wiley and Sons.

    Reed, P.G. (1986). Religiousness among terminally ill and healthy adults. Research in Nursing and Health, 9, 35-41.

    Reed, P.G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing and Health, 10, 335-344.

    Reed, P.G. (1991). Self-transcendence and mental health in oldest-old adults. Nursing Research, 40, 5-10.

    Reed, P.G. (1992). An emerging paradigm for the investigation of spirituality in nursing. Research in Nursing and Health, 15, 349-357.

    Roberts, K.T., & Aspy, C.B. (1993). Development of the Serenity Scale. Journal of Nursing Measurement, 1, 145-164.

    Sellers, S.C., & Haag, B.A. (1998). Spiritual nursing interventions. Journal of Holistic Nursing, 16, 338-354.

    Stoll, R. (1979). Guidelines for spiritual assessment. American Journal of Nursing, 79, 1574-1577.

    Streiner, D.L., & Norman, G.R. (1995). Health measurement scales: A practical guide to their development and use (2nd ed.). New York: Oxford University Press.

    Strickland, O.L. (1996). Internal consistency analysis: Making the most of what you've got. Journal of Nursing Measurement, 4, 3-4.

    Taylor, E.J., Amenta, M., & Highfield, M. (1995). Spiritual care practices of oncology nurses. Oncology Nursing Forum, 22, 31-39.

    Taylor, P.B., & Ferszt, G.G. (1990). Spiritual healing. Holistic Nursing Practice, 4, 32-38.

    VandeCreek, L., & Smith, D. (1992). Measuring the spiritual needs of hospital patients and their families. Journal of Pastoral Care, 46, 46-52.

    Wasner, M., Longaker, C., Fegg, M.J., & Borasio, G.D. (2005). Effects of spiritual care training for palliative care professionals. Palliative Medicine, 19, 99-104.

    Wright, K.B. (1998). Professional, ethical, and legal implications for spiritual care in nursing. Image: Journal of Nursing Scholarship, 30, 81-83.