Development and Validation of a Scale to Measure Religious and Spiritual Support in Sri Lankan Patients with Cancer

Abstract

Background: Religious and spiritual support (RSS) is considered a vital method of coping among patients with cancer and cancer survivors. Measuring religion and spiritual support received by cancer patients has very little evidence in Sri Lanka compared to the western countries. It would be affected on cancer care management and speedy recovery process of cancer patients; could be benefited to reduce long-term suffering of patients with cancer. This study aimed to develop and validate a tool to measure religion and spiritual support in patients with cancer.

Methods: WHO guidelines were incorporated into the cross-cultural adaptation of the newly developed religious and spiritual support scale (RSSS). Internal consistency for the overall RSSS was investigated using Cronbach’s alpha. Intra-class correlation coefficient (ICC) was used to examine the test-retest reliability of the RSSS for the same sample. Validity was checked using convergent and divergent validity. Principal component analysis (PCA) was performed to test factorial/construct validity.

Results: The Sinhalese version of RSSS showed a high internal consistency (Cronbach’s alpha-0.883). The scale revealed favourable test-retest reliability (ICC = 0.981). The overall RSSS score correlated negatively and positively with depressive symptoms (r= - 0.338, p<0.05) and quality of life scores; overall (r=0.421, p<0.001), physical (r=0.340, p<0.05), psychological (r=0.279, p=0.08), social (r=0.373, p<0.05) and environmental quality of life (r=0.429, p<0.001) confirming satisfactory divergent and convergent validity of the Sinhalese version of the RSSS. Factor analysis with PCA extracted two factors explaining 74.47% of the variance.

Conclusions: The Sinhalese version of RSSS is a reliable and valid scale to assess the religious and spiritual support of patients with cancer in Sri Lanka.