Ostermann T, Büssing A, Matthiessen P F
Medizintheorie und Komplementärmedizin, Universität Witten/Herdecke, Deutschland.
Forsch Komplementarmed Klass Naturheilkd. 2004 Dec;11(6):346-53. doi: 10.1159/000082816.
Life-threatening diseases are the standard situations which confront patients with spirituality and religiosity. Although both are wellknown factors in disease coping, their measurability and operationability remains a basic problem due to the variety of different meanings and interpretations of these terms. In this paper we describe the development of a questionnaire for the measuring of the patients' attitudes towards spirituality and religiosity and their disease coping (SpREUK).
For a first evaluation, 129 patients with a mean age of 54 years (SD 14.3) completed the questionnaire. 67% of them were women. 76% had a Christian denomination, 19% no denomination, and only 4% reported other religious traditions. 45% of the patients suffered from cancer, 18% from multiple sclerosis, 22% from other chronic diseases, and 15% from acute diseases. The questionnaire comprises 29 five-stage likert-scaled items. Apart from a descriptive analysis of the single items, reliability (Cronbach's alpha) and validity analysis (factor analysis) of the questionnaire was performed.
Factor analysis resulted in four dimensions: (1) 'Search for meaningful support', (2) 'Guidance, control and message of disease', (A) 'Support in relations with the external through spirituality/religiosity', and (B) 'Stabilization of the inner condition through spirituality/religiosity'. The reliability of the four scales of the SpREUK questionnaire is high: Cronbach's alpha 0.82, 0.62, 0.89, resp. 0.74. Women had significantly higher SpREUK scores for scales 1 and 2 than male patients. Non-denominational patients had significantly lower scores in all four scales than those with a Christian denomination. The scores did not correlate with disease or duration of disease; however, there might be a positive correlation between age and the score of scale 2.
The impact of spirituality and religiosity on the course of disease, coping skills, and health-related quality of life is broadly discussed not only in complementary medicine. With the SpREUK questionnaire we present a reliable and valid instrument to measure the patients' search for meaningful support through spirituality/religiosity in terms of disease coping and health restoration. Further evaluation of this instrument is planned with a focus on hospitals which are affiliated with a specific denomination, as a reasonable extension of quality management and concept development.
危及生命的疾病是患者面临精神性和宗教性问题的常见情况。尽管这两者都是应对疾病的众所周知的因素,但由于这些术语的含义和解释多种多样,其可测量性和可操作性仍然是一个基本问题。在本文中,我们描述了一份用于测量患者对精神性和宗教性的态度及其应对疾病方式的问卷(SpREUK)的开发过程。
为进行首次评估,129名平均年龄为54岁(标准差14.3)的患者完成了该问卷。其中67%为女性。76%为基督教徒,19%无宗教信仰,只有4%报告有其他宗教传统。45%的患者患有癌症,18%患有多发性硬化症,22%患有其他慢性病,15%患有急性病。该问卷包括29个五级李克特量表项目。除了对单个项目进行描述性分析外,还对问卷进行了信度(克朗巴哈系数)和效度分析(因子分析)。
因子分析得出四个维度:(1)“寻求有意义的支持”,(2)“疾病的指引、控制和信息”,(3)“通过精神性/宗教性与外部建立联系获得的支持”,以及(4)“通过精神性/宗教性实现内心状态的稳定”。SpREUK问卷四个量表的信度较高:克朗巴哈系数分别为0.82、0.62、0.89和0.74。女性在量表1和量表2上的SpREUK得分显著高于男性患者。无宗教信仰的患者在所有四个量表上的得分均显著低于基督教徒。得分与疾病或病程无关;然而,年龄与量表2的得分之间可能存在正相关。
精神性和宗教性对疾病进程、应对技能以及与健康相关的生活质量的影响不仅在补充医学中得到广泛讨论。通过SpREUK问卷,我们提供了一种可靠且有效的工具,用于测量患者在应对疾病和恢复健康方面通过精神性/宗教性寻求有意义支持的情况。计划对该工具进行进一步评估,重点关注隶属于特定教派的医院,作为质量管理和概念发展的合理延伸。