Michael Natasha G, Bobevski Irene, Georgousopoulou Ekavi, O'Callaghan Clare C, Clayton Josephine M, Seah Davinia, Kissane David
Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, Victoria, Australia
University of Notre Dame Australia, School of Medicine, Sydney, NSW, Australia.
BMJ Support Palliat Care. 2023 Oct;13(e1):e170-e176. doi: 10.1136/bmjspcare-2020-002636. Epub 2020 Dec 1.
While studies in palliative care use measures of spirituality and religious belief, there have been few validation studies of a screening tool that identifies unmet spiritual needs.
A multidisciplinary research team developed and examined the usefulness, reliability and validity of a 17-item Spiritual Concerns Checklist (SCC) as a screening tool for unmet spiritual needs. A cohort of patients recruited from three palliative care services in Sydney and Melbourne, Australia completed anonymous questionnaires. Factor structure and item response theory were used to examine its properties; concurrent validity employed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12).
Among 261 patients, while only 15% directly sought spiritual care, nearly 62% identified at least one spiritual concern. Existential needs (fear of the dying process 32%; loss of control 31%), regret (20%), need for forgiveness (17%), guilt (13%), loss of hope (13%) and meaning (15%) were prominent concerns. Eleven concerns were present for more than 10% of the participants and 25% of religiously orientated participants expressed >4 concerns. The 17-item SCC was unidimensional, with satisfactory reliability. Concurrent validity was evident in the reduced sense of meaning and peace on the FACIT-Sp-12.
This preliminary Rasch analysis of the newly developed SCC has demonstrated its usefulness, reliability and validity. Our findings encourage refinement and ongoing development of the SCC with further investigation of its psychometric properties in varying populations.
虽然姑息治疗研究使用了精神性和宗教信仰的测量方法，但针对识别未满足的精神需求的筛查工具进行的验证研究却很少。
一个多学科研究团队开发并检验了一份包含17个条目的精神关怀清单（SCC）作为未满足精神需求筛查工具的实用性、可靠性和有效性。从澳大利亚悉尼和墨尔本的三个姑息治疗服务机构招募的一组患者完成了匿名问卷调查。采用因子结构和项目反应理论来检验其特性；同时效度采用慢性病治疗功能评估-精神幸福感量表（FACIT-Sp-12）。
在261名患者中，虽然只有15%的患者直接寻求精神关怀，但近62%的患者指出了至少一项精神关怀。存在性需求（对死亡过程的恐惧32%；失去控制31%）、遗憾（20%）、需要宽恕（17%）、内疚（13%）、失去希望（13%）和意义（15%）是突出的关怀点。11项关怀点在超过10%的参与者中出现，25%有宗教倾向的参与者表达了超过4项关怀点。17项的SCC是单维的，具有令人满意 的可靠性。FACIT-Sp-12量表上意义感和安宁感的降低体现了同时效度。
对新开发的SCC进行的这项初步拉施分析证明了其有用性、可靠性和有效性。我们的研究结果鼓励对SCC进行完善和持续开发，并在不同人群中进一步研究其心理测量特性。
