Denver/Seattle Center of Innovation, Department of Veterans Affairs Eastern Colorado Health Care System (L.R.D., E.H., D.B.B.), Aurora, Colorado, USA.
Department of Psychology, University of Colorado Denver (K.S.M.), Denver, Colorado, USA.
J Pain Symptom Manage. 2021 Nov;62(5):1034-1040. doi: 10.1016/j.jpainsymman.2021.05.009. Epub 2021 May 19.
The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) is a 12-item measure of spiritual well-being in chronic illness originally developed in patients with cancer. The overall scale, a two-factor model (meaning/peace, faith), and a three-factor model (meaning, peace, faith) have been proposed for the FACIT-Sp, and consensus on the best factor structure has not been reached. In addition, the factor structure of the FACIT-Sp has not been considered in patients with heart failure.
To examine the factor structure of the FACIT-Sp in heart failure patients.
A confirmatory factor analysis framework was used to test three competing models on 217 patients with heart failure using data from the CASA (Collaborative Care to Alleviate Symptoms and Adjust to Illness) trial. The overall scale (single factor), two-factor, and three-factor models were tested using baseline data, then confirmed with 12-month data. Model modifications were made based on empirical inspection of baseline data and replicated using 12-month data. Cronbach's alpha and correlations with measures of quality of life and psychological health were examined.
All three models had strong factor loadings on all items except the negatively worded items. The two-factor and three-factor models fit reasonably well after modifications, but the single factor did not fit well (1/2/3-factor: RMSEA 0.14/0.09/0.06, CFI 0.85/0.93/0.97, SRMR 0.09/0.05/0.04). Internal consistency was sufficient for all factors.
The two-factor and three-factor models were supported in heart failure patients. The three-factor model demonstrated better statistical fit but was not more interpretable.
This study investigated the factor structure of the FACIT-Sp in patients with heart failure. The two-factor and three-factor models were supported, but the single factor model was not. Negatively worded items did not perform well.
慢性疾病治疗的功能评估-精神健康量表（FACIT-Sp）是一种针对慢性疾病患者精神健康的 12 项测量工具，最初在癌症患者中开发。该量表的整体、双因素（意义/平和、信念）和三因素（意义、平和、信念）模型已经提出，但其最佳因素结构尚未达成共识。此外，心力衰竭患者的 FACIT-Sp 因子结构尚未得到考虑。
检验心力衰竭患者中 FACIT-Sp 的因子结构。
使用协作护理减轻症状和适应疾病（CASA）试验的数据，对 217 例心力衰竭患者进行验证性因子分析框架，检验三个竞争模型。使用基线数据检验整体量表（单因素）、双因素和三因素模型，然后使用 12 个月的数据进行确认。根据基线数据的实证检验对模型进行修改，并使用 12 个月的数据进行复制。检查克朗巴赫α和与生活质量及心理健康测量的相关性。
除了负面措辞的项目外，所有三个模型在所有项目上的因子负荷都很强。经过修改后，双因素和三因素模型拟合较好，但单因素模型拟合不好（1/2/3 因素：RMSEA 0.14/0.09/0.06，CFI 0.85/0.93/0.97，SRMR 0.09/0.05/0.04）。所有因素的内部一致性都足够。
双因素和三因素模型在心力衰竭患者中得到支持。三因素模型表现出更好的统计学拟合，但更不可解释。
本研究调查了心力衰竭患者中 FACIT-Sp 的因子结构。支持双因素和三因素模型，但不支持单因素模型。负面措辞的项目表现不佳。
