Development of the Spiritual Distress Scale for Patients with Chronic Non-communicable Diseases in Thailand.

INTRODUCTION

A spiritual distress scale for Thai patients with chronic non-communicable diseases (SDS-Thai-NCDs) has not yet been developed. This study aimed to develop and evaluate its psychometric properties.

METHODS

A methodological approach was applied to develop and verify the quality of the scale through seven steps: defining concepts, formatting the scale, creating items, expert review, item selection, field testing, and psychometric property testing. The sample included 400 Thai patients with chronic NCDs from eight provinces, representing all regions of Thailand. The scale's quality was assessed through content validity, discrimination index, reliability, and exploratory factor analysis.

RESULTS

Initially, the scale contained 48 items, which were reduced to 46 items after expert review, with a content validity index of 0.97. Item analysis and selection revealed 43 items that met the criteria, with corrected item-total correlations greater than 0.30 and discrimination indices ranging from 0.336 to 0.906. The scale demonstrated excellent internal consistency, with a Cronbach's alpha coefficient of 0.986. During the field test and psychometric property testing, the 43 items were grouped into five factors, with eigenvalues ranging from 3.494 to 8.385, explaining 70.80% of the variance. The five factors identified were: Loss of self-esteem, meaning, and purpose of life; Loss of relationships with oneself and others; Loss of hope and inner strength; Loss of relationship with nature and a higher power; and Physical expression.

CONCLUSION

The SDS-Thai-NCDs is an effective tool for assessing spiritual distress and can be used in clinical practice or research to guide interventions aimed at alleviating spiritual distress among patients with chronic NCDs.