Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

Spiritual quality of life and spiritual coping: evidence for a two-factor structure of the WHOQOL spirituality, religiousness, and personal beliefs module

Authors: Christian U Krägeloh, D Rex Billington, Marcus A Henning, Penny Pei Minn Chai

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Background

The WHOQOL-SRPB has been a useful module to measure aspects of QOL related to spirituality, religiousness, and personal beliefs, but recent research has pointed to potential problems with its proposed factor structure. Three of the eight facets of the WHOQOL-SRPB have been identified as potentially different from the others, and to date only a limited number of factor analyses of the instrument have been published.

Methods

Analyses were conducted using data from a sample of 679 university students who had completed the WHOQOL-BREF quality of life questionnaire, the WHOQOL-SRPB module, the Perceived Stress scale, and the Brief COPE coping strategies questionnaire. Informed by these analyses, confirmatory factor analyses suitable for ordinal-level data explored the potential for a two-factor solution as opposed to the originally proposed one-factor solution.

Results

The facets WHOQOL-SRPB facets connected, strength, and faith were highly correlated with each other as well as with the religious coping sub-scale of the Brief COPE. Combining these three facets to one factor in a two-factor solution for the WHOQOL-SRPB yielded superior goodness-of-fit indices compared to the original one-factor solution.

Conclusions

A two-factor solution for the WHOQOL-SRPB is more tenable, in which three of the eight WHOQOL-SRPB facets group together as a spiritual coping factor and the remaining facets form a factor of spiritual quality of life. While discarding the facets connectedness, strength, and faith without additional research would be premature, users of the scale need to be aware of this alternative two-factor structure, and may wish to analyze scores using this structure.
Literature
1.
go back to reference Katerndahl D, Oyiriaru D. Assessing the biopsychosociospiritual model in primary care: development of the biopsychosociospiritual inventory (BioPSSI). Int J Psychiatry Med. 2007;37:393–414.CrossRefPubMed Katerndahl D, Oyiriaru D. Assessing the biopsychosociospiritual model in primary care: development of the biopsychosociospiritual inventory (BioPSSI). Int J Psychiatry Med. 2007;37:393–414.CrossRefPubMed
2.
go back to reference O’Connell KA, Skevington SM. The relevance of spirituality, religion and personal beliefs to health-related quality of life: Themes from focus groups in Britain. Br J Health Psychol. 2005;10:379–98.CrossRefPubMed O’Connell KA, Skevington SM. The relevance of spirituality, religion and personal beliefs to health-related quality of life: Themes from focus groups in Britain. Br J Health Psychol. 2005;10:379–98.CrossRefPubMed
3.
go back to reference Vivat B. Measures of spiritual issues for palliative care patients: a literature review. Palliat Med. 2008;22:859–68.CrossRefPubMed Vivat B. Measures of spiritual issues for palliative care patients: a literature review. Palliat Med. 2008;22:859–68.CrossRefPubMed
4.
go back to reference Ellison CW. Spiritual well-being: Conceptualization and measurement. J Psychol Theol. 1983;11:330–40. Ellison CW. Spiritual well-being: Conceptualization and measurement. J Psychol Theol. 1983;11:330–40.
5.
go back to reference Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24:49–58.CrossRefPubMed Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24:49–58.CrossRefPubMed
6.
go back to reference Büssing A, Ostermann T, Matthiessen PF. Role of religion and spirituality in medical patients: Confirmatory results of the SpREUK questionnaire. Health Qual Life Outcomes. 2005;3:10.CrossRefPubMedCentralPubMed Büssing A, Ostermann T, Matthiessen PF. Role of religion and spirituality in medical patients: Confirmatory results of the SpREUK questionnaire. Health Qual Life Outcomes. 2005;3:10.CrossRefPubMedCentralPubMed
7.
go back to reference Monod S, Brennan M, Rochat E, Martin E, Rochat S, Büla CJ. Instruments measuring spirituality in clinical research: a systematic review. J Gen Intern Med. 2011;26:1345–57.CrossRefPubMedCentralPubMed Monod S, Brennan M, Rochat E, Martin E, Rochat S, Büla CJ. Instruments measuring spirituality in clinical research: a systematic review. J Gen Intern Med. 2011;26:1345–57.CrossRefPubMedCentralPubMed
8.
go back to reference O’Connell KA, Skevington SM. To measure of not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life. Chronic Illn. 2007;3:77–87.CrossRefPubMed O’Connell KA, Skevington SM. To measure of not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life. Chronic Illn. 2007;3:77–87.CrossRefPubMed
9.
go back to reference Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ. Routine use of patient reported outcome measures in healthcare settings. BMJ. 2010;340:464–7.CrossRef Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr AJ. Routine use of patient reported outcome measures in healthcare settings. BMJ. 2010;340:464–7.CrossRef
10.
go back to reference Greenhalgh J, Long AF, Flynn R. The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory? Soc Sci Med. 2005;60:833–43.CrossRefPubMed Greenhalgh J, Long AF, Flynn R. The use of patient reported outcome measures in routine clinical practice: lack of impact or lack of theory? Soc Sci Med. 2005;60:833–43.CrossRefPubMed
11.
go back to reference WHOQOL Group. The World Health Organization Quality of Life assessment (WHOQOL): Development and general psychometric properties. Soc Sci Med. 1998;46:1569–85.CrossRef WHOQOL Group. The World Health Organization Quality of Life assessment (WHOQOL): Development and general psychometric properties. Soc Sci Med. 1998;46:1569–85.CrossRef
12.
go back to reference WHOQOL Group. The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med. 1995;41:1403–9.CrossRef WHOQOL Group. The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med. 1995;41:1403–9.CrossRef
13.
go back to reference WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551–8.CrossRef WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551–8.CrossRef
14.
go back to reference WHOQOL SRPB Group. A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life. Soc Sci Med. 2006;62:1486–97.CrossRef WHOQOL SRPB Group. A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life. Soc Sci Med. 2006;62:1486–97.CrossRef
15.
go back to reference Mandhouj O, Etter J-F, Courvoisier D, Aubin H-J. French-language version of the World Health Organization quality of life spirituality, religiousness and personal beliefs instrument. Health Qual Life Outcomes. 2012;10:39.CrossRefPubMedCentralPubMed Mandhouj O, Etter J-F, Courvoisier D, Aubin H-J. French-language version of the World Health Organization quality of life spirituality, religiousness and personal beliefs instrument. Health Qual Life Outcomes. 2012;10:39.CrossRefPubMedCentralPubMed
16.
go back to reference Moreira-Almeida A, Koenig HG. Retaining the meaning of the words religiousness and spirituality: A commentary on the WHOQOL SRPB group’s “A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life” (62: 6, 2005, 1486--1497). Soc Sci Med. 2006;63:843–5.CrossRefPubMed Moreira-Almeida A, Koenig HG. Retaining the meaning of the words religiousness and spirituality: A commentary on the WHOQOL SRPB group’s “A cross-cultural study of spirituality, religion, and personal beliefs as components of quality of life” (62: 6, 2005, 1486--1497). Soc Sci Med. 2006;63:843–5.CrossRefPubMed
17.
go back to reference Krägeloh C, Henning MA, Billington R, Hawken SJ. The relationship between quality of life and spirituality, religiousness, and personal beliefs of medical students. Acad Psychiatry, in press. Krägeloh C, Henning MA, Billington R, Hawken SJ. The relationship between quality of life and spirituality, religiousness, and personal beliefs of medical students. Acad Psychiatry, in press.
18.
go back to reference O’Connell KA, Skevington SM. Spiritual, religious, and personal beliefs are important and distinctive to assessing quality of life in health: a comparison of theoretical models. Br J Health Psychol. 2010;15:729–48.CrossRefPubMed O’Connell KA, Skevington SM. Spiritual, religious, and personal beliefs are important and distinctive to assessing quality of life in health: a comparison of theoretical models. Br J Health Psychol. 2010;15:729–48.CrossRefPubMed
19.
go back to reference Skevington SM, Gunson KS, O’Connell KA. Introducing the WHOQOL-SRPB BREF: developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Qual Life Res. 2013;22:1073–83.CrossRefPubMed Skevington SM, Gunson KS, O’Connell KA. Introducing the WHOQOL-SRPB BREF: developing a short-form instrument for assessing spiritual, religious and personal beliefs within quality of life. Qual Life Res. 2013;22:1073–83.CrossRefPubMed
20.
go back to reference Chai PPM, Krägeloh CU, Shepherd D, Billington R. Stress and quality of life in international and domestic university students: cultural differences in the use of religious coping. Mental Health Relig Cult. 2012;15:265–77.CrossRef Chai PPM, Krägeloh CU, Shepherd D, Billington R. Stress and quality of life in international and domestic university students: cultural differences in the use of religious coping. Mental Health Relig Cult. 2012;15:265–77.CrossRef
21.
go back to reference Carver CS. You want to measure coping but your protocol’s too long: Consider the Brief COPE. Int J Beh Med. 1997;4:92–100.CrossRef Carver CS. You want to measure coping but your protocol’s too long: Consider the Brief COPE. Int J Beh Med. 1997;4:92–100.CrossRef
22.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.CrossRefPubMed Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.CrossRefPubMed
23.
go back to reference Krägeloh CU, Kersten P, Billington DR, Hsu PH-C, Shepherd D, Landon J, et al. Validation of the WHOQOL-BREF quality of life questionnaire for general use in New Zealand: Confirmatory factor analysis and Rasch analysis. Qual Life Res. 2013;22:1451–7.CrossRefPubMed Krägeloh CU, Kersten P, Billington DR, Hsu PH-C, Shepherd D, Landon J, et al. Validation of the WHOQOL-BREF quality of life questionnaire for general use in New Zealand: Confirmatory factor analysis and Rasch analysis. Qual Life Res. 2013;22:1451–7.CrossRefPubMed
24.
go back to reference Krägeloh CU, Henning MA, Hawken SJ, Zhao Y, Shepherd D, Billington R. Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students. Educ Health. 2011;24:1–5. Krägeloh CU, Henning MA, Hawken SJ, Zhao Y, Shepherd D, Billington R. Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students. Educ Health. 2011;24:1–5.
25.
go back to reference Krägeloh CU. A systematic review of studies using the Brief COPE: Religious coping in factor analyses. Religions. 2011;2:216–46.CrossRef Krägeloh CU. A systematic review of studies using the Brief COPE: Religious coping in factor analyses. Religions. 2011;2:216–46.CrossRef
26.
go back to reference Jöreskog KG. New developments in LISREL: Analysis of ordinal variables using polychoric correlations and weighted least squares. Qual Quant. 1990;24:387–404.CrossRef Jöreskog KG. New developments in LISREL: Analysis of ordinal variables using polychoric correlations and weighted least squares. Qual Quant. 1990;24:387–404.CrossRef
27.
go back to reference Flora DB, Curran PJ. An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods. 2004;9:466–91.CrossRefPubMedCentralPubMed Flora DB, Curran PJ. An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods. 2004;9:466–91.CrossRefPubMedCentralPubMed
28.
go back to reference Marsh HW, Balla JR, McDonald RP. Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size. Psychol Bull. 1988;103:391–410.CrossRef Marsh HW, Balla JR, McDonald RP. Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size. Psychol Bull. 1988;103:391–410.CrossRef
29.
go back to reference Hu L, Bentler PM. Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods. 1998;3:424–53.CrossRef Hu L, Bentler PM. Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods. 1998;3:424–53.CrossRef
30.
go back to reference de Jager Meezenbroek E, Garssen B, van den Berg M, van Dierendonck D, Visser A, Schaufeli WB. Measuring spirituality as a universal human experience: a review of spirituality questionnaires. J Relig Health. 2012;51:336–54.CrossRefPubMedCentralPubMed de Jager Meezenbroek E, Garssen B, van den Berg M, van Dierendonck D, Visser A, Schaufeli WB. Measuring spirituality as a universal human experience: a review of spirituality questionnaires. J Relig Health. 2012;51:336–54.CrossRefPubMedCentralPubMed
31.
go back to reference Gardner TM, Krägeloh CU, Henning MA. Religious coping, stress, and quality of life of Muslim university students in New Zealand. Mental Health Relig Cult. 2014;17:327–38.CrossRef Gardner TM, Krägeloh CU, Henning MA. Religious coping, stress, and quality of life of Muslim university students in New Zealand. Mental Health Relig Cult. 2014;17:327–38.CrossRef
32.
go back to reference Li K, Kay NS, Nokkaew N. The performance of the World Healthy Organization’s WHOQOL-BREF in assessing the quality of life of Thai college students. Soc Indic Res. 2009;90:489–501.CrossRef Li K, Kay NS, Nokkaew N. The performance of the World Healthy Organization’s WHOQOL-BREF in assessing the quality of life of Thai college students. Soc Indic Res. 2009;90:489–501.CrossRef
Metadata
Title
Spiritual quality of life and spiritual coping: evidence for a two-factor structure of the WHOQOL spirituality, religiousness, and personal beliefs module
Authors
Christian U Krägeloh
D Rex Billington
Marcus A Henning
Penny Pei Minn Chai
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0212-x

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue