文摘
Context
Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. There is a need for a well-validated, psychometrically sound instrument to describe and measure spiritual needs.Objectives
<p>To develop a valid and reliable instrument to assess patients¡¯ spiritual needs.Methods
<p>Instrument development was based on a literature review, clinical and pastoral evaluation, and cognitive pretesting (n = 15 ambulatory cancer patients). Forty-seven ambulatory cancer patients completed cross-sectional and longitudinal surveys to test instrument validity and reliability. Internal reliability was assessed by Cronbach¡¯s ¦Á, test-retest reliability by Spearman¡¯s correlation coefficients, and construct validity by comparing instrument scores to a previously used single-item spiritual needs question.Results
<p>The Spiritual Needs Assessment for Patients (SNAP) comprises a total of 23 items in three domains: psychosocial (n = 5), spiritual (n = 13), and religious (n = 5). Sixty percent of participants were white, 21 % black, 13 % Hispanic, and 6 % Asian or other. Fifty-eight percent were Catholic, 13 % Jewish, 11 % Protestant, 2 % Buddhist, 2 % Muslim, and 2 % Hindu. Sixty-eight percent described themselves as spiritual but not religious; 15 % reported unmet spiritual needs; 19 % wanted help meeting their spiritual needs. Cronbach¡¯s ¦Á for the total SNAP was 0.95, and for the subscales was psychosocial = 0.74, spiritual = 0.93, and religious needs = 0.86. Test-retest correlation coefficients were total SNAP = 0.69, psychosocial needs = 0.51, spiritual needs = 0.70, and religious needs = 0.65. Participants reporting unmet spiritual needs had significantly higher mean scores on the total SNAP (66.3 vs. 49.4, P = 0.03) and on the spiritual needs subscale (39.0 vs. 28.3, P = 0.02).Conclusion
<p>The results provide preliminary evidence that the SNAP is a valid and reliable instrument for measuring spiritual needs in a diverse patient population.
