Journal of Religion and Health

, Volume 58, Issue 6, pp 2219–2240 | Cite as

Measuring Spiritual Well-Being in Brazilian Adolescents with Chronic Illness Using the FACIT-Sp-12: Age Adaptation of the Self-Report Version, Development of the Parental-Report Version, and Validation

  • Willyane Andrade de AlvarengaEmail author
  • Lucila Castanheira Nascimento
  • Claudia Benedita dos Santos
  • Ana Carolina Andrade Biaggi Leite
  • Holger Mühlan
  • Silke Schmidt
  • Monika Bullinger
  • Emília Campos de Carvalho
  • Jason Bredle
  • Benjamin Arnold
  • Robson de Castro Coelho
  • Margarida Vieira
Original Paper


Spiritual well-being is a major issue in health care, but instruments for measuring this construct in adolescents are lacking. This study adapted the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) for use with Brazilian adolescents with chronic diseases and developed a parental observer-rated version, using an expert panel, back-translation, and cognitive interviews with 72 participants. The psychometric properties of both versions were verified with two- and three-factor models by testing with 212 participants. The self- and parental-reported versions showed face validity, content validity, and acceptable levels of internal consistency for the overall scale and the two-factor model. The convergent validity was satisfactory for most items in both two- and three-factor models, but there was a lack of discrimination in the three-factor model using multitrait–multimethod analysis. This study presents the first instrument to assess the spiritual well-being of adolescents from their point of view and to allow their parents to serve as evaluators. However, we recommend further psychometric testing of the self- and parental-report scales to assess spiritual well-being in adolescents with chronic diseases in Brazil.


Validation studies Psychometrics Adolescents Parents Proxy Spirituality Spiritual well-being 



We acknowledge the funding received from the Coordination for the Improvement of Higher Education Personnel (CAPES) to first author, as a PhD’s Scholarship (# PDSE 99999.010691/2014-06 and Finance Code 001).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Willyane Andrade de Alvarenga
    • 1
    Email author
  • Lucila Castanheira Nascimento
    • 1
  • Claudia Benedita dos Santos
    • 1
  • Ana Carolina Andrade Biaggi Leite
    • 1
  • Holger Mühlan
    • 2
  • Silke Schmidt
    • 2
  • Monika Bullinger
    • 3
  • Emília Campos de Carvalho
    • 4
  • Jason Bredle
    • 5
  • Benjamin Arnold
    • 5
  • Robson de Castro Coelho
    • 6
  • Margarida Vieira
    • 7
  1. 1.Maternal-Infant and Public Health Nursing Department, WHO Collaborating Centre for Nursing Research DevelopmentUniversity of Sao Paulo at Ribeirao Preto College of NursingRibeirão PretoBrazil
  2. 2.Department Health and Prevention, Institute of PsychologyErnst-Moritz-Arndt-University of GreifswaldGreifswaldGermany
  3. 3.Department of Medical PsychologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Department of General and Specialized Nursing, WHO Collaborating Centre for Nursing Research DevelopmentUniversity of Sao Paulo at Ribeirao Preto College of NursingRibeirão PretoBrazil
  5. 5.FACIT.orgElmhurstUSA
  6. 6.Children and Young Adult’s Cancer HospitalBarretosBrazil
  7. 7.School of Nursing, Centre for Interdisciplinary Research in Health, Institute of Health SciencesUniversidade Católica PortuguesaPortoPortugal

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