Abstract
The aim of this study was to test a modified Spirituality and Spiritual Care Rating Scale (SSCRS) and report initial findings, based on a cross-sectional descriptive survey from eight nursing homes in the USA. This study examined the psychometric properties of a modified version of the SSCRS for assessing the perceptions of staff (i.e. nurses, rehabilitation staff, food and nutrition service staff, activities staff, social workers, and administrative staff) who work in nursing homes. The modified version of the SSCRS is measuring respondents’ perceptions of spirituality, spiritual care, religiosity, and personalized care. Confirmatory factor analysis showed satisfactory goodness of fit for the original four-factor structure of the SSCRS. The modified version demonstrated good internal consistency and reliability (Cronbach’s alpha ranging from 0.71 to 0.90). Initial findings showed statistically significant differences across all four sub-scales. Further research is needed to psychometrically test the modified tool.
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29 December 2023
A Correction to this paper has been published: https://doi.org/10.1007/s10943-023-01974-6
References
(2021, December 1). www.medicare.gov/care-compare
Bhattacharyya, K. K., Molinari, V., & Hyer, K. (2021). Self-reported satisfaction of older adult residents in nursing homes: Development of a conceptual framework. The Gerontologist, 62(8), e442–e456. https://doi.org/10.1093/geront/gnab061
Can Oz, Y., Duran, S., & Dogan, K. (2021). The meaning and role of spirituality for older adults: A qualitative study. Journal of Religion and Health, 61(2), 1490–1504. https://doi.org/10.1007/s10943-021-01258-x
Chen, M., Chen, Y., Lin, L., & Chuang, L. (2020). Factors influencing the self-perceived competencies in spiritual care of nurses in the long-term care facilities. Journal of Nursing Management. https://doi.org/10.1111/jonm.13080
Cleland, J., Hutchinson, C., Khadka, J., Milte, R., & Ratcliffe, J. (2021). What defines quality of care for older people in aged care? A comprehensive literature review. Geriatrics & Gerontology International, 21(9), 765–778. https://doi.org/10.1111/ggi.14231
Cooper, K. L., Chang, E., Luck, L., & Dixon, K. (2020). How nurses understand spirituality and spiritual care: A critical synthesis. Journal of Holistic Nursing, 38(1), 114–121. https://doi.org/10.1177/0898010119882153
Cosentino, C., Harrad, R. A., Sulla, F., Bertuol, M., Sarli, L., & Artioli, G. (2020). Nursing spiritual assessment instruments in adult patients: A narrative literature review. Acta Bio-Medica : Atenei Parmensis, 91(12-S), e2020015. https://doi.org/10.23750/abm.v91i12-s.10998
Ebrahimi, Z., Patel, H., Wijk, H., Ekman, I., & Olaya-Contreras, P. (2021). A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings. Geriatric Nursing, 42(1), 213–224. https://doi.org/10.1016/j.gerinurse.2020.08.004
Fallahi Khoshknab, M., Mazaheri, M., Maddah, S. S., & Rahgozar, M. (2010). Validation and reliability test of Persian version of the spirituality and spiritual care rating scale (SSCRS). Journal of Clinical Nursing, 19(19–20), 2939–2941. https://doi.org/10.1111/j.1365-2702.2010.03411.x
Garssen, B., Ebenau, A. F., Visser, A., Uwland, N., & Groot, M. (2016). A critical analysis of scales to measure the attitude of nurses toward spiritual care and the frequency of spiritual nursing care activities. Nursing Inquiry, 24(3), e12178. https://doi.org/10.1111/nin.12178
Gautam, S., Neville, S., & Montayre, J. (2019). What is known about the spirituality in older adults living in residential care facilities? An integrative review. International Journal of Older People Nursing. https://doi.org/10.1111/opn.12228
Gilbert, A. S., Garratt, S. M., Kosowicz, L., Ostaszkiewicz, J., & Dow, B. (2021). Aged care residents’ perspectives on quality of care in care homes: A systematic review of qualitative evidence. Research on Aging, 43(7–8), 294–310. https://doi.org/10.1177/0164027521989074
Green, A., Kim-Godwin, Y. S., & Jones, C. W. (2020). Perceptions of spiritual care education, competence, and barriers in providing spiritual care among registered nurses. Journal of Holistic Nursing, 38(1), 41–51. https://doi.org/10.1177/0898010119885266
Gurung, G., Jaye, C., Gauld, R., & Stokes, T. (2022). Lessons learnt from the implementation of new models of care delivery through alliance governance in the southern health region of New Zealand: A qualitative study. British Medical Journal Open, 12(10), e065635. https://doi.org/10.1136/bmjopen-2022-065635
Harrad, R., Cosentino, C., Keasley, R., & Sulla, F. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta Bio-Medica : Atenei Parmensis, 90(4S), 44–55. https://doi.org/10.23750/abm.v90i4-S.8300
Hawthorne, D. M., & Gordon, S. C. (2020). The invisibility of spiritual nursing care in clinical practice. Journal of Holistic Nursing, 38(1), 147–155. https://doi.org/10.1177/0898010119889704
Herlianita, R., Yen, M., Chen, C., Fetzer, S. J., & Lin, E. C. (2017). Perception of spirituality and spiritual care among Muslim nurses in Indonesia. Journal of Religion and Health, 57(2), 762–773. https://doi.org/10.1007/s10943-017-0437-6
Kaddourah, B., Abu-Shaheen, A., & Al-Tannir, M. (2018). Nurses’ perceptions of spirituality and spiritual care at five tertiary care hospitals in Riyadh, Saudi Arabia: A cross-sectional study. Oman Medical Journal, 33(2), 154–158. https://doi.org/10.5001/omj.2018.28
Kalkim, A., Sagkal Midilli, T., & Daghan, S. (2018). Nursing students’ perceptions of spirituality and spiritual care and their spiritual care competencies. Journal of Hospice & Palliative Nursing, 20(3), 286–295. https://doi.org/10.1097/njh.0000000000000446
Kalánková, D., Stolt, M., Scott, P. A., Papastavrou, E., & Suhonen, R. (2020). Unmet care needs of older people: A scoping review. Nursing Ethics, 28(2), 149–178. https://doi.org/10.1177/0969733020948112
Karaman, A., & Sagkal Midilli, T. (2021). The relationship between nurses’ perceptions and competency about spiritual care and influencing factors. Perspectives in Psychiatric Care, 58(3), 1021–1028. https://doi.org/10.1111/ppc.12894
Kincheloe, D. D., Stallings Welden, L. M., & White, A. (2018). A spiritual care toolkit: An evidence-based solution to meet spiritual needs. Journal of Clinical Nursing, 27(7–8), 1612–1620. https://doi.org/10.1111/jocn.14265
Koenig, H. G., & Al Zaben, F. (2021). Psychometric validation and translation of religious and spiritual measures. Journal of Religion and Health, 60(5), 3467–3483. https://doi.org/10.1007/s10943-021-01373-9
Kuepfer, J., Schmidt, A., O’Connor, T. S., & James, M. (2022). Spiritual care in Ontario long-term care: Current staffing realities and recommendations. Journal of Pastoral Care & Counseling: Advancing Theory and Professional Practice through Scholarly and Reflective Publications, 76(1), 29–36. https://doi.org/10.1177/15423050211073571
Ludlow, K., Churruca, K., Mumford, V., Ellis, L. A., & Braithwaite, J. (2021). Aged care residents’ prioritization of care: A mixed-methods study. Health Expectations, 24(2), 525–536. https://doi.org/10.1111/hex.13195
Lukovsky, J., McGrath, E., Sun, C., Frankl, D., & Beauchesne, M. A. (2021). A survey of hospice and palliative care nurses’ and holistic nurses’ perceptions of spirituality and spiritual care. Journal of Hospice & Palliative Nursing, 23(1), 28–37. https://doi.org/10.1097/njh.0000000000000711
Martins, A., Pinto, S., Caldeira, S., & Pimentel, F. (2015). Translation and adaptation of the spirituality and spiritual care rating scale in Portuguese palliative care nurses. Revista de Enfermagem Referência, IV Série(Nº 4), 89–97. https://doi.org/10.12707/riii13129
McSherry, W., Draper, P., & Kendrick, D. (2002). The construct validity of a rating scale designed to assess spirituality and spiritual care. International Journal of Nursing Studies, 39(7), 723–734. https://doi.org/10.1016/s0020-7489(02)00014-7
McSherry, W., & Jamieson, S. (2011). An online survey of nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(11–12), 1757–1767. https://doi.org/10.1111/j.1365-2702.2010.03547.x
Centers for Medicare & Medicaid Services CMS. (2021). MDS 3.0 frequency report. https://data.cms.gov/quality-of-care/minimum-data-set-frequency/data/q4-2021
Monod, S., Brennan, M., Rochat, E., Martin, E., Rochat, S., & Büla, C. J. (2011). Instruments measuring spirituality in clinical research: A systematic review. Journal of General Internal Medicine, 26(11), 1345–1357. https://doi.org/10.1007/s11606-011-1769-7
Montanič Starc, T., Karnjuš, I., & Babnik, K. (2019). Attitudes towards spirituality and spiritual care among nursing employees in hospitals. Obzornik Zdravstvene Nege, 53(1), 31–48. https://doi.org/10.14528/snr.2019.53.1.313
Mthembu, T. G., Roman, N. V., & Wegner, L. (2016). An exploratory factor analysis into the applicability of the spirituality care-giving scale, the spirituality and spiritual care rating scale and the spirituality in occupational therapy scale to the South African context. South African Journal of Occupational Therapy. https://doi.org/10.17159/2310-3833/2016/v46n1a14
National Academies of Sciences, Engineering, and Medicine. (2021). The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff. The National Academies Press. https://doi.org/10.17226/26526
Ozbasaran, F., Ergul, S., Temel, A. B., Gurol Aslan, G., & Coban, A. (2011). Turkish nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(21–22), 3102–3110. https://doi.org/10.1111/j.1365-2702.2011.03778.x
Pais, N. D., Suresh, S., & DCunha, S. (2022). Spirituality and spiritual care in nursing: Validity of the spirituality and spiritual care rating scale in an Indian context. Journal of Religion and Health, 62(3), 2131–2143. https://doi.org/10.1007/s10943-022-01634-1
Panczyk, M., Iwanow, L., Dobrowolska, B., Borowiak, E., Dyk, D., Grochans, E., Kozieł, D., Kózka, M., Kulik, H., Lewko, J., McSherry, W., Gotlib, J., & Jaworski, M. (2022). Validation study of the revised spirituality and spiritual care rating scale (SSCRS): A cross-sectional survey in Poland. Journal of Multidisciplinary Healthcare. https://doi.org/10.20944/preprints202202.0030.v1
Parozzi, M., Terzoni, S., Ferrara, P., Miseroni, F., D’Antuono, A., Di Prisco, L., McSherry, W., & Destrebecq, A. (2022). Validation of the Italian version of the spirituality and spiritual care rating scale (SSCRS-ita). International Journal of Nursing Knowledge, 34(2), 126–132. https://doi.org/10.1111/2047-3095.12385
Reich, A. J., Claunch, K. D., Verdeja, M. A., Dungan, M. T., Anderson, S., Clayton, C. K., Goates, M. C., & Thacker, E. L. (2020). What does “Successful aging” mean to you? — Systematic review and cross-cultural comparison of lay perspectives of older adults in 13 countries, 2010–2020. Journal of Cross-Cultural Gerontology, 35(4), 455–478. https://doi.org/10.1007/s10823-020-09416-6
Rykkje, L., Søvik, M. B., Ross, L., McSherry, W., Cone, P., & Giske, T. (2021). Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review. Journal of Clinical Nursing, 31(11–12), 1440–1464. https://doi.org/10.1111/jocn.16067
Schweighart, R., O’Sullivan, J. L., Klemmt, M., Teti, A., & Neuderth, S. (2022). Wishes and needs of nursing home residents: A scoping review. Healthcare, 10(5), 854. https://doi.org/10.3390/healthcare10050854
Sengupta, M., Penn Lendon, J., Caffrey, C., Melekin, A., & Singh, P. (2022). Post-acute and long-term care providers and services users in the United States, 2017–2018. Vital & Health Statistics., 3, 1–93. https://doi.org/10.15620/cdc:115346
Shah, S., Frey, R., Shipman, K., Gardiner, F., & Milne, H. (2018). A survey to explore health care staff perceptions of spirituality and spiritual care working in a single district health area in New Zealand. European Journal of Integrative Medicine, 22, 1–9. https://doi.org/10.1016/j.eujim.2018.07.006
Sun, C., Ding, Y., Cui, Y., Zhu, S., Li, X., Chen, S., Zhou, R., & Yu, Y. (2021). The adaptation of older adults’ transition to residential care facilities and cultural factors: A meta-synthesis. BMC Geriatrics. https://doi.org/10.1186/s12877-020-01987-w
Taylor, E. J., Gober-Park, C., Schoonover-Shoffner, K., Mamier, I., Somaiya, C. K., & Bahjri, K. (2019). Spiritual care at the bedside. Journal of Christian Nursing, 36(4), 238–243. https://doi.org/10.1097/cnj.0000000000000570
Taylor, E. J., & Trippon, M. (2020). What chaplains wish nurses knew. Holistic Nursing Practice, 34(5), 266–273. https://doi.org/10.1097/hnp.0000000000000401
Van Leeuwen, R., & Schep-Akkerman, A. (2015). Nurses’ perceptions of spirituality and spiritual care in different health care settings in The Netherlands. Religions, 6(4), 1346–1357. https://doi.org/10.3390/rel6041346
White, K. B., Barnes, M. J., Cadge, W., & Fitchett, G. (2020). Mapping the healthcare chaplaincy workforce: A baseline description. Journal of Health Care Chaplaincy, 27(4), 238–258. https://doi.org/10.1080/08854726.2020.1723192
Wu, L., & Lin, L. (2011). Exploration of clinical nurses’ perceptions of spirituality and spiritual care. Journal of Nursing Research, 19(4), 250–256. https://doi.org/10.1097/jnr.0b013e318236cf78
Yildirim, J. G., & Ertem, M. (2021). Professional quality of life and perceptions of spirituality and spiritual care among nurses: Relationship and affecting factors. Perspectives in Psychiatric Care, 58(2), 438–447. https://doi.org/10.1111/ppc.12794
Acknowledgements
This research is a result of participation in the Clinical Scholars Program offered to clinicians through Maine Medical Center, Portland, Maine. The authors thank the nursing home administrators and staff for assistance with data collection and on-going care for residents throughout the COVID19 pandemic. The authors thank AbouEl-Makarim Aboueissa, PhD, Professor of Mathematics and Statistics at the University of Southern Maine for his assistance with statistical analysis. Professor Wilfred McSherry for granting permission to use the SSCRS for our research.
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McEvoy, S., Hyrkäs, E.K. Confirmatory Factor Analysis of the Spirituality and Spiritual Care Rating Scale: A Cross-Sectional Study in Eight US Nursing Homes. J Relig Health 63, 1677–1697 (2024). https://doi.org/10.1007/s10943-023-01925-1
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DOI: https://doi.org/10.1007/s10943-023-01925-1