Psychometric testing of the Spiritual Well-Being Scale-Mandarin version in Taiwanese cancer patients

Objective: The spiritual well-being of terminally ill cancer patients is an important indicator of the quality of their lives and of the quality of hospice care, but no validated tools are available for assessing this indicator in Taiwan. Method: The present cross-sectional study validated the Spiritual Well-Being Scale-Mandarin version (SWBS-M) by testing its psychometric properties in 243 cancer patients from five teaching hospitals throughout Taiwan. Construct validity was tested by factor analysis and hypothesis testing. Patients' spiritual well-being and quality of life were assessed using the SWBS-M and the McGill Quality of Life Questionnaire (MQoL), respectively. Results: Overall, the SWBS-M had an internal consistency/reliability of 0.89. Exploratory factor analysis showed that the SWBS-M had an underlying two-factor structure, explaining 46.94% of the variance. SWBS-M scores correlated moderately with MQoL scores (r = 0.48, p < 0.01). Terminally ill cancer patients' spiritual well-being was inversely related to their average pain level during the previous 24 hours (r =-0.183, p = 0.006). Cancer patients' spiritual well-being also differed significantly with their experience of pain (t =-3.67, p < 0.001); terminally ill cancer patients with pain during the previous 24 hours had a lower sense of spiritual well-being than those without pain. Significance of results: Our findings support a two-factor model for the SWBS-M in terminally ill Taiwanese cancer patients. We recommend testing the psychometric properties of the SWBS-M in different patient populations to verify its factorial structure in other Asian countries.