The factor structure of the Daily Spiritual Experiences Scale: Exploring the role of theistic and nontheistic approaches at the end of life.

Abstract

The Daily Spiritual Experiences Scale (DSES; Underwood & Teresi, 2002) has made a distinctive contribution to the measurement of spirituality. However, the factor structure of the DSES has not been analyzed thoroughly and the instrument has not been administered to persons at the end of life (EOL). Thus, this study examined the dimensionality of the DSES using both exploratory and confirmatory factor analysis and examined the unique impact of different types of spiritual experiences on several EOL outcomes. In 2 samples— one comprised of patients receiving hospice care (n 153) and a second of health care professionals working in EOL contexts (n 148)—DSES items consistently loaded according to theistic and nontheistic experiences of spirituality. In addition, when controlling for the effects of religious affiliation and intrinsic religiousness, hospice patients’ responses on the theistic and nontheistic factors were differentially predictive of their attitudes toward death and psychological well-being. While other results were not entirely dismissive of a 1-factor solution for the instrument, the combined evidence of this investigation indicates that a failure to appreciate the role of theism could lead clinicians and researchers to overlook centrally defining aspects of the spiritual experiences of many people at the EOL.