Spiritual Constructs Research Articles

Spiritual Assessment in Clinical Setting: The Need for Future Research

Dr. Garssen et al. are correct in their assertion that there is a risk of confounding the constructs of spiritual well-being and psychological well-being. Such criticism was previously made for spirituality constructs,1 and could also have been mentioned in our paper. However, the purpose of our review was to systematically identify instruments that have been previously used in clinical research to measure spirituality and to classify them in categories that could be easily understandable for researchers and clinicians interested in choosing an instrument. Our purpose was not to critically review the spirituality constructs that formed the basis for these instruments, nor was it to endorse one measure over another. Nevertheless, we agree that future work should address this confound between spiritual well-being and mental health outcomes. This should be done not only from a “well-being” perspective but also from a “distress” perspective. In particular, distinction between spiritual distress and depression should be further discussed.2 We also understand Dr. Garssen et al.’s comments about the number of religious items in these instruments with regard to their suitability for individuals who may be spiritual but not religious in a traditional sense. However, they are not clear as to what this threshold for religious items should be. This begs the question of how many religious items are too many to use in spiritual assessments. The overlap between spirituality and religion has received considerable attention in the literature, and there has been no clear consensus from either a conceptual or measurement perspective as to how to address this issue. In our review, we did exclude instruments that focused exclusively on religion/religiousness, but decided to include others even though they had high proportions of religious items. As noted by Pargament,3 for many individuals, spirituality is expressed in the context of religion. Thus, the inclusion items referencing religiousness in assessments of spirituality is certainly warranted for some individuals. For others, who consider themselves spiritual but not religious, those same assessments may not be appropriate. It is up to the clinician or the researcher to decide which measure would be the most appropriate in any given circumstance. In conclusion, we would like to thank again Dr. Garssen et al. for their emphasis about the need for future research in the field of spiritual assessment in clinical settings.

The broad reach of the wellbeing debate: Emotional wellbeing and vision loss

What is meant by the term ‘wellbeing’? Much has been written on the relationship between chronic illness and mental health outcomes, particularly in terms of ‘happiness’, and the reciprocal relationship between physical and emotional health. Visual impairment research into wellbeing has tended to focus specifically on the concept of e motional wellbeing, and how functional disability may impact negatively on mental health. As a consequence of such research, there is an increasing awareness of the importance of ‘preventing’ negative mental health outcomes in the visually impaired population and ‘promoting’ emotional wellbeing. However, despite the many wellbeing interventions and initiatives, the actual meaning of the term remains rather nebulous. Depending on one’s standpoint, ‘wellbeing’ may translate as a physical, social, emotional or even spiritual construct and follow different models which all have their own agendas, aims, methodologies and discourse. Furthermore, a shift is evident towards a two-dimensional framework of wellbeing which considers not just what makes chronically ill individuals happy in terms of goals and aspirations, but what makes them ‘flourish’ and find meaning in life. It is specifically this second dimension of wellbeing which remains to be investigated in visual impairment research. The purpose of this article is therefore to present the theoretical underpinnings of the wellbeing agenda, the methodological implications, and the impact on future research into wellbeing and visual impairment.

Twenty-five years later—what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review

A diagnosis of cancer is a life-changing event for most people. The trauma and uncertainties of a breast cancer diagnosis can affect survivors' psychological well-being. Religion and/or spirituality can provide a means of support for many women as they live with the realities of a diagnosis of cancer. The purpose of this focused review is to critically analyze and synthesize relationships among psychological well-being, religion, and spirituality among women with breast cancer. MEDLINE, CINAHL, Web of Science, Cambridge Scientific Abstracts, Cochrane CENTRAL, and PsycINFO databases were searched: January 1985-March 2010. The search terms religi*(religious/religion), spiritu*(spiritual/spirituality), breast cancer, psychological adjustment, psychological outcomes, psychological distress, psychological well-being, and outcomes were searched for separately and in combination. Eighteen quantitative studies were analyzed in order to examine associations among religion, spirituality, and psychological well-being for women diagnosed with breast cancer. These three variables were operationally defined as follows: (a) religious practice, religious coping, and perception of God; (b) spiritual distress, spiritual reframing, spiritual well-being, and spiritual integration; and (c) combined measure of both the religion and spirituality constructs. Results of this review suggest that within this population, limited relationships exist among religion, spirituality, and psychological well-being. Given the various definitions used for the three variables, the strength and clarity of relationships are not clear. In addition, the time of assessment along the course of the disease varies greatly and in some instances is not reported. Diagnosis and/or prognosis, factors that could influence psychological well-being, are frequently not factored into results. There does, however, appear to be sufficient evidence to include a brief, clinically focused assessment of women diagnosed with breast cancer regarding the importance of a given belief system as they face the diagnosis and treatment of their disease. The implications for cancer survivors are as follows: (a) Psychological well-being of women diagnosed with breast cancer may depend to some extent on their belief system. (b) Coping through "turning to God" for women without a significant prior relationship with God, or minimal spiritual behaviors, may experience diminished well-being. (c) Longitudinal studies suggest that struggling with, or questioning, one's belief system in early survivorship may also be associated with lower levels of well-being. This diminished well-being often resolves over time.

Relationship of adherence determinants and parental spirituality in Cystic Fibrosis

The course of cystic fibrosis (CF) progression in children is affected by parent adherence to treatment plans. The Theory of Reasoned Action (TRA) posits that intentions are the best behavioral predictors and that intentions reasonably follow from beliefs ("determinants"). Determinants are affected by multiple "background factors," including spirituality. This study's purpose was to understand whether two parental adherence determinants (attitude towards treatment and self-efficacy) were associated with spirituality (religious coping and sanctification of the body). We hypothesized that parents' attitudes toward treatment adherence are associated with these spiritual constructs. A convenience sample of parents of children with CF aged 3-12 years (n = 28) participated by completing surveys of adherence and spirituality during a regular outpatient clinic visit. Type and degree of religious coping was examined using principal component analysis. Adherence measures were compared based on religious coping styles and sanctification of the body using unpaired t-tests. Collaborative religious coping was associated with higher self-efficacy for completing airway clearance (M = 1070.8; SD = 35.8; P = 0.012), for completing aerosolized medication administration (M = 1077.1; SD = 37.4; P = 0.018), and for attitude towards treatment utility (M = 38.8; SD = 2.36; P = 0.038). Parents who attributed sacred qualities to their child's body (e.g., "blessed" or "miraculous") had higher mean scores for self-efficacy (airway clearance, M = 1058.6; SD = 37.7; P = 0.023; aerosols M = 1070.8; SD = 41.6; P = 0.020). Parents for whom God was manifested in their child's body (e.g., "My child's body is created in God's image") had higher mean scores for self-efficacy for airway clearance (M = 1056.4; SD = 59.0; P = 0.039), aerosolized medications (M = 1068.8; SD = 42.6; P = 0.033) and treatment utility (M = 38.8; SD = 2.4; P = 0.025). Spiritual constructs show promising significance and are currently undervalued in chronic disease management.

Convergent/Divergent Validity of the Brief Multidimensional Measure of Religiousness/Spirituality: Empirical Support for Emotional Connectedness as a “Spiritual” Construct

The objective of this article is to determine the convergent/divergent validity of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS; Fetzer Institute & National Institute on Aging Working Group 1999) subscales by correlating it with the Temperament and Character Inventory (TCI) Self-Transcendence subscales (i.e., Mysticism, Transpersonal Identification, Self-Forgetfulness; Cloninger et al. 1994). The cross-sectional analysis of 97 undergraduate/graduate students from a Midwestern university was made. The results are (1) all five BMMRS spirituality subscales were significantly correlated with the TCI Mysticism scale; (2) two BMMRS scales (i.e., Daily Spiritual Experiences, Values/Beliefs) were significantly correlated with the TCI Transpersonal Identification scales; (3) no BMMRS spiritual subscales were significantly correlated with the TCI Self-Forgetfulness scale; and (4) of the BMMRS religion scales, only the Organizational Religiousness subscale was correlated with any TCI subscale (i.e., Mysticism). The BMMRS appears to have adequate convergent/divergent validity, although the need exists to determine specific dimensions of spirituality. Inspection of the specific items of the BMMRS and TCI spiritual subscales that were most consistently correlated (i.e., BMMRS Daily Spiritual Experiences, Values/Beliefs; TCI Mysticism, Transpersonal Identification) suggests the existence of a distinct spiritual construct that is best conceptualized as the experience of emotional connectedness to the divine, nature, and/or others.

The Multiple Determinants of Religious Behaviors and Spiritual Beliefs on Well-Being

The potential relationships among religious behaviors, spiritual beliefs, and well-being were investigated. Specifically, a canonical correlation analysis was used to explore the extent to which a set of religious and spiritual variables correlated with a set of well-being variables of general happiness, marital satisfaction, and physical health. The results demonstrated that the first two canonical dimensions Rc(1) = .166 and Rc(2) = .138, respectively, yielded noteworthy canonical correlations. The findings suggested important similarities and differences among various religious, spirituality, and well-being constructs that clearly warranted implications for counselors and other human service providers.

Singapore nursing students' perceptions about spirituality and spiritual care: a qualitative study

BackgroundSpiritual care is a central element of holistic and multidisciplinary care, but is not often integrated into practice. Some nurses may confuse spirituality with religion and refer this aspect of...

Voices From the Inside: African American Women’s Perspectives on Healthy Lifestyles

The author of this study conducted focus groups with African American women to explore their perspectives on obesity, disease causation, and their ideas on the functionality of cultural, social, historical, environmental, and psychological forces in altering healthy eating habits. Reoccurring themes centered on four areas: (a) the definition of health as a mind, body, and spiritual construct; (b) conceptualizations of cultural norms regarding healthy foods versus unhealthy foods; (c) the importance of eating and social rituals on food choices; and (d) the impact of the environment in sustaining healthy initiatives. Structural constraints that uphold legacies of disenfranchisement, environmental injustice, and segregation influence the food choices available in low-wealth communities. These factors continue to operate and are vital issues to consider when designing culturally relevant wellness programs.

Spirituality in the Workplace: Theory and Measurement

To integrate existing literature on spirituality in different disciplines and move it forward, the authors propose a new theoretical conceptualization of spirituality, based on which they develop a new scale of spirituality. Using structural equation modeling, the authors conduct confirmatory factor analysis on survey data collected from 2,230 individuals to test and cross-validate the spirituality scale. The authors find the construct of spirituality is best captured by three correlated, yet distinct, factors: interconnection with a higher power, interconnection with human beings, and interconnection with nature and all living things. Results show that the spirituality scale demonstrates content validity, face validity, discriminant validity, convergent validity, and structural reliability. In addition, the authors theoretically argue and empirically validate that the notion of spirituality incorporates and transcends religiousness.

Existential and religious dimensions of spirituality and their relationship with health-related quality of life in chronic kidney disease.

Spiritual aspects of health-related quality of life (HRQoL) in patients with chronic kidney disease (CKD) have not been fully assessed. This study described the religious and existential dimensions of spirituality of patients with CKD, provided evidence to support construct validity of the ESRD Spiritual Beliefs Scale, and examined the relationship between constructs of spirituality and HRQoL. This was a prospective, cohort study of 253 predominantly white (81.5%) prevalent patients with stage 4 or 5 CKD or receiving long-term dialysis. Participants completed the Kidney Dialysis Quality of Life Short Form, the ESRD Spiritual Beliefs Scale, the Spiritual Perspective Scale, and the Spiritual Well-Being Scale. Three subscales of ESRD Spiritual Beliefs Scale were highly correlated with other measures of religiosity and weakly correlated with existential well-being. Mean of three subscales of ESRD Spiritual Beliefs Scale and overall Spiritual Perspective Scale scores were 8.8 to 9.9 and 3.3, respectively. Mean ± SD existential and religious scores of the Spiritual Well-Being Scale were 42.9 ± 8.8 and 38.8 ± 11.4, respectively. Negligible correlations existed between religious scores and HRQoL. Conversely, existential well-being was moderately associated with several domains of HRQoL. Our study supports construct validity of the ESRD Spiritual Beliefs Scale as a measure of religiosity. It did not seem to capture the existential dimension of spirituality. The existential domain of spirituality was more clinically relevant to patients in this study and had a greater impact on HRQoL compared with measures of religiosity.

The Relationship Between Optimism and Quality of Life in Newly Diagnosed Cancer Patients

Understanding the relationships between social and psychological determinants of health-related quality of life (HRQOL) is a critical step in developing effective screening tools and targeted interventions for psychosocial care. The purpose of this study was to examine the relationship between dispositional optimism and HRQOL in newly diagnosed adult cancer patients. A cross-sectional, predictive correlational design was used. The sample consisted of 163 patients with mixed diagnoses and stages who were within 180 days since diagnosis and had completed a battery of psychosocial measures upon enrollment into a psychosocial data registry during their first outpatient visit or treatment. Hierarchical multiple regression analyses were conducted to determine predictors of HRQOL. Optimism was significantly correlated with spiritual well-being, anxiety, depression, and HRQOL. Optimism was not a significant predictor of HRQOL at initial diagnosis and treatment when age, scores on functional status, spiritual well-being, depression, and anxiety were entered into the regression equation. Dispositional optimism is not a primary factor in HRQOL at initial diagnosis and treatment. Further exploration is needed to determine if optimism exerts a greater influence on HRQOL at another point along the cancer trajectory and if there is overlap between the constructs of optimism and spirituality. Although systematic screening for dispositional optimism is not recommended, patients who display characteristics associated with low optimism require further assessment. Also, patients with poor functional status, young age, low levels of spirituality, and high levels of depression may be vulnerable for poor HRQOL.

A Comparison of Two Spirituality Instruments and Their Relationship With Depression and Quality of Life in Chronic Heart Failure

Spirituality is a multifaceted construct related to health outcomes that remains ill defined and difficult to measure. Spirituality in patients with advanced chronic illnesses, such as chronic heart failure, has received limited attention. We compared two widely used spirituality instruments, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) and the Ironson-Woods Spirituality/Religiousness Index (IW), to better understand what they measure in 60 outpatients with chronic heart failure. We examined how these instruments related to each other and to measures of depression and quality of life using correlations and principal component analyses. The FACIT-Sp measured aspects of spirituality related to feelings of peace and coping, whereas the IW measured beliefs, coping, and relational aspects of spirituality. Only the FACIT-Sp Meaning/Peace subscale consistently correlated with depression (r=-0.50, P<0.0001) and quality of life (r=0.41, P=0.001). Three items from the depression measure loaded onto the same factor as the FACIT-Sp Meaning/Peace subscale (r=0.43, -0.43, and 0.71), whereas the remaining 12 items formed a separate factor (Cronbach's alpha=0.82) when combined with the spirituality instruments in a principal component analysis. The results demonstrate several clinically useful constructs of spirituality in patients with heart failure and suggest that psychological and spiritual well-being, despite some overlap, remain distinct phenomena.

Christian Spirituality and the Well-being Agenda.

This article discusses demonization and toxicity as illustrative of the life of young people in the UK. It offers definitions of well-being and the role of spirituality within this. We propose that unless the underlying well-being of young people is taken seriously, improved upon and re-imagined, then the challenges some young people encounter will develop into long-term problems well into adulthood. Furthermore, those young people who have relatively few challenges and problems will be at risk of being contaminated by the assault upon their well-being resulting in damage to them that will manifest itself in personal, communal and social problems. We argue that without the spiritual dimension, however, constructs, policy and approaches to well-being are lacking.

Spiritual behaviour in the workplace as a topic for research

Spirituality at work is a fascinating and complex variable. It is linked to findings for business management such that it makes organizations grow faster, increases efficiency, enhances organizational performance, improves communication and a greater sense of team and community, and is related positively to employee's attitudes towards their work. Consequently, more employers are encouraging the expression of spirituality in the workplace as a way to boost loyalty and increase morale. However, there is empirical evidence that runs contrary to the common assertion of employees that they desire or expect organizational and supervisory involvement in their spirituality in the workplace. With the aim of specifying the construct of spirituality at work, the article proposes a theoretical approach that assumes that spirituality in the workplace is not independent of environmental influence. It investigates the various processes and elements that interact at individual, organizational, and societal levels.

Resilience in re-entering missionaries: why do some do well?

Re-entry to their country of origin is a significant disruption for a number of sojourners including missionaries. Although missionary re-entry has been studied in depth for over 20 years, little is known about what makes a missionary resilient to the challenges experienced in the stressful re-entry environment. Research suggests there are psychological, social, spiritual, and biological constructs connected with resilience. The aim of this paper is to answer the question “Why do some re-entering missionaries do well while others do not?” Fifteen adult Australian Christian cross-cultural missionary workers from four interdenominational Australian evangelical mission organisations completed semi-structured interviews and a survey. Results were analysed in two stages using modified consensual qualitative research methods. Links were established between resilience on re-entry and flexibility, expectancy, self-determination, denial using minimisation, mental health, social support, reintegration and personal spiritual connection with God. Implications for missionary care are discussed with suggestions for further research.

The empirical and conceptual value of the spiritual transcendence and religious involvement scales for personality research.

Despite their wide usage, the constructs of spirituality and religiosity have no universally accepted definitions, and very little research has examined how these numinous constructs relate both to one another and to established personality dimensions. Two studies are presented that examined the factor structure of a motivationally based measure of spirituality, the Spiritual Transcendence Scale (STS) and a behaviorally based measure of religiosity, the Religious Involvement Scale (RIS). Three causal models examining their relationships to one another and to psychological measures of growth and maturity, as well as their incremental validity in predicting a wide array of psychosocial outcomes over the influence of the Five-Factor Model domains were examined. Employing self and observer ratings and American and Filipino samples, the results demonstrated that these robust, cross-culturally generalizable scales provided insights into people not contained by traditional personality variables. The conceptual implications of these results were discussed.

Concepts of Spirituality within Traditional Management and Organisation Discourse

Over the last decade or so, we have witnessed a growing interest in the role of spirituality within traditional management and organisation discourse and research – a move beyond focusing on rational and non-rational issues, including those of emotion and intuition, to something perhaps more encompassing and holistic, maybe best popularised initially by Zohar andMarshall’s monograph on Spiritual Intelligence (2000). Yet, the questioning of the legitimacy of the construct of spirituality and its appropriateness in organisation discourse continues. In light of this ongoing debate, we offer an evolutionary-frame perspective on the development of the construct of spirituality, to demonstrate that while the ideas of organisational spirituality became quite popular in the twenty first century, the origins of this construct are present in the longer evolution of organisation and management thought. The paper forms part of a broader study of spirituality within contemporary organisations, investigating the relationship between employees and organisations from a spiritual perspective. The question addressed here is how did interest about and an increased presence of spirituality in organisational life evolve, the answers to which should assist comprehension of the phenomenon and contextualise further research in the field. In answering within the scope of a paper, we have combined the work of Bolman and Deal (2008) who provide a frame (multi-perspective) model that summarises traditional management and organisation literature, and that of Wilber (1996, 2000), whose meta-framework offers an integrated, non-dual perspective on reality, where external and internal, collective and individual are part and parcel of each other. We focus on how organisational thought developing within broader societal development, scientific discoveries, and achievements in philosophy, spurred the evolution of the concept of spirituality as connected and opposed to religion. This crucial dimension in answering our question is explored by outlining the main trends in conceptualising spirituality and religion, and making our case for defining both in the context of organisation discourse.

Нарративный аспект влияния евангельской керигмы о Христе на происхождение и развитие библейской психологии

The author considers the in黿uence of evangelistic sermon on Christ on origin and development of biblical psychology. The narrative aspect of phenomenon was discovered and it facilitates the appeal towards spiritual constructs of Christ personality and compare them with periods existing in the history of psychology

Client Spirituality and Substance Abuse Treatment Outcomes

A sample of 301 outpatient clients from a large substance abuse treatment facility was surveyed on spirituality and treatment outcome constructs utilizing a pretest/posttest design. Clients were surveyed prior to participating in outpatient treatment and then approximately seven months after discharge from treatment. Spirituality was measured multidimensionally to determine any contribution to treatment outcomes, including health, mental health, and substance use outcomes. Analyses were conducted to determine if spirituality changed over the study period and whether spirituality was affected by client characteristics at the beginning of treatment or impacted outcomes after treatment. Results indicated that many spiritual dimensions were important in treatment outcomes and that treatment history had some effect for posttest substance use. In general, the relationship was stronger for the spiritual dimensions than the religious dimensions.

Spirituality and Depressive Symptoms in a School-Based Sample of Adolescents: A Longitudinal Examination of Mediated and Moderated Effects

Purpose To prospectively examine whether personal agency beliefs and direct coping mediate the association between spirituality and depressive symptoms in a school-based sample of adolescents, and whether gender, race, or grade level moderate this model. Method Students ( N = 1096) from sixth through ninth grades in a northeastern public school system were administered self-report instruments in group format at baseline, 6-month follow-up, and 1-year follow-up. Demographic variables and constructs of spirituality, personal agency, direct coping, and depressive symptoms were assessed. Results Structural equation modeling was used to examine the longitudinal associations among the constructs while controlling for socioeconomic status and baseline depressive symptoms. For the total sample, the model predicted 21% of the variance in depressive symptoms over 1 year. The model was moderated by gender but not by race or grade level. The model explained 28% of the variance in depressive symptoms for girls and 16% of the variance in depressive symptoms for boys. Moreover, there was an indirect effect of spirituality on depressive symptoms for girls but not for boys. Conclusion These results suggest mechanisms by which spirituality may maintain lower levels of depressive symptoms among adolescent girls during periods of transition to middle and high school.