Development and validation of a Religious and Spiritual Support Scale in Sri Lanka: A psychometric study

Introduction: Religious and spiritual support reduces distress in patients with cancer. Accurate and reliable data on religious and spiritual support received and perceived by patients with cancer would assist health authorities in planning health promotion strategies targeted at patients with cancer. In this study, a new measurement tool of religious and spiritual support for patients with cancer in Sri Lanka was developed and validated. Methods: A new tool, the Religious and Spiritual Support Scale (RSSS) was developed based on the previous questionnaire and evaluated using 40 patients with cancer. Cross-cultural adaptation was made using WHO guidelines. Reliability was checked using Cronbach’s alpha. Intra-class correlation coefficient (ICC) was used to examine the test-retest reliability of the tool. Convergent and divergent validity of the tool was examined using the World Health Organization-Quality of Life-Brief scale (WHOQOL-BREF) and the Centre for Epidemiological Studies–Depression scale (CES-D). Exploratory factor analysis (EFA) was performed to test the construct validity of the RSSS. Results: The RSSS showed a high internal consistency (Cronbach’s alpha-0.874). The test-retest reliability of the scale was good (ICC = 0.981). As expected, the overall RSSS score correlated negatively with CES-D (r= - 0.338, p<0.05) and positively with overall QoL scores of the WHOQOL-BREF; (r=0.421, p<0.001), confirming satisfactory divergent and convergent validity of the RSSS. EFA revealed a structure comprised of two factors: Religious practice and religious support. Conclusions: The RSSS is a reliable and valid scale to assess religious and spiritual support received and perceived by patients with cancer in Sri Lanka.