Abstract
Purpose: This study aimed to develop a Spiritual Health Scale designed for elderly residents in LTC facilities and to establish the reliability and validity of the instrument.
Methods: This study adopted a scale development approach. Based on the Elderly Spiritual Health Scale by Li and Shih (2021), the researchers integrated additional components derived from the conceptual framework to create a revised scale consisting of 16 items distributed across four dimensions—personal, community, environmental, and transcendental—with four items per dimension. A dichotomous scoring system was employed with responses coded as 1 (presence) or 0 (absence) of a spiritual issue scores ranged from 0 to 16, with higher scores indicating better spiritual health. The content validity index (CVI), evaluated by three experts, reached a value of .84. Following Institutional Review Board (IRB) approval, participants were recruited from several southern Taiwan LTC institutions and data were collected from January to June, 2025.
Results: A total of 166 elderly residents consented to participate and analyzed. The internal consistency of the scale by Cronbach’s α, was .82, indicating good reliability. For discriminative validity, participants were categorized into three groups based on their total scores: low (0–5), medium (6–11), high (12–16) and significant differences were observed among the groups, demonstrating that the scale possesses adequate discriminative power. Construct validity was examined through exploratory factor analysis, which identified four factors collectively explained 54.9% of the total variance, indicating satisfactory construct validity. In terms of concurrent validity, the spiritual health scores were found to be negatively correlated with participants’ number of chronic illnesses, levels of emotional distress, and depression scores. Conversely, participants with better-maintained Activities of Daily Living (ADL) showed a positive correlation with spiritual health scores, supporting the scale’s concurrent validity.
Conclusion: The Spiritual Health Scale for Elderly Residents in LTC Facilities demonstrated satisfactory reliability and validity that can be used to assess the level of spiritual health among elderly individuals in institutional settings. Early detection of spiritual issues can inform the provision of individualized spiritual support interventions, potentially alleviating emotional distress and reducing the risk of depression in this population.
Notes
References: 1. Ahmad, N., Sinaii, N., Panahi, S., Bagereka, P., Serna-Tamayo, C., Shnayder, S., Ameli, R., & Berger, A. (2022). The FACIT-Sp spiritual wellbeing scale: a factor analysis in patients with severe and/or life-limiting medical illnesses. Ann Palliat Med, 11(12), 3663-3673.
2. Brañez-Condorena, A., Soriano-Moreno, D. R., Navarro-Flores, A., Solis-Chimoy, B., Diaz-Barrera, M. E., & Taype-Rondan, A. (2021). Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis. Public Library of Science ONE, 16(7), e0253899.
3.Coelho-Júnior, H. J., Calvani, R., Panza, F., Allegri, R. F., Picca, A., Marzetti, E., & Alves, V. P. (2022). Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Frontiers in Medicine, 9, 877213.
4. Li, Meng-Fen & Shih, Yang (2021). Development and Validation of the "Spiritual Health Scale for the Elderly. Journal of Educational Measurement, 68(3), 233–261.
5. Li, Meng-Fen & Shih, Yang (2022). A Study on the Influence of Social Support on the Spiritual Health of the Elderly: Verification of Mediating Effects. Bulletin of Educational Psychology, 54(1), 107–130.
6.Nooripour, R., Ghanbari, N., Hosseinian, S., Ronzani, T. M., Hussain, A. J., Ilanloo, H., Majd, M. A., Soleimani, E., Saffarieh, M., & Yaghoob, V. (2023). Validation of the Spiritual Well-being Scale (SWBS) and its role in Predicting Hope among Iranian Elderly. Ageing International, 48(2), 593-611.
7.Reissmann, M., Storms, A., & Woopen, C. (2021). Individual values and spirituality and their meaning for affective well-being and engagement with life in very old age. Journal for Gerontology and Geriatrics, 54 (Suppl 2), 85–92.
8.Tsai, K., Chang, P. J., Mathew, A. J., Richard, C., Davidson, H. A., & Hersch,G. I. (2022). Exploring Spirituality of Elders Relocating into Long-Term Care Facilities. The Open Journal of Occupational Therapy, 10(2), 1-11.
9.Wortman, E. S., & Lewis, J. P. (2021). Gerotranscendence and Alaska Native Successful Aging in the Aleutian Pribilof Islands. Journal of Cross-Cultural Gerontology, 36(1), 43–67.
10.Yoshizawa, T., Makram, A. M., Elsheikh, R., Nakamura, S., Makram, E. M., Kubota, K., Huy, N. T., & Moji, K. (2024). Spirituality, Quality of Life, and Health: A Japanese Cross-Sectional Study. European Journal of Investigation in Health, Psychology and Education, 14(3), 767-781.
Sigma Membership
Lambda Beta at-Large
Lead Author Affiliation
Fooyin University, Daliao District, Kaohsiung City, Taiwan
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Instrument and Tool Development, Long-Term Care, Health of Older People, Elder Care, Long-Term Health Care, Spirituality
Recommended Citation
Lee, Kuan-Pei and Ku, Ya-Lie, "Reliability and Validity of a Spiritual Health Scale for Older Adults in Long-Term Care Facilities" (2026). International Nursing Research Congress (INRC). 11.
https://www.sigmarepository.org/inrc/2026/posters_2026/11
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-22
Reliability and Validity of a Spiritual Health Scale for Older Adults in Long-Term Care Facilities
Toronto, Ontario, Canada
Purpose: This study aimed to develop a Spiritual Health Scale designed for elderly residents in LTC facilities and to establish the reliability and validity of the instrument.
Methods: This study adopted a scale development approach. Based on the Elderly Spiritual Health Scale by Li and Shih (2021), the researchers integrated additional components derived from the conceptual framework to create a revised scale consisting of 16 items distributed across four dimensions—personal, community, environmental, and transcendental—with four items per dimension. A dichotomous scoring system was employed with responses coded as 1 (presence) or 0 (absence) of a spiritual issue scores ranged from 0 to 16, with higher scores indicating better spiritual health. The content validity index (CVI), evaluated by three experts, reached a value of .84. Following Institutional Review Board (IRB) approval, participants were recruited from several southern Taiwan LTC institutions and data were collected from January to June, 2025.
Results: A total of 166 elderly residents consented to participate and analyzed. The internal consistency of the scale by Cronbach’s α, was .82, indicating good reliability. For discriminative validity, participants were categorized into three groups based on their total scores: low (0–5), medium (6–11), high (12–16) and significant differences were observed among the groups, demonstrating that the scale possesses adequate discriminative power. Construct validity was examined through exploratory factor analysis, which identified four factors collectively explained 54.9% of the total variance, indicating satisfactory construct validity. In terms of concurrent validity, the spiritual health scores were found to be negatively correlated with participants’ number of chronic illnesses, levels of emotional distress, and depression scores. Conversely, participants with better-maintained Activities of Daily Living (ADL) showed a positive correlation with spiritual health scores, supporting the scale’s concurrent validity.
Conclusion: The Spiritual Health Scale for Elderly Residents in LTC Facilities demonstrated satisfactory reliability and validity that can be used to assess the level of spiritual health among elderly individuals in institutional settings. Early detection of spiritual issues can inform the provision of individualized spiritual support interventions, potentially alleviating emotional distress and reducing the risk of depression in this population.
Description
Focus: Patients
Status: Completed Work/Project
This study aimed to develop a Spiritual Health Scale specifically designed for 166 elderly residents in LTC facilities and establish the reliability and validity of the instrument. The Spiritual Health Scale for Elderly Residents in LTC Facilities demonstrated satisfactory reliability as well as construct, discriminative, and concurrent validity.