Pilot Study for the Development of a Questionnaire for the Measuring
of the Patientsʼ Attitude towards Spirituality and Religiosity and Their
Disease Coping (SpREUK)
Objective: Life-threatening diseases are the standard situations which
confront patients with spirituality and religiosity. Although both are wellknown
factors in disease coping, their measurability and operationability
remains a basic problem due to the variety of different meanings and
interpretations of these terms. In this paper we describe the development
of a questionnaire for the measuring of the patientsʼ attitudes towards
spirituality and religiosity and their disease coping (SpREUK).
Material and Methods: For a first evaluation, 129 patients with a mean
age of 54 years (SD 14.3) completed the questionnaire. 67% of them
were women. 76% had a Christian denomination, 19% no denomination,
and only 4% reported other religious traditions. 45% of the patients
suffered from cancer, 18% from multiple sclerosis, 22% from other
chronic diseases, and 15% from acute diseases. The questionnaire comprises
29 five-stage likert-scaled items. Apart from a descriptive analysis
of the single items, reliability (Cronbachʼs alpha) and validity analysis
(factor analysis) of the questionnaire was performed. Results: Factor
analysis resulted in four dimensions: (1) ʼSearch for meaningful supportʼ,
(2) ʼGuidance, control and message of diseaseʼ, (A) ʼSupport in relations
with the external through spirituality/religiosityʼ, and (B) ʼStabilization
of the inner condition through spirituality/religiosityʼ. The reliability
of the four scales of the SpREUK questionnaire is high: Cronbach’s
alpha 0.82, 0.62, 0.89, resp. 0.74. Women had significantly higher
SpREUK scores for scales 1 and 2 than male patients. Non-denominational
patients had significantly lower scores in all four scales than those
with a Christian denomination. The scores did not correlate with disease
or duration of disease; however, there might be a positive correlation
between age and the score of scale 2. Discussion: The impact of
spirituality and religiosity on the course of disease, coping skills, and
health-related quality of life is broadly discussed not only in complementary
medicine. With the SpREUK questionnaire we present a reliable
and valid instrument to measure the patientsʼ search for meaningful
support through spirituality/religiosity in terms of disease coping and
health restoration. Further evaluation of this instrument is planned with
a focus on hospitals which are affiliated with a specific denomination, as
a reasonable extension of quality management and concept development.