Measuring meaning and peace with the FACIT–Spiritual Well-Being Scale: Distinction without a difference?

Abstract

The Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale (FACIT–Sp; Peterman, Fitchett, Brady, Hernandez, & Cella, 2002) has become a widely used measure of spirituality; however, there remain questions about its specific factor structure and the validity of scores from its separate scales. Specifically, it remains unclear whether the Meaning and Peace scales denote distinct factors. The present study addresses previous limitations by examining the extent to which the Meaning and Peace scales relate differentially to a variety of physical and mental health variables across 4 sets of data from adults with a number of chronic health conditions. Although a model with separate but correlated factors fit the data better, discriminant validity analyses indicated limited differences in the pattern of associations each scale showed with a wide array of commonly used health and quality-of-life measures. In total, the results suggest that people may distinguish between the concepts of Meaning and Peace, but the observed relations with health outcomes are primarily due to variance shared between the 2 factors. Additional research is needed to better understand the separate and joint role of Meaning and Peace in the quality of life of people with chronic illness.

Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-expanded (FACIT-Sp-Ex) across English and Spanish-speaking Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

“…The changes in the SRMR (Δ = .001) and RMSEA (Δ = .002) fit indices between the three-factor and four-factor models were minor; however, the change in the CFI (Δ = .01) bordered on the recommended change of > .01 (Cheung & Rensvold, 2002), with the four-factor model having slightly better fit than the three-factor model. Because there has been empirical support in chronic illness samples for separating Meaning and Peace into two separate factors (see Bredle et al, 2011; Peterman et al, 2014), in addition to research in chronic illness samples showing that the Peace subscale tends to account for significantly more of the unique variance in HRQOL outcomes than the Meaning subscale (Peterman et al, 2014), we decided to retain the four-factor model. This allowed us to examine whether the pattern found in chronic illness samples was comparable in a population-based sample.…”

“…Of note is that there may not have been a meaningful difference between the three-factor and four-factor models, although the change in the CFI fit index bordered on significant based on recommendations found in the literature, with the four-factor model having better fit than the three-factor model. In a study of four adult samples with various chronic health conditions, Peterman et al, (2014) found that although Meaning and Peace were empirically distinct factors, it was unclear whether Meaning and Peace were functionally different in their relationship to health outcomes. Future studies are needed in order to clarify this distinction in non-illness and Hispanic/Latino populations.…”

Spirituality and the recovery of quality of life following hematopoietic stem cell transplantation.

“…Participants were asked to report to what extent they experienced different aspects of spirituality in the past week, ranging from 0 (not at all) to 4 (very much). The FACIT-Sp can be divided into two or three subscales (e.g., Peterman et al, 2013; Murphy et al, 2010); we opted for two subscales on conceptual grounds: the 8-item meaning/peace subscale (e.g., “I feel a sense of harmony within myself”) and the 4-item religious faith subscale (e.g., “I find strength in my faith or spiritual beliefs”), which were moderately correlated in our sample ( r = .34–.41). The FACIT-Sp has been used successfully in prior studies of cancer populations (Cella et al, 1993) and, in our sample, had good reliability for both the meaning/peace (α = .79–.87) and religious faith (α = .85–.89) scales.…”

Spiritual Well-Being in Hispanic and Non-Hispanic Survivors of Allogeneic Hematopoietic Stem Cell Transplantation

“…In this study, the sample coefficient alpha was 0.90 for the SpWB subscale. Three factors, Meaning, Peace, and Faith, can be calculated, and have shown to exert a distinct influence various health outcomes (Murphy et al, 2010; Peterman et al, 2014). The score ranges for each of the three SpWB factors range from 0–16.…”