Validation of the Spiritual Distress Scale in Portuguese Cancer Patients Undergoing Chemotherapy: A Methodological Study

Abstract

Spiritual distress may ascend from unmet spiritual needs. The use of instruments to measure spiritual distress seems to facilitate the approach to spirituality, such as the Spiritual Distress Scale (SDS) that has been used worldwide. No instrument to assess spiritual distress in cancer patients is currently available in Portugal. This study aims to conduct the translation, adaptation and validation of the SDS in Portuguese cancer patients undergoing chemotherapy. Methodological study based on Sousa and Rojjanasrirat (2011), a seven-step approach, started with the linguistic translation to the psychometric tests. The main participants (55.4%) were older than 60 years; about 64.7% were females, married (68.0%), and 86.7% were Catholic. Moderate spiritual distress was experienced by 49.3% of the participants. Linguistic and conceptual equivalences were obtained. The SDS European Portuguese version has an overall Cronbach’s alpha of 0.91, and the subscales were as follows: “relationship with self” (0.92), “relationship with others” (0.63), “relationship with God” (0.64) and “facing death” (0.85). Four factors emerged after Varimax rotation. Overall, these results indicate that the SDS European Portuguese version has good psychometric characteristics and can used in assessing spiritual distress in cancer patients.

Spiritual Distress in Patients With Cancer Initiating Chemotherapy: A Cross‐Sectional Study

“…The second part included information regarding participants' health profiles. Finally, the last part included the Spiritual Distress Scale (SDS) (Martins, Caldeira, Domingues, Vieira, & Ku, 2019). This scale is a valid and reliable instrument to assess spiritual distress in patients with cancer, and it was previously translated, adapted, and validated in European Portuguese.…”

“…This instrument is scored on a 4-point Likert scale, with scores ranging between 30 and 120. The SDS had a good internal validity, with an overall Cronbach's α value of 0.91 (Martins et al, 2019). Data collection was conducted by the main author and was supervised by a senior researcher.…”

Prevalence, defining characteristics, and predictors of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy: A longitudinal study

“…The second section concerned disease‐related data (cancer location, stage, and type of chemotherapy) and was collected from the medical records. The third section was composed of the Spiritual Distress Scale (SDS), which is a reliable measure to assess spiritual distress and is available in European Portuguese (Martins et al, 2019). The SDS is a 30‐item questionnaire with the Likert scale and the scale range is 1 = never, 2 = rarely, 3 = sometimes, and 4 = most of the time.…”

“…The SDS scores range between 30 and 120, and the cut‐off point is 58.5 (Martins et al, 2019). The overall Cronbach's alpha shows good internal validity of 0.91 (Martins et al, 2019). In addition, regarding the divergent validity of the SDS, this tool has a statistically significant correlation with the spiritual well‐being concept (Martins et al, 2019).…”

“…The SDS comprises four dimensions: "relationship with self" (17 items), "relationship with others" (5 items), "relationship with God" (4 items), and "facing death (4 items). The SDS scores range between 30 and 120, and the cut-off point is 58.5 (Martins et al, 2019). The overall Cronbach's alpha shows good internal validity of 0.91 (Martins et al, 2019).…”