title: The Spirituality Index of Well-Being: a new instrument for health-related quality-of-life research.
abstract: OBJECTIVE
  Despite considerable interest in examining spirituality in health-related quality-of-life studies, there is a paucity of instruments that measure this construct. The objective of this study was to test a valid and reliable measure of spirituality that would be useful in patient populations.
  
  
  METHODS
  We conducted a multisite, cross-sectional survey using systematic sampling of adult outpatients at primary care clinic sites in the Kansas City metropolitan area (N = 523). We determined the instrument reliability (Cronbach's alpha, test-retest) and validity (confirmatory factor analysis, convergent and discriminant validation) of the Spirituality Index of Well-Being (SIWB).
  
  
  RESULTS
  The SIWB contains 12 items: 6 from a self-efficacy domain and 6 from a life scheme domain. Confirmatory factor analysis found the following fit indices: chi2 (54, n = 508) = 508.35, P < .001; Comparative Fit Index = .98; Tucker-Lewis Index = .97; root mean square error of approximation = .13. The index had the following reliability results: for the self-efficacy subscale, alpha = .86 and test-retest r = 0.77; for the life scheme subscale, alpha = .89 and test-retest r = 0.86; and for the total scale alpha = .91 and test-retest r = 0.79, showing very good reliability. The SIWB had significant and expected correlations with other quality-of-life instruments that measure well-being or spirituality: Zung Depression Scale (r = 0-.42, P < .001), General Well-Being Scale (r = 0.64, P < .001), and Spiritual Well-Being Scale (SWB) (r = 0.62, P < .001). There was a modest correlation between the religious well-being subscale of the SWB and the SIWB (r = 0.35, P < .001).
  
  
  CONCLUSIONS
  The Spirituality Index of Well-Being is a valid and reliable instrument that can be used in health-related quality-of-life studies.
authors.affiliation: Department of Family Medicine, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7595, USA. tim_daaleman@med.unc.edu
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Daaleman
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Frey
mesh_terms: D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007615:Kansas; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D029181:Spirituality; D011795:Surveys and Questionnaires