Spiritual assessment in African-Americans: a review of measures of spirituality used in health research.
BACKGROUND
A number of instruments have been developed for investigating relationships between spirituality and health, and have been used to assess spirituality in African-Americans. Yet, the cultural appropriateness for African-Americans of these instruments has not been investigated to date.


OBJECTIVE
To evaluate the construct validity and reliability of spirituality measures used in health research from 1982 to 2005.


METHODS
Systematic review of the literature.


RESULTS
Thirty five studies and five measures of spirituality met the inclusion criteria. Most of the spirituality measures were developed in primarily Caucasian-American samples. African-Americans were represented in 71% of the studies (n = 25) using spirituality measures in health research. Distinct cultural attributes of African-American spirituality were omitted in most of the spirituality measures. Two studies were retrieved in which psychometric evaluation was conducted in entirely African-American samples.


CONCLUSIONS
Spirituality is a significant cultural experience and belief that influences the health behaviors of African-Americans. The lack of a culturally appropriate measure of African-American spirituality is a major limitation of studies investigating spirituality and health in this population. Development of a culturally appropriate and sensitive measure of spirituality in African-Americans is suggested to strengthen the quality of research in this area.
Lewis
Lisa M
LM
Family and Community Health Department, School of Nursing, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA 19104-6096, USA. lisaml@nursing.upenn.edu
D000223:Adaptation, Psychological; D001741:Black or African American / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D003466:Cultural Characteristics; D005163:Factor Analysis, Statistical; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D011361:Professional Competence; D011594:Psychometrics; D011788:Quality of Life; D012069:Religion and Psychology; D015203:Reproducibility of Results; D029181:Spirituality