title: A psychometric evaluation of measures of spirituality validated in culturally diverse palliative care populations.
abstract: BACKGROUND
  Despite the need to accurately measure spiritual outcomes in diverse palliative care populations, little attention has been paid to the properties of the tools currently in use.
  
  
  OBJECTIVE
  This systematic review aimed to appraise the psychometric properties, multifaith appropriateness, and completion time of spiritual outcome measures validated in multicultural advanced cancer, HIV, or palliative care populations.
  
  
  METHODS
  Eight databases were searched to identify relevant validation and research studies. A comprehensive search strategy included search terms in three categories: palliative care, spirituality, and outcome measurement. Inclusion criteria were: validated in advanced cancer, HIV, or palliative care populations and in an ethnically diverse context. Included tools were evaluated with respect to psychometric properties (validity, reproducibility, responsiveness, and interpretability), multifaith appropriateness, and time to complete.
  
  
  RESULTS
  A total of 191 articles were identified, yielding 85 tools. Twenty-six tools (representing four families of measures and five individual tools) met the inclusion criteria. Twenty-four tools demonstrated good content validity and 12 demonstrated adequate internal consistency. Only eight tools demonstrated adequate construct validity, usually because specific hypotheses were not stated and tested. Seven tools demonstrated adequate test-retest reliability; two tools showed adequate responsiveness, and two met the interpretability criterion. Data on the religious faith of the population of validation were available for 11 tools; of these, eight were tested in multifaith populations.
  
  
  CONCLUSIONS
  Results suggest that, at present, the McGill Quality of Life Questionnaire, the Measuring the Quality of Life of Seriously Ill Patients Questionnaire, and the Palliative Outcome Scale are the most appropriate multidimensional measures containing spiritual items for use in multicultural palliative care populations. However, none of these measures score perfectly on all psychometric criteria, and their multifaith appropriateness requires further testing.
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK. lucy.selman@kcl.ac.uk
authors.forename: Lucy
authors.initials: L
authors.lastname: Selman
authors.forename: Richard
authors.initials: R
authors.lastname: Siegert
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Marjolein
authors.initials: M
authors.lastname: Gysels
authors.forename: Peter
authors.initials: P
authors.lastname: Speck
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D003469:Culture; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life; D029181:Spirituality; D011795:Surveys and Questionnaires