title: The FACIT-Sp spiritual well-being scale: an investigation of the dimensionality, reliability and construct validity in a cognitively intact nursing home population.
abstract: BACKGROUND
  Spiritual well-being has been found to be a strong individual predictor of overall nursing home satisfaction and a fundamental dimension of global as well as health-related quality-in-life among nursing home patients. Therefore, access to a valid and reliable measure of spiritual well-being among nursing home patients is highly warranted.
  
  
  OBJECTIVE
  The aim of this study was to investigate the dimensionality, reliability and construct validity of the Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing scale in a cognitively intact nursing home population.
  
  
  METHODS
  A cross-sectional design was applied, selecting two counties in central Norway from which 20 municipalities representing 44 different nursing homes took part in this study. Long-term care was defined as 24-hour care with duration of 6 months or longer. Participants were 202 cognitively intact long-term nursing home patients fulfilling the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 nursing homes was obtained. Explorative and confirmative factor analyses as well as correlation with selected construct were used.
  
  
  RESULTS
  Though three items loaded very low (λ = 0.22, 0.26, 0.32) indicating low reliability, the three-factor model for the FACIT-Sp spiritual well-being scale provided an acceptable fit (χ(2) = 101.15 (df = 50), p-value <0.001, RMSEA = 0.075 p = 0.030, NFI = 0.90, GFI = 0.91, AGFI = 0.85) for older nursing home patients, demonstrating acceptable measurement reliability. Construct validity was supported by significant correlations in the hypothesised direction with the selected constructs.
  
  
  CONCLUSIONS
  The three-factor model is an improvement over the original two-factor construct, based on these nursing home data. The measure yielded significantly factor loadings, good composite reliability and construct validity.
authors.affiliation: Faculty of Nursing, Research Centre for Health Promotion and Resources HIST &NTNU, Sør-Trøndelag University College, Trondheim, Norway.
authors.forename: Gørill
authors.initials: G
authors.lastname: Haugan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009664:Norway; D009735:Nursing Homes; D029181:Spirituality
keywords: FACIT-Sp; confirmatory factor analysis; construct validity; dimensionality; nursing home; reliability; spiritual well-being