title: Initial Validation of the Daily Spiritual Experiences Scale in Chinese Immigrants With Cancer Pain.
abstract: BACKGROUND
  Evaluating religious/spiritual influences in the growing Chinese-American population may inform the development of culturally relevant palliative care interventions.
  
  
  OBJECTIVE
  We assessed the psychometric properties and acceptability of the Daily Spiritual Experiences Scale-Chinese (DSES-C) in Chinese Americans with cancer-related pain.
  
  
  METHODS
  The translated 16-item DSES-C was administered as part of a symptom intervention for Chinese-American cancer patients. Patients were recruited from four New York community oncology practices.
  
  
  RESULTS
  Of 321 patients, 78.7% were born in Mainland China, 79.1% spoke Cantonese, and 70.2% endorsed a religious affiliation (Ancestor worship, 31.7%; Chinese God worship, 29.8%; Buddhism, 17.1%; Christianity, 14.0%). In total, 82.6% completed the DSES-C (mean age = 57.7 years; 60.8% women) and 17.4% declined (mean age = 59.3 years; 52.0% women). Reasons for declining included low religiosity or perceived relevance of the scale items and difficulties separating spirituality from religiosity terms. Individuals having a religious affiliation were more likely to complete the DSES-C, whereas those not engaging in individual spiritual/religious practices or frequent group spiritual/religious practices tended to decline (all P < 0.05). The DSES-C (mean total score = 43.6, SD = 19.3) demonstrated high reliability (alpha = 0.94). Exploratory factor analysis suggested a one-factor solution, with significant loadings (>0.40) across items except Item 14 ("Accept others"). Construct validity was suggested by a positive association between DSES-C scores and having a religious affiliation (P < 0.05).
  
  
  CONCLUSIONS
  In Chinese Americans with cancer pain, the DSES-C demonstrated acceptable psychometrics. Some participants experienced linguistic or cultural barriers preventing completion. Future investigations should provide additional validation in different Asian subgroups and those with varied medical conditions.
authors.affiliation: VA Pacific Islands Health Care System, Honolulu, Hawaii, USA.
authors.forename: Graciete
authors.initials: G
authors.lastname: Lo
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Chen
authors.affiliation: Consult-Stat: Complete Statistical Services, Macungie, Pennsylvania, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wasser
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Portenoy
authors.affiliation: MJHS Institute for Innovation in Palliative Care, New York, New York, USA. Electronic address: LDhingra@mjhs.org.
authors.forename: Lara
authors.initials: L
authors.lastname: Dhingra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D002681:China / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000523:psychology; D005260:Female; D006723:Hong Kong / Q000208:ethnology; D006801:Humans; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009518:New York; D010166:Palliative Care / Q000379:methods; D011581:Psychological Tests; D011594:Psychometrics; D029181:Spirituality
keywords: Daily Spiritual Experiences Scale–Chinese; cancer disparities; ethnic Chinese; immigrant health; pain; reliability; validity