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Spiritual Assessment in African-Americans: A Review of Measures of Spirituality Used in Health Research

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Abstract

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

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References

  • Baider, L., Holland, J. C., Russak, S. M., & De-Nour, A. K. (2001). The system of belief inventory (SBI-15): A validation study in Israel. Psycho-Oncology, 10(6), 534–540.

    Article  PubMed  CAS  Google Scholar 

  • Banks-Wallace, J., & Parks, L. (2004). It’s all sacred: African American women’s perspectives on spirituality. Issues in Mental Health Nursing, 25(1), 25–45.

    PubMed  Google Scholar 

  • Barg, F. K., & Gullatte, M. M. (2001). Cancer support groups: Meeting the needs of African Americans with cancer. Seminars in Oncology Nursing, 17(3), 171–178.

    Article  PubMed  CAS  Google Scholar 

  • Bauer, T., & Barron, C. R. (1995). Nursing interventions for spiritual care. Journal of Holistic Nursing, 13(3), 268–279.

    Article  PubMed  CAS  Google Scholar 

  • Beery, T. A., Bass, L. S., Fowler, C., & Allen, G. (2002). Spirituality in persons with heart failure. Journal of Holistic Nursing, 20(1), 5–26.

    Article  PubMed  Google Scholar 

  • Berry, D. (2005). Methodological pitfalls in the study of religiosity and spirituality. Western Journal of Nursing Research, 27(5), 628–647.

    Article  PubMed  Google Scholar 

  • Boland, C. S. (2000). Social support and spiritual well-being: Empowering older adults to commit to health-promoting behaviors. The Journal of Multicultural Nursing & Health, 6(3), 12–23.

    Google Scholar 

  • Boyd-Franklin, N. (1989). Black families in therapy: A multisystems approach. New York: Guilford.

    Google Scholar 

  • Brady, M. J., Peterman, A. H., Fitchett, G., Mo, M., & Cella, D. (1999). A case for including spirituality in quality of life measurement in oncology. Psycho-Oncology, 8(5), 417–428.

    Article  PubMed  CAS  Google Scholar 

  • Brome, D. R., Owens, M. D., Allen, K., & Vevaina, T. (2000). An examination of spirituality among African American women in recovery from substance abuse. Journal of Black Psychology, 26(4), 470–486.

    Article  Google Scholar 

  • Brown, C. M. (2000). Exploring the role of religiosity in hypertension management among African Americans. Journal of Health Care for the Poor & Underserved, 11(1), 19–32.

    Google Scholar 

  • Campesino, M. (2006). Spirituality among Latinas/os: Implications of culture in conceptualization and measurement. Advances in Nursing Science, 29(1), 69–81.

    PubMed  Google Scholar 

  • Carter, K. F. (2003). Behaviors of older men living in the community: Correlates producing active composure. Journal of Gerontological Nursing, 29(10), 37–45.

    PubMed  Google Scholar 

  • Chibnall, J. T., Videen, S. D., Duckro, P. N., & Miller, D. K. (2002). Psychosocial-spiritual correlates of death distress in patients with life-threatening medical conditions. Palliative Medicine, 16(4), 331–338.

    Article  PubMed  Google Scholar 

  • Coleman, C. L. (2003). Spirituality, psychological well-being, and HIV symptoms for African Americans living with HIV disease. Journal of the Association of Nurses in AIDS Care, 10(1), 42–50.

    Article  Google Scholar 

  • Coleman, C. L. (2004). The contribution of religious and existential well-being to depression among African American heterosexuals with HIV infection. Issues in Mental Health Nursing, 25(1), 103–110.

    Article  PubMed  Google Scholar 

  • Daughterty, C. K., Fitchett, G., Murphy, P. E., Peterman, A. H., Banik, D. M., Hlubocky, F., et al. (2005). Trusting God and medicine: Spirituality in advanced cancer patients volunteering for clinical trials of experimental agents. Psycho-Oncology, 14(2), 135–146.

    Article  Google Scholar 

  • Delaney, C. (2005). Development and psychometric testing of a holistic instrument to assess the human spiritual dimension. Journal of Holistic Nursing, 23(2), 145–167.

    Article  PubMed  Google Scholar 

  • Drayton-Brooks, S., & White, N. (2004). Health promoting behaviors among African American women with faith-based support. ABNF Journal, 15(5), 84–90.

    PubMed  Google Scholar 

  • Egbert, N., Mickley, J., & Coeling, H. (2004). A review and application of social scientific measures of religiosity and spirituality: Assessing a missing component in health communication research. Health Communication, 16(1), 7–27.

    Article  PubMed  Google Scholar 

  • Ellison, C. (1983). Spiritual well-being: Conceputalization and measurement. Journal of Psychology and Theology, 11, 330–340.

    Google Scholar 

  • Felix Aaron, K., Levine, D., & Burstin, H. R. (2003). African American church participation and health care practices [see comment]. Journal of General Internal Medicine, 18(11), 908–913.

    Article  PubMed  Google Scholar 

  • Fitzgibbon, M. L., Stolley, M. R., Ganschow, P., Schiffer, L., Wells, A., Simon, N., et al. (2005). Results of a faith-based weight loss intervention for black women. Journal of the National Medical Association, 97(10), 1393–1402.

    PubMed  Google Scholar 

  • Foley, L., Wagner, J., & Waskel, S. A. (1998). Spirituality in the lives of older women. Journal of Women & Aging, 10(2), 85–91.

    CAS  Google Scholar 

  • Frame, M., Williams, C., & Green, E. (1999). Balm in Gilead: Spiritual dimensions in counseling African-American women. . Journal of Multicultural Counseling and Development, 27(4), 182–192.

    Google Scholar 

  • Glik, D. C. (1990). Participation in spiritual healing, religiosity, and mental health. Sociological Inquiry, 60(2), 159–176.

    Article  Google Scholar 

  • Gomez, R., & Fisher, J. W. (2003). Domains of spiritual well-being and development and validation of the Spiritual Well-Being Questionnaire. Personality and Individual Differences, 35(8), 1075–1991.

    Article  Google Scholar 

  • Graham, G. N., Kim, S., James, B., Reynolds, G., Buggs, G., Hunter, M., et al. (2006). Benefits of standardized diabetes and hypertension screening forms at community screening events. Health Promotion Practice, 7(1), 26–33.

    Article  PubMed  Google Scholar 

  • Hall, T. W., & Edwards, K. J. (1996). The initial development and factor analysis of the Spiritual Assessment Inventory. Journal of Psychology and Theology, 24(3), 233–246.

    Google Scholar 

  • Hammermeister, J., & Peterson, M. (2001). Does spirituality make a difference? Psychosocial and health-related characteristics of spiritual well-being. American Journal of health Education, 32(5), 293–297.

    Google Scholar 

  • Hatch, R. L., Burg, M. A., Naberhasu, D. S., & Helmich, L. K. (1998). The spiritual involvement and beliefs scale: Development and testing of a new instrument. Journal of Family Practice, 46(6), 476–486.

    PubMed  CAS  Google Scholar 

  • Heinrich, C. R. (2003). Enhancing the perceived health of HIV seropositive. Western Journal of Nursing Research, 25(4), 367–387.

    Article  PubMed  Google Scholar 

  • Hodge, D. R., Cardenas, P., & Montoy, H. (2001). Substance use: Spirituality and religious participation as protective factors among rural youths. Social Work Research, 25(3), 153–161.

    Google Scholar 

  • Holt, C. L., Lewellyn, L. A., & Rathweg, M. J. (2005). Exploring religion-health mediators among African American parishoners. Journal of Health Psychology, 10(4), 511–527.

    Article  PubMed  Google Scholar 

  • Hungelmann, J., Kenkel-Rossi, E., Klassen, L., & Stollenwerk, R. (1996). Focus on spiritual well-being: Harmonious interconnectedness of mind-body-spirit—Use of the JAREL Spiritual Well-Being Scale. Geriatric Nursing, 17(6), 262–266.

    Article  PubMed  CAS  Google Scholar 

  • Isaia, D., Parker, V., & Murrow, E. (1999). Spiritual well-being among older adults. Journal of Gerontological Nursing, 25(8), 15–21.

    PubMed  CAS  Google Scholar 

  • Jackson, L. E., & Coursey, R. D. (1988). The relationship of God control and internal locus of control to intrinsic religious motivation, coping and purpose in life. Journal for the Scientific Study of Religion, 27(3), 399–410.

    Article  Google Scholar 

  • Jesse, D. E., & Alligood, M. R. (2002). Holistic Obstetrical Problem Evaluation (HOPE): Testing a theory to predict birth outcomes in a group of women from Appalachia. Health Care for Women International, 23(6–7), 587–599.

    Article  PubMed  Google Scholar 

  • Jesse, D. E., & Reed, P. G. (2004). Effects of spirituality and psychosocial well-being on health risk behaviors in Appalachian pregnant women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(6), 739–747.

    Article  PubMed  Google Scholar 

  • Kamya, H. A. (1997). African immigrants in the United States: The challenge for research and practice. Social Work 42(2), 154–165.

    Google Scholar 

  • Kass, J. D., Friedman, R., Lesserman, J., Zuttermeister, P. C., & Benson, H. (1991). Health outcomes and a new index of spiritual experiences. Journal of the Scientific Study of Religion, 30, 203–211.

    Article  Google Scholar 

  • Klonoff, E. A., & Landrine, H. (1996). Belief in the healing power of prayer: Prevalence and health correlates for African-Americans. Western Journal of Black Studies, 20(4), 207–210.

    Google Scholar 

  • Koenig, H. G., McCullough, M. E., & Larson, D. B. (2001). Handbook of religion and health. New York: Oxford University Press.

    Google Scholar 

  • Krejci, M. J., Thompson, K. M., Simonich, H., Crosby, R. D., Donaldson, M. A., Wonderlich, S. A., et al. (2004). Sexual trauma, spirituality, and psychopathology. Journal of Child Sexual Abuse, 13(2), 85–103.

    Article  PubMed  Google Scholar 

  • Levin, J. S. (2001). God, faith, and health: Exploring the spirituality-healing connection. New York: John Wiley & Sons, Inc.

    Google Scholar 

  • Lewis, L. M., Hankin, S., Reynolds, D., & Ogedegbe, G. (2007). African-American spirituality: A process of honoring God, others, and self. Journal of Holistic Nursing, 25(1), 16–23.

    Article  PubMed  Google Scholar 

  • Martsolff, D., & Mickey, J. (1998). The concept of spirituality in nursing theories: Differing world views and extent of focus. Journal of Advanced Nursing, 27, 294–303.

    Article  Google Scholar 

  • Mattis, J. S. (2000). African-American women’s definitions of spirituality and religiosity. Journal of Black Psychology, 26(1), 101–122.

    Article  Google Scholar 

  • Mattis, J. S. (2002). Religion and spirituality in the meaning-making and coping experiences of African-American women: A qualitative analysis. Psychology of Women Quarterly, 26, 309–321.

    Article  Google Scholar 

  • Meraviglia, M. (1999). Critical analysis of spirituality and its empirical indicators. Journal of Holistic Nursing, 17(1), 18–33.

    Article  PubMed  CAS  Google Scholar 

  • Mickley, J., & Soeken, K. (1993). Religiousness and hope in Hispanic-and Anglo-American women with breast cancer. Oncology Nursing Forum, 20(8), 1171–1177.

    PubMed  CAS  Google Scholar 

  • Miller, F., Fleming, W., & Brown-Anderson, F. (1998). Spiritual Well-Being Scale: Ethnic differences Caucasians and African-Americans. Journal of Psychology and Theology, 26(4), 358–364.

    Google Scholar 

  • Miller, R. L. (2005). Look what God can do: African American gay men, AIDS, and spirituality. Journal of HIV/AIDS & Social Services, 4(3), 25–46.

    Article  Google Scholar 

  • Miller, W. R., & Thoresen, C. E. (2003). Spirituality, religion, and health: An emerging research field. American Psychologist, 58(1), 24–35.

    Article  PubMed  Google Scholar 

  • Moberg, D. O. (2002). Assessing and measuring spirituality: Confronting dilemmas of universal and particular evaluative criteria. Journal of Adult Development, 9, 47–60.

    Article  Google Scholar 

  • Musgrave, C. F., Allen, E., Allen, C., & Gregory, J. (2002). Spirituality and health for women of color. American Journal of Public Health, 92(4), 557–560.

    Article  PubMed  Google Scholar 

  • Musgrave, C. F., & McFarlane, E. A. (2004). Intrinsic and extrinsic religiosity, spiritual well-being, and attitudes toward spiritual care: A comparison of Israeli Jewish oncology nurses’ scores. Oncology Nursing Forum, 31(6), 1179–1183.

    Article  PubMed  Google Scholar 

  • Nelson, C. J., Rosenfeld, B., Breitbart, W., & Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43(3), 213–220.

    Article  PubMed  Google Scholar 

  • Newlin, K., Knafl, K., & Melkus, G. D. (2002). African-American spirituality: A concept analysis. Advances in Nursing Science, 25(2), 57–70.

    PubMed  Google Scholar 

  • Noguchi, W., Ohno, T., Morita, S., Aihara, O., Tsujii, H., Shimozuma, K., & Matusushima, E. (2004). Reliability and validity of the Functional Assessment of Chronic Illness Therapy-Spirituality (FACIT-Sp) for Japanese patients with cancer. Support Care Cancer, 12, 240–245.

    Article  PubMed  Google Scholar 

  • Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being, and quality of life. In L. A. Peplau & D. Pearlman (Eds.), Loneliness: A sourcebook for practice (pp. 358–364). New York: Wiley Interscience.

    Google Scholar 

  • Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24(1), 49–58.

    Article  PubMed  Google Scholar 

  • Potter, M. L., & Zauszniewski, J. A. (2000). Spirituality, resourcefulness, and arthritis impact on health perception of elders with rheumatoid arthritis. Journal of Holistic Nursing, 18(4), 311–331.

    Article  PubMed  CAS  Google Scholar 

  • Potts, R. (1996). Spirituality and the experience of cancer in an African-American community: Implications for psychosocial oncology. Journal of Psychosocial Oncology, 14(1), 1–19.

    Article  Google Scholar 

  • Ramanaiah, N. V., Rielage, J. K., & Sharpe, J. P. (2001). Spiritual well-being and personality. Psychological Reports, 89(3), 659–662.

    Article  PubMed  CAS  Google Scholar 

  • Reed, P. G. (1986). Religiousness among terminally ill and healthy adults. Research in Nursing & Health, 9(1), 35–41.

    Article  CAS  Google Scholar 

  • Reed, P. G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing & Health, 10(5), 335–344.

    Article  CAS  Google Scholar 

  • Reed, P. G. (1991). Preferences for spiritually related nursing interventions among terminally ill and nonterminally ill hospitalized adults and well adults. Applied Nursing Research, 4(3), 122–128.

    Article  PubMed  CAS  Google Scholar 

  • Resnicow, K., Campbell, M. K., Carr, C., McCarty, F., Wang, T., Periasamy, S., et al. (2004). Body and soul. A dietary intervention conducted through African-American churches [see comment]. American Journal of Preventive Medicine, 27(2), 97–105.

    Article  PubMed  Google Scholar 

  • Resnicow, K., Wallace, D. C., Jackson, A., Digirolamo, A., Odom, E., Wang, T., et al. (2000). Dietary change through African American churches: baseline results and program description of the eat for life trial. Journal of Cancer Education, 15(3), 156–163.

    PubMed  CAS  Google Scholar 

  • Ruffing-Rahal, M. A. (1991). Initial psychometric evaluation of a qualitative well-being measure: The Integration Inventory. Health Values, 15(2), 10–20.

    Google Scholar 

  • Samuel-Hodge, C. D., Headen, S. W., Skelly, A. H., Ingram, A. F., Keyserling, T. C., Jackson, E. J., et al. (2000). Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multi-caregiver role, and other social context factors. Diabetes Care, 23(7), 928–933.

    Article  PubMed  CAS  Google Scholar 

  • Schnoll, R. A, Harolow, L. L., & Brower, L. (2000). Spirituality, demographic and disease factors, and adjustment to cancer. Cancer Practice, 8(6), 298–304.

    Article  PubMed  CAS  Google Scholar 

  • Smith, E. D., Merritt, S. L., & Patel, M. K. (1997). Church-based education: an outreach program for African Americans with hypertension. Ethnicity & Health, 2(3), 243–253.

    Article  CAS  Google Scholar 

  • Springer, M. B., Newman, A., Weaver, A. J., Siritsky, N., Linderblatt, C., Flannelly, K. J., Naditch, B., & VandeCreek, L. (2003). Spirituality, depression, and loneliness among Jewish seniors residing in New York City. The Journal of Pastoral & Counseling, 57(3), 305–318.

    Google Scholar 

  • Stein, K. D., Denniston, M., Baker, F., Dent, M., Hann, D. M., Bushhouse, S., et al. (2003). Validation of a modified Rotterdam Symptom Checklist for use with cancer patients in the United States. Journal of Pain and Symptom Management, 26(5), 975–989.

    Article  PubMed  Google Scholar 

  • Tanyi, R. A., & Werner, J. S. (2003). Adjustment, spirituality, and health in women on hemodialysis. Clinical Nursing Research, 12(3), 229–245.

    Article  PubMed  Google Scholar 

  • Tomich, P. L., & Helgeson, V. S. (2002). Five years later: A cross-sectional comparison of breast cancer survivors with healthy women. Psycho-Oncology, 11(2), 154–169.

    Article  PubMed  Google Scholar 

  • Tuck, I., McCain, N. L., & Elswick, R. K. (2001). Spirituality and psychosocial factors in persons living with HIV. Journal of Advanced Nursing, 33(6), 776–783.

    Article  PubMed  CAS  Google Scholar 

  • Vance, D. L. (2001). Nurses’ attitudes towards spirituality and patient care. MEDSURG Nursing, 10(5), 264–268.

    Google Scholar 

  • Utsey, S. O., Lee, A., Bolden, M. A., & Lanzier, Y. (2005). A confirmatory test of the factor validity of scores on the Spiritual Well-Being Scale in a community sample of African Americans. Journal of Psychology and Theology, 33(4), 251–257.

    Google Scholar 

  • Walker, C. C. (2000). An educational intervention for hypertension management in older African Americans. Ethnicity & Disease, 10(2), 165–174.

    CAS  Google Scholar 

  • Walton, J., & Sullivan, N. (2004). Men of prayer: Spirituality of men with prostate cancer: A grounded theory study. Journal of Holistic Nursing, 22(2), 133–151.

    Article  PubMed  Google Scholar 

  • Wright, V. (2003). A phenomenological exploration of spirituality among African American women recovering from substance abuse. Archives of Psychiatric Nursing, 18(4), 173–185.

    Article  Google Scholar 

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Acknowledgments

This study was supported by a Minority Post-Doctoral Research Supplement (MPDS) to R01 HL 067439 from the National Heart, Lung and Blood Institute of the National Institutes of Health.

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Lewis, L.M. Spiritual Assessment in African-Americans: A Review of Measures of Spirituality Used in Health Research. J Relig Health 47, 458–475 (2008). https://doi.org/10.1007/s10943-007-9151-0

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