Exploring the Psychometric Properties of the Spiritual Well-Being Scale Among Individuals with Substance Use Disorders

The impact of spiritual well-being and social support on substance use treatment outcomes within a sample of predominantly Black/African American adults

INTRO

Substance use and associated problems often return following treatment for substance use disorder (SUD), which disproportionally impact Black/African American (AA) individuals. Social support and spiritual well-being are sources of recovery capital identified as particularly important among Black/AA adults. Social support and spiritual well-being are also posited mechanisms in 12-step; thus, this study tested the effects of social support and spiritual well-being on substance use outcomes over time, distinct from 12-step involvement, among Black/AA adults post-SUD treatment. The study hypothesized that social support and spiritual well-being would demonstrate significant interactions with time, respectively, on substance use frequency and substance use consequences, above the effect of 12-step involvement.

METHOD

The study drew data from a study of 262 adults (95.4 % Black/AA) entering residential SUD treatment (NCT#01189552). Assessments were completed at pretreatment and at 3-, 6-, and 12-months posttreatment. Two generalized linear mixed models (GLMM) tested the effects of social support and spiritual well-being, above the effect of 12-step involvement, on substance use frequency and substance use consequences over the course of 12-months posttreatment.

RESULTS

Higher spiritual well-being predicted significantly less frequent substance use during recovery (β = 0.00, p = .03). Greater 12-step involvement predicted significantly fewer substance use consequences during recovery (β = 0.00, p = .02). In post hoc analyses the effect of spiritual well-being and 12-step involvement dissipated by 3.5- and 6.6-months posttreatment, respectively. The study found no significant effects of social support over time.

DISCUSSION

Spiritual well-being and 12-step involvement are associated with lower substance use and substance use consequences, respectively, in the early months of posttreatment recovery among Black/AA adults. These findings contribute to the growing recovery capital literature informing paths to recovery and sources of support outside of 12-step affiliation. However, these effects diminish over time.

Cross-Cultural Evaluation of the Psychometric Properties of the Spiritual Well-Being Scale: A Systematic Review

Since spiritual well-being has a significant role in individual and social health, using a valid scale to identify these properties is essential. Comparing factor structure and differences in the number of dimensions and items of subscales could be an indicator of differences in individuals' attitudes toward spirituality among diverse cultures. The present review was performed for psychometric evaluation of the spiritual well-being measures. A systematic review of international databases and Iranian databases was conducted to evaluate studies published between January 1, 1970, and October 1, 2022. QUADAS-2, STARD, and COSMIN scales were used for risk of bias assessment. Following two rounds of screening, 14 articles entered quality assessment. According to the results, studies examining the factor structure of the spiritual well-being scale (SWBS) instrument have been conducted for the years 1998 to 2022. The mean age of the participants in these studies ranged from 20.8 to 79.08 years. During the process of exploratory factor analysis, the researchers reported the presence of two to five latent factors, and the range of explained variance was between 35.6 and 71.4%. However, most of the reports indicated the existence of two or three latent factors. The findings of the present study provide an image of the psychometric status of the SWBS for researchers and clinicians in this field and can help them make optimum decisions in selecting a scale or conducting additional psychometric studies or adopting this scale for studies in new populations.

Coordinating assessment of spiritual needs: a cross-walk of narrative and psychometric assessment tools used in palliative care

Addressing spiritual needs of patients in healthcare settings improves patient experiences and clinical outcomes; however, non-chaplain providers typically assess spiritual needs differently (quantitative psychometric) than healthcare chaplains (long form narrative) and thus there is little shared language or cross-disciplinary evaluation frameworks across disciplines. This discrepancy impedes the provision of both team-based and patient-centered care. This paper used scoping review methodology to illustrate the overlap between narrative and psychometric assessment tools, comparing four narrative tools against eight psychometric tools. The SpNQ-120 and Brief RCOPE demonstrated consistent domain coverage across the four chaplain narrative tools. This work provides preliminary resources to aid clinicians and researchers in choosing an appropriate tool. Additionally, for those who do not work closely with chaplains, it provides a sense of what domains chaplains prioritize, from their professional and lived experience, in assessing the spiritual life of the patient. This improves interdisciplinary communication, and therefore, patient care.