Designation and psychometric assessment of a comprehensive spiritual health questionnaire for Iranian populations

Despite the considerable research documented regarding spiritual health through the last decades, there is still the lack of a comprehensive and acceptable definition for the term. Measuring spiritual health in Iranian populations initially requires a definition of spiritual health that meets the cultural, social and religious norms of our society. Hence designation and evaluation of an appropriate questionnaire to measure its conceptual constructs is essential. As one of the first efforts, this study aimed to explore the concept of spiritual health and to design and assess a comprehensive spiritual health questionnaire in an Iranian population. In this methodological cross-sectional study, a spiritual health questionnaire was developed based on three constructs, including “insight”, “tendency” and “behaviors” based on a review of Islamic literature approved by the spiritual health department of academy of medical sciences Islamic republic of Iran. Overall 506 individuals)64% females), aged ≥ 20 years, participated in the psychometric assessment process, were recruited from among residents of district 13 of Tehran. Test-retest reliability and internal consistency were used to assess reliability. Face, content and construct validity were examined. Forty-eight items were perceived as essential, relevant and comprehendible by both the experts and the community. Content validity was confirmed by a panel of experts. Exploratory factor analysis suggested a six-factor model in the structure of developed items, which was optimized in a two factor model that encompassed 1) cognitive/emotional and 2) behavioral constructs. The results of the confirmatory factor analysis indicated acceptable fits for the proposed models. The internal consistency, as measured by Cronbach’s alpha coefficients, exceeded the minimum reliability standard of 0.70 for all scales and subscales, all of which demonstrated satisfactory test-retest reliability over two weeks. Our results provide initial evidence that the much needed questionnaire developed is a valid and reliable instrument for measuring spiritual health in this urban Iranian population. Further research is suggested for different populations and regions in Iran.