Reliability and validity of the Chinese version of the spiritual health scale

Background: In recent years, spiritual health became a focus of interest and nurses' spiritual health is crucial to the quality of their own lives and patients' health care. In China, high workloads, tense nurse-patient relationships, and low social status have been found to have negative impacts on the work attitude and nursing quality and spiritual health offers direction for solving this problem. This study assessed the spiritual health levels of nurses on the Chinese mainland using a revised Chinese version of the spiritual health scale (SHS-C). Methods: A total of 747 nurses were recruited in Zhejiang Province, China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the revised SHS-C were performed using convenience sampling, with 291 and 456 nurses used for each analysis type, respectively. Items on the SHS-C were screened using the discrete trend method, the extreme group approach, correlation analysis, and EFA to create a revised mental health questionnaire for nurses. An internal consistency test and CFA were then performed to verify the spiritual health questionnaire for nurses. A self-reporting questionnaire consisting of demographic questions and the revised SHS-C items was used for this cross-sectional correlation study. Results: The revised SHS-C included 6 subscales comprising alpha total of 28 items. Cronbach's a and retest reliability for the revised questionnaire were 0.90 and 0.73, respectively. The fit of the model was analyzed by CFA [chi(2)/df =1.79; goodness of fit index (GFI) =0.83; adjusted GFI (AGFI) =0.79; root mean square error of approximation (RMSEA) =0.06; normed fit index (NFI) =0.86; comparative fit index (CFI) =0.93; non-NFI (NNFI) =0.92; incremental fit index (IFI) =0.93; parsimony NFI (PNFI) =0.76; parsimony CFI (PCFI) =0.83; and parsimony GFI (PGFI) =0.69; with each index score higher than those of the 5-subscale SHS short form previously developed by Hsiao et al.]. A reliability test showed that the overall Cronbach's alpha was 0.93, with alpha Cronbach's a of between 0.82 and 0.92 for each section. This study developed and validated a revised SHS-C. Conclusions: Our research will help policymakers, administrators, nursing leaders, and educators to identify areas for improvement regarding nurses' spiritual health, which could translate into significant improvements in patients' health care.