中華心理衛生協會

Purpose: Spiritual care is an essential part of providing palliative care services to patients. However, no studies have identified the abilities required for a palliative spiritual care provider in Taiwan. To understand what makes a good caregiver for terminally ill patients, we developed the Spiritual Care Competency Scale (SCCS) and examined its psychometric properties. Methods: We developed the initial 85 5-point Likert items of the SCCS based on our previous qualitative study of Christian-based competencies for hospice spiritual palliative care. That study identified 3dimensions of spiritual care: basic knowledge, attitude, and professional knowledge about spiritual care. We developed the SCCS in two stages. All participants had completed a spiritual care education course at the Schweitzer Christian Mission Foundation in Taiwan. Results: A total of 134 participants (23 male, 111 female) completed the initial measure. Following the item analysis and exploratory factor analysis, we selected 18 items comprising 3 factors for the final measure: Spiritual Care Knowledge (3 items), Spiritual Care Self Awareness (7 items), and Spiritual Care Practice (8 items). These 3 factors accounted for 58.34% of the total variance. In stage 2, 350 participants (61 males, 289 females) completed the 18-item measure. Analysis showed acceptable internal consistency coefficients for the three subscales (.81 to .88) and for the total scale (.92). The first 175 of the 350 participants were used to test the hypothesized 3-factor model using the confirmatory factor analysis (CFA). The results indicated that the overall goodness of fit of the proposed model was unsatisfactory. Subsequently, two items with a low factor loading were deleted from the SCCS, and the revised model was tested. The data from the remaining 175 participants of the original 350 were used for the second CFA to validate the revised model. The overall goodness of fit of the model and the internal structure of the measurement model fit were favorable. The revised model was more optimal than the originally hypothesized model. Conclusions: The results of the analysis of the revised model lend reasonable support to the validity and reliability of the SCCS. This scale highlights the important aspect of competency in spiritual palliative care, thus future education and training programs should consider including this aspect.