Assessing spiritual growth and spiritual decline following a diagnosis of cancer: reliability and validity of the spiritual transformation scale

This study assessed the factor structure, reliability, and validity of an instrument designed to assess spiritual transformations following a diagnosis of cancer-the Spiritual Transformation Scale (STS). The instrument was administering to 253 people diagnosed with cancer within the previous 2 years. Two underlying factors emerged (spiritual growth (SG) and spiritual decline (SD)) with adequate internal reliability (alpha = 0.98 and 0.86, respectively) and test-retest reliability (r = 0.85 and 0.73, respectively). Validity was supported by correlations between SG and the Positive and Negative Affect Scale (PANAS) Positive Affect Subscale (r = 0.23, p < 0.001), the Daily Spiritual Experiences Scale (r = 0.57, p < 0.001), and the Post-traumatic Growth Inventory (r = 0.68, p < 0.001). SD was associated with higher scores on the Center for Epidemiological Studies Depression scale (r = 0.38, p < 0.001) and PANAS-Negative Affect Subscale (r = 0.40, p < 0.001), and lower scores on the PANAS-Positive Affect Subscale (r = -0.23, p < 0.001), and the Daily Spiritual Experiences Scale (r = -0.30, p < 0.001). Hierarchical regression analyses indicated that the subscales uniquely predicted adjustment beyond related constructs (intrinsic religiousness, spiritual coping, and general post-traumatic growth). The results indicate that the STS is psychometrically sound, with SG predicting better, and SD predicting poorer, mental and spiritual well-being following a diagnosis of cancer.