Health and Social Care Chaplaincy, Vol 8, No 1 (2020)

Validation of the Patient Reported Outcome Measure of Spiritual Care (PROM) in an Australian Setting

Leila Karimi, Heather Tan
Issued Date: 2 Oct 2020


A multi-site study across five hospitals in Australia, undertaken as part of the study to evaluate the validity and reliability of the Patient Reported Outcome Measure of spiritual care (PROM) scale. Two hundred and eighty-one patients participated in the study. Data were analysed using AMOS (version 24) to assess the validity and reliability of the PROM using confirmatory factor analysis (CFA). Predictive (criterion) validity of the scale was also assessed by evaluating the relationship of the PROM scale with the quality of spiritual care. The results demonstrated acceptable validity, model-based reliability and predicative validity for the PROM scale. It is recommended that a further study for cross-validation of the scale in different samples and populations is undertaken. Controlling for other variables such as (positive-negative affect or personality characteristics) for future studies might shed more light on the content validity of  the PROM. The study has implications for the longer-term goal of building an evidence base for a spiritual care framework for Australian healthcare organizations and beyond.  It is hoped that the data collected will enable spiritual health organizations to contrib- ute to a larger database of evidence, both nationally and internationally.

Download Media

PDF (Price: £18.00 )

DOI: 10.1558/hscc.40705



Akaike, H. (1973). Information theory and an extension of the maximum likelihood principle. In B. N. Petrov & B. F. Csaki (Eds.), Second International Symposium on Information Theory, (pp. 267-281). Academiai Kiado: Budapest.


Australian Bureau of Statistics. 2016 census religious affiliation.


Australian Classification of Health Interventions (ACHI) (2017). Spiritual Intervention Codes. ICD-10-AM.ACHI/ACS Tenth Edition.

Bentler, P. M. (2006). EQS 6 structural equations program manual. Encino, CA: Multivariate Software ( Los Angeles.

Bollen, K.A. and Stine, R.A. (1992). Bootstrapping goodness-of-fit measures in structural equation models. Sociological Methods and Research, 21, 205-229


Borneman, T., Ferrell, B. & Puchalski, C. (2009). Defining Spiritual Care: An Exploratory Study. Journal of Pain and Symptom Management 40(2):  163-73.

Brown, J. & Gardner, J. (2017). The Role of Pastoral Practitioner in Health Outcomes and Well-being During Acute Illness: Exploring the Patient Experience of a Pastoral Visit. Journal of Pastoral Care and Counseling. 71(4), 230-236.

Byrne, B. M. (2009). Structural equation modeling with EQS: Basic concepts, application, and programming. New Jersey: Lawrence Elbaum Associates.

Burnham, K. P., & Anderson, D. R. (2004). Multimodel inference understanding AIC and BIC in model selection. Sociological Methods & Research, 33(2), 261e304.

Cramer, E. & Tenzek, K. (2012). The Chaplain Profession from the Employer Perspective: An Analysis of Hospice Chaplain Job Advertisements. Journal of Health Care Chaplaincy. 18(3), 133-150.

Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psyclwmetrika, 16, 297-334.

Delgado-Guay, M, et al (2011) Spirituality, Religiosity and Spiritual Pain in advanced Cancer Patients. Journal of Pain and Syptom Management 41(6) p, 986-984.

Drummond, D.A.(2019). Assessing Spiritual Well-being in residential Aged Care: An Exploratory Review. Journal of Religion and Health 58(2) P372-390.

Gordon, T. & Mitchell, D. (2004). A Competency Model for the Assessment and Delivery of Spiritual Care. Palliative Medicine. 18(7), 646-651.

Gray, M. (2011). Spiritual Health Inventory Scores and Abstinence. Dissertation Abstracts International: Section B - The Sciences and Engineering. 72(3-B): p 1816.

Hair, J. F. Hult,G., Ringle, C. and Sarstedt M. (2014). A primer on partial least squares structural equation modeling (PLS-SEM). SAGE Publications, Thousand Oaks, Calif.

Haugan, G. (2015). The FACIT-Sp Spiritual Well-being Scale: An Investigation of the Dimensionality, Reliability and Construct Validity in a cognitively Intact Nursing Home Population. Scandinavian Journal of Caring Sciences. 29: p152-164.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55

Karimi, L., & Meyer, D. (2015). Validity and model-based reliability of the Work Organisation Assessment Questionnaire among nurses. Nursing Outlook, 63(3), 318-330. 10.1016/j.outlook.2014.09.003.


Kline, R. B. (2010). Principles and Practice of Structural Equation Modeling. New York: The Guilford Press.

MacKenzie, S. B. Podsakoff, P. M. & Podsakoff, N. P. (2011): Construct Measurement and Validation Procedures in MIS and Behavioral Research, Integrating New and Existing Techniques. MIS Quarterly, 35 (2), 293–334.

Marin, D. et al., (2015). Relationship between Chaplain Visits and Patient Satisfaction. Journal of Health Care Chaplaincy. 21(1), 14-24.

Nakau, M. et al (2013). Spiritual Care of Cancer Patients by Integrated Medicine in Urban Green Space: A Pilot Study. EXPLORE: The Journal of Science and Healing. 9(2): p 87-90.

NCLS Research.

Paloutzian, R. F., Bufford, R. K., & Wildman, A. J. (2012). Spiritual Well-Being Scale: Mental and physical health relationships. In M. Cobb, C. M. Puchalski, & B. Rumbold (Eds.), Oxford textbooks in public health. Oxford textbook of spirituality in healthcare (pp. 353-358). New York, NY, US: Oxford University Press.


Puchalski, c., Vitillo, R., Hull, S., Reller, N. (2014). Improving the Spiriutal Dimension of Whole Person Care: Reaching National and International Consensus. Journal of Palliative Medicine. 17 (6), 642-656.


Raftery, Adrian E. (1995). Bayesian Model Selection in Social Research. Sociological Methodology 25:111-95.

Reise, S. P, Bonifay, W. E., & Haviland, M. G. (2012). Scoring and modeling psychological measures in the presence of multidimensionality. Journal of Personality Assessment, 95, 129-140.

Schumacker, R. E., & Lomax, R. G. (2004). A beginner's guide to structural equation modeling, Second edition. Mahwah, NJ: Lawrence Erlbaum Associates.

Schwarz, G. (1978). Estimating the dimension of a model. Annals of Statistics, 6, 461-464.

Snowden, A., et al., (2013) The construction of the Lothian PROM. The Scottish Journal of Healthcare Chaplaincy. 16: p. 3-16.


Snowden, A., et al., (2102) Healthcare Chaplaincy: the Lothian Patient Reported Outcome Measure (PROM). The construction of a measure of the impact of specialist spiritual care provision. The Scottish Journal of Healthcare Chaplaincy25(35): p. 111.


Snowden, A. and I. Telfer, (2017) Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.  23(4): p. 131-155.


Snowden, A., et al., (2018). ‘What’s on your mind?’The only necessary question in spiritual care. Journal for the Study of Spirituality.  8(1): p. 19-33.


Spiritual Care Australia a member).


Spiritual Health Victoria (2016). Capability Framework for Spiritual Care Practitioners in health Services.Available at; https://Spiriutal Health Victoria/standards and frameworks.


Vlasblom J. et al. (2014). Developments in Health Care Chaplaincy in the Netherlands and Scotland: A Content Analysis of Professional Journals. Health and Social Care Chaplaincy. 2(2), 235-254.

Whitford, M., Olver, I. & Haley P. (2008). Spirituality as a Core Domain in the Assessment of Quality of Life in Oncology. Pyscho-Oncology. 17: p 1121-1128.

Whitford, M. & Olver, I. (2012). The Multi-Dimensionality of Spiritual Well-being: Peace, Meaning and faith and their Association with Quality of Life and Coping in Oncology. Pyscho-Oncology. 21: p602-610.



  • There are currently no refbacks.

Equinox Publishing Ltd - 415 The Workstation 15 Paternoster Row, Sheffield, S1 2BX United Kingdom
Telephone: +44 (0)114 221-0285 - Email:

Privacy Policy