Psychometric Reevaluation of the Spiritual Support Scale

Purpose: Informal or unpaid Alzheimer’s disease (AD) caregivers provide a substantial amount of emotional, financial, physical, and social support to care recipients, commonly family members, diagnosed with the disease. AD caregivers often report immense levels of burden, which are associated with the demands of their caregiving responsibilities. Caregivers attempt to alleviate this burden through various means of coping. Individuals who successfully cope with the negative stressors related to AD caregiving demonstrate resilience. The purpose of this study was to involve a sample among this population to reevaluate the psychometric properties of the Spiritual Support Scale (SSS), a 12-item measure that addresses diverse belief patterns of spirituality. This caregiver population is highly germane for this study given their mostly commonly reported coping method of prayer.

Method: The SSS was initially evaluated among a sample of undergraduate and graduate students after the September 11th terrorist attacks. The current study reevaluated its properties among a sample of 691 AD caregivers in Louisiana. A mailing list from an Alzheimer’s service organization constituted the primary sampling frame. To reflect the ethnic proportion of Louisiana Alzheimer’s caregivers, we recruited an additional number of African American caregivers in churches and community centers. The sample completed self-report questionnaires that contained demographic items, the SSS and standardized measures of its theoretically linked constructs of coping strategies (task-, emotion-, avoidance-focused) and psychological resilience. Data analyses included confirmatory factor analysis; Cronbach’s alpha and Guttman’s split-half coefficients for reliability analysis; and zero-order correlations between the SSS and the coping and resilience measures for construct validity analysis.

Results: Proportionately reflecting the ethnic demography of Louisiana AD caregivers, the sample reported 62% Caucasian and 36% African American. The typical caregiver in the sample was a married female providing care for her husband in the middle-to-late stage of the disease. The average caregiver age was 62 years. The sample reported a high level of spiritual support. Confirmatory factor analysis of the SSS identified a unidimensional solution with all items of the scale loaded. The single factor had an eigenvalue of 9.422 and explained 78.5% of the variance in principal axis factoring. The SSS evidenced robust internal consistency: Cronbach’s alpha was .974; split-half coefficient was .940. In terms of construct validity, the SSS significantly correlated positively with resilience and task-focused coping, and negatively with emotion-focused coping.

Implications: This study provides an empirical perspective on spiritual support reported among AD caregivers. The SSS appears to be a psychometrically sound measure of spiritual support. Findings from the current study compare favorably to those reported in the originally study.   The SSS is a brief, easy-to-administer instrument that can be used to appraise perceived spiritual support; in this study, used among AD caregivers who frequently rely on spiritual coping. Social work professionals can utilize this appraisal to gain insight into the client’s sense of spiritual belonging, a key coping mechanism for many to avoid the detriment of isolation.