Empirical investigations of spirituality in health-related research have been dominated by studies of the religious dimensions of quality of life. Typically, these studies have shown that religious factors such as religious service participation and commitment are predictors of positive health outcomes. Additionally, frequently used measures of spirituality are often limited in their scope and could be seen as measures more closely associated with religiosity. While these studies have been useful in examining some of the spiritual aspects of life, they have neglected the multidimensional nature of spirituality, and how it might influence health-related quality of life.

The goal of this study was to test the psychometric properties of a new measure of spiritual health developed by medical researchers at the West Los Angeles Veterans Administration Medical Center, and to examine the relationships and potential overlap of spiritual health with health-related quality of life. This measure broadens the interpretation of spirituality to include Frankl's philosophical perspective of logotherapy. This existential interpretation defines spirituality as finding meaning and purpose in life. Given the importance of spirituality to older chronically ill adults, knowledge of spiritual health of is an essential part of the biopsychosocial assessment, and provides a more comprehensive holistic assessment of overall quality of life.

Using secondary data from a sample of 389 older chronically ill adults in Los Angeles, the instrument was factor analyzed and confirmed using confirmatory factor analysis. Convergent validity was demonstrated with an existing measure of spiritual well-being. Using structural equation modeling and canonical correlations, this study demonstrated that spiritual health was distinct from aspects of mental health, capturing unique psychological characteristics. This spiritual health dimension includes a more transcendent and philosophical state of how he or she finds meaning and purpose in life, which is important for understanding the sources of inner strength of older medically-impaired adults. The implications for practice are discussed as well as directions for future research to include the ongoing testing and development of this measure for potential inclusion into the assessment repertoire of social workers who provide care planning for older adults.