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Journal of Chinese Integrative Medicine ›› 2013, Vol. 11 ›› Issue (2): 106-115.doi: 10.3736/jintegrmed2013020

• Research Article • Previous Articles     Next Articles

Psychosocial and spiritual needs of patients with chronic diseases: Validation of the Chinese version of the Spiritual Needs Questionnaire

Arndt Büssinga, Xiao-feng Zhaib, Wen-bo Pengb, Chang-quan Lingb   

  1. a. Center for Integrative Medicine, Faculty of Medicine, University Witten/Herdecke, 58313 Herdecke, Germany
    b. Changhai Hospital of Traditional Chinese Medicine, Second Military Medical University, Shanghai 200433, China
  • Received:2012-11-22 Accepted:2012-12-26 Online:2013-03-10 Published:2013-03-15


Even in secular societies, a small portion of patients find their spirituality to help cope with illness. But for the majority of patients, psychosocial and spiritual needs are neither addressed nor even considered a relevant factor by health care professionals. To measure such specific needs, the Spiritual Needs Questionnaire (SpNQ) was developed. The aim of this study was to validate the Chinese version of the SpNQ (SpNQ-Ch) and thus to measure psychosocial and spiritual needs of Chinese patients.


This was a cross-sectional study among 168 patients with chronic diseases who were recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China using standardized questionnaires. We performed reliability and factor analyses, as well as analyses of variance, first order correlations and regression analyses.


The 17-item SpNQ-Ch had a similar factorial structure as the original version with two main and three minor factors which accounted for 64% of variance, and internal consistency estimates (Cronbach’s α) ranging from 0.51 to 0.81. Included were the 4-item scale Inner Peace Needs, the 5-item scale Giving/Generativity Needs, the 5-item scale Religious Needs (with 2 sub-constructs, Praying and Sources), and a 3-item scale Reflection/Release Needs. In Chinese patients with cancer (63%), pain affections (10%), or other chronic conditions (23%), the needs for Giving/Generativity (which refer to categories of Connectedness and Meaning) and Inner Peace Needs scored highest, while Religious Needs and the Reflection/Release Needs scored lower.


The SpNQ-Ch is congruent with its primary version, and can be used in future studies with the mostly nonreligious patients from China. First findings indicate specific psychosocial and spiritual needs which should be addressed by health care professionals to support patients in their struggle with chronic illness in terms of psycho-emotional stabilization, finding hope and meaning, and thus achieving peaceful states of mind despite chronic illness.

Key words: Spirituality, Chronic disease, Psychology, Adaptation, Psychological, Questionnaires

[1] Schmid-Büchi S, Halfens RJ , Dassen T, van den Borne B.A review of psychosocial needs of breast-cancer patients and their relatives[J]. J Clin Nurs, 2008,17(21):2895-2909
doi: 10.1111/jcn.2008.17.issue-21
[2] Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG . Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life[J]. J Clin Oncol, 2007,25(5):555-560
doi: 10.1200/JCO.2006.07.9046
[3] Balboni TA, Paulk ME, Balboni MJ, Phelps AC, Loggers ET, Wright AA, Block SD, Lewis EF, Peteet JR, Prigerson HG . Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death[J]. J Clin Oncol, 2010,28(3):445-452
doi: 10.1200/JCO.2009.24.8005
[4] Pearce MJ, Coan AD , Herndon JE 2nd, Koenig HG, Abernethy AP.Unmet spiritual care needs impact emotional and spiritual well-being in advanced cancer patients[J]. Support Care Cancer, 2012,20(10):2269-2276
doi: 10.1007/s00520-011-1335-1
[5] Büssing A, Janko A, Kopf A, Lux EA, Frick E . Zusammenhnge zwischen psychosozialen und spirituellen Bedürfnissen und Bewertung von Krankheit bei Patienten mit chronischen Erkrankungen[J]. Spiritual Care, 2012,1:57-73
[6] Büssing A, Koenig HG . Spiritual needs of patients with chronic diseases. Religions. 2010: 1(1):18-27.
doi: 10.3390/rel1010018
[7] Puchalski C, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, Chochinov H, Handzo G, Nelson-Becker H, Prince-Paul M, Pugliese K, Sulmasy D . Improving the quality of spiritual care as a dimension of palliative care: the report of the Consensus Conference[J]. J Palliat Med, 2009,12(10):885-904
doi: 10.1089/jpm.2009.0142
[8] Büssing A. Measures of spirituality in health care. In: Cobb M, Puchalski CM, Rumbold B.Oxford textbook of spirituality in healthcare[M]. Oxford: Oxford University Press, 2012, 323-331
[9] Büssing A, Balzat HJ, Heusser P . Spiritual needs of patients with chronic pain diseases and cancer — validation of the spiritual needs questionnaire[J]. Eur J Med Res, 2010,15(6):266-273
doi: 10.1186/2047-783X-15-6-266
[10] Büssing A, Fischer J, Haller A, Heusser P, Ostermann T, Matthiessen PF . Validation of the brief multidimensional life satisfaction scale in patients with chronic diseases[J]. Eur J Med Res, 2009,14(4):171-177
doi: 10.1186/2047-783X-14-4-171
[11] Büssing A, Ostermann T, Matthiessen PF . Role of religion and spirituality in medical patients: confirmatory results with the SpREUK questionnaire[J]. Health Qual Life Outcomes, 2005,3:10
doi: 10.1186/1477-7525-3-10
[12] Büssing A . The SpREUK-SF10 questionnaire as a rapid measure of spiritual search and religious trust in patients with chronic diseases[J]. J Chin Integr Med, 2010,8(9):832-841
[13] Büssing A . Spirituality as a resource to rely on in chronic illness: The SpREUK Questionnaire[J]. Religions, 2010,1(1):9-17
doi: 10.3390/rel1010009
[14] Büssing A, Keller N, Michalsen A, Moebus S, Dobos G, Ostermann T, Matthiessen PF . Spirituality and adaptive coping styles in German patients with chronic diseases in a CAM health care setting[J]. J Complement Integr Med, 2006,3(1):1-16
[15] Erikson EH . Dimensions of a new identity. New York: W. W. Norton and Company, Inc. 1974.
[16] Yong J, Kim J, Han SS, Puchalski CM . Development and validation of a scale assessing spiritual needs for Korean patients with cancer[J]. J Palliat Care, 2008,24(4):240-246
[17] Hsiao SM, Gau ML, Ingleton C, Ryan T, Shih FJ . An exploration of spiritual needs of Taiwanese patients with advanced cancer during the therapeutic processes[J]. J Clin Nurs, 2011,20(7-8):950-959
doi: 10.1111/j.1365-2702.2010.03278.x
[18] Moadel A, Morgan C, Fatone A, Grennan J, Carter J, Laruffa G, Skummy A, Dutcher J . Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population[J]. Psychooncology, 1999,8(5):378-385
doi: 10.1002/(ISSN)1099-1611
[19] Wong KF, Yau SY . Nurses’ experiences in spirituality and spiritual care in Hong Kong[J]. Appl Nurs Res, 2010,23(4):242-244
doi: 10.1016/j.apnr.2008.10.002
[20] Wong KF, Lee LY, Lee JK . Hong Kong enrolled nurses’ perceptions of spirituality and spiritual care[J]. Int Nurs Rev, 2008,55(3):333-340
doi: 10.1111/inr.2008.55.issue-3
[21] Mok E, Wong F, Wong D . The meaning of spirituality and spiritual care among the Hong Kong Chinese terminally ill[J]. J Adv Nurs, 2010,66(2):360-370
doi: 10.1111/jan.2010.66.issue-2
[22] Yeung SM, Wong FK, Mok E . Holistic concerns of Chinese stroke survivors during hospitalization and in transition to home[J]. J Adv Nurs, 2011,67(11):2394-2405
doi: 10.1111/jan.2011.67.issue-11
[23] Chan CHY, Chan CLW, Ng EHY, Ho PC, Chan THY, Lee GL, Hui WHC . Incorporating spirituality in psychosocial group intervention for women undergoing in vitro fertilization: A prospective randomized controlled study[J]. Psychol Psychother, 2012,85(4):356-373
doi: 10.1111/papt.2012.85.issue-4
[24] Ng SM, Fong TC, Tsui EY, Au-Yeung FS, Law SK . Validation of the Chinese version of Underwood’s Daily Spiritual Experience Scale — transcending cultural boundaries? Int[J] Behav Med. 2009; 16(2):91-97.
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