Spiritual Well-Being (SWB): A Case Study

Patients without renal function can continue living by dialysis for years. Although significant progresses has been created in medical care of End Stage Renal Disease (ESRD), patients' suffering caused by lower quality of life compared with the general population continues (1, 2). Dialysis Patients (DP) are encountered with multiple physical, psychological, and social stressors (3). Therefore, ESRD and its treatment, i.e., dialysis, generally cause serious disorders in lifestyle and severely affect daily life of patients (4). Patients should have some strategies to control their chronic disease (5).

Spiritual well-being (SWB) is an integral part of mental, emotional and physical health and is an important factor in the patient’s quality of

The SWBS, one of the most commonly used scales to study SWB, was first developed by Paloutzian and Ellison (1982) is a paper and pencil scale with approximately 20 items. The scale consists of two dimensions, namely religious well-being and existential well-being, which measure an individual’s relationship with God as well as life satisfaction, spirituality, and purpose in life, respectively (Ellison 1983; Paloutzian and Ellison 1982). This scale is for use with adults and the participant could complete in 10-15 minutes. The items are constructed in a modified Likert scale ranging from strongly disagree (numerical value of 1) to strongly agree (numerical value of 6) with no middle value. Scores will range from 10 to 60 on the subscales (EWB & RWB) and 20-120 on the SWBS value. Higher scores reflect a higher perception of well-being while lower scores reflect a lesser perception (10).Another popular scale used to measure SWB is the Spiritual Well-Being Questionnaire designed by Gomez and Fisher (2003). This scale assesses four aspects of SWB including personal, social, environmental, and transcendence (Gomez and Fisher 2003). A third measure is the Spiritual Orientation Inventory (Elkins et al. 1988) based on existential and valuable issues. Last, the JAREL Spiritual Well-Being Scale is another tool to measure SWB which includes personal questions about participants, others, and God (Hungelmann et al. 1996).

It provides an overall measure of an individual’s perception of the spiritual quality within their lives and consists of two subscales: religious well-being and existential well-being. The religious well-being subscale (10 items) provides a self-assessment of one’s relationship with God, while the existential well-being subscale (10 items) offers a self-assessment of one’s sense of life purpose and life satisfaction (Paloutzian and Ellison 1982). SWBS employs a six-point Likert-type scale that ranges from completely disagree (1) to completely agree (6). A reversed scoring method was used for negative questions (items 1, 2, 5, 6, 9, 12, 13, 16, and 18). The range of scores for each of the religious and existential subscales was between 10 and 60. Higher scores indicated higher religious and existential