Research design. This cross-sectional descriptive study was conducted between April and November 2019 to determine the correlation between SWB and QOL in patients with UI. Patients who had UI, were older than 18 years, and did not have hearing and/or visual impairments or dementia were included in the study. Participants were recruited using convenience sampling methods (N = 383) in the urology outpatient clinic of a university hospital in Turkey.
Data were collected using a demographic information form (the FACIT-Sp-12) and the I-QOL form. The FACIT-Sp-12 form was based on a literature review conducted by the researchers.2,7,9 The form elicited information on age, level of education, employment status, UI onset, hearing about spiritual care, believing in the necessity of spiritual care, and receiving spiritual care. Before collecting data, the researchers explained what “spiritual care” means to those who did not understand the questions about it. The researchers informed them that spiritual care was a broad concept encompassing individual values, beliefs, hope, and love and that it helped individuals to cope with despair and frustration. The researchers asked patients whether they had heard about spiritual care before, whether nurses had ever met their spiritual care needs, and whether they believed that spiritual care was necessary.
The I-QOL (Cronbach’s alpha of 0.95) was developed by Wagner et al22 to determine QOL in patients with UI living in Washington (N = 62). Özerdoğan adapted the I-QOL to Turkish and established its validity and reliability.23 It consists of 22 items and 3 subscales: limiting behavior (8 items), psychosocial impacts (9 items), and social embarrassment (5 items). The items are scored on a 5-point Likert-type scale (1 = very much, 5 = not at all). The total score is converted into a grade from 0 (lowest QOL) to 100 (highest QOL). Higher scores indicate higher QOL. Özerdoğan23 reported that the Turkish version of the I-QOL had a Cronbach’s alpha of 0.96; the Cronbach’s alpha was found to be 0.94 in the current study.
The FACIT-Sp-12 was developed by Peterman et al24 on 131 participants in the United States and adapted to Turkish by Aktürk et al.13 The FACIT-Sp-12 consists of 12 items and 3 subscales: meaning (4 items), peace (4 items), and faith (4 items). The subscale “meaning” assesses internal harmony, “peace” assesses inner peace, and “faith” assesses the comfort and strength found in one’s religious belief. The items are scored on a scale of 0 to 4 (0 = never, 4 = always). The total score ranges from 0 to 48. Higher scores indicate better SWB. Aktürk et al13 reported that the Turkish version of the FACIT-Sp-12 had a Cronbach’s alpha of 0.87; Cronbach’s alpha was 0.76 in the current study.
Data collection. Data were collected during routine visits through face-to-face interviews and using pen and paper. Patients were informed about the purpose and procedure of the study prior to participation. Written and verbal consent were obtained from those who met the inclusion criteria and agreed to participate. Afterward, they were asked to complete the data collection forms. The researcher was present to answer any questions regarding the forms and to read the items with which participants had difficulty. Data collection lasted 15 to 20 minutes. The data collection procedure was designed to protect confidentiality and anonymity. The interviews took place in a quiet and private room in the hospital. Only the researchers had access to data, and no data were shared with third parties. All identifying information was removed to ensure confidentiality and anonymity.
Ethical considerations. The study was approved by the Non-Interventional Ethics Committee (decision no. 2019.03.24). Permission was obtained from the hospital. Patients were informed about the purpose and procedure of the study prior to participation, and informed consent was obtained from those who agreed to participate.
Data analysis. Data were analyzed using the Statistical Package for Social Sciences (SPSS v. 22) at a significance level of 0.05. Two (2) researchers checked the databases and analyses. A third researcher removed the forms with missing data (2 or more unanswered items). Number, percentage, mean, and standard deviation were used for descriptive statistics. Normality was tested using skewness and kurtosis values. Skewness and kurtosis values in the range of -2 to +2 suggest that data meet the normality assumption.25 Neither I-QOL (skewness: 0.117; kurtosis: -0.876) nor FACIT-Sp-12 (skewness: -0.847; kurtosis: 1.704) scores were normally distributed. Therefore, an ordinal type of measurement and Spearman’s correlation were used to determine the correlation between the scale scores. The magnitudes of correlations were classified as follows: ≤ 0.25 = very low; 0.26 ≤ r ≤ 0.49 = low; 0.50 ≤ r ≤ 0.69 = moderate; 0.70 ≤ r ≤ 0.89 = high; and 0.90 ≤ r < 1 = very high.25