A 3-factor model for the FACIT-Sp

Objective: The 12-item Functional Assessment of Chronic Illness Therapy - Spiritual Well-being Scale (FACIT-Sp) is a popular measure of the religious/spiritual (R/S) components of quality of life (QoL) in patients with cancer. The original factor analyses of the FACIT-Sp supported two factors: Meaning/Peace and Faith. Because Meaning suggests a cognitive aspect of R/S and Peace an affective component, we hypothesized a 3-factor solution: Meaning, Peace, and Faith. Methods: Participants were 240 long-term female survivors of cancer who completed the FACIT-Sp, the SF-12, and the BSI 18. We used confirmatory factor analysis to compare the 2- and 3-factor models of the FACIT-Sp and subsequently assessed associations between the resulting solutions and QoL domains. Results: Survivors averaged 44 years of age and 10 years post-diagnosis. A 3-factor solution of the FACIT-Sp significantly improved the fit of the model to the data over the original 2-factor structure (Δχ² = 72.36, df = 2, p < 0.001). Further adjustments to the 3-factor model resulted in a final solution with even better goodness-of-fit indices (χ² = 59.11, df = 1, p = 0.13, CFI = 1.00, SMRM = 0.05). The original Meaning/Peace factor controlling for Faith was associated with mental (r = 0.63, p < 0.000) and physical (r = 0.22, p < 0.01) health on the SF-12, and the original Faith factor controlling for Meaning/Peace was negatively associated with mental health (r = -0.15, p < 0.05). The 3-factor model was more informative. Specifically, using partial correlations, the Peace factor was only related to mental health (r = 0.53, p < 0.001); Meaning was related to both physical (r = 0.18, p < 0.01) and mental (r = -0.17, p < 0.01) health; and Faith was negatively associated with mental health (r = -0.17, p < 0.05). Conclusion: The results of this study support a 3-factor solution of the FACIT-Sp. The new solution not only represents a psychometric improvement over the original, but also enables a more detailed examination of the contribution of different dimensions of R/S to QoL.