Spiritual and Religious Concerns Questionnaire

Abstract

The Spiritual and Religious Concerns Questionnaire (SRQ) is an 11-item clinical screening instrument designed to measure the spiritual and religious beliefs, attitudes, needs, and behaviors of newly hospitalized adolescents (ages 11–19). Developed by Silber and Reilly (1985), the scale’s primary objective is to gather clinically useful information to assist caregivers in delivering more focused and holistic services within an inpatient unit setting.

The SRQ is not based on a specific theoretical orientation but operates on the hypothesis that the intensity of an adolescent’s spiritual and religious concerns increases proportionally with the severity of their illness following hospitalization. Items are scored on a 9-point Likert continuum scale, although the descriptors for the continuum endpoints vary across items. The overall SRQ score is calculated by averaging the eleven items.

Keywords

Spiritual concerns, religious concerns, adolescent hospitalization, psychological assessment, inpatient care, pediatric psychology, Likert scale, holistic care, spiritual needs.

Authors

Silber, T. J., Reilly, M.

Purpose

The primary purpose of the Spiritual and Religious Concerns Questionnaire (SRQ) is to identify and quantify the spiritual and religious issues facing adolescents who are experiencing acute illness and hospitalization. This measurement is intended to be a practical, clinical tool.

The data collected from the SRQ is designed to provide immediate, actionable information to medical staff and chaplains. By understanding the patient’s level of spiritual distress or coping mechanisms, healthcare providers can offer more focused, appropriate, and wholistic services, thereby integrating spiritual health into the overall treatment plan for the hospitalized adolescent.

Construct

The SRQ measures the construct of spiritual and religious concerns, defined broadly to include an individual’s beliefs (e.g., belief in God/Supreme Being), attitudes (e.g., feelings toward God), needs (e.g., desire for help with concerns), and behaviors (e.g., frequency of prayer or participation in organized activities).

The core assumption underpinning the instrument is that the stress and severity associated with illness and hospitalization serve as catalysts, intensifying the adolescent’s focus on spiritual and religious matters. The 11 items explore various facets of this concern, including how the patient perceives the relationship between their illness and a Supreme Being, and how their spiritual practices have changed since the onset of their illness.

Validity

Formal statistical validation in the initial 1985 study was limited. However, Silber and Reilly specifically investigated the relationship between changes in adolescent spiritual/religious concerns and the measured severity of illness.

Analysis of two key items—Item 3 (changes in concerns since illness began) and Item 10 (changes in prayer frequency since entering the hospital)—showed a significant trend: higher scores on these items correlated with more serious illness, lending preliminary support for construct validity related to the stress of illness. The measure is also noted to possess strong face validity, as the items are clearly relevant to the spiritual and religious experience of a hospitalized individual. A recognized inconsistency is that Item 3 references the start of the illness, which may precede hospitalization by a significant period, potentially complicating interpretation of immediate hospitalization effects.

Reliability

No formal analysis of the psychometric reliability of the Spiritual and Religious Concerns Questionnaire was reported in the initial 1985 publication. Measures such as internal consistency (e.g., Cronbach’s alpha) or test-retest reliability were not assessed, indicating that further psychometric investigation is necessary to establish the stability and consistency of the instrument.

Factor Analysis

The original research did not include a report on factor analysis. The SRQ is generally treated as a unidimensional scale, where the average of the eleven items yields a total score reflecting the overall intensity of spiritual and religious concern. Given the scale’s primary clinical screening purpose and its limited number of items, a multi-factor structure was likely not intended or explored in the initial development phase.

Instrument

Test Type: Self-report questionnaire / Clinical screening instrument

Format: 11 scored items using varying 9-point Likert continuum scales. The questionnaire also includes six initial demographic/clinical data points (Sex, Age, Race, School, Religious affiliation, Medical diagnosis) and one final open-ended question regarding desired help.

Language Available: English (Original)

Population Group: Hospitalized adolescents

Age Group: 11 to 19 years

Population Details: The initial standardization sample consisted of 114 newly hospitalized adolescents in an inpatient unit. The sample was balanced across early (11-13), middle (14-15), and late (16-19) adolescent categories. Participants varied ethnically (African-American, Caucasian, Asian) and were classified by severity of illness (severe/fatal, severe, moderate).

Test Methodology: Administration was conducted by trained volunteers. No specific guidelines were provided for reading level or administration time. The overall score is the average of the eleven items, ranging from 1 (low concern) to 9 (high concern). Mean scores showed that females, African-Americans, and the most seriously ill participants reported higher levels of concern.

Keywords

Psychological assessment, spiritual needs, illness severity, hospitalization, prayer, religious beliefs, clinical screening, face validity, adolescent health.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Tomas J. Silber, M.D., Department of Adolescent Medicine, Children’s Medical Center, 10011 Michigan Ave. NW, Washington, DC 20010 (Address provided in subsequent research note, circa 1985).

Permissions & Fee and Test Year

Test Year: 1985

Permissions: The original article, “Spiritual and religious concerns of the hospitalized adolescent,” was published in Adolescence and copyrighted by Libro Publications, Inc. (1985). Researchers should contact the publisher or authors for current usage and permission guidelines.

Fee: Not specified in the source material.

Reference’s

Silber, T. J., & Reilly, M. (1985). Spiritual and religious concerns of the hospitalized adolescent. Adolescence, 20, 217-224. Copyright © 1985 Libro Publications, Inc.

Items of the SPIRITUAL AND RELIGIOUS CONCERNS QUESTIONNAIRE

Patient Questionnaire on Spiritual and Religious Concerns (SRQ)

1. Sex:
2. Age:
3. Race:
4. School:
5. Religious affiliation:
6. Medical diagnosis:

• While you are in the hospital, how often do you talk about spiritual and/or religious concerns?

  1	2	3	4	5	6	7	8	9
  Never				Average				Very Often

• Do you consider yourself a person with spiritual and/or religious concerns?

1 2 3 4 5 6 7 8 9

Not religious and/or spiritual at all Average Very religious and/or spiritual

• Have you had any changes in your concerns relating to spiritual and/or religious matters since your illness began?

l 2 3 4 5 6 7 8 9

Much less interested No change Much more interested

• Do you believe in God (Supreme Being)?

l 2 3 4 5 6 7 8 9

I don’t believe I sometimes believe I believe firmly

• If you believe in God (Supreme Being), how do you feel toward God (Supreme Being)?

1 2 3 4 5 6 7 8 9

Angry, abandoned Indifferent, don’t care Confident, grateful

• Have your feelings toward God (Supreme Being) changed since your illness began?

1 2 3 4 5 6 7 8 9

I feel negative about God (Supreme Being) No change I feel more positive about God (Supreme Being)

• Mark the numeral you feel relates best to your illness.

1 2 3 4 5 6 7 8 9

God (Supreme Being) has nothing to do with my illness I don’t know if God (Supreme Being) is involved in my illness God (Supreme Being) willed my illness

• How often do you pray?

1 2 3 Never 4 5 6 7 8 Sometimes 9 Often

• Since you have come to the hospital, do you pray?

1 2 3 4 5 6 7 8 9

Less than before Unchanged More than before

• If you pray about illness answer the following question: Prayer has helped …

• How often do you participate in organized spiritual and/or religious activities?

1 2 3 4 5 6 7 8 9

Never Average Very often (at least weekly)

• Would you like help with any of your spiritual and/or religious concerns?

___ Yes (If yes, what kind of help?) No