Cross-Cultural Adaptation and Validation of the Indonesian Version of the Spiritual Care Competence Scale among Nurses

Dian Herawaty; Sumarmi Sumarmi; Nur Hidayah; Eny Sutria

doi:10.24990/injec.v11i2.1173

Cross-Cultural Adaptation and Validation of the Indonesian Version of the Spiritual Care Competence Scale among Nurses

Dian Herawaty, Sumarmi Sumarmi, Nur Hidayah, Eny Sutria

= http://dx.doi.org/10.24990/injec.v11i2.1173

Abstract views = 178 times |

Abstract

Introduction: Spiritual care is an essential component of holistic nursing practice and contributes to patientsâ€™ psychological well-being, coping ability, and quality of life. The Spiritual Care Competence Scale (SCCS) is one of the most widely used instruments internationally for evaluating nursesâ€™ competence in providing spiritual care. Purpose: This study aimed to translate, culturally adapt, and validate the Indonesian version of the Spiritual Care Competence Scale (SCCS) among nurses. Methods: A methodological study was conducted following the cross-cultural adaptation guidelines proposed by Beaton et al. The translation process included forward translation, synthesis, backward translation, expert committee review, and pre-testing. Content validity was evaluated by five experts using the Content Validity Index (CVI). Reliability testing was conducted among 30 registered nurses using Cronbachâ€™s alpha coefficient. Results: The Indonesian version of the SCCS demonstrated excellent content validity and reliability. All items achieved acceptable Item-Level Content Validity Index (I-CVI) values ranging from 0.80 to 1.00, while the Scale-Level Content Validity Index (S-CVI/Ave) was 0.96. Reliability analysis showed excellent internal consistency, with a Cronbachâ€™s alpha coefficient of 0.959. Corrected itemâ€“total correlations ranged from 0.373 to 0.871, indicating satisfactory item discrimination. All 27 items met the predefined psychometric criteria and were retained in the final instrument. Conclusion: The Indonesian version of the SCCS is a valid and reliable instrument for assessing nursesâ€™ spiritual care competence. The instrument may be used in nursing education, clinical practice, and research to support the development and evaluation of spiritual care competencies among Indonesian nurses.

Keywords

spiritual care competence, nurses, cross-cultural adaptation, validation study, psychometric properties, Indonesia

References

Azanaw, Y. G., Woretaw, A. W., Azene, T., Ayele, D. G., Siyoum, T. M., Gebeyehu, T., Bazezew, K., Zeleke, K. A., Alemsht, E., & Tsega, S. S. (2025). Spiritual care competence and associated factors among nurses: a multi-center cross-sectional study. BMC nursing, 24(1), 606.

Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.

BoÅ¼ek, A., Nowak, P. F., & Blukacz, M. (2020). The relationship between spirituality, health-related behavior, and psychological well-being. Frontiers in psychology, 11, 552187.

ErÅŸahin, Z. (2021). Care, Spiritual Care, and Modern Health Care: Developments, Concepts, and Debates. Care, Healing, and Human Well-Being W ith in Interreligious Discourses, 66.

Fang, H.-F., Susanti, H. D., Dlamini, L. P., Miao, N.-F., & Chung, M.-H. (2022). Validity and reliability of the spiritual care competency scale for oncology nurses in Taiwan. BMC Palliative Care, 21(1), 16.

GarcÃa-InÃ©s, T. S., MartÃnez-Gimeno, M. L., JÃ³dar, R., Mc Sherry, W., Ribeiro, A. S., & Zulueta-Egea, M. (2025). Validation of the Spanish version of the EPICC spiritual care competency self-assessment tool for student nurses. Nurse Education in Practice, 86, 104395.

Green, A., Kim-Godwin, Y. S., & Jones, C. W. (2020). Perceptions of spiritual care education, competence, and barriers in providing spiritual care among registered nurses. Journal of Holistic Nursing, 38(1), 41-51.

Heidari, M., HoseinPour, M. A., Ardebili, M., & Yoosefee, S. (2022). The association of the spiritual health and psychological well-being of teachers with their organizational commitment. BMC psychology, 10(1), 55.

Kabakci, E. N., & Ã‡elik, N. (2022). Adaptation into Turkish and evaluation of the psychometric properties of the Spiritual Care Competence Scale. Central European Journal of Nursing and Midwifery, 13(2), 648.

Machul, M., van Leeuwen, R., Ozga, D., Jurek, K., Boczkowska, S., & Dobrowolska, B. (2022). The level of spiritual care competence of Polish nurses and the psychometric properties of the spiritual care competence scale (SCCS). BMC nursing, 21(1), 106.

Mirzazadeh-Qashqaei, F., Zarea, K., Rashidi, H., & Haghighizadeh, M. H. (2023). The relationship between self-care, spiritual well-being and coping strategies in patients with type 2 diabetes mellitus. Journal of Research in Nursing, 28(4), 259-269.

Nagy, D. S., Isaic, A., Motofelea, A. C., Popovici, D. I., Diaconescu, R. G., & Negru, S. M. (2024). The role of spirituality and religion in improving quality of life and coping mechanisms in cancer patients. Healthcare,

Najafi, K., Khoshab, H., Rahimi, N., & Jahanara, A. (2022). Relationship between spiritual health with stress, anxiety and depression in patients with chronic diseases. International Journal of Africa Nursing Sciences, 17, 100463.

Prieto-Crespo, V., Arevalo-Buitrago, P., Olivares-Luque, E., GarcÃa-Arcos, A., & LÃ³pez-Soto, P. J. (2024). Impact of spiritual support interventions on the quality of life of patients who receive palliative care: a systematic review. Nursing Reports, 14(3), 1906-1921.

Ramadhan, M. D., Pangestika, D. D., & Fitriana, N. F. (2020). The correlation between spiritual care giving and nursesâ€™ competences at critical care units. Journal Pendidikan Keperawatan Indonesia, 6(2), 122-127.

Ramezani, M., Ahmadi, F., Mohammadi, E., & Kazemnejad, A. (2014). Spiritual care in nursing: a concept analysis. International nursing review, 61(2), 211-219.

Salari, N., Kazeminia, M., Abdi, A., Abdolmaleki, A., Abdoli, N., Mohammadi, M., & Shohaimi, S. (2023). Effects of counselling and spiritual care program on anxiety in patients with chronic diseases: A systematic review and meta-analysis. Current Psychology, 42(12), 9943-9952.

Sitorus, B. D., Laoli, D., Juniarta, J., & Situmorang, K. (2025). Nursesâ€™ Spiritual Well-Being and Spiritual Care Competence: A Cross-Sectional Study in Indonesia. Nursing Current: Jurnal Keperawatan, 13(2), 178-186.

van Leeuwen, R., & Schep-Akkerman, A. E. (2024). Dissemination of the spiritual care competence scale (SCCS). Journal for the Study of Spirituality, 14(1), 75-91.

Wang, Z., Zhao, H., Zhang, S., Wang, Y., Zhang, Y., Wang, Z., Li, X., Xiao, L., Zhu, Y., & Han, G. (2022). Correlations among spiritual care competence, spiritual care perceptions and spiritual health of Chinese nurses: A cross-sectional correlational study. Palliative & Supportive Care, 20(2), 243-254.

Wirakhmi, I. N., & Purnawan, I. (2025). Effectiveness of structured spiritual care models in improving psychological and physiological outcomes in Intensive Care Unit (ICU) Patients: a systematic review. Journal of Health and Nutrition Research, 4(1), 273-286.

Yang, S.-H., Tsan, Y.-T., Hsu, W.-T., Liu, C.-F., Ho, W.-C., Wu, L.-F., Lin, C.-F., & Chu, W.-M. (2024). Association between self-efficacy, spiritual well-being and the willingness to provide spiritual care among nursing staff in Taiwan: a cross-sectional study. BMC nursing, 23(1), 299.

Yildirim, J. G., & Ertem, M. (2022). Professional quality of life and perceptions of spirituality and spiritual care among nurses: Relationship and affecting factors. Perspectives in psychiatric care, 58(2), 438-447.