Spirituality, religion and personal beliefs : a dimension of quality of life?
TIlls study presents the development of a domain to assess spiritual, religious and personal
(SRPB) in quality of life (QoL). TIlls study is part of a larger, international study, but reports
on the findings specific to the United Kingdom. The work presented here discusses whether
SRPB is an important component of QoL, and therefore should be included in its
measurement. To test this, the WHOQOL-100 (The World Health Organization Quality of
Life Assessment) is used as a basis to investigate this. The first part of this thesis focuses on
the analysis of international data (n = 900), using Persons Living with HIV / AIDS (PLWHA).
The results of this provide rationale for the importance of SRPB as a component of QoL. The
second part of this thesis reports on an international project to further develop the
WHOQOL-100 to more fully assess SRPB as it pertains to QoL in the general population. An
expert meeting generated concepts relevant to SRPB, and these were tested in international
focus groups. The thesis then reports on the focus group interviews (n = 10) conducted in the
UK, and the importance of these facets to QoL. Following this, the results are combined with
international findings, to develop and international pilot instrument. International pilot testing
in 17 countries is described (n = 5,600) and the selection of seven SRPB facets is presented.
The data collected in from the UK (n = 281) pilot is then used to observe the psychometric
properties of the instrument, and how the domain relates as a model of QoL. The
psychometric properties of the domain are promising: Cronbach's alpha for facets ranged
from (0.81 - 0.96), and the domain alpha was excellent at ex = 0.92, and inter-item correlations
were greater than r = 0.40 (p <0.01). Following this, the UK data was analysed to observe the
relationship of SRPB to QoL, using structural equation modelling. While the SRPB facets are
related to psychological or social well being, they appear to represent a concept that is
measurable and unique from other domains. Following this, the impact of SRPB on QoL is
analysed using different sub-groups. The data obtained show that while SRPB is related to
QoL, the strength of this effect varies amongst different sub-groups. The results from this
work have a number of implications that are presented in the final chapter.