Two Factor Structures Possible for the FACIT-Sp in Patients With Heart Failure.

Area of Science:

• Psychometrics
• Clinical Psychology
• Cardiology

Background:

• The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) is a 12-item measure assessing spiritual well-being in chronic illness.
• Previous research proposed overall, two-factor (meaning/peace, faith), and three-factor (meaning, peace, faith) models for the FACIT-Sp, with no consensus on the optimal structure.
• The factor structure of the FACIT-Sp has not been previously examined in patients with heart failure.

Purpose of the Study:

• To determine the factor structure of the FACIT-Sp in patients diagnosed with heart failure.
• To evaluate the suitability of previously proposed models (single-factor, two-factor, and three-factor) for the FACIT-Sp within a heart failure cohort.

Main Methods:

• A confirmatory factor analysis framework was employed using baseline data from 217 heart failure patients in the CASA trial.
• Three competing models (single-factor, two-factor, and three-factor) were tested and subsequently confirmed with 12-month data.
• Model modifications were performed based on empirical inspection of baseline data and validated with 12-month data; internal consistency and correlations with quality of life were assessed.

Main Results:

• All three models exhibited strong factor loadings, with the exception of negatively worded items.
• The two-factor and three-factor models demonstrated reasonable fit after modifications, whereas the single-factor model showed poor fit (RMSEA 0.14, CFI 0.85, SRMR 0.09).
• The two-factor (RMSEA 0.09, CFI 0.93, SRMR 0.05) and three-factor (RMSEA 0.06, CFI 0.97, SRMR 0.04) models showed improved fit, with sufficient internal consistency for all factors.

Conclusions:

• Both the two-factor and three-factor models of the FACIT-Sp are supported in patients with heart failure.
• The three-factor model provided a superior statistical fit, although its interpretability was not significantly enhanced compared to the two-factor model.
• These findings suggest that the FACIT-Sp can be reliably used with either a two-factor or three-factor structure in heart failure populations, with attention to item wording.