A study of university classroom strategies aimed at increasing spiritual health

College Student Journal, Dec, 2003 by Melissa McGee, Liza Nagel, Meighan K. Moore

Although commonly asserted to be the core of health, spirituality is a relatively unexplored area. The authors of this study proposed the research question: can spiritual health be enhanced through a planned educational intervention? This study examined the malleability of spirituality among students at a southwestern university, using a quasi-experimental study with pre- and post-analyses of a treatment group and two comparison groups. The hypothesis stated that university students who received a spiritual health intervention based on Seaward's (1994, 1997) description would exhibit higher levels of spirituality as measured by the Spirituality Assessment Scale. A one-way ANOVA procedure revealed a statistically significant difference between the three groups, with the treatment group demonstrating the highest levels of spiritual health. If, indeed, spirituality is at the core of one's health, the implications for promoting health are significant. This study suggests that individuals can take an active, primary role in personal healing.

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Historically, spirituality and spiritual wellbeing were largely ignored in Western medical practice. Classified as non-empirical by the medical community, the very nature of spirituality, in that it is transcendent and cannot be discerned through the five senses, labeled it an inappropriate subject for Western medical concern. (1) Recently however, this perspective has begun to change.

Inspired by the World Health Organization's decision to redefine health as "a state of complete physical, mental and social wellbeing," (2) researchers and clinicians began to include spiritual wellbeing in their definitions of health. Spirituality formed the core of the holistic health movement by the 1970s. Although originated and championed by church leaders, the spiritual dimension of health was quickly adopted and supported by many secular leaders and researchers in the health and medical fields. (3-7) Osman and Russell (1979) ushered health professionals along the spiritual health path with the statement, "... the time now has come to accept the spiritual as an important aspect of individual and corporate life and a legitimate dimension of wellbeing." (8)

Recent research supports the connection between spirituality and health. (9-12) Schafer's (1997) study of the relationship between religiosity/spirituality and personal distress among college students found those students with a clear sense of meaning and direction reported lower personal distress. Adams, Bezner, Drabbs, Zambarano, and Steinhardt (2000) examined the association between spirituality and perceived wellness among college students. They found the indices of life purpose, optimism and sense of coherence was positively related to perceived overall wellness. Due, in part to the outcomes of these studies, there has been increased attention to include spirituality in not only the preparation of health educators but also within the fields of Counseling and Medicine. (11,12)

The spiritual health movement has been fueled by the idea that individuals can take an active, primary role in personal healing and that spiritual wellbeing plays a critical role in this process. (5, 13-15) Indeed, reports of classroom models for promoting health through increasing spirituality have recently emerged. (16-18) Should spiritual wellbeing have the power to heal and promote health, research has yet to show persuasive evidence of whether this vital component of wellness can actually be enhanced through planned intervention. Compounding this dilemma is the fact that a standard, operational definition of spirituality and spiritual wellbeing has yet to be agreed upon.

In light of these challenges, the authors of this study proposed the following research question--can spiritual health be enhanced through a planned educational intervention? The assumption inherent in this question is that spirituality is flexible and can be exercised and improved with conscious effort. Although no prior health or medical research has explored this assumption, it is a well-established assumption in the fields of theology and philosophy. (19-21) Furthermore, a review of the literature revealed an operational definition and companion assessment tool of spiritual health that encompassed the broadest and most common characteristics attributed to spirituality and spiritual wellbeing. (22)

In comparison to other instruments designed to assess spiritual wellbeing, Howden's Spirituality Assessment Scale (SAS) appears the most promising due to the comprehensiveness of its definition. Developed in 1992, the SAS measures spirituality by focusing on four attributes deemed by researchers and scholars to be critical to spiritual health: purpose and meaning in life, innerness or inner resources, unifying interconnectedness, and transcendence (see Figure 1). (22) Content validity of the scale was evaluated by six experts in the area of spirituality and spiritual health and subjected to a pilot test to assess readability, reliability and validity. In a study of 189 subjects, the SAS was found to have high internal consistency (alpha=0.9164). (22) Each subscale was also found to have reasonably high internal consistency: 1) purpose and meaning in life (4 items), alpha=0.9117; 2) innerness or inner resources (9 items), alpha=0.7944; 3) unifying interconnectedness (9 items), alpha=0.8017; and 4) transcendence (6 items), alpha--0.7091. This study marks the first attempt to use the SAS to assess spiritual health in a quasi-experimental research study.