| Sumario: | Context: Research provides hints that organized religious activities are associated with better rates of survival, at least for healthy individuals. Specific religious activities such as church attendance, however, may or may not be as relevant to health in secular societies compared to societies with vital religiosity. Regardless of the relevance of church attendance, researchers also have to ask whether other, nonorganized forms of spiritual engagement are relevant to health. To address this question in new studies, researchers must rely on instruments with a broader conceptualizations of spiritual practices than just church attendance. Objective: To analyze the external validity of the SpREUK-P SF17 (SpREUK is an acronym of the German translation of 'Spiritual and Religious Attitudes in Dealing with Illness'), a modified version of the SpREUK-P (practices), which may be suited particularly to secular societies because of its wide range of addressed religious and secular activities. Design: For the current study, the research team relied on data obtained in prior and current studies that used the SpREUK-P. To improve that questionnaire's relevance for future health-service research, the team developed a modified version ofthat practices survey, the SpREUK-P SF17 that measures the frequency of engagement in distinct forms of spirituality. For this analysis, 576 patients with chronic diseases were enrolled. Participants: The participants came from different recruiting centers: the Department of Internal and Integrative Medicine at the Essen-Mitte Clinics (52%), the Orthopedic Clinic in Bad Bocklet and Baumrain Clinic in Bad Berleburg (16%), the Pain Outpatient Clinic and Tumor Outpatient Clinic of the Communal Hospital Herdecke (16%), the Department of Psychiatry and Psychotherapy of the University Clinic Freiburg (15%), and other (1%). Outcome Measures: The research team performed reliability (Cronbach's coefficient a) and factor analyses (principal component analysis using varimax rotation with Kaiser's normalization), analyses of variance, crosstabulation (Pearson's x), correlation and regression analyses with SPSS 17.0 for Windows (SPSS GmbH Software, Munich). The team judged P<.05 as significant. With respect to the correlation analyses, the team regarded r<0.5 as a strong correlation, an r between 0.3 and 0.5 as a moderate correlation, an r between 0.2 and 0.3 as a weak correlation, and r<0.2 as no or a negligible correlation. Results: The research team confirmed that the modified, 17-item version of the questionnaire, the SpREUK-P SF17, is a valid and reliable instrument that differentiates 5 main factors (i.e., religious practices; humanistic practices; existential practices; gratitude/reverence; mind-body practices) with good internal consistency coefficients (Cronbach's a ranges from 0.72 to 0.82): (1) religious practices, (2) humanistic practices, (3) existential practices; (4) gratitude or reverence, and (5) (spiritual) mindbody practices. Conclusions: Researchers can address both religious and secular forms of spirituality with a generic instrument that has no bias for or against a particular religious commitment.
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