Learning Objective #1: Describe the benefits of utilizing a qualitative method as one phase in the development of a Spiritual Transformation Scale for use with cancer-diagnosed persons

Learning Objective #2: Identify the major spiritual themes for persons experiencing positive or negative spiritual change following cancer diagnosis and treatment

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Accumulating data suggest that people at times undergo significant spiritual transformations (ST) when diagnosed with cancer and that these transformations lead to profound changes in world views, behaviors, and well-being. To facilitate further investigations into the role of ST for people coping with cancer, the investigators are conducting a three-phase study to develop and test a Spiritual Transformation Scale (STS). Phase Two—the focus of this report—utilized a qualitative methodology with the goal of designing a refined scale reflecting the experiences, spiritual/religious beliefs, and language of those reporting ST following a cancer diagnosis. Qualitative interviews were conducted with 15 participants who self-identified as experiencing a spiritual change since their diagnosis. Data were obtained about the nature of spiritual changes through structured open-ended interviews and from participants' critiques of Phase One STS items. Data were analyzed using the qualitative technique of researcher triangulation. Findings revealed major spiritual themes in six domains: world-view; goals; relationships-to-others, to-self, and with-God; and change in pathways—regardless of whether the change was experienced as positive or negative. Findings were used to revise the STS for psychometric testing in Phase Three—including language changes to items, new items generated to cover missed themes, and dropping of identified problematic items. This work may contribute to efforts to explore ST and the field of spirituality and health by emphasizing the need to address negative as well as positive spiritual change in persons coping with cancer diagnoses and treatments. The findings have implications for nurse researchers regarding the contribution of qualitative methods in scale development, especially in the area of spirituality—with its profound quality of life impact; and for oncology nurses regarding the potential for effective intervention to promote positive spiritual change—whether through enhancing positive or facilitating a shift from negative change among persons diagnosed with cancer.