Advancing Spiritual Care Through Research

A scale to assess religious beliefs in end‐of‐life medical care

Background: Studies postulate that certain religious beliefs related to medical care influence the end‐of‐life (EOL) medical decision making and care of patients with advanced cancer. Because to the best of the authors’ knowledge no current measure explicitly assesses such beliefs, in the current study the authors introduced and evaluated the Religious Beliefs in EOL Medical Care (RBEC) scale, a new measure designed to assess religious beliefs within the context of EOL cancer care. Methods: The RBEC scale consists of 7 items designed to reflect religious beliefs in EOL medical care. Its psychometric properties were evaluated in a sample of 275 patients with advanced cancer from the Coping With Cancer II study, a National Cancer Institute–funded, multisite, longitudinal, observational study of communication processes and outcomes in EOL cancer care. Results: The RBEC scale proved to be internally consistent (Cronbach α, .81), unidimensional, positively associated with other indicators of patients’ religiousness and spirituality (establishing its convergent validity), and inversely associated with patients’ terminal illness understanding and acceptance (establishing its criterion validity), suggesting its potential clinical usefulness in promoting informed EOL decision making. The majority of patients (87%) reported some (“somewhat,” “quite a bit,” or “a great deal”) endorsement of at least 1 RBEC item and a majority (62%) endorsed ≥3 RBEC items. Conclusions: The RBEC scale is a reliable and valid tool with which to assess religious beliefs within the context of EOL medical care, beliefs that frequently are endorsed and inversely associated with terminal illness understanding.