Table 2.

Religiosity and / or spirituality measures used in the included studies

Religiosity and/or spirituality measure [reference]	Number of items	Instrument description	Scoring system	Studies that used measure in this review
Spiritual desires, constraints, and needs questionnaire [30]	3	Instrument developed for this specific study based on prior qualitative study findings on spiritual needs. Items were “‘Do you want your doctor and other healthcare providers to attend to your spiritual needs?,’ ‘How much do you feel limited or constrained in discussing your spiritual issues with your doctor and other health care providers?,’ and ‘How well are your spiritual needs getting met right now?.’” No psychometric properties of the scale or validation procedure were reported	Responses for each item ranged from 1 (not at all) to 4 (very much/a great deal)	[30]
Church service attendance [39]	1	Single item assessing the frequency of church service attendance in the previous 6 months	Item response is scored using a five-point Likert-type scale ranging from 1 (least frequency of attendance) to 5 (most frequent service attendance)	[39]
Islamic religious attitude questionnaire [40]	25	A self-report scale with 6 dimensions on learning and reading the Quran; Knowledge of God and faith in God; belief in afterlife; attitude to Islamic religious rituals; positive attributes; devotion to religious worship; and praying. The instrument was developed for the purpose of the study [11]. Psychometric validation of the instrument was conducted with test–retest correlation coefficient of 0.86 and internal consistency Cronbach’s α = 0.89	4-point Likert Scale with response items ranging from 1 = strongly disagree to 4 = strongly agree	[40]
The Religious Coping Activities Scale [42]	29	A validated instrument which assesses the degree to which people use religion to cope with stressful life events. Six types of religious coping are assessed: spiritually based activities (12 items), good deeds (6 items), discontentment (3 items), interpersonal religious support (2 items), pleading and bargaining with a Supreme Being (3 items), and religious avoidance (3 items)	A 4-point Likert scale is used to assess how participants rely on each religious coping strategy. Higher scores imply greater reliance on religion for coping. Subscale and total scores are derived from the mean of the individual items	[31, 32]
Functional Assessment of Chronic Illness Therapy FACIT-Sp-12 [43]	12	A validated self-report measure of overall spiritual well-being. Two subscales are assessed: “Meaning/Peace” (8 items) and Faith (4 items). The meaning/peace subscale assesses one’s sense of meaning, peace, harmony, and life’s purpose. The faith subscale measures the relationship between faith, spiritual beliefs, and illness, and seeking solace in one’s faith	The response to each item ranges from 0 (not at all) to 4 (very much). A composite score ranging from 0 to 48 is derived from the subscales with higher scores indicating greater spiritual well-being	[37, 38]
Religious identification [44]	1	A validated measure of the extent to which an individual considered themselves religious	Scored from 0 (not at all) to 4 (extremely). Dichotomized in the study as low and high	[27]
Religious comfort—Daily spiritual experience scale [44]	3	Religious comfort assessed from the Daily spiritual experience scale. Respondents rate how they feel about the presence of God, derived comfort or strength in their religion or spirituality, and experienced God’s love directly or via others	Responses range from 0 (never or almost never to 6 (many times a day), with higher scores reflecting greater religious comfort	[27]
Brief Multidimensional Measure of Religion/Spirituality (BMMR/S) [44]	23	The following dimensions of religiousness/spirituality is assessed with the BMMMR/S: Forgiveness (3 items), daily spiritual experiences (8 items), belief in life after death (1 item), religious identity (1 item), religious support (2 items), public religious practices (2 items), and positive religious/spiritual coping (4 items)	Each dimension is scored separately: Forgiveness (1–4), daily spiritual experience (1—never to 8—many times a day), belief in life after death (0—no, 1—undecided, 2—yes), religious identity (0—not considered a religious person to 4—extremely religious), religious support (1—none to 4—a great deal), public religious practices (1—never to 8—several times a week), positive R/S coping (1—not at all to 4—a great deal)	[28, 30]
Religious struggle—Religious strain scale [45]	6	Instrument derived from the brief version of the religious strain scale. Respondents rate their agreement with the items on their feeling of anger or alienation from God	Responses range from 0 (not at all) to 10 (extremely). Summed scores range from 0 to 60, with higher scores implying greater religious struggle	[27, 28]
Spiritual Well-Being Scale [46]	20	A validated 10-item subscales assessing religious well-being (RWB) and existential well-being (EWB), respectively. Items on the RWB make direct reference to God while items on the EWB measure a sense of purpose or meaning to life with direct reference to God	6-point Likert scale where higher numbers indicate greater endorsement of the statement. Negative items are reversely scored. The 10 items are scored from 10 to 60 and the scores from the two subscales can be added to derive an overall spiritual well-being score ranging from 20 to 120 with higher scores indicating better spiritual well-being	[33]
The Spiritual Perspective Scale [47]	10	A validated measure of spirituality with adequate psychometric properties. The items measure the extent to which spirituality permeates one’s life, one’s engagement in spiritually related interactions, perceived spiritual perspectives, and an individuals’ practice and belief system	There are 5 response options scored from 1 (not at all/strongly disagree) to 6 (about once a day/strongly agree). The total score ranges from 10 to 60, higher scores indicate greater spiritual perspective and higher levels of self-transcendence	[34]
Functional Assessment of Chronic Illness Therapy FACIT-Sp-4 [48]	4	Derived from the FACIT-Sp-12. Measures the extent of strength and comfort derived from one’s faith	Scores range from 0 to 4, with higher scores indicating greater spirituality	[35]
Religious coping—COPE measure [49]	4	The COPE measure is a validated 60-item instrument with 15 subscales that measures how individuals cope with stressful life situations. The Religious subscale (4 items) assesses how people turn to religion by seeking God’s help, putting their trust in God, finding comfort in their religion, and praying more than usual during stressful periods	The response to each item is scored from 1 (I usually do not do this at all)–4 (I usually do this a lot), indicating the frequency with which an individual carries out religious coping. Subscales are assessed individually with scores ranging from 4 to 16. Higher scores imply greater religious coping	[36]
Ironson–Woods Spirituality/Religiousness Index (IW) [50]	25	A validated self-report instrument that measures spirituality in two dimensions: traditional religiousness and private spirituality. Four subscales assess an individuals’ “sense of peace” (9 items), “faith in God” (6 items), “religious behavior” (5 items), and “compassion view of others” (5 items)	Responses indicate how strongly one agrees with each item with scores from 1 (strongly disagree) to 5 (strongly agree)	[38]
Intrinsic religiousness [51]	9	The Intrinsic religiousness subscale is derived from the Religious Orientation Scale	Responses are scored using a five-point Likert-type scale, with lower scores indicating higher intrinsic religiousness	[39]
The Religiosity Measure [52]	8	A validated instrument which assesses the impact of religion on an individual’s daily life. Comprises four subscales with two items each: ritual religiosity, consequential religiosity, ideological religiosity, and experiential religiosity. Ritual religiosity assesses the frequency of attendance in religious services, and the practice of meditation or prayer. Consequential religiosity measures the extent to which religion affects respondent’s decision and daily life. Ideological religiosity assesses belief in a Supreme Being and life after death. Experiential religiosity assesses the respondent’s religious devotion and comfort from religion	Each item is scored on a 5-point Likert scale from 0 (least religiosity) to 4 (greatest religiosity) except the item on religious service attendance that is scored from 1 to 4 with increasing frequency of service attendance. Each subscale has a maximum score of 8 and the overall score for the religiosity measure is 32	[31, 32]
The Spiritual and Religious Concerns Questionnaire (SRQC) [53]	11	A validated instrument which assesses the strength of spiritual beliefs (7 items) and religious practices (4 items). Originally designed to assess spiritual concerns in adolescents who were hospitalized. Adapted for use in adult population to assess spiritual concerns broadly and in keeping with the respondent’s illness	Each response is scored from 1 (least spiritual/religious) to 9 (most spiritual/religious). The overall score is derived from the mean of the 11 items	[32]