N09 Italian translation and validation of the Spiritual Needs Questionnaire - Extended Version in Inflammatory Bowel Disease: preliminary results
Authors: Martinato RN PhD M , Monaco E , Iervolino C , Arndt B , Comoretto R I , Gregori D 
Published: January 2025

Abstract

Background
Addressing the existential and spiritual needs of patients with Inflammatory Bowel Disease (IBD) is crucial for holistic patient care. However, limited research has been conducted on spiritual well-being among IBD patients [1,2]. This study focused on translating and validating the Spiritual Needs Questionnaire - Extended Version (SpNQ-EV – Figure 1), a 32-item 4-point Likert scale questionnaire with 3 open-ended questions, for Italian patients with IBD.

Methods
The study employed a rigorous 6-step translation and validation process, including forward- and back-translation, expert review, and both quantitative and qualitative validation (Figure 2) already adopted in previous studies [3]. Face and content (quantitative) validation involved a panel of 10 experts in nursing, psychology, and gastroenterology, and IBD patients who evaluated its clarity, relevance, and comprehensiveness. The qualitative validation, aims at confirming item- and scale-validity and ensuring user-friendly administration. Is adopting the Thinking Out Loud (TOL) technique (think-aloud method) asking 20 participants to verbalize their thoughts while completing the questionnaire to capture real-time insights into their understanding, interpretation, and potential challenges with questionnaire’s items.

Results
The face validation process showed that experts and patients rated the questionnaire items as clear and easily understandable with a rate between 0.9 and 1.0 in every single item and an overall rate of 0.93, excluding the need for items reformulation. For content validity, the Scale Content Validity Index (S-CVI) was calculated at 0.96, while the Item Content Validity Index (I-CVI) was in a range between 0.9 and 1.0 in every item, indicating excellent relevance and coverage of the spiritual needs constructs. The qualitative validation, conducted so far with the participation of 4 out of 20 patients, confirmed the understanding and correct interpretation of the individual items and of the whole questionnaire, ruling out potential challenges in completing the questionnaire.

Conclusion
The Italian version of the SpNQ-EV is a valid tool for assessing the spiritual needs of Italian IBD patients, as confirmed by both face and content validation. This validated questionnaire can facilitate the integration of spiritual care into clinical practice, enabling healthcare professionals to better address holistic well-being. A pilot study adopting the TOL technique is confirming the clarity and cultural relevance of the translated questionnaire. The finalized Italian version will be subsequently administered to IBD patients in a larger pilot study [4] to assess its reliability. Further research will explore its application in other European languages and settings.

References
[1]Starnella G, Rosato I, Canova C, et al. N47 Spiritual needs of patients with IBD: preliminary results of a pilot study. J Crohns Colitis. 2024;18(Supplement_1):i2256. doi:10.1093/ecco-jcc/jjad212.1419
[2]Büssing A. The Spiritual Needs Questionnaire in Research and Clinical Application: a Summary of Findings. J Relig Health. 2021;60(5):3732-3748. doi:10.1007/s10943-021-01421-4
[3]Martinato M, Ranzato C, Faggian E, et al. Knowledge assessment among subjects with chronic venous leg ulcer in outpatient setting: Translation and adaptation of a tool to identify subjects at risk of poor understanding. Wound Repair Regen. 2023;31(5):679-687. doi:10.1111/wrr.13107
[4]Martinato M. N-ECCO Grant Spiritual needs of patients with inflammatory bowel disease and their caregivers: a European cross-sectional nursing study. J Crohns Colitis. 2024;18(Supplement_1):i2274. doi:10.1093/ecco-jcc/jjad212.1437