Cross-Cultural Adaptation and Psychometric Properties of the Persian Version of the Spiritual Distress Scale (P-SDS) Among Older Adults with Cancer in Iran.

Spiritual health integrates physical, mental, and social aspects of life and helps adapt to disease. This study aimed to assess the psychometric properties of the Spiritual Distress Scale (SDS) in Iranian older adults diagnosed with cancer, as no existing measure was available in Iran. Conducted between May and July 2024, this methodological study used convenience sampling at the Cancer Institute in Tehran, Iran. The SDS was translated and culturally adapted, and its psychometric properties were examined. Floor and ceiling effects were examined and the level of statistical significance was set at p < 0.05. A total of 300 older patients aged 60 or older, participated in this study. Face, content (SCVI/average = 0.96) and cross-cultural validity were established by the experts. Confirmatory factor analysis demonstrated that the extracted model was a good fit (χ2/df = 2.16, RMSEA = 0.06 and CFI = 0.90). The Pearson correlation between P-SDS and spiritual wellbeing scale was significant and inverse (r =  - 0.82; p-value = 0.001). The internal consistency (Cronbach's α = 0.95) and test-retest reliability (ICC = 0.94) of the Persian version (P-SDS) were both satisfactory. Several variables, including gender (p value = 0.001), cancer stage (p value = 0.001), occupation (p value = 0.0006), and living arrangements (p value = 0.020) showed significant relationships with the P-SDS scores. No floor or ceiling effects were found. The P-SDS demonstrates high reliability and validity, making it a valuable tool for researchers to assess SD among older adults in clinical settings.