• spiritual transformation;
  • spiritual change;
  • spiritual growth and spiritual decline;
  • religion;
  • spirituality and cancer


This study assessed the factor structure, reliability, and validity of an instrument designed to assess spiritual transformations following a diagnosis of cancer—the Spiritual Transformation Scale (STS). The instrument was administering to 253 people diagnosed with cancer within the previous 2 years. Two underlying factors emerged (spiritual growth (SG) and spiritual decline (SD)) with adequate internal reliability (alpha=0.98 and 0.86, respectively) and test–retest reliability (r=0.85 and 0.73, respectively). Validity was supported by correlations between SG and the Positive and Negative Affect Scale (PANAS) Positive Affect Subscale (r=0.23, p<0.001), the Daily Spiritual Experiences Scale (r=0.57, p<0.001), and the Post-traumatic Growth Inventory (r=0.68, p<0.001). SD was associated with higher scores on the Center for Epidemiological Studies Depression scale (r=0.38, p<0.001) and PANAS-Negative Affect Subscale (r=0.40, p<0.001), and lower scores on the PANAS-Positive Affect Subscale (r=−0.23, p<0.001), and the Daily Spiritual Experiences Scale (r=−0.30, p<0.001). Hierarchical regression analyses indicated that the subscales uniquely predicted adjustment beyond related constructs (intrinsic religiousness, spiritual coping, and general post-traumatic growth). The results indicate that the STS is psychometrically sound, with SG predicting better, and SD predicting poorer, mental and spiritual well-being following a diagnosis of cancer. Copyright © 2007 John Wiley & Sons, Ltd.