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Cited by 70Religion, Spirituality, and PsychologyMindfulness and Compassion InterventionsCancer survivorship and care

The Brief Serenity Scale

Open access
Kreitzer, Mary Jo, Gross, Cynthia R., Waleekhachonloet, On-anong, Reilly-Spong, Maryanne, Byrd, Marcia·2009·Journal of Holistic Nursing
DOI 10.1177/0898010108327212PMC PMC2818779
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Abstract

Purpose: This article describes a factor analysis of a 22-item version of the Serenity Scale, a tool that measures spirituality and well-being. Method: A sample of 87 participants, enrolled in a National Institutes of Health—funded clinical trial examining the impact of mindfulness-based stress reduction on symptom management post-solid organ transplantation, completed the abbreviated instrument. Findings: Exploratory factor analysis yielded three subscales: acceptance, inner haven, and trust. The Serenity Scale was positively associated with positive affect and mindful awareness and inversely related to negative affect, anxiety, depression, health distress and transplant-related stress. Conclusions: Serenity, a dimension of spirituality that is secular and distinct from religious orientation or religiosity, shows promise as a tool that could be used to measure outcomes of nursing interventions that improve health and well-being. Implications: Spirituality is recognized as being an essential component of holistic nursing practice. As nurses expand their use of spiritual interventions, it is important to document outcomes related to nursing care. The Serenity Scale appears to capture a dimension of spirituality, a state of acceptance, inner haven and trust that is distinct from other spirituality instruments.

Integrity signals

Registry

Crossref · 10.1177/0898010108327212

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 9 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Scores on the Brief Serenity Scale showed significant correlations with the other self-report measures in the directions expected.

    “The brief Serenity Scale was significantly correlated with the other self-report measures in the expected directions as described in Table 3.”
    Quote in the paperSubstantial claim
  • Findingown data

    With gender, age, education, and life-saving transplant status controlled, greater serenity significantly predicted better quality of life.

    “As shown in Table 4, participants that reported a higher level of serenity were significantly more likely to report having a higher (e.g., better) quality of life.”
    Quote in the paperSubstantial claim
  • Interpretationreasoning

    The Inner Haven factor reflects the capacity to draw on an inner source of comfort.

    “Thus, the second factor, Inner Haven, reflects a person’s ability to tap into an inner resource of comfort.”
    Quote in the paperSubstantial claim
  • Interpretationown data

    The Brief Serenity Scale shows promise as a valid and reliable tool for measuring serenity and its acceptance, inner haven, and trust facets in clinical research.

    “Our evaluation of the brief Serenity Scale suggests that it is a promising instrument to provide valid and reliable measurement of serenity and its facets of acceptance, inner haven and trust, for clinical research.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: A sample of solid organ transplant recipients is suitable for psychometric study of a spirituality measure.
  • Interpretationreasoning

    This study broadens the Serenity Scale's use to patient populations.

    “The present study extends the application of the Serenity Scale to patients.”
    Quote in the paperSubstantial claim
  • May combine two claims. 28
  • Classified as probably not a substantial claim. 14
  • The quote only partly states this claim. 2

  • May combine two claims.

    Findingown data

    The Inner Haven factor comprised eight items, explained 8.64% of the variance, and had a Cronbach's alpha of .94.

    “The eight items associated with this factor had factor loadings ranging from.53 t o.91. Item-to-total correlations ranged from.71 to.88, and this factor explained 8.64% of the variance. Cronbach’s alpha for Inner Haven was also high, .94.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Every participant finished the Brief Serenity Scale at the baseline assessment, with no missing items.

    “All participants completed the scale at the baseline assessment without missing items.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The three-factor model was the best fitting model and was significantly better than the one- and two-factor alternatives.

    “Based on the goodness of fit indices and χ2 difference test, as shown in Table 2, the 3 factor model was not only the best fitting model, it was significantly better than the simpler alternatives.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Trust factor comprised four items, explained 4.47% of the variance, and had a Cronbach's alpha of .88.

    “Factor 3 replicated the Trust factor in Roberts and Aspy’s 9-factor solution, and explained 4.47% of the variance. The 4 items representing the Trust factor had factor loadings ranging from.42 to.85. Item-to-total correlations ranged from.59 to.81, and Cronbach’s alpha was also high, .88.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Acceptance factor comprised 10 items, explained 45.6% of the variance, and had a Cronbach's alpha of .89.

    “Factor 1 contained 10 items, all but one with a factor loading over.40. Item-to-total correlations for these items ranged from.40 to.71. Factor 1 explained 45.6% of the variance, and the Cronbach’s alpha for this factor was high, .89.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In the sample of 87 solid organ transplant recipients, the 22-item Brief Serenity Scale showed high internal consistency reliability, with a Cronbach's alpha of .95.

    “The scores of the 22 item Serenity Scale ranged from 1.86 to 5.0, and its internal consistency reliability was high (Cronbach’s alpha = .95).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Greater serenity was linked to more positive affect and mindful awareness, and to less negative affect, anxiety, depression, health distress, and transplant-related stress.

    “Higher serenity scores were positively associated with positive affect and mindful awareness and inversely related to negative affect, anxiety, depression, health distress and transplant-related stress.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Serenity Scale scores in this sample did not differ significantly by age, gender, marital status, education level, or type of transplant.

    “There were no significant differences in Serenity Scale scores among the participants based on age, gender, marital status, education level, or type of transplant.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Exploratory factor analysis of the 22-item Serenity Scale identified three factors-Acceptance, Inner Haven, and Trust-that together accounted for 58.72% of the variance.

    “EFA identified three factors (See Table 1), explaining a total of 58.72% of the variance.”
    • Also stated in: § DISCUSSION · plain
      “Our analysis of the 22 item Serenity Scale revealed 3 distinct factors: Acceptance, Inner Haven and Trust.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Responses to all 22 items were relatively evenly distributed across the response options, with no very large ceiling or floor effects.

    “For all 22 items, responses were relatively evenly distributed over the range of the response options. No very large ceiling or floor effects were identified.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    About 46% of participants had undergone a transplant classified as life-saving (lung, liver, heart, double lung, or heart/lung).

    “Approximately 46% of the sample had received a transplant that is considered life saving – lung, liver, heart, double lung or heart/lung.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Participants averaged 54.4 years old; 46% were women, 60% were married, and 69% had finished college or postgraduate education.

    “The average age of participants was 54.4 years, about half were women (46%), 60% were married and the majority (69%) had completed college or post-graduate education.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The three subscales for Acceptance, Inner Haven, and Trust each show high reliability.

    “The current analysis suggests that the subscales representing these three factors have high reliability and may be used individually.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The 22-item version may be sensitive enough to detect increases or decreases in serenity and to distinguish among different degrees of serenity.

    “Thus the 22 item version has the potential to be a sensitive measure to detect enhancements or decrements in serenity and able to differentiate among various degrees of serenity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The observed correlations ran in the expected directions and were small to moderate in size, matching what convergent and discriminant validation tests anticipated.

    “The direction and small to moderate magnitudes of the observed correlations were consistent with the expectations for these convergent and discriminant validation tests.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § The Brief Serenity Scale: A Psychometric Analysis of a Measure of Spirituality and Well-Being

    Roberts and Aspy found nine separate factors in the 40-item version, including Inner Haven, Acceptance, Trust, and several others.

    “Roberts and Aspy identified 9 distinct factors in this 40 item version: Inner Haven, Acceptance, Belonging, Trust, Perspective, Contentment, Present Centered, Beneficence, and Cognitive Restructuring.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Roberts and Aspy (1993)

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The Spiritual Well-Being Scale has two subscales, one for religious well-being and one for existential well-being.

    “The Spiritual Well-Being Scale (Paloutzian & Ellison, 1982) consists of two subscales: a measure of religious well-being (the person’s relationship with God) and existential well-being (one’s sense of purpose and satisfaction with life).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Paloutzian & Ellison, 1982

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The number of factors and the strength of item correlations are recognized as affecting how adequate a sample size is.

    “It is recognized, however, that issues such as the number of factors and the strength of the correlations among the items influence the adequacy of the sample size (Spicer, 2002).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Spicer, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation
    § The Brief Serenity Scale: A Psychometric Analysis of a Measure of Spirituality and Well-Being

    Kruse et al. reported that the 40-item Serenity Scale had internal consistency and reliability (Cronbach's alpha = 0.93), but its subscales were unstable; they concluded the scale measures one concept.

    “In this study, the investigators found that the Serenity Scale was internally consistent and reliable (Cronbach’s alpha = 0.93), however, the subscales were not found to be stable. Kruse et al. concluded that the Serenity Scale measures a single concept.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kruse et al (2005) source

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The Serenity Scale seems to measure an inner-peace state that may be a separate and valuable result of nursing interventions.

    “The Serenity Scale, in comparison, appears to capture a state of “inner peace” that could be a distinct and important outcome of nursing interventions.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Serenity is related to spirituality yet separate from religiosity and general values.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationown data

    The Acceptance factor covers accepting outcomes beyond one's control, staying aware of the present moment, taking a broader perspective, and forgiving oneself and others.

    “The first factor, Acceptance, includes items related to a person’s ability to accept outcomes that they may not be able to control while maintaining present-moment awareness, a wider perspective and a sense of forgiveness for themselves and others.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The Spiritual Orientation Inventory seems to measure spiritual values rather than spiritual well-being, and its length would hinder use in many clinical groups.

    “While there is some overlap between this instrument and the Serenity Scale, it appears to be more oriented towards the measurement of values believed to be spiritual in nature rather than a state of spiritual well-being, and the length of this scale would be a barrier to its use in many clinical populations.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    For convergent and discriminant validation, the study could only use instruments already collected at the trial's baseline, and these were not chosen from a theoretical model of spirituality.

    “Also, the measures used for convergent and discriminant validation testing were limited to instruments collected at baseline for the trial, and not determined by a theoretical model of spirituality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The Serenity Scale is easy to administer, and its short length should not burden participants in studies where serenity is one of many outcomes.

    “It is an easily administered tool and the brevity of this version is such that it will not contribute to subject burden in a research study where serenity is among a large set of outcome variables being studied.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    Earlier development and psychometric work used older adult volunteers and university students.

    “Previous developmental and psychometric analyses have used older adult volunteers and university students.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    A common guideline for factor analysis requires at least five participants per variable.

    “The traditional rule of thumb for factor analysis is a minimum of 5 subjects per variable.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § The Brief Serenity Scale: A Psychometric Analysis of a Measure of Spirituality and Well-Being

    The Serenity Scale drew on Roberts and Fitzgerald's concept analysis and on a definition of serenity as an inner-peace spiritual experience not tied to outside events.

    “The Serenity Scale, developed by Roberts and Aspy (1993), is based on the earlier concept analysis completed by Roberts and Fitzgerald (1991) and the definition of serenity as being a spiritual experience of inner peace that is independent of external events.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Roberts and Aspy (1993)
    • cites Roberts and Fitzgerald (1991) source

  • May combine two claims.

    Study design and conductreasoning

    The few factors, their strong reliability, and their interpretability support both the analysis's trustworthiness and the sample size's adequacy.

    “In this study, a small number of factors, each with high reliability and a meaningful interpretation support the trustworthiness of the analysis and adequacy of the sample size.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Because the sample was small, the confirmatory factor analysis used the same participants as the exploratory factor analysis.

    “However, because of size limitations, the confirmatory factor analysis was conducted on the same sample as the exploratory factor analysis.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The existential well-being subscale of the Spiritual Well-Being Scale is closely related to serenity.

    “The concept of existential well-being as defined in this tool is closely related to the concept of serenity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The Brief Serenity Scale has good psychometric properties and is easy to administer.

    “Overall, our experience with this version of the scale indicates that it has good psychometric properties and is easy to administer.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The Trust factor contains items about trusting a larger plan and believing that some good exists in every event because events unfold as they should.

    “The final factor, named Trust, includes statements related to a person’s sense of trust in a larger plan, that there is some good in all events because things happen as they should.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The University of Minnesota's Institutional Review Board approved the Wellness Interventions after Transplant trial.

    “The Wellness Interventions after Transplant trial was approved by the Institutional Review Board at the University of Minnesota.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Serenity comes from accepting events within a broader view, drawing on inner comfort, and trusting that events unfold as they should within a larger plan.

    “Our analysis suggests that serenity is achieved through acceptance of events in a wider perspective, using inner resources of comfort and the ability to trust that events unfold as they should, as part of a larger plan.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Serenity can improve even as disease progresses.
34 of 34

  • The paper relies on this without support.

    Serenity can improve even as disease progresses.

    “Serenity is an aspect of spiritual health and well-being that may be improved despite disease progression.”

  • The paper relies on this without support.

    Serenity is related to spirituality yet separate from religiosity and general values.

    “It is important that these measures tap specifically into the phenomena of serenity as a concept related to spirituality, but independent of religiosity or overall values in general.”

  • The paper relies on this without support.

    A sample of solid organ transplant recipients is suitable for psychometric study of a spirituality measure.

    “Our work with solid organ transplant recipients offered a unique opportunity to measure serenity and explore the psychometrics of a shorter version of the Serenity Scale in a sample of patients who have survived organ failure and subsequent organ transplantation and currently face chronic health problems and increased health risks associated with lifelong immunosuppressive therapy.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • An original factor is given two names

    Minor

    The original nine-factor solution names one factor Beneficence, but the later description calls an original factor Benevolence. The text does not establish whether these are meant to be the same factor.

  • Reported scale scores conflict with summative scoring

    Minor

    With 22 items scored from 1 to 5, a summed score cannot be below 22. The reported minimum of 1.86 appears to use a different scoring method, but the text does not say so.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. Colliton, M. (1981). The spiritual dimensions of nursing. In E. Belland & J Passos (Eds.), Clinical nursing (pp. 901-1012). New York: Macmillan.
  2. Gerber, W., 1986, Serenity: Living with equanimity, zest, and fulfillment by applying the wisdom of the world's greatest thinkers
  3. Legere, T., 1984, Studies in Formative Spirituality, 5, 375
  4. Mische, P. (1982). Toward a global spirituality. In P. Mische (Ed.), Whole earth papers (pp. 76-83). East Grange, NJ: Global Education Association .
  5. Paloutzian, R.F. & Ellison, C.W. (1982). Loneliness, spiritual well-being and quality of life. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research and therapy (pp. 224-237). New York: Wiley Interscience.
  6. Roberts, K., 1993, Journal of Nursing Measurement, 1, 145

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Authors
Kreitzer, M. J., Gross, C. R., Waleekhachonloet, O.-A., Reilly-Spong, M., & Byrd, M.
Affiliations
  • University of Minnesota (US)
  • Clinical Pharmacy and Research Group at Mahasarakham University, Thailand
  • St. Catherine University (US)
ORCID
Kreitzer, Mary Jo
Venue
Journal of Holistic Nursing
Publisher
SAGE Publications
Published
2009-01-24
Volume
27
Issue
1
Pages
7-16
ISSN
  • 0898-0101 (ISSN-L)
  • 1552-5724
DOI
10.1177/0898010108327212
PMC
PMC2818779
OpenAlex
W2081177989
Cited by
70
References
33
Citations by year
2026: 5 · 2025: 1 · 2024: 7 · 2023: 7 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 5 · 2015: 2 · 2014: 2 · 2013: 6 · 2012: 2
FWCI
3.09
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Holistic Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Nursing Research (R01NR008585)
Topics
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
tranquility, spirituality, well-being, acceptance, trust, mindfulness-based stress reduction, solid organ transplantation, anxiety, depression, health distress, positive affect, negative affect, mindful awareness, spiritual intervention, nursing outcomes
MeSH terms
Adaptation, Psychological, Adult, Aged, Attitude to Health, Female, Holistic Health, Humans, Male, Middle Aged, Personality Assessment, Psychometrics, Quality of Life, United States, Nursing Methodology Research, Holistic Nursing, Mind-Body Relations, Metaphysical, Spirituality

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