The purpose of this study was to determine the association between different aspects of spiritual function (intra- and interpersonal relationships, connectedness to God, and practices) and health-related quality of life, and to determine if perceived spirituality and perceived religiosity were significantly related to spiritual function and health-related quality of life. The study analyzed secondary data collected in the third year of a three year (1997-1999) Ambulatory Care Quality Improvement Project (ACQUIP) of the Veteran's Administration. A sample of 500 male veterans were randomly selected from a larger sub- sample of six Veterans Hospital Administration facilities across the U.S., having one or more of seven condition-specific chronic illnesses. Analysis was conducted on 232 returned and completed self-administered questionnaires, including a general health status questionnaire (MOS SF-36) used to measure health-related quality of life (Ware & Sherboume, 1992), and 11 items used to measure spiritual function (Rosenfeld, 1997). Confirmatory factor analysis on the spiritual items indicated that the proposed model for spiritual functioning was a poor fit to the data. Exploratory factor analysis on the spiritual function items yielded a significant transcendent (practices and connectedness to God items) and horizontal (intra and interpersonal connectedness items) factor. No significant associations were observed between the transcendent factor and the MOS-SF 36 health-related quality of life items, but strong significant relationships between intra and interpersonal connectedness and health-related quality of life items were observed. Significant associations were also observed between spiritual practices, transcendent, intra and interpersonal connectedness and perceived spirituality and perceived religiosity. No significant relationships were observed, however, between perceived spirituality and health-related quality of life, and only two domains from the MOS-SF 36 scale were significantly associated with perceived religiosity. Definitions of spiritual health and health-related quality of life, and implications for health education practice and measuring the spiritual component in health-related quality of life research are discussed.


School of Public Health

First Advisor

Joyce Hopp

Second Advisor

Jerry W. Lee

Third Advisor

Grenith Zimmerman

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)

Spring 2003



Library of Congress/MESH Subject Headings

Chronic Disease; Quality of Life; Spirituality



Page Count

xi; 90

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives