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BMC Health Serv Res. 2017 Feb 11;17(1):132. doi: 10.1186/s12913-017-2050-5.

Got spirit? The spiritual climate scale, psychometric properties, benchmarking data and future directions.

Author information

Adventist Health, Palo Alto, CA, USA.
Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
, Residency Office MC 5906, Lucile Packard Children's Hospital Room 0111, 725 Welch Rd, Palo Alto, CA, 94304, USA.
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
Duke Patient Safety Center, Duke University Health System, Durham, NC, USA.
Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA.



Organizations that encourage the respectful expression of diverse spiritual views have higher productivity and performance, and support employees with greater organizational commitment and job satisfaction. Within healthcare, there is a paucity of studies which define or intervene on the spiritual needs of healthcare workers, or examine the effects of a pro-spirituality environment on teamwork and patient safety. Our objective was to describe a novel survey scale for evaluating spiritual climate in healthcare workers, evaluate its psychometric properties, provide benchmarking data from a large faith-based healthcare system, and investigate relationships between spiritual climate and other predictors of patient safety and job satisfaction.


Cross-sectional survey study of US healthcare workers within a large, faith-based health system.


Seven thousand nine hundred twenty three of 9199 eligible healthcare workers across 325 clinical areas within 16 hospitals completed our survey in 2009 (86% response rate). The spiritual climate scale exhibited good psychometric properties (internal consistency: Cronbach α = .863). On average 68% (SD 17.7) of respondents of a given clinical area expressed good spiritual climate, although assessments varied widely (14 to 100%). Spiritual climate correlated positively with teamwork climate (r = .434, p < .001) and safety climate (r = .489, p < .001). Healthcare workers reporting good spiritual climate were less likely to have intentions to leave, to be burned out, or to experience disruptive behaviors in their unit and more likely to have participated in executive rounding (p < .001 for each variable).


The spiritual climate scale exhibits good psychometric properties, elicits results that vary widely by clinical area, and aligns well with other culture constructs that have been found to correlate with clinical and organizational outcomes.


Safety climate; Safety culture; Scale; Spiritual climate; Spirituality; Survey; Workplace spirituality

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