The majority of participants in both groups were Orthodox Christians (for group A: N = 106, 62.4% for group B: N = 68, 58.6%) as compared to smaller percentages of those with no religious faith (for group A: N = 5, 2.9% for group B: N = 4, 3.4%) Roman Catholics (for group A: N = 19, 11.2% for group B: N = 12, 10.3%) Protestants (for group A: N = 18, 10.6% for group B: N = 14, 12.1%) Sunni Muslims (for group A: N = 1, 0.6% for group B: N = 1, 0.9%) and those belonging to other religions (for group A: N = 21, 12.4% for group B: N = 17, 14.7%).
A total of 18 out of 207 participants of the test group (8.7%) stated that they had no religious or spiritual understanding of their life; 44 (21.1%) reported a religious belief; 18 (8.7%) told of a spiritual belief and the vast majority of participants (61.4%) reported both a religious and a spiritual belief. In group B, responses were similar. Those with a spiritual or religious understanding of their life explained that they believed in God, the Saints, the Holy Trinity, a superior creature, or the Bible.
Spiritual belief differed in a statistically significant manner between the two genders of the test population (x2 = 25.808, df = 3, p < .001) as shown in table . The vast majority of women (66.8%), rather than men (41.4%), reported religious and spirituals beliefs and only 2.1% of the women and 12.6% of the men had neither religious nor spiritual beliefs. Logistic regression analysis indicated that women (OR 2.3, 95%CI 1.1–4.6) were significantly more likely to hold a religious and spiritual view of life. Table presents the gender-specific difference of mean scores of spiritual scale.
Difference of mean scores of spiritual scale between two genders
Four persons (1.5%) answered that they underwent an intense experience at a time when they almost died, but were eventually revived. Four other persons were uncertain as to whether or not they had had such an experience. For these four persons, the mean effect of this experience on their lives was moderate (4.69 ± 2.9). The majority of persons participating in our study answered that they prayed by themselves (N = 215, 77.3%) or with others (N = 24, 8.6%). Only 57 persons (20.5%) stated that religious ceremonies play a central role in their faith; 43.2% said the same of meditation, 60.8% of reading and study, 36.3% of contact to religious leaders and 7.2% none of the above.
After we tallied the scores of participants for questions 3, 7 to 11, which make up the spiritual scale, we found that during the test phase the t-test was significant (t = -3.562, df = 256, p < .001) and showed that the mean scores of the participants on the spiritual scale differed significantly between women (mean = 36.10 ± 10.54) and men (mean = 31.80 ± 11.25), as shown in table . The retest did not lead to the same result, as the t-test showed no statistical difference between the two genders (p = .563). There was a gender-specific difference (Fisher's exact test p = .001), though, between those who believed that prayer plays an important role in their faith: the majority of women (75.6%) like to pray alone, instead of men (60.9%) who prefer to pray with others.
One hundred and sixty-five participants (62%) answered that they do not communicate with a spiritual power at all, i.e. by way of prayer or contact via a medium. Eleven persons (4.1%) were uncertain. Women communicate more often by praying than do men (Chi-Square test 7,595 df = 2 p = .022). Twenty-five percent of the men, as against 45% of the women communicate with a spiritual power in some other way.
The percentage of those who believe that we continue to exist in some form after death (37.5%) was similar to those who were uncertain (39.3%). Thirty-two participants (23.9%) had had an intense experience through which they sensed some deep new meaning in life that lasted for a few moments, hours or even days. Eleven of them felt it once (44%) and ten of them had had eleven to fourteen such intense experiences (40%). This experience lasted for 7.96 ± 8.53 days. For some, it lasted 4.88 ± 0.61 hours, for others 5.02 ± 0.65 minutes and for a few individuals it lasted for 5 seconds.
When asked to describe this experience, they answered that the incident was a prophetic dream, the recovery from an accident or an illness, the presence of an invisible force, the birth of their child, a detachment of the material body, a strong feeling of happiness, of feeling protected from harm. Further analysis of this open question (describe the intense experience) put to those participants who had had an intense experience rendered a description of a dreamy journey to an unknown place, filling them with a strong euphoric feeling of happiness, wellness and inner peace. The main characteristic of this experience was the lack of any sense of control over the circumstances. They felt no fear, although it was an unusual experience – perhaps precisely because it was a perceived spiritual experience, providing an opportunity to become closer to God or clarifying the grace of God. It was an isolated moment of physical and bodily sensation, or a sharing emotion. For others it was a unique and private emotional experience, or simply a prophetic reassurance of future recovery from a difficult situation. Some of the respondents were not able to describe it, even though their experience had been very intense.
Between those 90 participants (67.2%) who had never felt an intense experience, two persons mentioned that they had undergone an intense experience at a time when they almost died but were eventually revived. It was an incident that changed their lives.
Fourteen (88.9%) of the 18 participants with a spiritual belief communicate in some way with a spiritual power, compared to 26 (59.1%) of the 44 persons with a religious faith and 67 (52.8%) of the 127 persons with both a religious and a spiritual belief (Chi Squared 18.20, df = 6, p = .006). Respondents who reported having intensely experienced a power were more likely to believe in a spiritual power that influences the universe (5.52 ± 3.30) than those who had never had such an experience (4.25 ± 2.54). Belief in the existence of some form of life after death was more common among Muslims and those who do not belong to a specific religion. The majority of Orthodox Christians did not believe in life after death (73.6%). Forty-nine (38.9%) of the 126 persons who spoke of both a religious and spiritual faith believed in life after death, as against forty-five (35.7%) persons who were uncertain.
There was a major difference in mean scores on the spiritual scale between persons who expressed a religious/spiritual view of life on the Royal Free Questionnaire and those who did not [37.2 (sd 10.2) cf 23.1 (sd 18.3), mean diff 14.0, CI 6.6 to 21.5, df (equal variance) 131, p < 0.0001]. Those who communicate with a spiritual power obtained higher mean scores on the spiritual scale than those who do not [42.4 (sd 8.9) cf 31.1 (sd 9.7), mean diff 11.3, CI 8.5 to 14.1, df (unequal variance) 156.55, p < 0.0001]. Women expressed a higher spirituality than did men [37 (sd 12) cf 31 (sd 10.7), mean diff -5.97, CI -9.4 to -2.5, df (unequal variance) 125,64, p < 0.0001].
Internal consistency of the spiritual scale and test – retest reliability
The internal consistency of the spiritual scale for the test group proved to be good, as standardised inter-item reliability / Cronbach's alpha was 0.83. This is above the accepted limit of 0.70 [35
]. Item-total correlations ranged from 0.51 to 0.73. They indicated very good levels of differentiation, thus showing that questions were appropriate. Internal consistency of the spiritual scale for the retest group proved as good as for the test group. Standardized inter-item reliability / Cronbach's alpha was 0.84. Item-total correlations ranged from 0.52 to 0.75.
Kappa statistics for categorical items are summarized in table . Kappa is a chance-corrected measure of agreement, as it represents the proportion of agreement obtained after removing the proportion of agreement that could be expected to occur by chance. Kappa is always less than or equal to 1. A value of 1 implies perfect agreement and values of less than 1 imply less than perfect agreement. Kappa coefficients ranged from 0.70 to 0.74, indicating good agreement [32
]. Table presents the results of the test – retest reliability of the Greek version of the Royal Free Interview for Spiritual and Religious Beliefs, while in table the mean test-retest score, intra-class correlation coefficient (ICC), test-retest correlation (rho) and p value are presented. As shown in table , the Pearson correlation coefficient for the total test-retest score of the spiritual scale was 0.754 (p < 0.001).
Test retest reliability of spiritual scale
The mean test-retest score, intraclass correlation coefficient (ICC), test retest correlation (rho) and p value
The bivariate scatterplot between the total test and retest scores of the spiritual scale are shown in figure . It gives a good visual picture of the relationship between the two variables and facilitates the interpretation of the regression model. As we see in figure , the points of test-retest plot are very close to or follow the regression line. This finding reasserts the test-retest reliability of the spiritual scale.
Bivariate scatterplot between the test and retest total scores of the spiritual scale