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Statistical Fit is like Beauty: a Rasch and Factor Analysis of the Scottish PROM

Snowden, Austyn; Karimi, Leila; Tan, Heather


Leila Karimi

Heather Tan


Chaplains help people face some of the most complex, intractable and traumatic issues in their lives. Spiritual care works. Unfortunately, spiritual needs are rarely met in health and social care because a) spiritual distress is not recognised as such, and b) chaplain interventions are undervalued and misunderstood. The Scottish Patient Reported Outcome Measure (PROM) © was created to help provide evidence for the impact of chaplain interventions. The aim of this study was to establish whether the PROM could also be used to identify patients in need of chaplain interventions. To test this psychometrically, Rasch and Confirmatory Factor Analysis was conducted on an international dataset of post intervention PROMS from UK, Europe and Australia completed between 2018–2020 (n = 1117). The data fit the Rasch model, and the PROM demonstrated uni-dimensionality, construct validity and reliability, meaning PROM scores represent a coherent concept. Higher scores represented lower levels of spiritual distress, and the mean score was 12 out of 20. PROM score of 9 was one standard deviation below the norm, a metric routinely used to identify ‘clinically important difference’ in psychometric scales. A Scottish PROM© score of 9 and under could therefore identify people for whom chaplaincy may be beneficial. The clinical implications of this are considerable.


Snowden, A., Karimi, L., & Tan, H. (2022). Statistical Fit is like Beauty: a Rasch and Factor Analysis of the Scottish PROM. Journal of Health Care Chaplaincy, 28(3), 415-430.

Journal Article Type Article
Acceptance Date Apr 9, 2021
Online Publication Date May 26, 2021
Publication Date 2022
Deposit Date Jun 8, 2021
Publicly Available Date Jun 8, 2021
Journal Journal of Health Care Chaplaincy
Print ISSN 0885-4726
Electronic ISSN 1528-6916
Publisher Routledge
Peer Reviewed Peer Reviewed
Volume 28
Issue 3
Pages 415-430
Keywords Chaplain, confirmatory factor analysis, psychometrics, Rasch analysis, screening, spirituality
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Statistical Fit Is Like Beauty: A Rasch And Factor Analysis Of The Scottish PROM (2 Mb)

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This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.

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