Measures of Religiosity and Spirituality Used in Spanish-Speaking Health Contexts and Health Research and Their Conception of Religiosity/Spirituality: A Systematic Review

Research on religiosity and spirituality (R/S) in health is growing in Spain and other Spanish-speaking contexts, highlighting the need for reliable instruments reflecting diverse R/S conceptualizations. This systematic review aimed to identify, categorize, and critically evaluate Spanish-adapted measures used in health contexts and health research in Spain and Latin America, and to examine their underlying R/S conceptions. A systematic search of five databases was complemented by supplementary searches. A total of 98 studies were included, identifying 58 unique measures: 34 R/S-specific measures, 21 broader constructs with an explicit R/S dimension, and 3 professional spiritual-care measures. Measures covered heterogeneous domains, including spiritual well-being, spiritual experience and transcendence, religious beliefs and practices, relationship with God or the sacred, R/S coping, and R/S needs and distress. Psychometric evidence was uneven, with structural validity, internal consistency, and hypothesis testing/construct validity most frequently assessed. Nine measures had sufficient evidence for three or more measurement properties, 16 for two, 9 for one, and 24 for none. No measure met COSMIN category A criteria; 51 were classified as category B and 7 as category C. These findings underscore the need for careful instrument selection based on the construct, population, cultural context, and measurement evidence, and support further validation across diverse Spanish-speaking populations.