@article { author = {Yousefi Afrashteh, Majid and Moradi, Masoumeh}, title = {The Spiritual Health and Social Support with Quality of Life in the Rural Elderly: The Mediating Role of Resilience and Hope}, journal = {Aging Psychology}, volume = {8}, number = {3}, pages = {266-251}, year = {2022}, publisher = {Razi University}, issn = {2423-7647}, eissn = {2476-6836}, doi = {10.22126/jap.2022.8239.1647}, abstract = {Nowadays, due to the increasing rate of elderly populaion in Iran, it seems necessary to maintain and improve the health and the quality of life (QOL) of them as a vulnerable demographic group. Recent studies have revealed that spiritual health, social support, resilience, and hope may improve QOL in the elderly. Therefore, this study aims to determine the model of QOL based on spiritual health and social support through the mediating role of resilience and hope in the elderly. The study population included all the elderly living in villages of qazvin province, Iran, among whom 300 were selected using convenience sampling method. The measures applied in the current study consisted of Paloutzian and Ellison’s spiritual health, Vaux’s social support, Connor & Davidson’s resilience, Snyder’s hope and the World Health Organization QOL questionnaires. Path analysis was used to analyze the causal model. The results indicated the fit of the model with the data. The results also demonstrated a direct and significant effect between spiritual health (β=0.15, P<0.05), social support (β=0.21, P<0.05), hope (β=0.35, P<0.05) and resilience (β=0.25, P<0.05) with QOL. Moreover, the analysis of the role of multiple mediators using Preacher and Hayes’s approach confirmed the mediating role of resilience and hope in the relationship between spiritual health and social support with QOL. The results contribute to the theoretical knowledge regarding how social support and spiritual health affect QOL in the elderly. The findings showed that social support and spiritual health have the power to predict the QOL through hope and resilience among the elderly. All the four predictive variables can be improved and can be used in QOL-related interventions in the rural elderly. ReferencesAbbasi, M., Azizif., S., GoshkiaI., Naseri Radem, M., & Akbari Luckham, M. (2012). Conceptual definition and operationalization of spiritual health: A methodological study. Journal of Medical Ethics-Scientific Research, 6 (20), 11-44. https://doi.org/10.22037/mej.v6i20.3629 [Persian]Abdolahrezaee, N., Khanmohammadi, A., Dadfar, M., Rashedi, V., & Behnam, L. (2020). Prediction of hope, physical health, and mental health by mediating variable of religious spiritual well-being in elderly. Mental health, religion & culture, 23(10), 928-940.‏ https://doi.org/10.1080/13674676.2020.1819220 [Persian]Abdullahi, S., Zarani, F., & Fathabadi, J. (2016). The role of resilience and social support in the quality of life of adolescents with chronic kidney disease. Scientific-Research Quarterly Journal of Health Psychology, 6 (24), 31-52. https://doi.org/20.1001.1.23221283.1396.6.24.2.0 [Persian]Aghayari hir T, ghasemzade D, Ebrahimi Orang A. A study of relationship between social support and health-related quality of life among elderly people in Tabriz. Journal of Gerontology, 2(2), 20-28. http://joge.ir/article-1-115-fa.html [Persian]Ang, S., Lim, E., & Malhotra, R. (2021). Health-related difficulty in internet use among older adults: Correlates and mediation of its association with quality of life through social support networks. The Gerontologist, 61(5), 693-702. https://doi.org/10.1093/geront/gnaa096Angela Sammarco, R. N., & Konecny, L. M. (2010). Quality of life, social support, and uncertainty among Latina and Caucasian breast cancer survivors: a comparative study. Oncology Nursing Society, 37(1), 37-93. https://doi.org/10.1188/10.ONF.93-99Azadi, F. (2016). Investigating the relationship between social support and attachment styles with the resilience of female household heads (Master's thesis). Islamic Azad University, Marodasht branch, Shiraz. [Persian]Azami, Y., Motamedi, A., Dostian, Y., Jalalund, M., & Farzangan, M. (2011). The role of resilience, spirituality and religiosity in predicting life satisfaction in the elderly. Culture of Counseling and Psychotherapy, 3 (12), 1-20. https://doi.org/10.22054/QCCPC.2011.5906Bai, Y., Bian, F., Zhang, L., & Cao, Y. (2020). The impact of social support on the health of the rural elderly in China. International Journal of Environmental Research and Public Health, 17(6),1-18. https://doi.org/10.3390/ijerph17062004Bluvol, A., & Ford-Gilboe, M. (2004). Hope, health work and quality of life in families of stroke survivors. Journal of Advanced Nursing, 48(4), 322-332. https://doi.org/10.1111/j.1365-2648.2004.03004.xBonanno, G. A. (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American psychologist, 59(1), 20-28 https://doi.org/10.1037/0003-066X.59.1.20Braga, I. B., Braga, E. B., de Araújo Oliveira, M. C., & Guedes, J. D. (2015). A percepção do Idoso sobre a Saúde e Qualidade de Vida na Terceira Idade. Id on Line Revista de Psicologia, 9(26), 211–222.Chen, L., Guo, W., & Perez, C. (2021). Social support and life satisfaction of ethnic minority elderly in China. The International Journal of Aging and Human Development, 92(3), 301-321.‏ https://doi.org/10.1177/0091415019896Chenary, R., Noroozi, A., & Tahmasebi R. (2013). Health promoting behaviors in veterans in ilam province. Journal of Military Medicine, 15 (1), 95-102.  http://militarymedj.ir/article-1-1097-fa.html [Persian]Choudhary, P., Devi, R., Naz, S., & Rai, K. (2021). Social connectedness, spirituality, quality of life, and hopelessness among older adults. Annals of the Romanian Society for Cell Biology, 25(6), 12241-12253.‏ https://annalsofrscb.ro/index.php/journal/article/view/7842Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300-314. https://doi.org/10.1097/00006842-197609000-00003Cocks, K., King, M. T., Velikova, G., Fayers, P. M., & Brown, J. M. (2008). Quality, interpretation and presentation of european organisation for research and treatment of cancer quality of life questionnaire core 30 data in randomised controlled trials. European Journal of Cancer, 44(13), 1793-1798.‏ https://doi.org/10.1016/j.ejca.2008.05.008Craven, R. F., & Hirnle, C. J. (1992). Fundamentals of nursing: human health and function. Lippincott.‏Dewi, D. S. E., & Hamzah, H. B. (2019). The relationship between spirituality, quality of life, and resilience. In 6th International Conference on Community Development (ICCD 2019) (pp. 145-147). Atlantis Press. https://doi.org/10.2991/iccd-19.2019.39 Ebrahimi Qavam, P. (1992). Examining the validity of the three concepts of locus of control, self-esteem and social support (Unpublished Master's thesis). Islamic Azad University, Research Sciences Unit, Tehran. [Persian]Farhadi, A., Barazandeh Chaqaei, S., Mokhtarpour, H., Karmi, K., Chainazadeh, A. (2014). The role of social support, spiritual well-being and self-efficacy in predicting the mental well-being of the elderly. Psychology of Aging, 1(2), 35-48. [Persian]Forman E. M., Herbert J. D. (2009). New directions in cognitive behavior therapy: Acceptance-based therapies. In W. O’Donohue, J. E. Fisher, (Eds.). General principles and empirically supported techniques of cognitive behavior therapy. Hoboken, NJ: Wiley, 4(1), 102–114.Haase, J. E., Kintner, E. K., Robb, S. L., Stump, T. E., Monahan, P. O., Phillips, C., & Burns, D. S. (2017). The Resilience in Illness Model (RIM) Part 2: Confirmatory evaluation in adolescents and young adults with cancer. Cancer Nursing, 40(6), 454–463. https://doi.org/10.1097/NCC.0000000000000450Harun Rashidi, H., & Mansoori Rad, Vahed. (2016). The relationship between perceived social support and resilience with psychological helplessness of mothers of exceptional children. Journal of Exceptional Education, 17(3), 15-22. [Persian]‏Hasanain, N., Wazid, S. W., & Hasan, Z. (2014). Optimism, hope and happinessas correlstes of psychological well-being among young adult assamesemales and females. IOSR Journal of Humanities and Social Science, 19(2),44-51. https://doi.org/10.1097/NCC.0000000000000450Hawro, T., Maurer, M., Hawro, M., Kaszuba, A., Cierpiałkowska, L., Królikowska, M., & Zalewska, A. (2014). In psoriasis, levels of hope and quality of life are linked. Archives of Dermatological Research, 306(7), 661-666.‏ https://doi.org/10.1007/s00403-014-1455-9Herrera, M. S., Elgueta, R., Fernández, M. B., Giacoman, C., Leal, D., Marshall, P., & Bustamante, F. (2021). A longitudinal study monitoring the quality of life in a national cohort of older adults in Chile before and during the COVID-19 outbreak. BMC Geriatrics, 21(1), 1-12. https://doi.org/10.1186/s12877-021-02110-3Ivtzan, I., Chan, C. P., Gardner, H. E., & Prashar, K. (2013). Linking religion and spirituality with psychological well-being: Examining self-actualisation, meaning in life, and personal growth initiative. Journal of Religion and Health, 52(3), 915-929.‏ https://doi.org/10.1007/s10943-011-9540-2Juliana, N., Azmani, S., Abu, I. F., Talib, N. A. M.F, Abdullah, F, Intan, Z.S, Teng, N. I. M. F. T, Amin, N. A, Azmi, N. A. S. M. & Aziz, N. A. S. A. (2022). Impact of religious activities on quality of life and cognitive function among elderly. Journal of Religion and Health, 61(2), 1564-1584.‏ https://doi.org/10.1007/s10943-021-01408-1Kang, H. W., Park, M., & Wallace, J. P. (2018). The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults. Journal of Sport and Health Science, 7(2), 237-244. https://doi.org/10.1016/j.jshs.2016.05.003Kasprzak, E. (2010). Perceived social support and life satisfaction. Polish Psychological Bulletin, 41(4), 144–154. https://doi.org/10.2478/v10059-010-0019-xKhabaz, M., Behjati, Z., & Naseri, M. (2011). The relationship between social support and coping styles with resilience in adolescent boys. Applied Psychology Quarterly, 5 (1), 108-123.  http://refahj.uswr.ac.ir/article-1-1487-en.html [Persian]Khaledian, M., & Sohrabi, F. (2013). The effect of group-based meaning therapy on reducing depression and increasing hope in the elderly with empty nest syndrome. Clinical Psychology Studies, 4 (15), 79-104. [Persian]Khalji, T. (2007). The relationship between hope, the source of academic inhibition and the academic success of the pre-university course in Tehran in the academic year 2010-2018 (Master's thesis). Al-Zahra University, Tehran. [Persian]Khoshnodfar, Z., Omidhar, B., & Tahmasabi, S. (2017). Investigating the relationship between self-compassion and spiritual health with quality of life and mood states in women with breast cancer. Sadra Journal of Medical Sciences, 7(1), 23-36. https://doi.org/ 10.30476/smsj.2018.44752 [Persian]‏Ko, H., Park, Y. H., Cho, B., Lim, K. C., Chang, S. J., Yi, Y. M., & Ryu, S. I. (2019). Gender differences in health status, quality of life, and community service needs of older adults living alone. Archives of Gerontology and Geriatrics, 83(1), 239-245. https://doi.org/10.1016/j.archger.2019.05.009Kong, L. N., Zhang, N., Yuan, C., Yu, Z. Y., Yuan, W., & Zhang, G. L. (2021). Relationship of social support and health-related quality of life among migrant older adults: the mediating role of psychological resilience. Geriatric Nursing, 42(1), 1-7. https://doi.org/10.1016/j.gerinurse.2020.10.019Lee, S., Hong, S. H., & Song, H. Y. (2022). Factors associated with health-related quality of life among older adults in rural south korea based on ecological model. International Journal of Environmental Research and Public Health, 19(12), 7021-7038. https://doi.org/10.3390/ijerph1912702Lee, Y. H., & Salman, A. (2018). The mediating effect of spiritual well-being on depressive symptoms and health-related quality of life among elders. Archives of Psychiatric Nursing, 32(3), 418-424.‏ https://doi.org/10.1016/j.apnu.2017.12.008Li, J., Yu, J., Chen, X., Quan, X., & Zhou, L. (2018). Correlations between health-promoting lifestyle and health-related quality of life among elderly people with hypertension in Hengyang, Hunan, China. Medicine, 97(25), 1-7. https://doi.org/10.1016/j.apnu.2017.12.008Lima, S., Teixeira, L., Esteves, R., Ribeiro, F., Pereira, F., Teixeira, A., & Magalhães, C. (2020). Spirituality and quality of life in older adults: A path analysis model. BMC Geriatrics, 20(1), 1-8. https://doi.org/10.1186/s12877-020-01646-0Lucchetti, A. L, Peres, M. F., Vallada, H. P., Lucchetti, G. (2015). Spiritual Treatment for Depression in Brazil: An Experience from Spiritism. Journal of Explore (NY), 11(5), 377-86. https://doi.org/10.1016/j.explore.2015.07.002Luszczynska, A., Pawlowska, I., Cieslak, R., Knoll, N., & Scholz, U. (2013). Social support and quality of life among lung cancer patients: A systematic review. Psycho‐oncology, 22(10), 2160-2168. https://doi.org/10.1002/pon.3218Luthar, S. S., & Cicchetti, D. (2000). The construct of resilience: Implications for interventions and social policies. Journal of Development and psychopathology, 12(4), 857-885.‏  https://doi.org/10.1017/s0954579400004156Madhi, S., Najafi, M. (2018). The relationship between spiritual well-being and hope with quality of life, and happiness in older adults. Scientific-research journal of psychological sciences, 17(65), 78-94. http://psychologicalscience.ir/article-1-109-en.html [Persian]Mair, C. A, & Thivierge-Rikard, R. V. (2010). The strength of strong ties for older rural adults: regional distinctions in the relationship between social interaction and subjective well-being. The International Journal of Aging and Human Development, 70(2), 119-143. https://doi.org/10.2190/AG.70.2.bMasten, A. S. & Reed, M. G. (2002) Resilience in Development. In C. R. Snyder, S. J. Lopez, (Eds.). The handbook of positive psychology (pp.74-88). Oxford University Press.Milioni, M., Alessandri, G., Eisenberg, N., Castellani, V., Zuffianò, A., Vecchione, M., & Caprara, G. V. (2015). Reciprocal relations between emotional self‐efficacy beliefs and ego‐resiliency across time. Journal of personality, 83(5), 552-563.‏ https://doi.org/10.1111/jopy.12131Moehling, K. K., Nowalk, M. P., Zimmerman, R. K., Bromberger, J. T., Lin, C. J., Ford, S. E., & Bertolet, M. (2021). Spirituality, quality of life and frailty in community-dwelling adults≥ 50 years. Journal of Psychology of Religion and Spirituality,‏ 50(4), 454-470. https://doi.org/10.1037/rel0000387Mohammadi, M. (2005). Investigating factors affecting resilience in people exposed to substance abuse (Doctoral thesis). University of Welfare and Rehabilitation Sciences, Tehran. [Persian]Mohammadzadeh, M., & jahandari, P. (2019). The Relationship of Resilience and Emotional Regulation with Life Expectancy among Soldiers. Journal of Military Care Sciences, 6(3), 198-206.  http://mcs.ajaums.ac.ir/article-1-262-en.html [Persian]Momeni, K., Amani, R., Janjani, P., Majzoobi, M. R., Forstmeier, S., & Nosrati, P. (2022). Attachment styles and happiness in the elderly: The Mediating role of reminiscence styles. BMC Geriatrics, 22, Article 349.  https://doi.org/10.1186/s12877-022-03053-zMomeni, Kh., Amani, R., Janjani, P., Majzoobi, M. R., & Hadian Hamedani, K. (2021). The Relationship between attachment styles with positive and negative affect in the elderly: The Mediating role of reminiscence styles. Aging Psychology, 7(4), 407-422. https://doi.org/10.22126/JAP.2022.7492.1606 [Persian]Mueller, P. S., Plevak, D. J., & Rummans, T. A., (2001). Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clinic Proceedings, 76(12), 1225-1235. https://doi.org/10.4065/76.12.1225Murrell, S. A., Salsman, N. L., Meeks, S. (2003). Educational attainment, positive psychological mediators, and resources for health and vitality in older adults. The Journal of Aging and Health, 15(4), 591–615. https://doi.org/10.1177/08982643032561Nam, S. J. (2021). Mediating effect of social support on the relationship between older adults’ use of social media and their quality-of-life. Current Psychology, 40(9), 4590-4598.‏  https://doi.org/10.3390/ijerph17218069Naz Tabar, H., & Shataban, N. (2018). The relationship between spiritual health and social adjustment and quality of life in cancer patients. Journal of Health and Care, 21(4), 292-283 https://doi.org/10.22038/jmrh.2021.50953.1631  [Persian]Nejat, S., Montazeri, A., Holakouie Naieni, K., Mohammad, K., & Majdzade, S. (2006). The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. Quarterly Journal of the Faculty of Health and Health Research Institute, 4(4), 1-12.http://sjsph.tums.ac.ir/article-1-187-en.html [Persian]Özdemir, A. A., Kavak Buda, F., Dural, G., & Gültekin, A. (2022). The Relationship between spiritual well-being, life satisfaction and hope in elderly individuals in Turkey. Journal of Religion and Health, 80(5), 1-14. https://doi.org/10.1007/s10943-022-01517-5Pahlevan Sharif, S., Amiri, M., Allen, K. A., Sharif Nia, H., Khoshnavay Fomani, F., Hatef Matbue, Y., & Waheed, H. (2021). Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults. Health and Quality of Life Outcomes, 19(1), 1-10. https://doi.org/10.1186/s12955-021-01695-yPaknahad, Z., & ebrahimy, M. (2017). The relationship between social development and social support with students’ resilience. Quarterly Social Psychology Research, 7(27), 49-66. [Persian]Pessotti, C. F. C., Fonseca, L. C., Tedrus, G. M. D. A. S., & Laloni, D. T. (2018). Family caregivers of elderly with dementia Relationship between religiosity, resilience, quality of life and burden. Dementia & neuropsychologia, 12, 408-414.‏  https://doi.org/10.1590/1980-57642018dn12-040011Qolizadeh, A., & Shirani, E. (2009). The relationship between individual, family, social and economic factors with the level of life satisfaction of the elderly in Isfahan. Journal of Applied Sociology, 21(1), 69-82. https://doi.org/ 20.1001.1.20085745.1389.21.1.4.3 [Persian]Ralston M. (2018). The role of older persons’ environment in aging well: quality of life, illness, and community context in South Africa. The Gerontologist, 58(1), 111-20. https://doi.org/10.1093/geront/gnx091Reher, D. S. (2015). Baby booms, busts, and population ageing in the developed world. Population studies, 69(1), 57-68.‏ https://doi.org/10.1080/00324728.2014.963421Rezaie Shahsavarloo Z, Lotfi M, Taghadosi M, Mousavi M, Yousefi Z, Amirkhosravi N. (2015). Relationship between components of Spiritual well-being with hope and life satisfaction in elderly cancer patients in Kashan. Journal of Geriatric Nursing, 1(2) ,43-54. http://jgn.medilam.ac.ir/article-1-76-en.html [Persian]‏Rustoen, T., Cooper, B.A., & Miaskowski, C. (2010). The importance of hope as a mediator of psychological distress and life satisfaction in a community sample of cancer patients. Cancer nurs, 33(4), 258-267. https://doi.org/10.1097/NCC.0b013e3181d6fb61Safurai Parisi, S., & Safurai Parisi, M. (2019). The relationship between social support and resilience with the mediating role of life expectancy in corona patients. Islamic Psychology Research, 3(1), 75-102. http://hdq.uswr.ac.ir/article-1-371-en.html  [Persian]Saleh Manijeh, H., Rostami, M., & Ahmadboukani, S. (2021). Development of the coronavirus anxiety model in the elderly: based on hope and health-related quality of life with the mediating role of perceived social support. Gerontology and Geriatric Medicine, 7(1), 1-5. https://doi.org/10.1177/23337214211048324Salehi, L., Salaki, S., & Alizadeh, L. (2012). Health-related quality of life among elderly member of elderly centers in Tehran. Iranian Journal of Epodemiology, 8 (1), 14-20. http://irje.tums.ac.ir/article-1-15-fa.html [Persian]Silva, E. G. D., Eulálio, M. D. C., Souto, R. Q., Santos, K. D. L., Melo, R. L. P. D., & Lacerda, A. R. (2019). The capacity for resilience and social support in the urban elderly. Ciencia & saude coletiva, 24(2), 7-16.‏ https://doi.org/10.1590/1413-81232018241.32722016Skevington, S. M., Lotfy, M., & O'Connell, K. A. (2004). The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of life Research, 13(2), 299-310.‏ https://doi.org/10.1023/B:QURE.0000018486.91360.00Souza, É. N., Oliveira, N. A. D., Luchesi, B. M., Gratão, A. C. M., Orlandi, F. D. S., & Pavarini, S. C. I. (2017). Relationship between hope and spirituality of elderly caregivers. Texto & Contexto-Enfermagem, 26(1), 67-80.‏ https://doi.org/10.1590/0104-07072017006780015Tan, M. M., Reidpath, D. D., Ting, R. S. KAllotey, P., & Su, T. T. (2022). Religiousness and quality of life among older adults of different ethnic groups in Malaysia: A five-year follow-up study. Journal of Religion and Health, 61(2), 1548-1563. https://doi.org/10.1007/s10943-021-01371-xThe World Health Organization (2019). Availableonline https://data. The World HealthOrganization.org.cn/indicator/SP.POP.65UP.TO.ZS?view=chart. worldHealthOrganization (WHO).Thomas, L. J., & Revell, S. H. (2016). Resilience in nursing students. Nurse Education Today, 1(36) 457–462. https://doi.org/10.1016/j.nedt.2015.10.016Wedgeworth, M., LaRocca, M. A., Chaplin W. F., & Scogin F. (2017). The role of interpersonal sensitivity, social support, and quality of life in rural older adults. Geriatr Nurs, 38(1), 6-22. https://doi.org/10.1016/j.gerinurse.2016.07.001‏Wu, M., Yang, Y., Zhang, D., Zhao, X., Sun, Y., Xie, H., & Li, Y. (2018). Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Quality of Life Research, 27(3), 783-792. https://doi.org/10.1007/s11136-017-1730-2Yang, X. J., Wang, F. L., & Zhang, X. L. (2018). Impact of family care and social support on health promotion behavior among older residents. Chinese Journal of Public Health, 34(9), 1266–1269.  https://doi.org/10.11847/zgggws1114857Yousefi Afrashete, M., & Rezaei, Sh. (2021). Spirituality and quality of life in the elderly: the mediating role of self-compassion and sense of coherence. Psychology of Aging, 7(2), 151-137. https://doi.org/10.22126/JAP.2021.6358.1526 [Persian]}, keywords = {Social Support,rural elderly,resilience,spiritual health,quality of life,Hope}, title_fa = {سلامت معنوی و حمایت اجتماعی با کیفیت زندگی در سالمندان روستایی: نقش میانجی تاب آوری و امید}, abstract_fa = {امروزه با توجه به رشد روز افزون جمعیت سالمندان در ایران، حفظ و ارتقای سلامت و کیفیت زندگی آنها به عنوان یک گروه جمعیتی آسیب‌پذیر بیش از پیش ضروری به نظر می‌رسد. پژوهش‌های اخیر نشان می‌دهد سلامت معنوی، حمایت اجتماعی، تاب‌آوری و امید ممکن است کیفیت زندگی را در سالمندان ارتقا بخشد، بنابراین پژوهش حاضر با هدف مدلیابی کیفیت زندگی بر مبنای سلامت معنوی و حمایت اجتماعی از طریق نقش میانجی تاب‌آوری و امید در سالمندان بود. جامعه پژوهش شامل سالمندان روستاهای استان قزوین بود از بین آنها 300 نفر به شیوه در دسترس انتخاب شدند. ابزار اندازه‌گیری شامل پرسش‌نامه‌های سلامت معنوی پولوتزین و والیسون، حمایت اجتماعی واکس، امید آشنایدر و همکاران، تاب‌آوری کانر و دیویدسون و کیفیت زندگی سازمان بهداشت جهانی بود. برای تحلیل مدل علّی از تحلیل مسیر استفاده شد. نتایج نشانگر برازش کامل مدل با داده‌ها بود. همچنین نتایج تأثیر مستقیم و معناداری را بین سلامت معنوی (p<0.05،β=0.15 )، حمایت اجتماعی (p<0.05،β=0.21 )، امید (p<0.05، β=0.35)، تاب‌آوری (p<0.05، β=0.25) با کیفیت زندگی نشان دادند. بعلاوه، تحلیل نقش میانجی چندگانه با رویکرد پرچهر و هایز، میانجگری تاب‌آوری و امید را در رابطه بین سلامت معنوی و حمایت اجتماعی با کیفیت زندگی تأیید کرد. این نتایج به دانش نظری در مورد اینکه حمایت اجتماعی و سلامت معنوی چگونه بر کیفیت زندگی در سالمندان تأثیر می‌گذارد کمک می‌کند. یافته‌ها نشان داد حمایت اجتماعی و سلامت معنوی بواسطه امید و تاب‌آوری، توان لازم برای پیش‌بینی کیفیت زندگی در بین سالمندان را دارد. هر چهار متغیر پیش‌بینی قابل ارتقاء هستند و می‌توانند در مداخلات کیفیت زندگی در جمعیت سالمندان روستایی مورد استفاده قرار گیرند. }, keywords_fa = {حمایت اجتماعی,سالمندان روستایی,تاب آوری,سلامت معنوی,کیفیت زندگی,امید}, url = {https://jap.razi.ac.ir/article_2354.html}, eprint = {https://jap.razi.ac.ir/article_2354_212a006d8cc13bc331d86a3adb1932d5.pdf} }