The Relationship Between Spiritual Health and Sense of Coherence in the Elderly: The Mediating Role of Psychological Hardiness

Document Type : Original Article

Authors

1 Dept. of Psychology, Women Research Center, Alzahra University, Tehran, Iran

2 Dept. of Psychology, Ferdows Azad University, Ferdows, Iran

3 Dept. of Medical Surgical Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran

Abstract

The growing trend of aging population and the importance of psychological cohesion of the elderly has made it more important to study the factors associated with it. Therefore, the aim of this study was to investigate the relationship with psychological cohesion through the mediating role of psychological hardiness. The research method was descriptive, of  structural equations modeling type. The statistical population included all the elderly under the care of welfare nursing homes in Mashhad in the first three months of 2022, of whom 100 eligible individuals were selected using convenience sampling method. The measures included Paloutzian and Ellison’s spiritual health, Kiamrei et al.’s psychological hardiness and Antonovsky’s sense of coherence questionnaires. Pearson’s correlation coefficient and structural equations modeling were used to analyze the data in SPSS-22 and Smart PLS software. The results revealed that the path coefficient between spiritual health and psychological cohesion was positive and significant (P<0.01), the path coefficient between spiritual health and psychological hardiness was positive and significant (P<0.01), and the path coefficient between psychological hardiness and psychological cohesion was positive and significant (P<0.05). Besides, the path coefficient of the mediating role of psychological hardiness was positive and significant (P<0.05). In general, the research model had sufficient fit. Therefore, the results of the study convey the importance of spiritual health and psychological hardiness in the psychological cohesion of the elderly.
 
 References
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Antonovsky, A. (1987). Unraveling the mystery of health. San Francisco
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Quarterly of The Horizon of Medical Sciences, 27(1), 18-33.  https://doi.org/10.32598/hms.27.1.3093.2 [Persian]Bagheri, H., Sadeghi, M., Esmaeili, N., Naeimi, Z. (2016). Relationship between spiritual health and depression and quality of sleep in the older adults in Shahroud. Journal of Gerontology, 1 (1) ,55-62. URL: http://joge.ir/article-1-73-fa.html [Persian]Bastani, F., Pourmohammadi, A., Haghani, H. (2014). Relationship between perceived stress with spiritual health among older adults with diabetes registered to the association of diabetes prevention and control in Babol. Journal of Hayat, 20 (3), 6-18. URL: http://hayat.tums.ac.ir/article-1-841-fa.html [Persian]
Crowley, B. J., Hayslip, B. J., & Hobdy, J. (2003). Psychological hardiness and adjustment to life events in adulthood. Journal of Adult Development, 10(4), 237-248.
De Freitas, F.B., Vannuchi, MO., Haddad, M. L., De Carvalho Silva, L. G., & Rossaneis, M.A. (2017). Hardiness and occupational stress in nurse’s managers of hospital institutions. Journal of nursing UFPE, 11(10), 1981-1988.
Dehshiri, G. H., Esmroud, S., Jafari, A., Najafi, M. (2008). psychometric properties of the spiritual well-being scale among students. Quarterly journal of psychological studies, 4(3), 129-144. [Persian]Esfahani, M. (2011). Spiritual health and perspectives. Medical Ethics, 4(14), 41-49.  https://doi.org/10.22037/mej.v4i14.12117 [Persian]Eyni, S., Hashemi, Z., Tagavi, R. (2019). Elderly perceived stress: The Predictive role of spiritual well-being, coping strategies, and sense of cohesion. Journal of Gerontology, 4 (3), 25-34.
URL: http://joge.ir/article-1-353-fa.html [Persian]
Fisher, J. (2010). Development and application of a spiritual well-being questionnaire called SHALOM. Religions, 1(1), 105-121.
Ghazi Mohseni, M., Soleimanian, A. A., Heidarnia, A. (2016). Examining the effectiveness of hope-based group training on the life quality of the elderly people. Salmand: Iranian Journal of Ageing, 11 (2), 300-309. URL: http://salmandj.uswr.ac.ir/article-1-1052-fa.html [Persian]
Hashemi, N., Souri, A., Ashoori, J. (2016). The relationship between social capital and psychological hardiness with general health of patients with type II diabetes. The Journal of Diabetes Nursing, 4 (1), 43-53. URL: http://jdn.zbmu.ac.ir/article-1-149-fa.html [Persian]
Hashemi, Z., Eyni, S. (2019). Elderly perceived stress: the predictive role of spiritual well-being, coping strategies, and sense of cohesion. Islamic Life Style, 3(4), 54-61. URL: http://islamiclifej.com/article-1-325-fa.html [Persian]
Hoseyni, M., Abdkhodai, M., Aghamohammadian Sherbaf, H. (2017). Role of mediating sense of coherence in relationship between duration and number of physical complications of diabetes with mental health in patients with type 2 diabetes mellitus. Internal Medicine Today, 23 (4), 311-317. URL: http://imtj.gmu.ac.ir/article-1-2662-fa.html [Persian]
Holt, C. L., Caplan, L., Schulz, E., Blake, V., Southward, P., Buckner, A., & Lawrence, H. (2009). Role of religion in cancer coping among African Americans: A qualitative examination. Journal of Psychosocial Oncology, 27(2), 248-273.
Jadidi, A., Farahaninia, M., Janmohammadi, S., Haghani, H. (2011). The Relationship between spiritual well-being and quality of life among elderly people residing in kahrizak senior house. The Iran Journal of Nursing, 24 (72), 48-56. URL: http://ijn.iums.ac.ir/article-1-1025-fa.html [Persian]
Jafari, A., Khazan, F., & Faghanim, R. (2013). The relationship between spiritual well-being, hardiness, and mental health in the elderly. Journal of Research in Behavioural Sciences, 10 (6) ,431-440. URL: http://rbs.mui.ac.ir/article-1-276-fa.html [Persian]
Kiamarsi, A., Ilbigi GhaleNee, R. (2012). The relationship of a sense of coherence and alexithymia with life satisfaction in girl students with ADHD symptoms. Quarterly Journal of School Psychology Institutions,1(1), 76-92. [Persian]
Kiamarsi, A., NaJarian, B., & Mehrabizadeh, M. (1998). Construction and validation of a scale to measure psychological toughness. Psychology, 7, 271-284. [Persian]
Kim, S.S., Kim-Godwin, Y. S., & Koenig, H. G. (2016). Family spirituality and family health among Korean-American elderly couples. Journal of Religion and Health, 55(2), 729-746.
Kohls, N., Walach, H., & Wirtz, M. (2009). The relationship between spiritual experiences, transpersonal trust, social support, and sense of coherence and mental distress—a comparison of spiritually practising and non-practising samples. Mental Health, Religion & Culture, 12(1), 1-23.
Maddi, S. R. (2006). Hardiness: The courage to grow from stresses. The Journal of Positive Psychology, 1(3), 160-168.
Maddi, S. R., Khoshaba, D. M., Jensen, K., Carter, E., & Harvey, R. H. (2002). Hardiness training for high-risk undergraduates. NACADA Journal, 22(1), 45-55.
Mahammadzadeh, A., Poursharifi, H., Alipour, A. (2010). Validation of Sense of Coherence (SOC) 13-item scale in Iranian sample. Procedia-Social and Behavioral Sciences, 5, 1451-1455.
Mak, W., & Law, R. W. (2007). Sense of coherence, parenting attitudes and stress among mothers of children with autism in Hong Kong. Journal of Applied Research in Intellectual Disabilities, 20(2), 157-167.
Mikaeeli, N., Eyni, S., & Taghavi, R. (2017). Role of self-compassion and sense of coherence and thought action fusion in prediction of psychological well- being among post-traumatic stress disorder veterans. Iranian Journal of War and Public Health, 9 (34), 33-39. [Persian]Miri, M.R., Salehiniya, H., Tiyuri, A., Bahlgerdi, M., & Taghizadeh, A. A. (2014). Prevalence of mental disorders and its related factors among elderly of Birjand. Journal of Geriatric Nursing, 2(2), 94-103. [Persian]Mirzaie, M., & Darabi, S. (2017). Population aging in Iran and rising health care costs. Salmand: Iranian Journal of Ageing, 12(2), 156-169. URL: http://salmandj.uswr.ac.ir/article-1-1226-fa.html [Persian]National Statistics Center of Iran. (2016). The results of the general population and housing census of 2015, Tehran, Iran.
Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being and the quality of life. Loneliness: A sourcebook of current theory, research and therapy, 224-237.
Pisula, E., & Kossakowska, Z. (2010). Sense of coherence and coping with stress among mothers and fathers of children with autism. Journal of Autism and Developmental Disorders, 40(12), 1485-1494.
Salmabadi, M., Rajabi, M. J., & Safara, M. (2018). Effectiveness of training the review of life on life satisfaction and sense of coherence middle-aged women and elderly nursing home residents in Qazvin. Salmand: Iranian Journal of Ageing, 13 (2), 198-209.
URL: http://salmandj.uswr.ac.ir/article-1-1229-fa.html [Persian]
Seligman, M. E. (2004). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment: Simon and Schuster.
Shahsavar, R., Ghaffari, M., & Makhtoum Nejhad, R. (2018). Mediating role of psychological hardiness and perceived social support on the relationship between spiritual intelligence and happiness in the elderly women. Journal of Gerontology, 3 (1), 11-21. URL: http://joge.ir/article-1-184-fa.html [Persian]
Stevens, JP. (2012). Applied multivariate statistics for the social sciences. Routledge.
World Health Organization. (2011). Global health and ageing. Geneva: World Health Organization.
Yousefi, F., Mohammadi, F., Motalebi, S. A., & Pahlevan Sharif, S. (2020). The Relationship between spiritual health and successful aging. Salmand: Iranian Journal of Ageing, 15 (2), 246-256. URL: http://salmandj.uswr.ac.ir/article-1-1868-fa.html [Persian].

Keywords


 References
Abbasi, F., Azizi, E., Shamsi Gooshki, M., Naseri Rad, M., Akbari Lakeh, M. (2013). Conceptual definition and operationalization of spiritual health: a methodological study. Quarterly Journal of Medical Ethics, 6 (20), 11-44. https://doi.org/10.22037/mej.v6i20.3629 [Persian]Abolghasemi, A., Zahed, M., Nariman, M. (2011). The correlation of sense of coherence and type-D personality with health in coronary artery patients. Journal of Fundamental of Mental Health, 11(3), 213-222. [Persian]Alah Bakhshian, M., Jafarpour Alavi, M., Parvizi, S., Haghani H. (2011). A Survey on relationship between spiritual wellbeing and quality of life in multiple sclerosis patients. Zahedan Journal of Research in Medical Sciences, 12 (3), 29-33. [Persian]
Antonovsky, A. (1987). Unraveling the mystery of health. San Francisco
Asadzandi, M. (2013). The approach of a healthy heart in the conceptualization of spiritual health. Medical Figh, 6(18-19), 143-174.  https://doi.org/10.22037/mfj.v6i19-18.8092 [Persian]Aslani, Y., Hosseini, R., Alijanpour-Aghamaleki, M., Javanbakhtian-Ghahfarokhi, R., Borhaninejad, V. (2018). Spiritual health and life satisfaction in older adults in Shahrekord hospitals. Journal of Clinical Nursing and Midwifery, 6(4), 1-10. URL: http://78.39.35.47/article-1-609-fa.html [Persian]Azadi, R. (2016). Effect of hardiness training on self-esteem and adjustment of addicted male. Journal of Holistic Nursing and Midwifery, 26(4), 1-9. [Persian]Azadi, R., Ahadi, H., Hatami, H. R. (2021). The Relationship of psychological wellbeing and psychological hardiness with the mediating role of social support in women with breast cancer.
Quarterly of The Horizon of Medical Sciences, 27(1), 18-33.  https://doi.org/10.32598/hms.27.1.3093.2 [Persian]Bagheri, H., Sadeghi, M., Esmaeili, N., Naeimi, Z. (2016). Relationship between spiritual health and depression and quality of sleep in the older adults in Shahroud. Journal of Gerontology, 1 (1) ,55-62. URL: http://joge.ir/article-1-73-fa.html [Persian]Bastani, F., Pourmohammadi, A., Haghani, H. (2014). Relationship between perceived stress with spiritual health among older adults with diabetes registered to the association of diabetes prevention and control in Babol. Journal of Hayat, 20 (3), 6-18. URL: http://hayat.tums.ac.ir/article-1-841-fa.html [Persian]
Crowley, B. J., Hayslip, B. J., & Hobdy, J. (2003). Psychological hardiness and adjustment to life events in adulthood. Journal of Adult Development, 10(4), 237-248.
De Freitas, F.B., Vannuchi, MO., Haddad, M. L., De Carvalho Silva, L. G., & Rossaneis, M.A. (2017). Hardiness and occupational stress in nurse’s managers of hospital institutions. Journal of nursing UFPE, 11(10), 1981-1988.
Dehshiri, G. H., Esmroud, S., Jafari, A., Najafi, M. (2008). psychometric properties of the spiritual well-being scale among students. Quarterly journal of psychological studies, 4(3), 129-144. [Persian]Esfahani, M. (2011). Spiritual health and perspectives. Medical Ethics, 4(14), 41-49.  https://doi.org/10.22037/mej.v4i14.12117 [Persian]Eyni, S., Hashemi, Z., Tagavi, R. (2019). Elderly perceived stress: The Predictive role of spiritual well-being, coping strategies, and sense of cohesion. Journal of Gerontology, 4 (3), 25-34.
URL: http://joge.ir/article-1-353-fa.html [Persian]
Fisher, J. (2010). Development and application of a spiritual well-being questionnaire called SHALOM. Religions, 1(1), 105-121.
Ghazi Mohseni, M., Soleimanian, A. A., Heidarnia, A. (2016). Examining the effectiveness of hope-based group training on the life quality of the elderly people. Salmand: Iranian Journal of Ageing, 11 (2), 300-309. URL: http://salmandj.uswr.ac.ir/article-1-1052-fa.html [Persian]
Hashemi, N., Souri, A., Ashoori, J. (2016). The relationship between social capital and psychological hardiness with general health of patients with type II diabetes. The Journal of Diabetes Nursing, 4 (1), 43-53. URL: http://jdn.zbmu.ac.ir/article-1-149-fa.html [Persian]
Hashemi, Z., Eyni, S. (2019). Elderly perceived stress: the predictive role of spiritual well-being, coping strategies, and sense of cohesion. Islamic Life Style, 3(4), 54-61. URL: http://islamiclifej.com/article-1-325-fa.html [Persian]
Hoseyni, M., Abdkhodai, M., Aghamohammadian Sherbaf, H. (2017). Role of mediating sense of coherence in relationship between duration and number of physical complications of diabetes with mental health in patients with type 2 diabetes mellitus. Internal Medicine Today, 23 (4), 311-317. URL: http://imtj.gmu.ac.ir/article-1-2662-fa.html [Persian]
Holt, C. L., Caplan, L., Schulz, E., Blake, V., Southward, P., Buckner, A., & Lawrence, H. (2009). Role of religion in cancer coping among African Americans: A qualitative examination. Journal of Psychosocial Oncology, 27(2), 248-273.
Jadidi, A., Farahaninia, M., Janmohammadi, S., Haghani, H. (2011). The Relationship between spiritual well-being and quality of life among elderly people residing in kahrizak senior house. The Iran Journal of Nursing, 24 (72), 48-56. URL: http://ijn.iums.ac.ir/article-1-1025-fa.html [Persian]
Jafari, A., Khazan, F., & Faghanim, R. (2013). The relationship between spiritual well-being, hardiness, and mental health in the elderly. Journal of Research in Behavioural Sciences, 10 (6) ,431-440. URL: http://rbs.mui.ac.ir/article-1-276-fa.html [Persian]
Kiamarsi, A., Ilbigi GhaleNee, R. (2012). The relationship of a sense of coherence and alexithymia with life satisfaction in girl students with ADHD symptoms. Quarterly Journal of School Psychology Institutions,1(1), 76-92. [Persian]
Kiamarsi, A., NaJarian, B., & Mehrabizadeh, M. (1998). Construction and validation of a scale to measure psychological toughness. Psychology, 7, 271-284. [Persian]
Kim, S.S., Kim-Godwin, Y. S., & Koenig, H. G. (2016). Family spirituality and family health among Korean-American elderly couples. Journal of Religion and Health, 55(2), 729-746.
Kohls, N., Walach, H., & Wirtz, M. (2009). The relationship between spiritual experiences, transpersonal trust, social support, and sense of coherence and mental distress—a comparison of spiritually practising and non-practising samples. Mental Health, Religion & Culture, 12(1), 1-23.
Maddi, S. R. (2006). Hardiness: The courage to grow from stresses. The Journal of Positive Psychology, 1(3), 160-168.
Maddi, S. R., Khoshaba, D. M., Jensen, K., Carter, E., & Harvey, R. H. (2002). Hardiness training for high-risk undergraduates. NACADA Journal, 22(1), 45-55.
Mahammadzadeh, A., Poursharifi, H., Alipour, A. (2010). Validation of Sense of Coherence (SOC) 13-item scale in Iranian sample. Procedia-Social and Behavioral Sciences, 5, 1451-1455.
Mak, W., & Law, R. W. (2007). Sense of coherence, parenting attitudes and stress among mothers of children with autism in Hong Kong. Journal of Applied Research in Intellectual Disabilities, 20(2), 157-167.
Mikaeeli, N., Eyni, S., & Taghavi, R. (2017). Role of self-compassion and sense of coherence and thought action fusion in prediction of psychological well- being among post-traumatic stress disorder veterans. Iranian Journal of War and Public Health, 9 (34), 33-39. [Persian]Miri, M.R., Salehiniya, H., Tiyuri, A., Bahlgerdi, M., & Taghizadeh, A. A. (2014). Prevalence of mental disorders and its related factors among elderly of Birjand. Journal of Geriatric Nursing, 2(2), 94-103. [Persian]Mirzaie, M., & Darabi, S. (2017). Population aging in Iran and rising health care costs. Salmand: Iranian Journal of Ageing, 12(2), 156-169. URL: http://salmandj.uswr.ac.ir/article-1-1226-fa.html [Persian]National Statistics Center of Iran. (2016). The results of the general population and housing census of 2015, Tehran, Iran.
Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being and the quality of life. Loneliness: A sourcebook of current theory, research and therapy, 224-237.
Pisula, E., & Kossakowska, Z. (2010). Sense of coherence and coping with stress among mothers and fathers of children with autism. Journal of Autism and Developmental Disorders, 40(12), 1485-1494.
Salmabadi, M., Rajabi, M. J., & Safara, M. (2018). Effectiveness of training the review of life on life satisfaction and sense of coherence middle-aged women and elderly nursing home residents in Qazvin. Salmand: Iranian Journal of Ageing, 13 (2), 198-209.
URL: http://salmandj.uswr.ac.ir/article-1-1229-fa.html [Persian]
Seligman, M. E. (2004). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment: Simon and Schuster.
Shahsavar, R., Ghaffari, M., & Makhtoum Nejhad, R. (2018). Mediating role of psychological hardiness and perceived social support on the relationship between spiritual intelligence and happiness in the elderly women. Journal of Gerontology, 3 (1), 11-21. URL: http://joge.ir/article-1-184-fa.html [Persian]
Stevens, JP. (2012). Applied multivariate statistics for the social sciences. Routledge.
World Health Organization. (2011). Global health and ageing. Geneva: World Health Organization.
Yousefi, F., Mohammadi, F., Motalebi, S. A., & Pahlevan Sharif, S. (2020). The Relationship between spiritual health and successful aging. Salmand: Iranian Journal of Ageing, 15 (2), 246-256. URL: http://salmandj.uswr.ac.ir/article-1-1868-fa.html [Persian]