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Health Spiritual Med Ethics 2021, 8(2): 123-132 |
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Shakerian A, Maroofi Y, Nateghi F. The Structural Equation Modeling of the Relationship Between Spirituality and Psychological Wellbeing Mediated by Spiritual Health. Health Spiritual Med Ethics 2021; 8 (2) :123-132
URL: http://jhsme.muq.ac.ir/article-1-391-en.html
URL: http://jhsme.muq.ac.ir/article-1-391-en.html
1- Department of Educational Sciences, Faculty of Humanities, Arak Branch, Islamic Azad University, Arak, Iran.
2- Department of Educational Science, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran., Educational Sciences Department, Bu Ali Sina University ,y.maroufi@basu.ac.ir
3- Department of Educational Sciences, Faculty of Humanities, Arak Branch, Islamic Azad University, Arak, Iran., Azad University, Arak Branch
2- Department of Educational Science, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran., Educational Sciences Department, Bu Ali Sina University ,
3- Department of Educational Sciences, Faculty of Humanities, Arak Branch, Islamic Azad University, Arak, Iran., Azad University, Arak Branch
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| Abstract (HTML) (2637 Views)
June 2021. Volume 8. Number 2
June 2021. Volume 8. Number 2
June 2021. Volume 8. Number 2
June 2021. Volume 8. Number 2
<20 128(27.7)
21-25 233(50.4)
2630 44(9.5)
≥31 57(12.3)
Associate degree 41(11.31)
Undergraduate 365(79.5)
Masters 53(9.19)
Humanities 170(36.7)
Nursing 89(19.2)
Educational Science 99(21.4)
Engineering 71(15.3)
Science 30(6.5)
Agriculture 4(0.9)
Azad Aslami 209(45.3)
Medical Sciences 141(30.6)
Kurdestan 111(24.1)
June 2021. Volume 8. Number 2
Spiritual health 0.58**
Religious health 0.56**
Existential health 0.48**
Psychological well-being 0.52**
Self-acceptance 0.36**
Positive relationships with others 0.27**
Self-efficacy 0.25**
Mastery of the environment 0.50**
Purposeful life 0.23**
Individual growth 0.42**
June 2021. Volume 8. Number 2
Psychological well-being 0.59**
Self-Acceptance 0.57**
Positive relationships with others 0.30**
Self-Efficacy 0.22**
Mastery of the environment 0.53**
Purposeful life 0.23**
Individual growth 0.46**
June 2021. Volume 8. Number 2
Index df X2 X2/df P RSMEA NFI IFI AGFI CFI
Amounts 2127 5224.687 2.46 0.001 0.06 0.84 0.84 0.93 0.82
A1
A2
A3
A4
A5
A6
A7
A8
A9
A10
A11
A12
A13
A14
A15
A16
A17
A18
A19
A20
A21
A22
A23
A24
A25
A26
A27
A28
S1
S2
S3
S4
S5
S6
S7
S8
S9
S10
S11
S12
S13
S14
S15
S16
S17
S18
q1
q2
q3
q4
q5
q6
Q7
q8
q10
q9
June 2021. Volume 8. Number 2
June 2021. Volume 8. Number 2
June 2021. Volume 8. Number 2
Full-Text: (741 Views)
| 123 |
| Ata Shakarian1 , Yahya Maroufi1,2* , Faezeh Nateghi1 1. Department of Educational Sciences, Faculty of Humanities, Arak Branch, Islamic Azad University, Arak, Iran. 2. Department of Educational Science, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran. *Corresponding Author: Yahya Maroufi, PhD. Address: Department of Educational Science, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran. Phone: +98 (903) 1086100 E-mail: y.maroufi@basu.ac.ir Research Paper: The Structural Equation Modeling of the Relation ship Between Spirituality and Psychological Wellbe ing Mediated by Spiritual Health Background and Objectives: Spirituality is an individual’s effort and searches for meaning and purpose in life. Spirituality includes the connection with religious beliefs and some of the chosen beliefs, values, and duties that give meaning to life to achieve the desired perfection. This study aimed to model the structural equations of the relationship between spirituality and psychological wellbeing mediated by spiritual health. Methods: This was a descriptive and correlational study, especially of cause-effect modeling. The statistical population included students of higher education centers in Sanandaj City, Iran, in 2018. Of them, 464 subjects were selected as the research sample by cluster random sampling approach. Measurement tools included researcher-made spirituality questionnaires (2020), Ryff’s Scales of Psychological Well-Being (1980), and the Spiritual Well-Being Scale (Paloutzian & Ellison, 1983). Results: Data analysis was performed using Cronbach’s alpha coefficient, heuristic factor analysis, and confirmatory factor analysis by structural equation modeling. The results on the model of the relationship between spirituality, psychological well-being, and spiritual health indicated the acceptable desirability of the indicators of goodness of fit of the model (P≤0.01). Other results suggested that higher levels of spirituality were associated with psychological well being and spiritual health. Conclusion: The present research data revealed an overlap between spirituality, psychological well-being, and spiritual health. Spirituality positively affected psychological wellbeing and spiritual health concerning individual and social adjustment. A B S T R A C T Keywords: Spirituality, Religion, Mental health, Spiritual healing Please cite this article as Shakarian A, Maroufi Y, Nateghi F. The Structural Equation Modeling of the Relationship Between Spirituality and Psychological Wellbeing Mediated by Spiritual Health. Health, Spirituality and Medical Ethics Journal. 2021; 8(2):123-132. http://dx.doi.org/10.32598/hsmej.8.2.8 :http://dx.doi.org/10.32598/hsmej.8.2.8 Use your device to scan and read the article online Article info: Received: 28 Jul 2020 Accepted: 04 Apr 2021 Publish: 01 Jun 2021 |
| 124 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| Introduction pirituality as a multidimensional structure [1]. It has a wide range of definitions that have changed over time depending on the attitudes or worldviews of different popu lations [2]. These definitions were initially related to religiosity; however, in recent decades, its mean ing is more widespread and includes other concepts, such as purpose and meaning in life, communication with oth ers, peace, harmony, and Psychological Wellbeing (PWB) [3]. Various definitions were provided by researchers in the research literature. In these definitions, there is a theme from belief in a unified world to the need for meaning and purpose; a sense of belonging; a relationship with one self, others, and the environment; excellence, and sanctity [4]. Attempts to define this ambiguous word have turned spirituality into a universal word that can be established in almost all stages and aspects of life [5, 6]. An aspect re lated to spirituality is PWB; studies emphasize the overlap between PWB and the aspects of spirituality [7]. Ryff ad dresses PWB as “the pursuit of perfection in the realization of one’s true potential” and the feeling of wellbeing as a positive feeling and a sense of general satisfaction with life in various areas of family, work, and so on [8]. According to Ryff’s model, PWB consists of the following 6 factors: self-acceptance, positive relationships with others, auton omy, purposeful life, personal growth, and mastery of the environment [9]. There has been a growing approach to the literature that recognizes the importance of spirituality, religion, and its role in biopsychological health and PWB [10-13]. The main hypothesis is that exposure to spiritual and philosophical ideas positively affects psychological health and PWB [14]. Despite differences in the defini tions of spirituality, studies supported that spirituality is a predictor and pioneer in positive psychological and mental health outcomes [15]. Research revealed that spirituality is an essential and effective component in improving cop ing ability and promoting mental health [16], as well as reducing anxiety [17] and stress [18]. Another concept re lated to spirituality and PWB is Spiritual Health (SH). SH is a multidimensional structure, referring to a relationship with God and a sense of purpose in life and life satisfaction [19]. Spirituality becomes a state of being; however, SH becomes a state of having; it indicates a sense of accep tance, positive emotions, morality, and interaction with a ruling and superior holy power, others, and self [20]. Evidence suggested that SH and its dimensions, i.e., religious and existential health were positively and sig nificantly related to PWB [21-24]. It seems that having different aspects of health, including SH, can improve individuals’ confrontations. SH is associated with psy chosocial adjustment, effective coping skills, and resil ience to stress and life crises; concurrently, it increases individuals’ mental health. Therefore, when SH is en dangered, the subject may experience loneliness, depres sion, and the loss of meaning in life [25-27]. Individuals with strong SH can effectively adapt to their problems [28]. Other domestic and international studies also sig nified that spirituality and education can be effective at improving SH, spiritual care, and PWB in students [29, 30]. The literature highlighted that research variables are paired between a specific sample or a particular cultural context; however, it has never been comprehensively studied as a model of structural equations. Such data can play a role in enriching the limited relevant research. Considering the existing literature, the present study aimed to use the structural equation modeling technique to examine spirituality, PWB, and SH. Accordingly, the main purpose of the present study was to explore the fit ness of the proposed model with the observed data for PWB in students. Methods The present study was applied concerning the purpose and correlational respecting the collection and analysis of the data; especially causal modeling technique or struc tural equation modeling. The statistical population of the study included all students of governmental and non-gov ernmental higher education centers in Sanandaj City, Iran, in 2018. The study sample included 464 individuals (247 females & 217 males) from different educational levels. Applying multistage random cluster and class sampling unit methods, the study participants were selected. First, 3 universities (Kurdistan, Azad, & Medical Sciences) were selected from 8 higher education centers. Then, 4 faculties from each university and 6 classes from each faculty were considered; the selected students were en tered into the study after expressing their informed con sent. Structural equation models have been proposed in various approaches. Moler (1996) suggests that the free parameters of the model should be considered to deter mine the sample size. He states the minimum and maxi mum ratio of a sample size to free parameter to equal 5 to one and 20 to one [31]. Therefore, in the present model, for sampling adequacy, the minimum and maximum required sample equaled 210 and 840 subjects. Accord ingly, 464 subjects were selected as the research sample. Structural equations were used to study the model and factor analysis, confirmation, and model development. In this statistical method, initially, the steps of confirma tory factor analysis were performed for the question naires. Besides, we considered that, in the confirmatory S |
| 125 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| factor analysis, if the fit indices present the desired value, the structure is approved, otherwise, we have examined the covariance-variance error among the questions. In confirmatory factor analysis, the Chi-squared value of the degree of freedom, the fit of absolute fit indices, and relative fit indices should be addressed in the analyses. Relative indices include Normed Fit Index (NFI), Com parative Fit Index (CFI) Goodness of Fit Index (GFI), and Incremental Fit Index (IFI), indicating the degree of agreement of the obtained model with the desired model. If the Chi-squared value is not significant, it signifies the difference between the model and the desired model. Another absolute fit index for examining the variance covariance ratio of data is called the Root Mean Square Error of Approximation (RMSEA). Studies documented that for RMSEA, the value of 0.06-0.08 is good and ≤0.06 is excellent; for the relative indices of the same value, ≥0.90 is suitable [32]. Spirituality Questionnaire: This questionnaire was developed by the researcher. This tool includes 29 items with the dimensions of spiritual experiences and religious experiences [4]. The first dimension (spiritual experiences) includes 4 factors; spiritual effort, a perva sive worldview of compassionate self-concept, support ive and benevolent ethics, and tolerance. Moreover, the second dimension (religious experiences) addresses two factors; religious commitment and religious participa tion. The tool is answered on a Likert-type scale (strong ly agree, agree, disagree, & strongly disagree). The fac tor of spiritual effort (including questions 1-4), covers the active effort to answer the basic questions of life; the extent to which individuals are seriously involved in the basic questions of life and attempt to find a personal and conscious answer to the meaning and purpose of life. The worldview factor (questions 5-9) manifests a uni versal perspective that promotes selfishness and ethnic ity. The factor of compassionate self-concept (questions 10-15) reflects how critical the well-being of others is, how willing they are to help those who are suffering. The factor of tolerance (questions 16-19) assesses the mental capacity that enables a subject to maintain calmness and sobriety, especially in difficult situations. The factor of religious commitment (questions 20-26) is a criterion that indicates the degree of commitment and dependence on religious principles as well as religious participation (questions 27-29), an objective criterion specifying the extent to which the subject practically adheres to reli gious duties, such as prayer, fasting, and participating in religious ceremonies. The Cronbach’s alpha coefficient method was used to calculate the reliability of the ques tionnaire. The reliability of the questionnaire for the con firmed dimensions in factor analysis, including spiritual experiences and religious experiences, and the whole questionnaire was computed to be 0.88, 0.90, and 0.92, respectively [4]. Ryff’s Scales of Psychological Well-Being: This tool was designed by Ryff in 1998. It consists of 18 items and 6 subscales; self-acceptance, positive relationship with others, autonomy, purposeful life, personal growth, and the mastery of the environment. The validity and reli ability of this scale were reported in several appropriate studies. Dierendonck reported the internal consistency of the subscales as appropriate and the relevant Cronbach’s alpha coefficients to range between 0.77 and 0.90 [33]. The validity of the Persian version of the questionnaire was obtained as 0.87 based on the expressive and Ko chaki’s study (2008) [34]. Spiritual Well-Being Scale (SWBS): This tool was de signed by Paloutzian and Ellison in 1983. This question naire consists of 20 items that include 10 questions of re ligious health and 10 other questions of existential health; finally, the total score of spiritual health is obtained from the sum of these scores. The Cronbach’s alpha coeffi cient of the religious and existential health and the whole scale was reported as 0.91, 0.91, and 0.93, respectively [35]. The validity of the questionnaire was confirmed af ter translation into Persian through the content validity method. Besides, the reliability of the questionnaire was calculated using Cronbach’s alpha as 0.82 [36]. Results The demographic characteristics of the study subjects and the descriptive information of the research variables are presented in Tables 1 and 2. Before presenting the structural equation model, simple correlation coeffi cients are manifested in Tables 3 and 4. Table 3 indicates that SH (r=0.58), religious health (r=0.56), and existen tial health (r=0.48) presented a positive and significant relationship with spirituality. Furthermore, the dimen sions of PWB, such as self-acceptance (r=0.36), positive relationships with others (r=0.27), self-efficacy (r=0.25), and mastery of the environment (r=0.50), purposeful life (r=0.23), and personal growth (r=0.42), as well as PWB (r=0.52) provided a positive and significant relationship with spirituality. Table 4 suggests that the dimensions of PWB, such as self-acceptance (r= 0.57), positive relationships with others (r= 0.30), self-efficacy (r= 0.22), and mastery of the environment (r= 0.53), purposeful living (r= 0.23) and personal growth (r= 0.46) as well as PWB (r= 0.59) presented a positive and significant relationship with SH. |
| 126 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| Structural equation modeling is among the most appro priate multivariate analysis approaches. By this method, the acceptability of theoretical models in a specific com munity can be tested using correlation, non-experimen tal, and experimental data. Initially, the factor structure of the questionnaires was examined. The review process included the following: the measurement models were first drawn on the emus graphic screen. Accordingly, the main variables were plotted as hidden; for each of them, the desired dimensions were considered as the observed variables. The results of factor analysis were reported in the tools section; the relevant data indicated an accept able fit of the measured models. In confirmatory factor analysis, 4 components were identified for the dimen sion of spiritual experiences. The component of spiri tual effort with 5 indicators, pervasive worldview with 4 indicators, compassionate self-concept, supportive and benevolent ethics with 6 indicators, and tolerance with 4 indicators, as well as the dimension of religious experi ences with 1 subject and 10 indicators, were included in the model. Furthermore, in the Psychological Well being Scale, after confirmatory factor analysis, this ques tionnaire presented 6 components. The components of self-acceptance, positive relationships with others, self efficacy, mastery of the environment, purposeful living, and personal growth were individually entered into the model with 3 indicators. The Spiritual Health Scale was entered into the model with 2 components of existential health and religious health, each with 10 indicators. By analyzing and modifying the model, appropriate fit in dices were obtained, i.e., fitted in Tables 5 and 6 of the estimates and goodness fit indices. Moreover, the final model is presented in Figure 1. The goodness-of-fit indi ces data of the model (Table 2) revealed that the obtained Chi-squared value was significant concerning the degree of freedom (P≥0.01). This Chi-squared value was not a valid indicator. If the Chi-squared value is divided by the degree of freedom, a more valid index is obtained. Table 1. The demographic characteristics of the study subjects Variable No. (%) Gender Male 217(46.8) Female 247(53.2) Age category, y Educational level Major University of study |
<20 128(27.7)
21-25 233(50.4)
2630 44(9.5)
≥31 57(12.3)
Associate degree 41(11.31)
Undergraduate 365(79.5)
Masters 53(9.19)
Humanities 170(36.7)
Nursing 89(19.2)
Educational Science 99(21.4)
Engineering 71(15.3)
Science 30(6.5)
Agriculture 4(0.9)
Azad Aslami 209(45.3)
Medical Sciences 141(30.6)
Kurdestan 111(24.1)
| 127 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| Table 2. The descriptive information of the research variables Characteristic N Min. Max. Mean±SD Spirituality 463 28 98 54.18±14.149 Spiritual effort 463 4 15 7.62±2.389 Comprehensive worldview 463 4 19 8.74±2.862 Compassionate self-concept, supportive and benevolent ethics 463 5 21 10.38±3.441 Patience 463 1 16 7.63±2.405 Religious experiences 463 10 40 19.81±6.812 Spiritual health 464 20 120 53.74±18.335 Religious health 464 11 66 30.05±11.879 Existential health 464 9 54 23.69±9.000 Psychological well-being 464 19 93 49.84±11.776 Self-acceptance 464 3 18 8.63±3.081 Positive relationships with others 464 3 18 8.56±3.051 Self-efficacy 464 2 18 8.64±2.999 Mastery of the environment 464 3 18 8.06±2.842 Objective life 464 2 18 8.25±2.647 Personal growth 464 3 18 7.70±3.269 Table 3. Simple correlation coefficients between the dimensions of spiritual health and spirituality Dimensions of Spiritual Health Spirituality **The significance level |
Spiritual health 0.58**
Religious health 0.56**
Existential health 0.48**
Psychological well-being 0.52**
Self-acceptance 0.36**
Positive relationships with others 0.27**
Self-efficacy 0.25**
Mastery of the environment 0.50**
Purposeful life 0.23**
Individual growth 0.42**
| 128 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| The value obtained from the division of Chi-squared on the degree of freedom equaled 2.46, indicating a good fit of the model. This is because a value of <3 is a good indicator for the fit of the model. Furthermore, the root of the mean squared error for the model was measured to be 0.06; this index equaled <0.05 for good models and <0.08 for acceptable models, and >0.10 for weak models. Adjusted Goodness of Fit Index (AGFI) for the Table 5. The estimates and general specifications of the presented model Paths Non-Standard Estimates Standard Estimates t P Spirituality ← spiritual health 1.028 0.834 6.226 0.001 Spirituality ← Experiences of spirituality 0.693 0.742 7.092 0.001 Spirituality← Psychological well-being 0.331 0.191 3.356 0.001 Spirituality health← Psychological well-being 0.757 0.538 3.498 0.001 Experience spirituality ← spiritual effort 0.521 0.660 6.222 0.001 Experience spirituality ← worldview 1.000 0.905 5.132 0.001 Experience the spirituality ← self-concept 0.906 0.907 7.035 0.001 Experience spirituality ← tolerance 0.599 0.702 6.140 0.001 Spirituality ← Religious experiences 1.000 0.837 5.159 0.001 Psychological well-being ← self-acceptance 1.000 1.050 6.342 0.001 Psychological well-being ← Communication with others 0.231 0.644 4.350 0.001 Psychological well-being ← self-awareness 0.074 0.757 4.880 0.001 Psychological well-being ← mastery of the environment 1.163 1.091 9.320 0.001 Psychological well-being ← purposeful living 0.389 0.807 4.059 0.001 Psychological well-being ← personal growth 0.920 0.939 8.372 0.001 Spiritual health ← Religious health 0.988 0.903 5.982 0.001 Spiritual health ← Existential health 1.000 0.857 7.40 0.001 Table 4. The simple correlation coefficients between the dimensions of psychological well-being and spiritual health Dimensions of Psychological Well-Being Spiritual Health **The significance level |
Psychological well-being 0.59**
Self-Acceptance 0.57**
Positive relationships with others 0.30**
Self-Efficacy 0.22**
Mastery of the environment 0.53**
Purposeful life 0.23**
Individual growth 0.46**
| 129 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| model was 0.93, Normed Fit Index (NFI) was 0.84, and Comparative Fit Index (CFI) was 0.82. These values equal ≥0.90 for goodness models and 0.80 for accept able models, i.e., acceptable in the present model [37]. According to the indicators, this model presented an ac ceptable model fit. Discussion The present study results concerning modeling the re lationship between spirituality and PWB, by the mediat ing role of SH indicated that PWB and its dimensions (self-acceptance, positive relationships with others, self efficacy, mastery of the environment, purposeful life, & Table 6. The goodness of fit indicators of the model of spirituality and psychological well-being 0.54 0.19 0.83 0.84 0.74 /70 . 0.91 0.90 0.66 0.64 0.94 0.81 0.68 0.90 0.86 0.76 0.70 0.96 Autonomy Religious health Ecumenical Worldview Spirituality Religious health E69 E67 E68 E70 E71 E72 E73 E74 E75 E76 E77 E1 E2 E3 E4 E5 E6 E7 E8 E9 E10 E11 E12 E13 E14 E15 E16 E17 E18 E19 E20 E21 E22 E23 E24 E25 E26 E27 E28 E29 E30 E31 E32 E33 E34 E35 E36 E37 E38 E39 E40 E41 E42 E43 E44 E45 E46 E47 E48 E49 E50 E51 E52 E53 E54 E55 E56 E57 E58 E59 E60 E61 E62 E63 E64 E65 E66 27 q11 q12 q13 q14 q15 q16 q17 q18 q19 q20 Spiritual experience s psychological well-being Self acceptance Positive relation ship Environmental mastery Purpose in Life Personal growth Existential health Spiritual Health Compassionate self-concept, Spiritual Quest tolerance Figure 1. The structural equation model of the relationship between spirituality and psychological well-being considering the mediating role of health |
Index df X2 X2/df P RSMEA NFI IFI AGFI CFI
Amounts 2127 5224.687 2.46 0.001 0.06 0.84 0.84 0.93 0.82
A1
A2
A3
A4
A5
A6
A7
A8
A9
A10
A11
A12
A13
A14
A15
A16
A17
A18
A19
A20
A21
A22
A23
A24
A25
A26
A27
A28
S1
S2
S3
S4
S5
S6
S7
S8
S9
S10
S11
S12
S13
S14
S15
S16
S17
S18
q1
q2
q3
q4
q5
q6
Q7
q8
q10
q9
| 130 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| personal growth), and spirituality presented a positive and significant relationship with SH. This finding is con sistent with those of other researchers [3, 7, 13-10, 15]. Zarzycka and Zietek as well as Zarzycka and Puchalska emphasize that spirituality and religion are critical parts of life for numerous individuals; they can be important predictors of biopsychological health, PWB, and person al adjustment [12, 13]. In various definitions of spiritual texts related to spirituality, referring to concepts, such as striving and searching for meaning and purpose in life, finding addressed the mysteries of life, and developing a meaningful philosophy of life, compassionate self-con cept, including criteria, like determining one’s talent for some attributes, such as compassion, kindness, forgive ness, and a commitment to certain values, such as help ing others in trouble, reducing suffering in others and the world, and turning the world into a better environment, as well as other components, such as a sense of calm, and the ability to find meaning in difficult situations; there is a strong sense of connection with all of humanity in this re gard [4]. Therefore, spirituality includes connection with spiritual and religious beliefs, as well as some selected beliefs, values, and duties that give meaning to life; thus, they motivate individuals to reach the desired perfection. The relationship that grows through spirituality not only brings belief, hope, and peace to the individual but also empowers their PWB [4]. According to these research components defined for spirituality, the overlap between PWB and spirituality can be better understood [7]. Studies acknowledged that spirituality is a predictor and pioneer in positive psychological outcomes and mental health among individuals [15], i.e., strongly related to some aspects of PWB, such as optimism, gratitude, for giveness, resilience, and kindness. Higher levels of spiri tuality and religion are associated with improved quality of life, as well as psychosocial and environmental rela tions, optimism, and happiness [15, 38]. In other words, individuals’ PWB is affected by their level of self-aware ness, optimism, and spirituality. Th e more self-aware, optimistic, and higher in spirituality individuals are, the more they feel wellbeing and satisfied [39]. Other results revealed that SH and its dimensions (religious & existen tial health), as a sub-concept of spirituality, are related to the components of spirituality [20]. The present study data suggested that SH was significantly correlated with PWB. This finding was consistent with those of Shari fian et al. [39], Hystad et al. [40], and Heckman and Clay [41]. In other words, SH, as an individual characteristic, can assist individuals to feel better about themselves and the world around them; therefore, they feel more satis fied and successful in life. Individuals with SH have a role model that sets an example in commitment, con trol, and struggle. Besides, these patterns lead to healthy positive outcomes that help them cope with problems and illnesses, and gain a sense of efficiency and control over the conditions [42]. SH is associated with positive psychological components, such as self-efficacy, resil ience, hope, optimism, and hard work; these structures play an essential role in strengthening the psychological strength of individuals in various aspects of life and lead to becoming stronger and increasing competence; con sequently, promoting individuals’ PWB [20]. In general, the components of SH, apart from being related to PWB, also overlap with spirituality and religiosity. Moreover, they are achieved through a dynamic and harmonious process of cognition, emotion, action, and personal con sequence [43]. Impairment in SH may lead to mental health conditions, such as loneliness, depression, and the loss of meaning in life, which in turn, can make life difficult [43]. A high SH leads to strengthening the psy chological strength of individuals in various aspects of life; becoming stronger, increasing competence, conse quently, promoting their PWB [20]. The limitations of this study consisted of the lack of clarity and uncertainty of the concepts with similar do mains to the concept of spirituality, i.e., common and equivalent. It seems that we must first reach a general agreement in this area to facilitate each of them. More over, according to the prevailing local and cultural con ditions, we can have comprehensive and at the same time acceptable definitions of these concepts. Subsequent researchers are advised to test other di mensions and components of spirituality based on the literature on the subject of spirituality, and even other models of spirituality, especially indigenous and Islamic patterns, concerning their effect on student behavior. In the present study, only some variables were addressed. Future studies can examine other cognitive and emo tional variables in a comprehensive and coherent model. Conclusion The current research results indicated that the place and importance of spirituality in mental health, PWB, and SH to enjoy a good and happy life is undeniable. According to the available findings, the existence and feeling of meaning in life act as a key that can signify health and wellbeing indicators, such as self-acceptance, positive relationship with others, autonomy, purposeful life, personal growth, and mastery of the environment in individuals’ performance and encourage them to take positive actions. Accordingly, meaningful life is often considered an essential factor in PWB. The obtained |
| 131 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| results can be considered at both theoretical and practi cal levels. At the theoretical level, the collected findings supported the assumptions of the models related to the relationship between research variables. At the applied level, the achieved results can be a suitable experimental basis for developing educational, intervention, and treat ment programs. Ethical Considerations Compliance with ethical guidelines All ethical principles are considered in this article. The participants were informed about the purpose of the re search and its implementation stages. They were also as sured about the confidentiality of their information. They were free to leave the study whenever they wished, and if desired, the research results would be available to them. Funding The study was extracted from the PhD. dissertation of the first author at the Department of Educational Scienc es, Faculty of Humanities, Arak Branch, Islamic Azad University, Arak. Authors' contributions Conceptualization and supervision: Ata Shakerian, Yahya Maroufi and Faezeh Nateghi; Methodology: Ata Shakerian and Yahya Maroufi; Review, writing - original draft, and writing - reviewing and editing: All Authors; Data collection, data analysis, financing and resources: Ata Shakerian. Conflict of interest The authors declared no conflict of interest. References [1] Hooker SA, Masters KS, Carey KB. Multidimensional assess ment of religiousness/spirituality and health behaviors in col lege students. Int J Psychol Relig. 2014; 24(3):228-40. [DOI:10.10 80/10508619.2013.808870] [2] Sharma SK, Sharma OP. Spirituality leads to happiness: A correlative study. Int J Indian Psychol. 2016; 3(2):50-4. [DOI:10.25215/0302.177] [3] Malinakova K, Kopcakova J, Kolarcik P, Geckova AM, Solcova IP, Husek V, et al. The Spiritual Well-Being Scale: Psychometric evaluation of the shortened version in Czech adolescents. J Re lig Health. 2017; 56(2):697-705. [DOI:10.1007/s10943-016-0318- 4] [PMID] [PMCID] [4] Shakerian A, Maroofi Y, Nateghi F. [Development and vali dation of the spirituality questionnaire among university students in higher educational centers of Sanandaj in 2017 (Persian)]. J Pizhūhish dar Dīn va Salāmat. 2020; 6(1):100-15. [DOI:10.22037/jrrh.v6i1.21301] [5] Gilder MC. Spiritual development as a component of holis tic development higher education [MA. thesis]. Baton Rouge, LA: Louisiana State University; 2011. https://digitalcommons. lsu.edu/cgi/viewcontent.cgi?article=3390&context=gradscho ol_theses [6] Rosmarin DH. Spirituality, religion, and cognitive-behav ioral therapy: A guide for clinicians. New York: Guilford Publications; 2018. pp. 41-43. https://books.google.com/ books?id=KvVKDwAAQBAJ&dq [7] Moons Ph, Luyckx K, Dezutter J, Kovacs AH, Thomet C, Budts W, et al. Religion and spirituality as predictors of pa tient-reported outcomes in adults with congenital heart disease around the globe. Int J Cardiol. 2019; 274:93-9. [DOI:10.1016/j. ijcard.2018.07.103] [PMID] [8] Chow HPH. Psychological well-being and scholastic achieve ment among university students in a Canadian Prairie City. Soc Psychol Educ. 2007; 10(4):483-93. [DOI:10.1007/s11218- 007-9026-y] [9] Cheng ST, Chan ACM .Measuring psychological well being in the Chinese. Pers Individ Dif. 2005; 38(6):1307-16. [DOI:10.1016/j.paid.2004.08.013] [10] Panzini RG, Mosqueiro BP, Zimpel RR, Bandeira DR, Rocha NS, Fleck MP. Quality-of-life and spirituality. Int Rev Psychia try. 2017; 29(3):263-82. [DOI:10.1080/09540261.2017.1285553] [PMID] [11] Wagani R, Colucci E. Spirituality and wellbeing in the con text of a study on suicide prevention in North India. Religions. 2018; 9(6):183. [DOI:10.3390/rel9060183] [12] Zarzycka B, Puchalska-Wasyl MM. Can religious and spir itual struggle enhance well-being? Exploring the mediating ef fects of internal dialogues. J Relig Health. 2020; 59(4):1897-912. [DOI:10.1007/s10943-018-00755-w] [PMID] [PMCID] [13] Zarzycka B, Zietek P.Spiritual growth or decline and mean ing-making as mediators of an xi-ety and satisfaction with life during religious struggle. J Relig Health. 2018; 58(4):1072-86. [DOI:10.1007/s10943-018-0598-y] [PMID] [PMCID] [14] Deb S, McGirr K, Sun J. Spirituality in Indian university stu dents and its associations with socioeconomic status, religious background, social support, and mental health. J Relig Health. 2016; 55(5):1623-41. [DOI:10.1007/s10943-016-0207-x] [PMID] [15] Lau WWF, Hui CH, Lam J, Lau EYY, Cheung SF. The re lationship between spirituality and quality of life among university students: An autoregressive cross-lagged panel analysis. High Educ. 2015; 69(6):977-90. [DOI:10.1007/s10734- 014-9817-y] [16] Shimako Abe J. Spirituality and culture: Implications for mental health service delivery to diverse populations. In: Pa niagua FA, Yamada AM, editors. Handbook of Multicultural Mental Health: Assessment and Treatment of Diverse Popula tions. San Diego, CA: Academic Press; 2013. pp. 147-164. htt ps://books.google.com/books?id=Vs6atH-JaaMC&dq [17] Barrera TL, Zeno D, Bush AL, Barber CR, Stanley MA. Inte grating religion and spirituality into treatment for late-life anxi |
| 132 Shakarian A, et al. Structural Model of Spirituality With Psychological Well-being. Health Spiritual Med Ethics J. 2021; 8(2):123-132. |
| ety: Three case studies. Cogn Behav Pract. 2012; 19(2):346-58. [DOI:10.1016/j.cbpra.2011.05.007] [18] Varghese SP, Florentin OD, Koola MM. Role of spirituality in the management of major depression and stress-related disor ders. Chronic Stress. 2021; 5. [DOI:10.1177/2470547020971232] [PMID] [PMCID] [19] Fry LW. Toward a theory of spiritual leadership. Leadersh Q. 2003; 14(6):693-727. [DOI:10.1016/j.leaqua.2003.09.001] [20] Sotoodeh H, Shakerinia I, Ghasemi Jobaneh R, Kheyrati M, Hoseini Seddigh MS. [Role of family health and spiritual health on nurses psychological wellbeing (Persian)]. Med Hist. 2016; 7(25):161-84. [DOI:10.22037/mhj.v7i25.13601] [21] Fisher JW. Assessing adolescent spiritual health and well-be ing (commentary related to Social Science & Medicine - Popula tion Health, ref: SSMPH-D-15-00089). SSM Popul Health. 2016; 2:304-5. [DOI:10.1016/j.ssmph.2016.04.002] [PMID] [PMCID] [22] Karimi L, Shomoossi N, Safee Rad I, Ahmadi Tahor M. [The relationship between spiritual well-being and mental health of university students (Persian)]. J Sabzevar Univ Med Sci. 2011; 17(4):274-80. http://jsums.medsab.ac.ir/article_46.html [23] Unterrainer HF, Lewis AJ, Fink A. Religious/spiritual well-being, personality and mental health: A review of re sults and conceptual issues. J Relig Health. 2014; 53(2):382-92. [DOI:10.1007/s10943-012-9642-5] [PMID] [24] Snider AM, McPhedran S. Religiosity, spirituality, mental health, and mental health treatment outcomes in Australia: A systematic literature review. Ment Health Relig Cult. 2014; 17(6):568-81. [DOI:10.1080/13674676.2013.871240] [25] Bonelli RM, Koenig HG. Mental disorders, religion and spir ituality 1990 to 2010: A systematic evidence-based review. J Re lig Health. 2013; 52(2):657-73. [DOI:10.1007/s10943-013-9691-4] [PMID] [26] Moreira-Almeida A, Koenig HG, Lucchetti G. Clinical im plications of spirituality to mental health: Review of evidence and practical guidelines. Braz J Psychiatry. 2014; 36(2):176-82. [DOI:10.1590/1516-4446-2013-1255] [PMID] [27] Rezaei M, Seyed Fatemi N, Givari A, Hoseini F. [Relation between prayer activity and spiritual well-being in cancer pa tients undergoing chemotherapy (Persian)]. Iran J Nurs. 2007; 20(52):51-61. http://ijn.iums.ac.ir/article-1-364-en.html [28] Lopez V, Leigh MC, Fischer I, Larkin D, Webster S. Per ceptions of spirituality in Australian undergraduate nursing students: A pre- and post-test study. Nurs Pract Today. 2015; 2(1):10-5. https://npt.tums.ac.ir/index.php/npt/article/ view/35 [29] Khalifi T, Seyedfatemi N, Mardani-Hamooleh M, Haghani H. [The effect of spiritual education on spiritual health of nurs ing students: A quasi-experimental study (Persian)]. Med Eth ics Hist Med. 2018; 11(1):152-64. http://ijme.tums.ac.ir/article- 1-5945-en.html [30] Ahmadian H, Mirdrekvand A, Ghadampoor E. [Develop ing and testing the model of academic disability (Persian)]. Res Teach. 2019; 7(2):213-33. https://trj.uok.ac.ir/article_61249. html [31] Gholami Kh, Tirri K. The cultural dependence of the ethical sensitivity scale questionnaire: The case of Ira nian Kurdish teachers. Educ Res Int. 2012; 2012:387027. [DOI:10.1155/2012/387027] [32] van Dierendonck V. The construct validity of Ryff’s Scales of psychological well-being and its extension with spiritual well-being. Pers Individ Dif. 2004; 36(3):629-43. [DOI:10.1016/ S0191-8869(03)00122-3] [33] Bayani AA, Mohammad Koochekya A, Bayani A. [Reli ability and validity of Ryff’s psychological well-being scales (Persian)]. Iran J Psychiatry Clin Psychol. 2008; 14(2):146-51. http://ijpcp.iums.ac.ir/article-1-464-en.html [34] Allahbakhshian M, Jaffarpour alavi M, Parvizy S, Haghani H. [A survey on relationship between spiritual wellbeing and quality of life in multiple sclerosis patients (Persian)]. Zahedan J Res Med Sci. 2010; 12(3):e94299. https://sites.kowsarpub. com/zjrms/articles/94299.html [35] Dehshiri GR, Sohrabi F, Jafari I, Najafi M. [Investigating the psychometric properties of comparing spiritual well-being among students (Persian)]. J Psychol Stud. 2008; 4(3):129-44. [DOI:10.22051/PSY.2008.1637] [36] Vahedi Sh. [A psychometric evaluation and factor structure of revised version of teacher observation of classroom adapta tion scale (Persian)]. J Fundam Ment Health. 2012; 14(53):36-45. [DOI:10.22038/JFMH.2012.931] [37] Vitorino LM, Lucchetti G, Leão FC, Vallada H, Peres MFP. The association between spirituality and religiousness and mental health. Sci Rep. 2018; 8:17233. [DOI:10.1038/s41598- 018-35380-w] [PMID] [PMCID] [38] Adler MG, Fagley NS. Appreciation: Individual differences in finding value and meaning as a unique predictor of subjec tive well‐being. J Personal. 2005; 73(1):79-114. [DOI:10.1111/ j.1467-6494.2004.00305.x] [PMID] [39] Sharifian M, Jandaghi F, Nazarchoob Masjedi M, Azizi S. [Mediating role of spiritual health in relationship of irrational beliefs and dysfunctional attitudes with psychological well being in patient with multiple sclerosis by Structural equation modeling approach (Persian)]. Islam Life Style. 2020; 4(2):28- 37. http://islamiclifej.com/article-1-380-en.html [40] Hystad SW, Eid J, Laberg JC, Johnsen BH, Bartone PT. Academic stress and health: Exploring the moderating role of personality hardiness. Scand J Educ Res. 2009; 53(5):421-9. [DOI:10.1080/00313830903180349] [41] Heckman CJ, Clay DL. Hardiness, history of abuse and women’s health. J Health Psychol. 2005; 10(6):767-77. [DOI:10.1177/1359105305057312] [PMID] [42] Abbasi M, Azizi F, Shamsi Gooshki E, Naseri Rad M, Ak bari Lakeh M. [Conceptual definition and operationalization of spiritual health: A methodological study (Persian)]. Fa slnamah-i Akhlaq-i Pizishki. 2014; 6(20):11-44. [DOI:10.22037/ mej.v6i20.3629]. [43] Craven RF, Hirnle CJ, Jensen S. Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins; 2012. https:// books.google.com/books/about/Fundamentals_of_Nursing. html?id=ioiEZwEACAAJ&source=kp_book_description |
Type of Study: Original Article |
Subject:
Special
Received: 2020/07/28 | Accepted: 2021/07/4 | Published: 2021/08/1
Received: 2020/07/28 | Accepted: 2021/07/4 | Published: 2021/08/1
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eISSN: 2383-3610
pISSN: 2322-4304
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