Volume 14, Issue 1 (Spring 2019)
Salmand: Iranian Journal of Ageing 2019, 14(1): 96-113 |
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Khoshbakht Pishkhani M, Mohammadi Shahboulaghi F, Khankeh H, Dalvandi A. Spiritual Health in Iranian Elderly: A Concept Analysis by Walker and Avant’s Approach. Salmand: Iranian Journal of Ageing 2019; 14 (1) :96-113
URL: http://salmandj.uswr.ac.ir/article-1-1424-en.html
URL: http://salmandj.uswr.ac.ir/article-1-1424-en.html
Maryam Khoshbakht Pishkhani1 
, Farahnaz Mohammadi Shahboulaghi * 
2, Hamidreza Khankeh1 , Asghar Dalvandi1
, Farahnaz Mohammadi Shahboulaghi * 2, Hamidreza Khankeh1 , Asghar Dalvandi1
1- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,f.mohammadi@uswr.ac.ir
2- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ,
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Extended Abstract
1. Objectives
Aging has begun from the beginning of creation and continues throughout life [1]. The aging population is increasing in the world and in Iran [2, 3]. An issue affecting the lives of older adults is their health status [1]. According to the World Health Organization, health has biopsychosocial and spiritual dimensions. Spiritual health is related to other health aspects and affects them [4]. It is among the main dimensions of health in humans [5]. Considering the increasing population of elderly people, it is necessary to pay attention to this age group’s issues [6]. Conceptual controversies exist in the definition of spiritual health; thus, this study was conducted to help clarify this concept.
2. Methods and Materials
This qualitative study (concept analysis) was conducted to clarify and define the characteristics of the concept of spiritual health in the Iranian elderly. The present research was conducted by reviewing the literature and using Walker and Avant's approach in 8 stages, as follows: concept selection, defining the goal of concept analysis, identifying concept uses, finding characteristics defining the concept, constructing a model case, finding borderline, related and contrary cases, identifying antecedents and consequences, and defining empirical references. To find related articles and abstracts for review, we searched for articles published between 1996 and 2016 in MedLine, CINHAL PubMed, Scopus, Google scholar, IranMedex, MagIran and SID databases. We used the following keywords: “Spirituality, Spiritual health, Spiritual wellbeing, older adult, geriatric, elderly, elderly people, and elderly person”. Inclusion criteria for articles were availability in both Persian and English, the existence of determined keywords in their title and abstract, being relevant to the spiritual health concept, accessibility to their full texts, and the lack of duplicability. The articles in other languages were excluded from the study. Eventually, 32 articles remained for the review. The quality of selected papers was evaluated based on the authors' reputation and the scientific validity of the journals in which the articles had been published. This study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences.
3. Results
The conceptual definition for the spiritual health of the elderly in Iran is a dynamic and multidimensional concept that indicates the manifestation of a divine spirit in an older person which causes to experience God's love and strengthens, and the feeling of closeness to a supernal power. This allows the elderly to have a spiritual and psychological balance in facing oneself, others and God, and maintain their biopsychosocial health. Some characteristics of spiritual health include cognitive, functional, and affective components [7, 8], and spiritual gains [8]; stability in life, harmony, feeling close to God, self, society and environment [5, 9]; loving the Creator [10, 11]; a manifestation of Brahman, Buddha, Dao, reality or truth [11], psychological balance and attention to afterlife [11]; chastity, belief in supernatural or divine power, happiness and a meaningful life [10, 11]; peace [9, 10, 11]; inner peace and a sense of connection with superior power [10]; getting close to God Excellence and having connection to divine, individual, social and natural powers [12]; belief in a supreme power, the need for connection to others, internal coordination, the preservation of one’s existential integrity and strong supportive systems, caring for nature and the sense of connection with the world around [13, 14]; having a pure heart, a sincere life, a special thought or knowledge of God, man and creation, and their mutual relationship, being God-oriented, performing acts of kindness, avoiding evil, and forgiving others [15]. Moreover, antecedents were belief in a transcendent existence, understanding his presence and connection to him [7, 16-18]; tendencies and abilities [12, 19]; gaining insight and having existential capacities [12]; participation in supportive groups [20], physical health, disease prevention, proper diet, mental relaxation, stress management, faith, as well as trust and commitment to ethics [21]. Spiritual health also has the following consequences: divine nearness, nearness to God, and peace, hope, and a higher quality of life [6, 11, 22-24].
4. Conclusion
The conceptual definition of spiritual health for the elderly presented in this study can help the healthcare providers to better understand this concept. It can also be beneficial to evaluate their actions to promote the health of older adults. According to the achieved results, spiritual health is an important health aspect among older adults and the understanding of spirituality is very effective for their health. Given the increasing number of elderly people in Iran, further studies are recommended on the concept of spiritual health and its operational definition in the Iranian population and culture. By conducting further studies in this field and a better understanding of this concept, we can obtain a better knowledge of the health-related issues in older people; it can, in turn, lead to a happier and healthier community.
Ethical Considerations
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
All authors contributed in preparing this article.
Conflict of interest
The authors declared no conflict of interest.
1. Objectives
Aging has begun from the beginning of creation and continues throughout life [1]. The aging population is increasing in the world and in Iran [2, 3]. An issue affecting the lives of older adults is their health status [1]. According to the World Health Organization, health has biopsychosocial and spiritual dimensions. Spiritual health is related to other health aspects and affects them [4]. It is among the main dimensions of health in humans [5]. Considering the increasing population of elderly people, it is necessary to pay attention to this age group’s issues [6]. Conceptual controversies exist in the definition of spiritual health; thus, this study was conducted to help clarify this concept.
2. Methods and Materials
This qualitative study (concept analysis) was conducted to clarify and define the characteristics of the concept of spiritual health in the Iranian elderly. The present research was conducted by reviewing the literature and using Walker and Avant's approach in 8 stages, as follows: concept selection, defining the goal of concept analysis, identifying concept uses, finding characteristics defining the concept, constructing a model case, finding borderline, related and contrary cases, identifying antecedents and consequences, and defining empirical references. To find related articles and abstracts for review, we searched for articles published between 1996 and 2016 in MedLine, CINHAL PubMed, Scopus, Google scholar, IranMedex, MagIran and SID databases. We used the following keywords: “Spirituality, Spiritual health, Spiritual wellbeing, older adult, geriatric, elderly, elderly people, and elderly person”. Inclusion criteria for articles were availability in both Persian and English, the existence of determined keywords in their title and abstract, being relevant to the spiritual health concept, accessibility to their full texts, and the lack of duplicability. The articles in other languages were excluded from the study. Eventually, 32 articles remained for the review. The quality of selected papers was evaluated based on the authors' reputation and the scientific validity of the journals in which the articles had been published. This study was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences.
3. Results
The conceptual definition for the spiritual health of the elderly in Iran is a dynamic and multidimensional concept that indicates the manifestation of a divine spirit in an older person which causes to experience God's love and strengthens, and the feeling of closeness to a supernal power. This allows the elderly to have a spiritual and psychological balance in facing oneself, others and God, and maintain their biopsychosocial health. Some characteristics of spiritual health include cognitive, functional, and affective components [7, 8], and spiritual gains [8]; stability in life, harmony, feeling close to God, self, society and environment [5, 9]; loving the Creator [10, 11]; a manifestation of Brahman, Buddha, Dao, reality or truth [11], psychological balance and attention to afterlife [11]; chastity, belief in supernatural or divine power, happiness and a meaningful life [10, 11]; peace [9, 10, 11]; inner peace and a sense of connection with superior power [10]; getting close to God Excellence and having connection to divine, individual, social and natural powers [12]; belief in a supreme power, the need for connection to others, internal coordination, the preservation of one’s existential integrity and strong supportive systems, caring for nature and the sense of connection with the world around [13, 14]; having a pure heart, a sincere life, a special thought or knowledge of God, man and creation, and their mutual relationship, being God-oriented, performing acts of kindness, avoiding evil, and forgiving others [15]. Moreover, antecedents were belief in a transcendent existence, understanding his presence and connection to him [7, 16-18]; tendencies and abilities [12, 19]; gaining insight and having existential capacities [12]; participation in supportive groups [20], physical health, disease prevention, proper diet, mental relaxation, stress management, faith, as well as trust and commitment to ethics [21]. Spiritual health also has the following consequences: divine nearness, nearness to God, and peace, hope, and a higher quality of life [6, 11, 22-24].
4. Conclusion
The conceptual definition of spiritual health for the elderly presented in this study can help the healthcare providers to better understand this concept. It can also be beneficial to evaluate their actions to promote the health of older adults. According to the achieved results, spiritual health is an important health aspect among older adults and the understanding of spirituality is very effective for their health. Given the increasing number of elderly people in Iran, further studies are recommended on the concept of spiritual health and its operational definition in the Iranian population and culture. By conducting further studies in this field and a better understanding of this concept, we can obtain a better knowledge of the health-related issues in older people; it can, in turn, lead to a happier and healthier community.
Ethical Considerations
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
All authors contributed in preparing this article.
Conflict of interest
The authors declared no conflict of interest.
Type of Study: Research |
Subject:
gerontology
Received: 2018/10/12 | Accepted: 2019/01/25 | Published: 2019/04/01
Received: 2018/10/12 | Accepted: 2019/01/25 | Published: 2019/04/01
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