Volume 15, Issue 2 (Summer 2020)                   Salmand: Iranian Journal of Ageing 2020, 15(2): 144-159 | Back to browse issues page


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Sadoughi M, Hesampour F. Prediction of Psychological Well-Being in the Elderly by Assessing their Spirituality, Gratitude to God, and Perceived Social Support. Salmand: Iranian Journal of Ageing 2020; 15 (2) :144-159
URL: http://salmandj.uswr.ac.ir/article-1-1347-en.html
1- Department of Psychology, Faculty of Humanities, University of Kashan, Kashan, Iran. , sadoughi@kashanu.ac.ir
2- Department of Psychology, Faculty of Psychology & Educational Sciences, University of Semnan, Semnan, Iran.
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Extended Abstract
1. Introduction

Aging is one of the most challenging stages of life; a complicated set of physical, psychological, and social changes impose a heavy burden on the elderly’s psycho-social functioning and well-being. Previous studies have shown that positive psychological traits such as positive affect, positive relations, and meaning in life have a significant relationship with better psychological well-being outcome. Along with the development of positive psychology in the last decade, a new perspective in the field of geriatrics has been developed which is in contrast with common negative perspective. It is based on new concepts related to aging such as psychological well-being, happiness, life satisfaction, social support, spirituality, and positive aging. 
There are various important factors for the well-being and life satisfaction of the elderly, one of which is spiritual and religious coping strategies. Spirituality is defined as the sense of receiving meaning or purpose from a higher source and is related to a person’s perception of health and well-being. Spirituality has a key role in coping with stress and mental distress. In fact, religious beliefs, especially when combined with group activities, can prevent loneliness and reduce depression, anxiety, and other psychological symptoms. 
Gratitude to God is another component of positive psychology that is expected to be associated with the psychological well-being of the elderly. Studies have shown that gratitude is one of the most beneficial positive personality traits. McAdams et al. [22] believe that the gratitude is more importance for the elderly, since it helps them better pass through their last stages of adulthood and achieve cohesion. On the other hand, perceived social support has a relationship with the elderly’s psychological well-being. In fact, social support is one of the most important forms of social relations and can be different in individuals considering their age, gender, personality, and even culture. At each stage of life, some aspects of social support may become more important and more effective. 
There is scanty empirical evidence on positive aging in Iranian samples and there are few studies have explored the effect of positive psychology components on psychological well-being of the elderly. Therefore, the present study is an attempt to examine the relationship of psychological well-being with spirituality, gratitude to God, and perceived social support in the elderly, also measure the contribution of each of these variables in predicting psychological well-being of the elderly. 

2. Methods & Materials
This is a descriptive-correlational study. Study population consists of all older people aged 60-75 years in Kashan, Iran in 2016. Of these, 211 participants were participated in the study and filled out Paloutzian and Ellisons’ Spirituality Well-Being Scale (SWBS), short form of Ryff’s Psychological Wellbeing Scale (PWBS), Emmons and Crumpler’s Gratitude to God Questionnaire (GGQ), and Zimet’s Multidimensional Scale of Perceived Social Support (MSPSS) . In addition, a demographic form was used to record their information including age, marital status, education, and socio-economic status.
The SWBS has 20 items rated on a 6-point Likert scale ranging from ‘completely disagree’ to ‘completely agree’. In our study, the Cronbach’s alpha coefficient for the internal consistency of its two sub-scales of religious well-being and existential well-being were obtained 0.84 and 0.73, respectively. The GGQ has 4 items rated on a 5-point Likert scale with a Cronbach’s alpha of 0.96 reported by Emmons’ et al. [19]. In our study, it was obtained 0.76, indicating the high reliability of its Persian version. The MSPSS measures perceived social support received from family members, frieٌnds, significant others. It includes 12 phrases, and its good validity and reliability have been reported in other studies. In the current study, the Cronbach’s alpha coefficients for its three sub-scales of support from significant others, family members, and friends were obtained 0.70, 0.72, and 0.83, respectively. Finally, the short form of PWBS has 18 items rated on a 6-point Likert scale. The Cronbach’s alpha for this scale was obtained 0.71 in the present study, showing its satisfactory reliability. 
3. Results
Mean±SD for different study variables and their components are as follows: Psychological well-being =7.1±10.68; Spirituality =90.22±15.36; Gratitude to God =14.09±2.41; Social support from family members =21.6±4.2; Social support from friends =16.5±5.8; and Social support from significant others = 20.23±5. The results of stepwise regression analysis indicated that spirituality (β=0.47, ∆R2=0.22, F1,209=62.02, P=0.001), social support from family members (β=0.21, ∆R2=0.039, F1,208=11.06, P=0.001) and gratitude to God (β=0.16, ∆R2=0.017, F1,207=4.80, P=0.001) could significantly explain 27% of the psychological well-being variance in the elderly.

4. Conclusion
The results of the present study are in line with those of Garsen [16], Wilt [38], and Moon & Kim [39] who reported a direct relationship between spirituality and psychological well-being in the elderly. Spirituality is known as the indicator of significant positive outcome of well-being and quality of life. Spirituality can be very useful as a positive strategy for increasing meaning in life, hope, and social interactions and coping with psychological problems such as depression and loneliness in the elderly. Cowlishaw et al. [41] found that spirituality has a significant relationship of life satisfaction with psychological well-being of the elderly, leading to their better understanding and positive appraisal of life events.
The findings of this study indicated a positive relationship between gratitude to God and psychological well-being, which is consistent with the results of Booker et al. [46], Ramírez [47], Sapmaz et al. [48]. Krause [49] showed that gratitude to God helps the elderly to effectively deal with undesirable life events. A study suggested that gratitude is an important force that should be strengthened in the elderly because it may help them experience less fear and anxiety about death by making them realize they may have a good life [51]. Other studies on different samples of the elderly have shown that those who express gratitude can better prioritize positive aspects of life [18]. These people spend more time thinking about the positive aspects of life and the benefits of social interactions [57].
The results of the present study showed a significant relationship between perceived social support received from family members and psychological well-being in the elderly. These results are consistent with those of Sun et al. [55], Lee et al. [26], and Kishimoto et al. [56]. Sun et al. [55] found that relatives and non-relatives play different roles in the lives of the elderly. Family members always play the most supportive role in the psychological well-being of the elderly, while friends usually provide less of such support. Emotional support is provided by both family members and friends. The older people’s friends accompany them in social activities more than their children or relatives. Family members, compared to friends, exert more social control and the elderly expect social support from them when needed. 
Spiritual assessments, due to cultural differences, are necessary for the centers where health care services for the elderly are designed and provided. In addition to assessing the mental health states of the elderly, improvement of their social support can play an important role in increasing their satisfaction and, thus, their psychological well-being. In overall, it seems that , by strengthening spirituality, gratitude to God, and perceived social support, we can help the elderly to develop strategies to maintain their psychological and physical well-being. 

Ethical Considerations
Compliance with ethical guidelines

All ethical principles were considered in this article. The participants were informed about the purpose of the research and its implementation stages; they were also assured about the confidentiality of their information; Moreover, They were allowed to leave the study whenever they wish, and if desired, the results of the research would be available to them.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
Conceptualization: Fatemeh Hesampour, Majid Sadoughi; Methodology, analysis, research and review: Majid Sadoughi; writing Manuscript: Fatemeh Hesampour; Supervi-sion: Majid Sadoughi.
Conflicts of interest
The authors declared no conflicts of interest.

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Type of Study: Applicable | Subject: gerontology
Received: 2017/09/25 | Accepted: 2018/07/02 | Published: 2020/07/01

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