Korean J Adult Nurs.  2022 Oct;34(5):478-487. 10.7475/kjan.2022.34.5.478.

The Effects of Spiritual Well-Being on Elderly People’s Cognitive Function: Mediating Effects of Health-Promoting Behaviors and Depression

• Kim SJ
• Oh PJ

• KMID: 2534892
• DOI: http://doi.org/10.7475/kjan.2022.34.5.478

Abstract

Purpose
This study investigated the effects of spiritual well-being on the cognitive function of elderly people, focusing on the mediating effects of health-promoting behaviors and depression.
Methods
Using convenience sampling, 136 elderly people were recruited from October 2018 through February 2019 for a cross-sectional survey. Data were collected through the Spiritual Well-Being Scale, Health-Promoting Lifestyle Profile, Geriatric Depression Scale, Everyday Cognition, and Montreal Cognitive Assessment and analyzed using descriptive statistics and correlation. Mediation analysis was also conducted using Hayes’ PROCESS macro (Model 4).
Results
The mean scores for spiritual well-being, health-promoting behaviors, depression, objective cognitive function, and subjective cognitive function were 60.96, 108.09, 18.58, 19.49, and 63.35. The mediation effects in step 1 indicated that spiritual well-being had a statistically significant positive effect on health-promoting behaviors (B=0.32, p<.001) (R² =32.0%) and a significant negative effect on depression (B=-0.09, p=.001) (R² =31.0%). In step 2, spiritual well-being had a significant negative effect on subjective cognitive function (B=-0.12, p=.007) (R² =23.0%). In step 3, the direct effect of spiritual well-being on subjective cognitive function was not significant when the mediating variables (healthpromoting behaviors and depression) were introduced. Health-promoting behaviors (B=-0.18, p=.047) and depression (B=0.41, p=.008) had complete mediating effects on the relationship between spiritual well-being and subjective cognitive function.
Conclusion
These findings suggest that there is a need to develop and implement nursing strategies that can improve spiritual well-being, and to develop a holistic nursing intervention that considers depression and health-promoting behaviors, when applicable, to improve cognitive function in elderly people.

Keyword

Aged; Cognition; Depression; Health behavior; Spirituality