Exploring spiritual needs in older adults with chronic illnesses across diverse cultures in China s: a cross-sectional analysis

Chronic illness significantly increases spiritual needs among older adults. Unmet spiritual needs can result in spiritual distress and impaired well-being. However, research on these needs remains limited in multicultural developing countries. This study aims to explore spiritual needs among older adults in China. A multicenter, cross-sectional study was conducted from October 2022 to May 2023 with 726 participants. Data were collected through convenience sampling using a demographic characteristics questionnaire and the Spiritual Needs Scale (SNS) to assess participants’ spiritual needs. Descriptive statistics including frequencies and percentages were calculated. The Mann-Whitney U, Kruskal-Wallis test, and Spearman rank correlation analysis were performed. Multivariate stepwise regression was applied to analyze factors influencing spiritual needs. The median score for spiritual needs was 84.0, with an interquartile range of 76.0 to 94.0,indicating moderately high spiritual needs.The hierarchy of spiritual needs, ranked from highest to lowest, included: meaning and purpose, love and connection, acceptance of dying, hope and peace, and relationship with transcendence.Regression analysis revealed significant predictors of spiritual needs (F = 12.54, P < 0.001; R²=0.41). Positive associations included family support (β = 0.227), higher income levels (β = 0.091–0.146), medical insurance coverage (β = 0.093–0.105), and fatalistic coping (β = 0.097–0.140). Negative predictors were unemployment (β =-0.224), major health issues (β =-0.156), and formal support-seeking (β =-0.162) (all P < 0.05). Chinese older adults with chronic illnesses demonstrated moderate levels of spiritual needs, with meaning and. purpose being the most prominent domains. These needs were significantly influenced by individual, interpersonal, environmental, and transcendental factors, underscoring the necessity for culturally adapted spiritual care approaches.