The Impact of Death Anxiety and Spirituality Level on Psychological Well-Being of Geriatric Home Care Patients: Machine Learning Approach

OBJECTIVE: To investigate the effects of death anxiety and spirituality on the psychological well-being of geriatric home care patients. METHODS: A descriptive cross-sectional design was conducted between January and June 2024 with 280 individuals aged ≥65 years living in a provincial center in eastern Türkiye. Data were collected using the personal information form, Spiritual Orientation Scale, Psychological Well-being Scale, and Death Anxiety Scale. Descriptive statistics, t-tests, and machine learning based Shapley value analysis were applied. RESULTS: Psychological well-being was significantly associated with death anxiety and spirituality. Lower death anxiety (t=-4.253, p<0.001) and higher spirituality (t=4.728, p<0.001) were linked to better psychological well-being. Shapley value analysis identified spirituality as the strongest predictor. CONCLUSION: Reducing death anxiety and enhancing spirituality may improve psychological well-being in geriatric home care patients. Integrating spirituality-based psychosocial interventions into geriatric care may strengthen emotional resilience and quality of life. Future longitudinal studies are recommended to better understand the causal relationships between death anxiety, spirituality, and psychological well-being in geriatric home care populations.