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The Relationship Between Spiritual Well-Being and Quality of Life in Cardiac Patients After Pacemaker Implantation: The Mediating Roles of Death Anxiety and Hope
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Ziba Roshan   , Mehrangiz Paivastegar * , Zohreh Khosravi |
| Alzahra University, Tehran, Iran. , mpaivastegar@alzahra.ac.ir |
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Abstract: (15 Views) |
Introduction: The quality of life (QoL) of cardiac patients following pacemaker implantation may be influenced by various psychological factors. This study aimed to examine the relationship between spiritual well-being and quality of life, with death anxiety and hope as mediating variables. Methods: This descriptive-correlational study employed structural equation modeling (SEM) and included 400 cardiac patients with pacemakers who were referred to Shahid Ayatollah Rouhani Specialized Hospital in Babol in 2025. Participants were selected using convenience sampling. Data were collected using the Raymond F. Paloutzian and Craig W. Ellison Spiritual Well-Being Scale, Charles Richard Snyder Hope Scale, Waqar Husain et al. Death Anxiety Scale, and World Health Organization (WHO) Quality of Life Questionnaire (WHOQOL). Data were analyzed using Karl Pearson’s correlation coefficient and structural equation modeling. Indirect effects were examined using bootstrapping.
Results: Spiritual well-being was negatively associated with death anxiety and positively associated with hope and quality of life (p < 0.001). Death anxiety was negatively associated with quality of life, whereas hope was positively associated with quality of life (p < 0.001). The indirect effects of spiritual well-being on quality of life through death anxiety (β = 0.48) and hope (β = 0.25) were significant. The total indirect effect was also significant (β = 0.33), while the direct effect of spiritual well-being on quality of life remained significant.
Conclusion: Spiritual well-being is associated with quality of life among cardiac patients following pacemaker implantation, with death anxiety and hope playing mediating roles in this relationship. Addressing these psychological factors alongside physical care may contribute to improving the quality of life of these patients.
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| Keywords: Spiritual well-being, Death anxiety, Hope, Quality of life, Cardiac patients, Pacemaker. |
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Full-Text [DOCX 194 kb]
(2 Downloads)
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Type of Study: Psychiatric and Mental Health Nursing |
Subject:
behavioral sciences
Received: 2026/08/18 | Accepted: 2026/09/21 | Published: 2026/10/2
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