Association between Daily Spiritual Experiences and Medication Adherence among Elderly with Diabetes: A Cross-Sectional Study in Golestan Province, Iran

Background: Given the growing elderly population, the high prevalence of chronic diseases such as diabetes, and the critical importance of medication adherence for disease control, this study was conducted to determine the association between daily spiritual experiences and medication adherence among elderly patients with diabetes in Golestan Province, Iran, in ۲۰۲۳. Methods: This descriptive-cross-sectional study included ۲۰۰ elderly participants selected via a multi-stage cluster random sampling method based on the inclusion criteria. Sampling was conducted from clinics and endocrinology offices in various cities of Golestan Province. Data were collected using a demographic questionnaire (age, gender, marital status, education level, medication and smoking history, and diabetes history), the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, and the Daily Spiritual Experience Scale (DSES). Data analysis was performed using SPSS software version ۲۶, with a significance level of P < ۰.۰۵. Results: A significant negative association was found between spiritual experiences and medication adherence (P < ۰.۰۰۱). Low adherence had the highest mean spiritual experience score (۷۵.۷۱ ± ۹.۸۸), while high adherence had the lowest (۶۵.۰۸ ± ۱۰.۶۱). Adherence was higher among those using ۳–۵ medications (P < ۰.۰۰۱) and those without hospitalization history (P = ۰.۰۰۱). Higher spiritual experiences were associated with re-employment, having four children, primary education, using ۳–۵ medications, hospitalization history, lower self-rated health vs peers, and disease duration of ۶–۱۰ years (P < ۰.۰۵). Conclusion: The results demonstrate a significant negative association between daily spiritual experiences and medication adherence among elderly patients with diabetes. This counterintuitive finding, potentially influenced by unmeasured confounders such as health literacy, socioeconomic status, or social support, suggests that higher spirituality may be associated with poorer adherence. Further qualitative and interventional research is warranted to clarify the underlying mechanisms.

کلیدواژه ها:

Spirituality ، Medication Adherence ، Aged ، Diabetes Mellitus ، Type ۲