In recent decades, the material and economic conditions of China’s elderly population have steadily improved, shifting attention toward their higher-level needs, particularly spiritual well-being. With the rapid growth of the aging population, spiritual support has become a critical yet often overlooked issue in gerontology, social policy, and health promotion. While there is broad recognition of the importance of spiritual care for older adults, the academic literature still lacks a clear conceptual framework, well-defined characteristic dimensions, and validated measurement tools for spiritual support. Moreover, the mechanisms through which spiritual support affects the health and quality of life of elderly individuals remain insufficiently understood. Addressing these gaps is essential for both advancing theory and guiding the design of effective interventions and policy initiatives in the context of contemporary China.
This study sought to establish a comprehensive understanding of spiritual support for older adults by combining theoretical analysis with empirical research. A mixed-methods approach was employed across three sequential studies. In Study 1, in-depth qualitative interviews were conducted with elderly individuals and their caregivers to explore perceptions, experiences, and expectations of spiritual support. These interviews were analyzed using grounded theory to generate an inductive model of spiritual support, leading to the identification of its core dimensions. Based on these findings, a preliminary measurement scale was developed. In Study 2, a large-scale survey involving 1,117 elderly participants was conducted to validate this scale. The results confirmed the factor structure, internal consistency, and construct validity of the instrument, establishing it as a reliable tool for assessing perceived spiritual support. In Study 3, a longitudinal survey of 237 older adults examined the predictive role of spiritual support on health-related outcomes over time, thereby testing the practical significance of the proposed framework.
The analyses revealed that spiritual support for elderly individuals comprises five key dimensions: health security (sense of security), social interaction (sense of belonging), educational activities (sense of competence), independence and freedom (sense of autonomy), and meaning in life (sense of value). Together, these dimensions capture the multifaceted nature of spiritual support in the Chinese cultural and social context, integrating both individual needs and broader social relationships. The newly developed measurement scale based on these dimensions demonstrated strong psychometric properties across different samples. Furthermore, the longitudinal findings indicated that higher levels of perceived spiritual support significantly predicted positive health outcomes, including improved physical and mental quality of life, reduced frailty, and better cognitive functioning. These results highlight the protective and promotive role of spiritual support in aging, extending beyond immediate psychological benefits to long-term well-being.
This research makes several contributions. Theoretically, it clarifies the concept of spiritual support and identifies its characteristic dimensions, providing a foundation for future studies in gerontology, psychology, and social work. Methodologically, it develops and validates a culturally sensitive measurement tool that enables the systematic assessment of spiritual support among older adults in China. Practically, the findings underscore the necessity of incorporating spiritual support into community services, caregiving practices, and public policy. By demonstrating the substantial long-term effects of spiritual support on both physical and mental health, this study provides strong empirical evidence to inform interventions and strategies aimed at enhancing the overall well-being of older adults.
