The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study

Abstract Background/Aims Research shows that low self-care ability and hopelessness are common in schizophrenia patients. Spirituality can be a key coping resource in managing mental illnesses. However, the mediating effect of spirituality on the relationship between self-care ability and hope in sc...

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Main Authors: Zeynep Öztürk, Mustafa Durmuş, Emrah Ay, Ayşe Okanli
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-07078-7
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author Zeynep Öztürk
Mustafa Durmuş
Emrah Ay
Ayşe Okanli
author_facet Zeynep Öztürk
Mustafa Durmuş
Emrah Ay
Ayşe Okanli
author_sort Zeynep Öztürk
collection DOAJ
description Abstract Background/Aims Research shows that low self-care ability and hopelessness are common in schizophrenia patients. Spirituality can be a key coping resource in managing mental illnesses. However, the mediating effect of spirituality on the relationship between self-care ability and hope in schizophrenia patients is unknown. This study aims to explore the mediating role of spiritual well-being in the relationship between self-care agency and hope in schizophrenia. Method This study is cross-sectional and correlational study with a descriptive design. The study was conducted with 116 schizophrenia patients who presented to the psychiatry outpatient clinic of a university hospital in eastern Turkey between 10.02. 2023 and 10.01. 2024. Descriptive Information Form, Self-Care Agency Scale, Herth Hope Index and Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale were used to collect the data. Structural equation modelling and bootstrapping method were used to analyse the data. Results In this study, the effect of self-care agency on hope (β = 0.12) was positive but not significant. However, self-care agency positively influenced spiritual well-being (β = 0.47), and spiritual well-being had a significant positive effect on hope (β = 0.83). Spiritual well-being fully mediated the relationship between self-care agency and hope, with the total mediated effect on hope being significant (β = 0.52). The model explained 23% of the variance in spiritual well-being and 80% of the variance in hope. Conclusion It was determined that self-care agency affected spiritual well-being positively and spiritual well-being affected hope positively in schizophrenia patients. It was also found that spiritual well-being mediated the relationship between self-care agency and hope. It is expected that this research model will be useful in formulating strategies to improve hope and self-care in schizophrenia patients.
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spelling doaj-art-89838e085d01456cba2281e28919e77f2025-08-20T03:37:38ZengBMCBMC Psychiatry1471-244X2025-07-0125111010.1186/s12888-025-07078-7The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational studyZeynep Öztürk0Mustafa Durmuş1Emrah Ay2Ayşe Okanli3Faculty of Health Science, Department of Psychiatric Nursing, Erzurum Technical UniversityFaculty of Health Sciences, Department of Nursing, Muş Alparslan UniversityFaculty of Nursing, Department of Nursing Fundamentals, Ataturk UniversityFaculty of Health Science, Department of Psychiatric Nursing, Istanbul Medeniyet UniversityAbstract Background/Aims Research shows that low self-care ability and hopelessness are common in schizophrenia patients. Spirituality can be a key coping resource in managing mental illnesses. However, the mediating effect of spirituality on the relationship between self-care ability and hope in schizophrenia patients is unknown. This study aims to explore the mediating role of spiritual well-being in the relationship between self-care agency and hope in schizophrenia. Method This study is cross-sectional and correlational study with a descriptive design. The study was conducted with 116 schizophrenia patients who presented to the psychiatry outpatient clinic of a university hospital in eastern Turkey between 10.02. 2023 and 10.01. 2024. Descriptive Information Form, Self-Care Agency Scale, Herth Hope Index and Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale were used to collect the data. Structural equation modelling and bootstrapping method were used to analyse the data. Results In this study, the effect of self-care agency on hope (β = 0.12) was positive but not significant. However, self-care agency positively influenced spiritual well-being (β = 0.47), and spiritual well-being had a significant positive effect on hope (β = 0.83). Spiritual well-being fully mediated the relationship between self-care agency and hope, with the total mediated effect on hope being significant (β = 0.52). The model explained 23% of the variance in spiritual well-being and 80% of the variance in hope. Conclusion It was determined that self-care agency affected spiritual well-being positively and spiritual well-being affected hope positively in schizophrenia patients. It was also found that spiritual well-being mediated the relationship between self-care agency and hope. It is expected that this research model will be useful in formulating strategies to improve hope and self-care in schizophrenia patients.https://doi.org/10.1186/s12888-025-07078-7SchizophreniaSelf-care agencySpiritualityHope
spellingShingle Zeynep Öztürk
Mustafa Durmuş
Emrah Ay
Ayşe Okanli
The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
BMC Psychiatry
Schizophrenia
Self-care agency
Spirituality
Hope
title The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
title_full The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
title_fullStr The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
title_full_unstemmed The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
title_short The mediating role of spiritual well-being in the relationship between self-care agency and hope in patients diagnosed with schizophrenia: a cross-sectional and correlational study
title_sort mediating role of spiritual well being in the relationship between self care agency and hope in patients diagnosed with schizophrenia a cross sectional and correlational study
topic Schizophrenia
Self-care agency
Spirituality
Hope
url https://doi.org/10.1186/s12888-025-07078-7
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