Spirituality and health status among elderly people in nursing home in Riau, Indonesia

Abstract

Objective

The purpose of this study was to examine the relationship between spirituality and health status outcome in nursing home (PSTW Khusnul Khotimah) in Pekanbaru, Riau-Indonesia.

Method

This study methods was a cross-sectional study with 36 elderly people as samples and it was taken by total sampling technique. JAREL Spiritual Well-Being Scale was used to assess elderly people spirituality level. Univariate and bivariate use non-parametric analysis were performed to determine the relationship between elderly people spirituality and self-reported health status.

Results

Majority marital status of respondent (85.8%) were divorce with their couple. Seventy two point two percent elderly health status was not good and 52.8% (the results spiritual statement of indicates: When I was sick, I reduced spiritual welfare 33.3%, I cannot accept changes in my life 27.8%) of them have less spirituality. This study also found that the elderly people who has low spirituality level more likely have health problems. There was significant correlation between spirituality and elderly health status in nursing home (p = 0.035).

Conclusion

It was important to increase the elderly people spirituality to prevent health status degradation in elderly people in nursing home.

Background

Various diseases increase in elderly people, especially a disease cardiovascular, endocrine disorder as diabetes mellitus, etc. Elderly people suffer at least one chronic disease, but most of them are suffering more than one disease. It can be neutralized and eliminated with high spirituality on their daily lif.⁹

Spirituality is all aspect which is about the person's relationship with non-material life or higher strength.¹² Spirituality was two dimensions concept i.e. vertical and horizontal dimension.⁹ Spirituality can help someone is convinced to what happened, it is a part of the higher strength (God). According by research, the spiritual belief is very important because it can affect the health level and behavior self-care clients.⁴

Based on the result research, showed with the better spirituality of elderly people will motivate them to maintain their health.¹⁰ The research it showed the result of significant correlation among spirituality elderly people and their lifestyle.¹ It means that good spirituality will have healthy lifestyle and absolutely will improve the status of elderly people health.

However based on the results of the introduction story to 10 elderly people that was conducted in Technical Implementation Unit of Tresna Werdha Social Service Khusnul Khotimah Pekanbaru, there is 7 elderly people of 10 people always attend the spiritual event held by the nursing home officers. The spiritual event held is to learn, Wirid, religion discussion by Ustad (Ceramah) held on Monday and Friday. While doing interview conducted by an officer social, these officers said that only 20% elderly people attend the spiritual event.

Based on these phenomena, the researchers want to know whether there was correlation between the spirituality and the status of elderly spirituality health.

Methods

This study was a cross-sectional study with 36 elderly as sample and it was taken by total sampling technique. The questionnaire used by the research is a questionnaire JAREL spiritual well-being scale, that is an instrument spirituality developed.⁶ Univariate and bivariate to use non-parametric analysis are performed to determine the correlation between the elderly spirituality and self-reported health status.

Results

The majority of elderly age is being 60–74 range of the year. Education respondents mostly from elementary school (primary) and those with widower of 16 people (44.4%). Health status less well as the number of 26 (72.2%). But the status of spiritual elderly is low of 19 people (52.8%) (Table 1).

Table 1.

Characteristics of respondents.

Characteristics	Frequency	Percentage (%)
Age
60–74 years	21	58.3
75–90 years	15	41.7
Gender
Man	19	52.8
Women	17	47.2
Education
Elemt. school	22	61.1
Junior high	6	16.7
Senior high	7	19.4
College	1	2.8
Religion
Islam	34	94.4
Buddha	2	5.6
Marital
Married	5	13.9
Widow	15	41.4
Widower	16	44.4
Health status
Good healthy	10	27.8
Unhealthy	26	72.2
Spiritual
High	17	47.2
Low	19	52.8

Elderly with low spiritual hence having health status less well as many as 89.5%. The analysis bivariat indicated significant relations between spirituality on health elderly (p value = 0.035) (Table 2).

Table 2.

Correlation sprituality and elderly health status.

Spirituality	Health status				Total		p value
	Good		Less well		N	%
	N	%	N	%
High	8	47.1	9	52.9	17	100	0.035
Low	2	10.5	17	89.5	19	100
Total	10	27.8	26	72.2	36	100

Discussion

The research was elderly people with the middle age have more time to attend he religion activity and trying to understand the value of religion belief to be.³ At the time of the researchers found many respondents men than women in accordance with criteria of inclusion of the elderly who do not have health problems heavy (stroke) or who has reliance on an apparatus (stick). Thus, men have chance to be respondents than women in nursing home Khusnul Khotimah Pekanbaru.

The result of research showed that the latest education of elderly people most of them graduated from elementary school. This is consistent with the results of the study from National Commission for Elderly (Komisi Nasional Lanjut Usia) (2009) that the records are 65.70% elderly in Indonesia never schools and no schooling. This is in line with Raka (2016), a type of education will have an effect on the individual.¹¹

The result showed that the faith value of elderly people is foundation to think and consider life in their old age. According by research that Islam has mental dimension from 5 pillars of Islam, then Islam can teach people to believe of Allah SWT will look after them until the end of time.⁵ Religion approach is highly recommended to the elderly people to be able to overcome the problems or be spared from all disease issues.

Marital status on the research indicated that five respondents (13.9%) is still married, the rest of elderly people live in Khotimah of Nursing House are widow for 15 persons (41.4%) and widower for 16 persons (44.4%). Functions as a spouse support in many ways e.g. emotion, problem solving, financial, and parenting. Spouse existence is available or have no spouse due to divorce, died, never been married.⁷

The unhealthy (sick) elderly need coaching, assistance and nursing service including the spiritual service, in order to they feel prosperous, appreciated, respected as the man who at the age of youth ever accomplished.⁹

Health status is one of the important elements for elderly people, they can fulfill their basic needs and spirituality needs. With an healthy condition elderly capable of running the religious uninhibited. Based on the research, healthy is one of important elements for the quality of life for elderly people.² This research is also supported from the result research that the chronic disease can decrease the elderly quality of life.¹³ Based on the result data of elderly diseases on the research respondent of PSTW Khusnul Khotimah clinic is chronic disease i.e. hypertension (19 persons), gastritis (7 persons), osteoarthritis (5 persons) and many more. Moreover there are elderly whom suffer from more than one disease i.e. 16 persons i.e. hypertension and DM, gastritis and osteoarthritis.

The level of low spiritual would affect low behavior psychology. Low level spiritual of someone will affect low behavior psychosocial and it would be bad for elderly were easy to surrender, discourage.^8,15 Otherwise, when elderly has high spirituality will live calmly and deal with casually, can handle of living in a broader context.¹¹

Elderly with low spirituality will affect psychosocial conduct faster, easily discourage, less handling of his life. This showed that the comprehension of spiritual needs are limited.¹⁵

The result research is supported from the research, stating that the confidence steadily with spirituality there is feeling peaceful and capable of acceptance experienced and believes what happened to them is regulated from God creation.¹⁴ Boswell results, Kaha and Dilworth-Anderson (2006),¹ explained that spirituality and religion affect welfare or physical fitness of elderly. From her research,¹ explained that the spiritual status of elderly people associated with their lifestyle.

Conclusion

Elderly people with low spiritual also having unhealthy status are 89.5%. The analysis bivariate indicated that there is significant correlation between spirituality of elderly people's health (p value = 0.035).