Patterns of spirituality and health among aging adults and dying adults living in the community.

This research tests and refines a middle range theoretical model about unitary developmental patterns in aging adults and dying adults. The primary aim was to explore the relationships among four unitary patterns of Health (power, personal death awareness, perceived symptoms in transition, and well-being) and three unitary patterns of Spirituality (self-transcendence, spiritual perspective, and meaning and purpose in life and death). A secondary aim was to explore the personal meanings of death for participants. A descriptive, cross-sectional design was used to answer the research questions. The sample was composed of 35 aging adults and 35 dying adults. Descriptive statistics were used to examine relationships among demographic and study variables. Relationships among variables were explored using bivariate and canonical correlational analysis. Content analysis was used to describe the meaning of death paragraphs. Analysis of variance and covariance was used to describe differences between the groups. Dying adults had greater death awareness than aging adults. There were no differences between the two groups for the other three patterns of Health. There were no differences in self-transcendence or meaning and purpose in life and death. Differences in spiritual perspective were gender-related, aging men having less spiritual perspective than aging women, dying men, or dying women. Different patterns of relationships were identified for each group. Greater purpose and self-transcendence were positively associated with greater well-being, more positive and fewer negative symptoms in transition, and more power for aging adults. For dying adults, less purpose, self-transcendence, and spiritual perspective were associated with less well-being, less positive and more negative symptoms, less power and more death awareness. Moderate or high scores were obtained on instruments measuring power, well-being, self-transcendence, spiritual perspective, and purpose in life. Both groups attributed positive evaluations, acceptance, and self-transcendence to meanings of death. This research enhances understanding of the potential for personal transformation and ongoing development in persons facing death. It also provides direction for nursing care in terms of fostering a sense of purpose in life, promoting spiritual expression, and assisting identification of patterns of power, symptoms in transition, and death awareness