Relationship between Spiritual Well-Being, Death Anxiety and Life Satisfaction in Coronary Artery Patients and Their Primary Caregivers: A Comparative Study

Relationship between Spiritual Well-Being, Death Anxiety and Life Satisfaction in Coronary Artery Patients and Their Primary Caregivers: A Comparative Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Relationship between Spiritual Well-Being, Death Anxiety and Life Satisfaction in Coronary Artery Patients and Their Primary Caregivers: A Comparative Study Ebru AYMAN KILIÇ, Abdullah ATLI, Funda GÜMÜŞ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8126639/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Aim: This study aims to compare the relationship between spiritual well-being, death anxiety, and life satisfaction among patients diagnosed with coronary artery disease and their primary caregivers. Methods This cross-sectional, correlational study was conducted with 233 patients diagnosed with Coronary Artery Disease (CAD) and 233 primary caregivers at the Cardiology Clinic of Mardin Training and Research Hospital between November 9, 2024, and January 15, 2025. Data were collected using the Spiritual Well-Being Scale (SWBS), the Death Anxiety Scale (DAS), and the Adult Life Satisfaction Scale (ALSS). Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to analyze the data. The normal distribution of scale scores and numerical variables was assessed using kurtosis and skewness values. Relationships between scale score means were evaluated using Pearson or Spearman correlation tests. Scale scores according to sociodemographic variables were analyzed using Student’s t-test, ANOVA, and Tukey’s post hoc test. In cases where normal distribution was not achieved, the Kruskal-Wallis test was applied. To determine the effect of DAS and SWBS total scores, as well as being a patient or a primary caregiver, on ALSS scores, multiple linear regression analysis was performed using the Enter method. Results: The mean age of the patients was 56.77 (SD = 11.47), while that of the primary caregivers was 39.31 (SD = 13.68). A weak but statistically significant negative correlation was found between the total scores of the Death Anxiety Scale (DAS) and the Adult Life Satisfaction Scale (ALSS) in both patients (r = -0.25, p < 0.001) and primary caregivers (r = -0.23, p <0.001). Primary caregivers had significantly higher DAS scores compared to patients. Rather than the role of being a patient or a primary caregiver, the total scores of the Spiritual Well-Being Scale (SWBS) and the Death Anxiety Scale (DAS) were found to be statistically significant predictors of life satisfaction, accounting for 31% of the variance (R² = 0.31). Conclusion: The findings of this study revealed that both patients diagnosed with Coronary Artery Disease (CAD) and their primary caregivers exhibited high levels of spiritual well-being and experienced death anxiety, with primary caregivers reporting significantly higher levels of death anxiety compared to patients. Considering the statistical significance of the total scores of the Spiritual Well-Being Scale (SWBS) and the Death Anxiety Scale (DAS) as predictors of life satisfaction (ALSS), it is recommended that the death anxiety and spiritual well-being of both patients and primary caregivers be assessed, and that appropriate interventions be planned and implemented accordingly. Coronary Artery Disease Death Anxiety Spiritual Well-Being Life Satisfaction Figures Figure 1 1. Introduction Coronary artery disease (CAD) is a pathological condition that occurs when the myocardium is insufficiently nourished due to reduced or interrupted blood flow, often caused by the formation of atheromatous plaque in the coronary arteries. It progresses slowly and insidiously, and symptoms are usually observed in the advanced stage of the disease [1]. It is also called coronary heart disease [2]. As it accounts for approximately 7 million deaths annually worldwide, Coronary Artery Disease (CAD) ranks among the leading causes of mortality [3] and also contributes to the development of mental health problems [4]. Moreover, the fact that CAD is a serious condition that directly threatens life, and that individuals with CAD are at risk of experiencing sudden and potentially fatal events such as myocardial infarction, may lead them to confront the reality of death more concretely and imminently than others, thereby increasing their death anxiety. The perception of being close to death, having a life-threatening illness, or facing the death of loved ones or primary caregivers can evoke fear in these individuals. [5]. Primary caregivers of patients with CAD may experience intense anxiety, sadness, and helplessness when faced with the risk of their loved one's death. Spiritual well-being in chronic life-threatening illnesses can increase coping skills and help people cope more effectively with the physical and psychological stress they experience. In addition, spiritual well-being supports psychological resilience by reducing negative emotions such as depression, anxiety, and death anxiety [6]. Individuals with high life satisfaction adapt better to the treatment process by improving their coping skills with the disease and gain an advantage in maintaining their general mental health. Individuals with low life satisfaction have an 80 per cent higher risk of cardiovascular disease compared to those with high life satisfaction [7]. Kasar et al. (2016) report that the presence of physical illness adversely affects death anxiety [8]. For these reasons, nurses need to determine the death anxiety levels of patients with CAD and their primary caregivers, as well as the factors influencing this anxiety, to preserve their psychosocial integrity. They should also incorporate interventions aimed at reducing death anxiety into the care process. Spiritual well-being is an essential component during the treatment process. Through interventions that draw patients’ attention to optimism and positive thinking, nurses can help maintain and enhance this dimension of Health [6]. Boehm et al. (2011) reported that life satisfaction may support cardiac health [9]. While high life satisfaction in patients promotes both physical and psychological recovery, the satisfaction of primary caregivers directly influences the quality of the care they provide. High life satisfaction in both patients and their primary caregivers strengthens the perception of social support and enhances resilience in coping with illness. Therefore, assessing and promoting life satisfaction within nursing care for patients with CAD and their primary caregivers may be a crucial factor in comprehensive and practical health management. In the literature, some studies examine the death anxiety, spiritual well-being, and life satisfaction of patients with CAD separately [10, 11, 12, 13, 14, 15]. However, no study has been found that examines these variables together or investigates their interrelationships. Moreover, no research has been identified in the literature that explores death anxiety, spiritual well-being, and life satisfaction among primary caregivers of patients diagnosed with CAD. In line with this information, the present study was conducted to determine and compare the relationship between spiritual well-being, death anxiety, and life satisfaction in patients diagnosed with CAD and their primary caregivers, thereby providing a meaningful contribution to the literature. Aim of the study This study was conducted to compare the relationship between spiritual well-being, death anxiety, and life satisfaction of coronary artery disease patients and their primary caregivers. Research Questions The study questions were: 1. What are the levels of spiritual well-being, death anxiety, and life satisfaction in patients with coronary artery disease and their primary caregivers? 2. What are the factors affecting the levels of spiritual well-being, death anxiety, and life satisfaction of coronary artery patients and their primary caregivers? 3. Is there a relationship between spiritual well-being levels, death anxiety, and life satisfaction of coronary artery patients and their primary caregivers? 4. Are spiritual well-being, death anxiety, and life satisfaction levels higher in coronary artery disease patients or primary caregivers? 2. Methodology Study Design This study was conducted in a comparative, cross-sectional, and correlational design to examine the relationship between spiritual well-being, death anxiety, and life satisfaction of coronary artery disease patients and their primary caregivers. Setting This study was conducted between November 9, 2024, and January 15, 2025, among patients hospitalized with a diagnosis of CAD in the cardiology clinic of an educational and research hospital, along with their primary caregivers. Patients diagnosed with coronary artery disease (myocardial infarction, acute coronary syndrome) and their primary caregivers were included in the study. The research population consisted of patients hospitalized in the clinic during the study period who met the inclusion criteria, as well as their primary caregivers. Participants and sampling In the study, an attempt was made to reach the entire population, and participants who met the inclusion criteria and voluntarily agreed to participate were selected through convenience sampling. The data were collected through individual, face-to-face interviews conducted by the researcher (EAK), who is a nurse in the cardiology ward. Each interview lasted approximately 20–30 minutes, and the questionnaire and scale items were read aloud to the patients diagnosed with coronary artery disease and their primary caregivers, with responses recorded accordingly. The reason for this was that some patients and primary caregivers in the study area were unable to read or write in Turkish, and they requested that the questions be read to them. Sample size The study population consisted of patients hospitalized in the clinic and their primary caregivers who met the study criteria on the study dates. The adequacy of the sample size of the study was determined based on the statistical power level required by multiple linear regression analysis. G*Power 3.1 software was used by targeting a moderate effect size (f² = 0.15), 95% confidence level (α = 0.05), and 80% power (1-β = 0.80), and as a result of the analysis, it was calculated that a sample of at least 77 individuals would be sufficient [16]. Accordingly, the study included a total of 466 participants, comprising 233 individuals from each group (patients with coronary artery disease and their primary caregivers). This sample size is sufficient to enhance the reliability and generalizability of the analyses. Study Tools The data were collected with the Participant Information Form, Spiritual Well-Being Scale (SWBS), Death Anxiety Scale (DEAS), and Adult Life Satisfaction Scale (ALSS). Participant Information Form This form, which was prepared as a result of the literature review, includes the age, gender, place of residence, educational status, marital status, employment status, family type, cohabitants, smoking-alcohol use, presence of chronic disease, type of hospital admission, duration of hospitalisation, medical diagnosis, when the disease was diagnosed, current health perception, The study consisted of 20 questions about the presence of disease-related concerns and the nature of these concerns and 11 questions about the age, gender, place of residence, educational status, marital status, employment status, family type, cohabitants, smoking-alcohol use, and presence of chronic disease of the primary caregivers (Appendix-1) [11, 17, 18]. Spiritual Well-Being Scale (SWBS) The validity and reliability studies of the scale developed by Ekşi and Karadaş in 2017, which was based on the opinions of 17 experts to measure the spiritual well-being of adults, were conducted using 865 adult participants. As a result of the analyses, a structure consisting of 29 items with a 5-point Likert-type response format was obtained. The scale comprises a three-factor structure, including transcendence, harmony with nature, and anomie. In the Likert scale, responses range from 1 to 5, where one means “Not at all suitable for me,” 2 means “Not suitable for me,” 3 means “Somewhat suitable for me,” 4 means “Quite suitable for me,” and five means “Completely suitable for me”. Scores obtained from the scale range from 29 to 145. In the case of a total score, the items under the anomie sub-dimension are calculated inversely. The total Cronbach's Alpha value of the scale was found to be α=0.886, α=0.953 in the transcendence subscale, α=0.864 in the harmony with nature subscale, and α=0.853 in the anomie subscale [19]. In the present study, the Cronbach's alpha coefficient of the SIOQ was found to be 0.95 in patients and 0.92 in primary caregivers. Death Anxiety Scale (DAS) The scale, initially developed by Templer (1970), was adapted into Turkish by Akça and Köse (2008). It consists of 15 items arranged in a proper- false format and is a dichotomous Likert-type scale. Correct responses are scored as 1 point, while incorrect responses are not included in the scoring. The total scores that can be obtained from the scale range from 0 to 15, and higher scores are interpreted as indicating that the individual has a higher level of death anxiety. The reliability coefficient of the scale, determined by the test-retest method, was 0.79, and the internal consistency coefficient, calculated using the Kuder-Richardson formula, was 0.75 [20, 21]. In this study, the Kuder Richardson 20 coefficient for the SCS was found to be 0.82 in patients and 0.84 in primary caregivers. Adult Life Satisfaction Scale (ALSS) The ALSS is a 21-item, 5-point Likert-type self-report scale developed by Kaba, Erol, and Güç to assess life satisfaction among adults in accordance with Turkish culture. The scale consists of five subdimensions: general life satisfaction, relationship satisfaction, self-satisfaction, social environment satisfaction, and job satisfaction. The total scores that can be obtained range from 21 to 105, and high scores indicate that the individual has positive perceptions about their life. As a result of the application for criterion validity, a positive and significant relationship was determined between ALSS and the General Satisfaction with Life Scale (Diener, Emmons, Laresen & Griffin, 1985) (r=.67, p <.01), and in the reliability study of ALSS, the cronbach alpha internal consistency coefficient of the 21 questions in the scale was calculated as 0.89 [22, 23]. In this study, the Cronbach alpha coefficient for ALSS was 0.90 in patients and 0.91 in primary caregivers. Statistical analysis The research data were analyzed using SPSS version 25.00. Descriptive statistics, including frequency, percentage, standard deviation, and mean values, were calculated. The normality of scale scores and numerical variables was assessed using kurtosis and skewness values within the range of -1.96 to +1.96 [24], indicating that the scale score means were usually distributed. Therefore, relationships between total scale score means were evaluated using the Pearson correlation test. Since the length of hospital stay did not follow a normal distribution, its relationship with total scale scores was assessed using the Spearman correlation test. For groups with n = 30, the Kruskal-Wallis or Mann-Whitney U tests were applied. To analyze whether scale scores differed according to sociodemographic variables, the Student’s t-test was used for binary variables, and the ANOVA test was applied for variables with three or more groups. For variables found significant in the ANOVA test, Tukey’s post hoc test was conducted. Due to the small number of participants in certain groups (e.g., alcohol use, family type, employment status, and cohabitation), the Kruskal-Wallis test was used as a non-parametric alternative. To determine the effect of DAS and SWBS total scores, as well as the role of being a patient or a primary caregiver, on ALSS scores, multiple linear regression analysis was performed using the Enter method. Internal consistency of the SWBS and ALSS was assessed using Cronbach’s alpha coefficient, while the dichotomous nature of the DAS required the use of Kuder-Richardson 20 analysis. All findings were evaluated at a significance level of p < 0.05. Ethical considerations Written permission was obtained from the Dicle University Social and Humanities Ethics Committee (06.09.2024/769033) and from the Provincial Health Directorate of Mardin Training and Research Hospital, where the study was conducted (30.10.2024/E-90410089-799-234236292). Before the commencement of the study, permission was obtained via email from the researchers who had established the validity and reliability of the scales used. Participants were first informed about the purpose of the study. Participation in the research process was based on the principle of voluntariness, in accordance with the Declaration of Helsinki, and informed consent was obtained through both verbal and written consent forms. For participants who declined to provide written consent, only verbal consent was obtained. “It does not require consent for publication.” 3. Results Comparison of sociodemographic characteristics and scale scores of patients The demographic variables of the patients who participated in the study are presented in Table 1. The mean age of the patients was 56.77 years (11.47), and 64.4% were male. When the education levels were analysed, it was determined that 25.8% were illiterate, 91% were married, and 43.8% lived in the district. It was found that 48.5% of the patients were not employed in an income-generating job, 76.5% had a nuclear family, and 81.5% lived with their spouses and children. Patients living with others were found to live only with their children, spouse, and grandchildren. A positive, weak, statistically significant relationship was found between age and SWBS. A significant difference was found in DAS total scores between genders, with male participants having higher death anxiety scores than females. Regarding family type, patients with a nuclear family structure had significantly higher SWBS total scores compared to those with an extended family structure. Additionally, the variable of cohabiting individuals revealed significant differences in both the total scores of SWBS and ALSS across groups. Accordingly, participants living with their spouse and children had significantly higher SWBS total scores compared to those living alone or with parents. Similarly, those living with others also had significantly higher SWBS scores than individuals living alone or with parents. In parallel, participants living with their spouse and children had significantly higher ALSS total scores than those living alone or with parents, and those living with others had significantly higher ALSS scores than those living alone. No statistically significant differences were found between groups for other variables. Comparison of patients' physical health-related characteristics with scale scores The physical health-related characteristics of the patients are given in Table 2. 47.2% of the patients were smokers, and 2.6% were alcohol users. 60.1% of the patients had a chronic physical disease. The most common physical diseases were hypertension (HT), diabetes mellitus, and rheumatic diseases. Forty-eight point five per cent of the patients perceived their health at a moderate level, 43.8% had hopelessness, and 48.9% had anxiety about the disease. When the sources of concern were questioned, 26.2% stated that they had concerns about the treatment, 16.3% about feeling inadequate, and 14.2% about the caregiver. It was determined that the patients were hospitalised in the clinic for a mean of 1.82 (1.02) days, and 53.2% had a diagnosis of coronary artery disease (CAD) of less than 6 months. A statistically significant difference was found in DAS total scores based on smoking status. Participants who had quit smoking had significantly higher DAS scores compared to current smokers. Individuals with chronic illnesses had significantly higher SWBS total scores than those without chronic conditions. Regarding perceived health status, both SWBS and ALSS total scores varied significantly across groups. Participants who perceived their health as good had significantly higher SWBS scores than those with moderate or poor health perceptions. Similarly, ALSS scores were significantly higher among those with moderate health perceptions compared to those with poor perceptions, and among those with good health perceptions compared to those with poor perceptions. Participants who did not experience hopelessness related to their illness had significantly higher SWBS and ALSS total scores, and significantly lower DAS total scores, compared to those who did. Similarly, those who did not experience illness-related anxiety had significantly higher SWBS and ALSS scores and significantly lower DAS scores than those who did. Patients diagnosed with CAD for 1–2 years had significantly higher DAS scores compared to those diagnosed for 6 months to 1 year. No statistically significant differences were found between groups for other variables. Comparison of primary caregivers' sociodemographic characteristics and scale scores The sociodemographic variables of the primary caregivers who participated in the study are presented in Table 3. The mean age of primary caregivers was 39.31 years (SD = 13.68), and 56.7% were female. When their educational level was analysed, it was found that 22.7% were high school graduates, 75.5% were married, and 46.4% lived in the district. It was found that 60.5% of the primary caregivers were gainfully employed, 75.1% had nuclear families, and 66.5% lived with their spouses and children. The comparison of sociodemographic characteristics among primary caregivers and their scale scores is presented in Table 3. The total DAS scores of male primary caregivers were statistically higher compared to those of female primary caregivers. A significant difference was found in the total ALSS scores in terms of educational level. The total ALSS scores of participants with a university degree or higher were statistically higher than those of individuals who were literate or illiterate. The total DAS scores of unemployed primary caregivers were significantly higher than those of employed primary caregivers. In terms of family structure, it was found that individuals living in nuclear families had statistically higher total SWBS and ALSS scores compared to those living in extended families. Comparison of physical health-related characteristics of primary caregivers with scale scores The characteristics of primary caregivers related to physical health are shown in Table 4. It was found that 54.1% of primary caregivers did not smoke, 94% did not use alcohol, and 77.3% did not have a chronic physical disease. When chronic physical diseases were analysed, hypertension, diabetes, asthma, and thyroid dysfunction were frequently found. When the physical health status of the primary caregivers and the mean total scores of the SWBS and ALSS were compared between the groups, it was determined that the scores of the SWBS and ALSS changed statistically according to alcohol use. Non-alcohol users had statistically significantly higher scores on the SWBS and ALSS than alcohol users (p<0.05). Mean scale scores of patients and primary caregivers, and the relationship between them The scale scores of patients and primary caregivers are presented in Table 5. Group differences were analyzed using the independent samples t-test, and a statistically significant difference was found only in the DAS total scores between the two groups. Primary caregivers had significantly higher DAS scores compared to patients. According to Pearson correlation analysis, a statistically significant correlation was found between the scale scores of both patients and primary caregivers. A negative and very weak correlation was found between the mean total scores of the SWBS and the DAS scores of the patients, and a positive and moderately significant correlation was found between the mean total scores of the SWBS and the ALSS scores. Similarly, a negative and statistically weak relationship was found between the mean total scores of the SWBS and DAS scores, and a positive and statistically significant relationship was found between the mean total scores of the SWBS and ALSS scores. A statistically weak and negative correlation was found between the mean scores of DAS and ALSS total scores for both patients and primary caregivers. The effect of being a patient and primary caregiver and scale scores on the ALSS In a simple linear multiple regression analysis conducted to determine the effect of being a patient or a primary caregiver on ALSS, along with total SWBS and DAS scores, the Enter method was used. The model was found to be statistically significant (F = 71.48, p < 0.001). Accordingly, as predictors of ALSS, total SWBS and DAS scores were found to be statistically significant rather than the status of being a patient or a primary caregiver (R² = 0.31). In this model, SWBS and DAS explained 31% of the variance in ALSS (Adjusted R² = 0.31) (Table 6). A scatter plot was used to test the assumptions of the simple linear multiple regression analysis. ALSS was taken as the dependent variable, and DAS, SWBS, and group status were included as the standardized predictors in the regression. In the scatter plot, R² was depicted as 0.31 (Figure 1). 4. Discussion Discussion of sociodemographic characteristics and scale scores of the patients Among the patients who participated in the study, those of older age and those living in a nuclear family with their spouse and children were found to have higher levels of spiritual well-being. Additionally, individuals living with others had significantly better spiritual well-being compared to those living alone. In a study conducted by Eston Armond et al. (2022) examining the relationship between CAD and spiritual well-being, no significant association was found between age and spiritual well-being levels [11]. However, Amni and Akbar (2024) suggested that the increase in spiritual well-being among older patients with CAD may be attributed to a closer relationship with God or a Creator as age advances [25]. Age may not be a direct factor in enhancing spiritual well-being; instead, other elements such as life experiences, health status, and social support systems are believed to play a significant role [26]. In a study conducted by Seher and Çiftçi (2025) in Turkey, which examined the relationship between spiritual well-being and levels of hopelessness among 151 patients who had experienced myocardial infarction and undergone angiography, no significant association was found between patients’ age or family type and their spiritual well-being. However, married individuals scored significantly higher than single individuals in the transcendence subdimension of spiritual well-being. Transcendence reflects the belief in a higher power that provides comfort, ease, and resilience. It has been suggested that this may be due to married individuals taking on more responsibilities compared to single individuals [10]. Additionally, in their study, Soleimani et al. (2018) found that social support significantly predicted spiritual well-being [17]. Spiritual well-being is a subdimension of overall well-being and is influenced by perceived social support [27]. It is thought that the spiritual well-being levels of patients living with others are higher than those living alone, due to the higher perceived social support these individuals receive. Accordingly, it can be said that social support is effective in increasing the spirituality of the individual. Among the patients who participated in the study, those who lived with someone had higher life satisfaction than those who lived alone. In a study on life satisfaction and healthy life behaviours in patients after MI, no significant difference was found between family type and life satisfaction [15]. In a study examining the mediating role of social support in the relationship between loneliness and life satisfaction among older adults, it was found that elderly individuals who were married and living with their spouse had higher levels of life satisfaction and perceived social support compared to those who were widowed and living alone. The same study also identified a significant relationship between loneliness and life satisfaction, indicating that loneliness has a negative impact on life satisfaction [28]. In a study conducted to determine loneliness, life satisfaction, and death anxiety among elderly individuals living at home, it was found that older adults living with their spouses had lower levels of loneliness and higher life satisfaction [29]. This finding demonstrates the enhancing effect of social support and cohabitation on life satisfaction. Individuals with greater social support tend to have higher levels of life satisfaction [30]. It is therefore suggested that the social support provided by cohabitation has a positive effect on life satisfaction. In this study, male patients were found to have higher levels of death anxiety compared to female patients. Contrary to these findings, studies conducted by Yiğitalp and Bürçün (2025), Yıldırım and Kocatepe (2023), and Turan Kavradım et al. (2022), involving patients diagnosed with CAD, did not identify any significant relationship between gender and death anxiety [5, 12, 13]. On the other hand, a study examining the relationship between death anxiety, life satisfaction, and psychological well-being among individuals aged 40–59 found that women experienced higher levels of death anxiety than men [31]. In a study conducted to examine the effects of status and gender on death anxiety, life orientation, and life satisfaction, it was found that women had higher levels of death anxiety compared to men [32]. Soleimani et al. (2018), in their study with patients who had experienced Acute Myocardial Infarction (AMI), reported that women experienced higher death anxiety than men [17]. In contrast, Buruntekin (2022), in a study with MI patients, found that male patients experienced higher levels of death anxiety [18]. The relationship between gender and death anxiety varies across studies. The observation that male patients report higher death anxiety than female patients may be attributed to men’s greater reluctance to express their fears and anxieties and their tendency to conceal these emotions [17]. In contrast, although women may have higher levels of anxiety [32, 33], they tend to express anxiety symptoms more openly. Consequently, men may verbalize death anxiety less frequently but internalize it, experiencing it more intensely and chronically. Discussion of patients' characteristics related to physical health with scale scores In this study, patients who quit smoking had a higher fear of death than smokers. Patients with chronic disease had significantly higher spiritual well-being than patients without chronic disease. In this study, it was determined that those who perceived their health as good had higher spiritual well-being and life satisfaction. In a study conducted by Okutan et al. (2024) to examine the relationship between death anxiety and healthy lifestyle behaviors among individuals who underwent percutaneous coronary intervention, a negative correlation was found between healthy lifestyle behaviors and death anxiety [34]. The higher levels of death anxiety observed among individuals who have quit smoking may be associated with regret over past health behaviors and an increased perception of health threats. Moreover, it is possible that existing death anxiety played a role in their decision to quit smoking. There are also studies reporting that individuals with chronic illnesses exhibit high [35, 36] or moderate [37, 38] levels of spiritual well-being. The observation that individuals with additional chronic illnesses exhibit higher levels of spiritual well-being can be explained by their more frequent use of spiritual coping strategies in managing multiple health challenges. These individuals tend to experience spiritual concepts such as life meaning, patience, acceptance, and inner peace more intensely, which is thought to enhance their level of spiritual well-being. It was determined that those who did not experience hopelessness about the disease had higher spiritual well-being and life satisfaction and lower fear of death than those who experienced hopelessness. In a study conducted by Şolpan et al. (2023) involving patients with STEMI and hypertension, 60% of the participants reported fear of experiencing another myocardial infarction, and death anxiety was observed among the patients [39]. In another study examining the relationship between spiritual well-being, hope, and health anxiety in patients with advanced coronary artery disease, a significant and inverse relationship was found between hope levels and health anxiety among CAD patients. Hope is not only an emotional support factor for patients with CAD but also a practical psychological resource for coping with health-related concerns. It has the potential to reduce health anxiety by strengthening self-efficacy, optimism, and other positive psychological traits [40]. In a study examining the relationship between death anxiety, loneliness, and hope levels in patients treated in a cardiac intensive care unit, it was found that patients had moderate levels of hope and that there was no significant relationship between hope and death anxiety [41]. It is thought that feelings of hopelessness regarding their illness and concerns about disease recurrence may contribute to death anxiety in patients with CAD. Discussion of sociodemographic characteristics and scale scores of primary caregivers In this study, fear of death was higher in males and unemployed primary caregivers. Additionally, it was found that primary caregivers with a university degree or higher had higher life satisfaction than those with a lower level of education, including literate and illiterate caregivers. It was found that both spiritual well-being and life satisfaction were higher in those with nuclear families. When examining the death anxiety levels of primary caregivers, Ying et al. (2024) found that female caregivers of cancer patients exhibited higher levels of death anxiety compared to their male counterparts [42]. Similarly, Soleimani et al. (2017) reported that female caregivers experienced significantly higher death anxiety than male caregivers [43]. In a study conducted by Beydag (2012) involving caregivers of cancer patients, a significant difference was found in death anxiety scores based on gender, with female caregivers scoring higher than males [44]. Discussion of scale scores of physical health-related characteristics of primary caregivers It was found that both spiritual well-being and life satisfaction were higher in primary caregivers who did not use alcohol. In a study examining life satisfaction in cardiovascular diseases, it was determined that participants with moderate alcohol use had lower life satisfaction [7]. Similarly, in a study conducted with individuals aged 60–80, occasional alcohol consumption was found to be associated with higher life satisfaction compared to daily consumption [45]. On the other hand, Och et al. (2022), in a study with randomly selected individuals from the general population, reported a relationship between high life satisfaction and high alcohol consumption [46]. In a study by Sezek et al. (2023) involving caregivers who provided home health services, alcohol consumption was not found to have a significant effect on caregivers’ life satisfaction [47]. This discrepancy is thought to be due to the low proportion of primary caregivers who consumed alcohol in our study. Discussion of the mean scale scores of patients and primary caregivers and the relationship between them In this study, the mean DAS score for patients was 8.09 (SD = 3.94), while that for primary caregivers was 9.95 (SD = 3.96). It was also determined that primary caregivers experienced significantly higher levels of death anxiety compared to patients. In a study conducted by Turan Kavradım et al. (2022) involving patients with myocardial infarction (MI), more than half of the participants were reported to experience moderate levels of death anxiety [12]. In a study by Yıldırım and Kocatepe (2023) conducted with individuals who had previously experienced MI, it was found that the majority of patients experienced severe or panic-level death anxiety [13]. In Rahimi et al.’s (2021) study, the level of death anxiety in patients with MI was reported to be moderate to high [14]. Yiğitalp and Bürçün (2025), in their study examining death anxiety, psychological resilience, religious attitudes, and related factors in cardiology patients with and without Acute Myocardial Infarction, found that death anxiety was at a moderate level in both groups [5]. On the other hand, in a study conducted by Şolpan et al. (2023) involving patients with ST-segment elevation myocardial infarction (STEMI) and hypertension (HT), it was reported that hypertensive patients experienced moderate levels of death anxiety. In contrast, STEMI patients exhibited lower levels of death anxiety [39]. The variability in death anxiety among patients with coronary artery disease (CAD) across studies may be attributed to factors such as life satisfaction, personal beliefs, physical health, environment, and cultural values. To date, no studies have been identified in the literature that specifically examine death anxiety among primary caregivers of patients with CAD. However, studies on caregivers of cancer patients have shown that they tend to experience moderate to high levels of death anxiety [43, 44). Consistent with the results of this study, research indicates that the mean DAS scores of caregivers are higher than those of patients [48]. Studies showing that death anxiety decreases with age suggest that this may be due to the higher average age of patients and the lower average age of primary caregivers [48, 49]. In addition, Yalom (2008) states that experiences of grief and loss can initiate a process of “awakening” in individuals [50]. In this context, the confrontation of primary caregivers with the illness of their loved ones and the reality of death may also trigger their own death anxiety. Although patients may not be able to eliminate their death anxiety entirely, directly facing their illness might help reduce it to some extent. In contrast, primary caregivers, confronted with the possibility of losing a loved one and facing their own mortality, may experience more intense anxiety and fear about the future. In this study, the higher levels of death anxiety observed among primary caregivers compared to patients may be associated with these processes. In this study, it was found that as spiritual well-being increased in both patients and primary caregivers, life satisfaction also increased, and death anxiety decreased. In a study conducted in Turkey to examine the effect of spiritual well-being on life satisfaction and hope among elderly individuals, a statistically positive and moderately significant relationship was found between spiritual well-being and life satisfaction [51]. In a study investigating the effect of spirituality on the quality of life and life satisfaction of elderly individuals after MI, no significant relationship was found between spiritual well-being and patients’ life satisfaction [52]. Soleimani et al. (2018), in their study involving patients who had experienced acute myocardial infarction (AMI), reported no direct relationship between spiritual well-being and death anxiety. However, they emphasized that spiritual well-being may play a significant role in reducing death anxiety among married patients. They suggested that it could serve as a fundamental psychosocial factor in coping with death anxiety [17]. In another study conducted during the COVID-19 pandemic to examine the role of spiritual well-being and coping strategies in death anxiety among patients with a history of coronary artery bypass graft (CABG) surgery, a negative correlation was found between spiritual well-being and its subdimensions and death anxiety, although this relationship was not statistically significant [53]. In a meta-analysis examining death anxiety and spiritual well-being in chronic illnesses, a negative relationship was found between spiritual well-being and death anxiety [54]. Studies show varying results regarding the relationship between patients’ spiritual well-being, life satisfaction, and death anxiety. The effect of being a patient and primary caregiver and scale scores on the ALSS In this study, spiritual well-being and death anxiety were identified as predictors of life satisfaction. A study conducted in Turkey during the COVID-19 pandemic, examining the effect of nurses’ death anxiety on life satisfaction, showed that death anxiety negatively affected life satisfaction [55]. Similarly, a study by Bahçecioğlu Turan et al. (2024), conducted in Turkey to examine the effect of spiritual well-being on life satisfaction among hematological cancer patients aged 65 and older, found that spiritual well-being positively influences life satisfaction [56]. The literature shows that studies investigating the predictive role of spiritual well-being and death anxiety on life satisfaction are limited, and the existing studies are consistent with the findings of this research. Limitations of the study Since the study was conducted using a cross-sectional design, it is not possible to establish causal relationships. The fact that the study was carried out at a single center (Mardin Training and Research Hospital) may limit the generalizability of the findings to other populations. The use of self-report measures introduces the risk of social desirability bias and response errors. It should also be considered that psychosocial variables may be influenced by individuals’ cultural, religious, and socioeconomic backgrounds. The absence of longitudinal follow-up prevented the exploration of the dynamic nature of relationships between variables over time. 5. Conclusıon Patients diagnosed with coronary artery disease and their primary caregivers were found to experience death anxiety, while also exhibiting high levels of life satisfaction and spiritual well-being. Among the total scores of SWBS, DAS, and ALSS, a statistically significant difference between the two groups was observed only in DAS scores, with primary caregivers scoring significantly higher than patients. It was found that, in patients, there was a negative and very weak relationship between the total SWBS scores and DAS scores, and a positive and moderately significant relationship between the total SWBS scores and ALSS scores. Similarly, in primary caregivers, there was a negative and very weak relationship between the total SWBS scores and DAS scores, and a positive and moderately significant relationship between the total SWBS scores and ALSS scores. For both patients and primary caregivers, a statistically significant negative and weak relationship was observed between DAS and ALSS total scores. Additionally, as a predictor of ALSS, total SWBS and DAS scores were found to be statistically significant, rather than the status of being a patient or a primary caregiver. Further studies with larger sample sizes are recommended to explore the relationship between spiritual well-being, death anxiety, and life satisfaction in patients with coronary artery disease (CAD) and their primary caregivers. Considering that death anxiety negatively affects life satisfaction, it is suggested that nurses provide both patients and their primary caregivers with group interventions or individual support programs aimed at coping with death anxiety. Given that both CAD patients and their primary caregivers experience death anxiety, it is recommended that nurses assess the level of death anxiety, identify the influencing factors, and incorporate interventions aimed at reducing death anxiety into the care process to help preserve the psychosocial well-being of both groups. Declarations Authorship Statement Confirming and Authors Contributions Conceptualization, EAK, AA, FG; methodology, EAK, AA, FG; data collection; EK; data analysis: EAK, AA, FG; writing—original draft preparation, EAK, AA, FG; writing—review and editing, EAK, AA, FG. Acknowledgments All the data in this study were based on a part of Masters Thesis prepared by Ebru AYMAN KILIÇ under supervision by Dr. Abdullah ATLI and Funda GÜMÜŞ, Institute of Health Sciences, Dicle University, Turkey. Funding The authors did not receive any financial support in conducting this study. Data Availability and Materials Data of this study could be shared upon reasonable request from the corresponding author. Ethics Approval We (all authors) confirm that the research presented in the paper has received permission from a stated Research Ethics Committee (REC), including adherence to the legal requirements of the study country. Informed Consent: Informed consent was obtained from all participants. 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The effects of spiritual wellbeing on life satisfaction in hematologic cancer patients aged 65 and older in Turkey: Mediating role of hope. Psychogeriatrics. 2024;24(5):1149–59. Tables Table 1. Comparison of Sociodemographic Characteristics and Scale Scores of Patients Characteristics Mean (SD) SWBS DAS ALSS Age 56.77 (11.47) r: 0.18 p: 0.04 r: -0.11 p: 0.86 r: 0.04 p: 0.53 Mean (SS) Mean (SS) Mean(SS) Gender Female Male 83 (35.6) 150 (64.4) 131.43(13.49) 130.95(13.85) 7.34 (3.76) 9.45 (3.91) 78.50 (13.45) 81.35 (11.89) Test/p t: -0.25 p: 0.79 t: -4.05 p<0.01 t: 1.66 p: 0.09 Marital Status Married Single/Widowed 212 (91) 21 (9) 131.74(12.86) 124.90(19.65) 8.18 (3.93) 7.14 (3.99) 80.96 (11.89) 74.00 (16.68) Test/p Z: -1.23 p: 0.36 Z: -1.09 p: 0.27 Z: -1.76 p: 0.78 Education Illiterate Literate Primary School Middle School High School University + 60 (25.8) 42 (18) 53 (22.7) 28 (12) 32 (13.7) 18 (7.7) 132.60(11.05) 130.64(13.61) 133.75(11.12) 129.14(16.84) 127.87(15.49) 128.44(18.96) 9.01 (4.26) 8.28 (4.15) 7.96 (3.78) 7.67 (3.45) 7.53 (3.80) 6.61 (3.44) 78.050(13.25) 82.00 (11.22) 82.16 (12.30) 77.21 (11.50) 81.75 (10.96) 81.05 (16.60) Test/p X 2 : 4.23 p: 0.51 X 2 : 6.46 p: 0.26 X 2 : 8.73 p: 0.13 Place of Residence City District Village 77 (33) 102 (43.8) 52 (22.3) 128.54(16.92) 132.42(12.26) 131.98(10.48) 8.09 (3.96) 7.95 (3.96) 8.51 (3.92) 78.66 (14.18) 81.96 (10.99) 79.36 (12.69) Test/p F: 1.92 p: 0.14 F: 0.36 p: 0.69 F: 1.70 p: 0.18 Employment status Employed Unemployed Retired 91 (39.1) 113 (48.5) 29 (12.4) 129.04(16.11) 131.69(12.03) 135.41(10.29) 8.09 (3.97) 8.28 (4.01) 7.34 (3.60) 80.85 (11.56) 78.65 (13.72) 85.27 (8.77) Test/p X 2 : 3.76 p: 0.15 X 2 : 1.62 p: 0.44 X 2 : 5.86 p: 0.05 Family Type Nuclear Extended 179 (76.8) 54 (23.2) 132.45(13.83) 126.70(12.38) 7.91 (3.86) 9.08 (4.17) 81.64 (12.03) 76.01 (13.20) Test/p t: 2.74 p: 0.007 t: -1.29 p: 0.19 t: 2.94 p: 0.004 Living Companions n (%) Spouse and/or children Alone Parents Other 190 (81.5) 5 (2.1) 5 (2.1) 33 (14.2) 131.66(13.10) 114.20(27.86) 112.20(17.74) 133.48(10.05) 8.24 (3.98) 6.00 (4.63) 9.20 (2.28) 7.39 (3.72) 81.04 (12.03) 64.20 (17.62) 66.00 (13.96) 80.90 (11.87) Test/p KW: 8.84 p:0.03 1>2 1>3 4>2 4>3 KW: 3.16 p: 0.36 KW: 10.35 p:0.01 1>2 1>3 4>2 SD: Standard Deviation. t: Student t test. F: ANOVA. Z: Mann Whitney U Test. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale Table 2. Comparison of Patients' Physical Health Related Characteristics with Scale Scores Characteristics n (%) SWBSS Mean (SD) DAS Mean (SD) ALSS Mean (SD) Smoking Status Yes¹ 110 (47.2) 129,67 (14.16) 8,27 (3.95) 79.86 (12.23) No² 89 (38.2) 131.79 (12.54) 9.40 (3.93) 79.48 (13.15) Quit³ 34 (14.6) 134.05 (14.83) 9.81 (3.78) 84.11 (11.31) Test/p F: 1.51 p: 0.22 F: 3.76 p:0.02 2>3 F: 1.85 p: 0.16 Alcohol Use Mean Rank Mean Rank Mean Rank Yes 6 (2.6) 63.17 116.50 98.17 No 220 (94.4) 119.00 116.84 116.69 Quit 7 (3.0) 100.43 122.43 143.00 Test/p KW: 4.45 p: 0.10 KW: 0.47 p: 0.97 KW: 1.51 p: 0.46 Chronic Disease Yes 140 (60.1) 132.67 (13.05) 8.07 (3.85) 80.52 (12.35) No 93 (39.9) 128.79 (14.37) 8.12 (4.09) 80.06 (12.82) Test/p t: 2.13 p: 0.03 t: -0.10 p: 0.91 t: 0.27 p:0.78 Perceived Health Status Poor¹ 22 (9.4) 124.27 (12.58) 9.09 (4.25) 69. 45 (11.16) Moderate² 113 (48.5) 129.42 (13.26) 8.50 (4.04) 79.75 (11.89) Good³ 98 (42.1) 134.62 (13.60) 7.39 (3.66) 83.45 (12.13) Test/p KW: 21.28 p1 3>2 KW: 5.32 p: 0.07 KW: 23.24 p1 2>1 Hopelessness Present 102 (43.8) 127.30 (15.00) 9.21 (4.04) 76.18 (12.36) Absent 131 (56.2) 134.09 (11.82) 7.22 (3.64) 83.57 (11.49) Test/p t: -3.75 p<0.001 t: 3.94 p<0.001 t: -4.66 p<0.001 Disease-Related Concern Present 114 (48.9) 128.71 (14.33) 8.85 (3.97) 77.97 (12.03) Absent 119 (51.1) 133.42 (12.70) 7.36 (3.79) 82.06 (12.59) Test/p t: -2.65 p: 0.008 t: 1.50 p: 0.004 t: -2.86 p:0.005 Mean (SD) Length of Hospital Stay (days)* 1.82 (1.02) r: 0.22 p: 0.73 r:-0.63 p: 0.34 r: 0.05 p: 0.40 Duration of CAD Diagnosis n (%) < 6 months¹ 124 (53.2) 130.79 (14.45) 7.67 (3.43) 80.83 (12.35) 6 months–1 year² 21 (9) 128.52 (13.04) 6.90 (4.38) 81.04 (11.31) 1–2 years³ 22 (9.4) 128.13 (14.07) 9.72 (4.26) 75.36 (14.27) ≥ 2 years⁴ 66 (28.3) 133.57 (13.70) 8.71 (4.39) 80.83 (12.47) Test/p KW: 4.91 p: 0.17 KW: 8.07 p: 0.04 3>2 KW: 4.32 p: 0.22 SS: Standard Deviation. t: Independent Groups t Test. F: ANOVA. KW: Kruskal Wallis Test. *Spearman Correlation test. p.0.01 level is significant. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale Table 3. Comparison of primary caregivers' sociodemographic characteristics and scale scores Characteristics Mean (SD) SWBSS Mean (SD) DAS Mean (SD) ALSS Mean (SD) Age 39.31 (13.68) r: 0.71 p: 0.28 r: 0.06 p: 0.34 r: -0.05 p: 0.94 Gender n (%) Female 132 (56.7) 127.82 (12.80) 7.70 (4.11) 77.96 (12.96) Male 101 (43.3) 130.60 (13.51) 9.91 (3.56) 80.07 (13.23) Test/p t: 1.66 p: 0.11 t: -4.38 p<0.001 t: 1.21 p: 0.22 Marital Status Married 176 (75.5) 129.46 (12.95) 9.12 (3.91) 79.29 (12.56) Single/Widowed 57 (24.5) 127.70 (13.78) 8.43 (4.09) 77.64 (14.66) Test/p t: 0.87 p: 0.38 t: 1.13 p: 0.25 t: 0.82 p: 0.41 Education Illiterate 26 (11.2) 131.07 (10.60) 10.03 (4.04) 74.76 (15.06) Literate 44 (18.9) 123.20 815.32) 9.56 (4.01) 76.95 (11.66) Primary School 29 (12.4) 133.62 (10.75) 9.31 (4.18) 81.67 (12.95) Middle School 30 (12.9) 131.80 (14.55) 7.76 (4.34) 79.93 (15.40) High School 53 (22.7) 129.83 (12.35) 8.90 (3.92) 78.41 (12.69) University and above 18 (7.7) 127.94 (12.16) 8.43 (3.45) 81.00 (12.00) Test/p KW: 7.52 p: 0.18 KW: 7.44 p: 0.19 KW: 13.18 p: 0.02 6>1 6>2 Place of Residence City 78 (33.5) 128.56 (12.83) 8.58 (4.00) 78.81 (13.79) District 108 (46.4) 129.12 (13.74) 9.04 (4.09) 79.97 (11.40) Village 47 (20.2) 129.59 9.36 (3.61) 76.51 (15.37) Test/p F: 0.09 p: 0.91 F: 0.60 p: 0.54 F: 1.14 p: 0.31 Employment Status Mean Rank Mean Rank Mean Rank Employed 141 (60.5) 116.70 102.73 120.99 Unemployed 84 (36.1) 116.83 140.90 109.88 Retired 8 (3.4) 124.06 117.44 114.31 Test/p KW: 0.09 p: 0.95 KW: 16.99 p1 KW: 1.65 p: 0.43 Family Type Mean Rank Mean Rank Mean Rank Nuclear 175 (75.1) 124.38 118.84 123.19 Extended 56 (24) 93.93 111.14 98.21 Other 2 (0.9) 117.00 120.00 46.50 Test/p KW: 8.67 p: 0.01 1>2 KW: 0.56 p: 0.75 KW: 8.07 p: 0.01 1>2 Living Companions n (%) Mean Rank Mean Rank Mean Rank Spouse and/or children 155 (66.5) 122.83 122.03 118.81 Alone 5 (2.1) 106.20 94.40 98.60 Parents 55 (23.6) 103.65 111.33 117.66 Other 18 (7.7) 110.58 97.31 98.19 Test/p KW: 3.61 p: 0.30 KW: 3.73 p: 0.33 KW: 1.89 p: 0.59 SD: Standard Deviation. r: Pearson Correlation. t: Independent Groups t Test.. F: ANOVA. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS Adult Life Satisfaction Scale Table 4. Comparison of Physical Health Related-Characteristics of Primary Caregivers with Scale Scores Characteristics n (%) SWBS Mean (SD) DAS Mean (SD) ALSS Mean (SD) Smoking Status Mean Rank Mean Rank Mean Rank Yes¹ 96 (41.2) 109.28 105.11 109.24 No² 126 (54.1) 120.43 124.76 122.97 Quit³ 11 (4.7) 145.09 131.86 106.32 Test/p KW: 3.50 p: 0.17 KW: 5.22 p: 0.07 KW: 2.54 p: 0.28 Alcohol Use Mean Rank Mean Rank Mean Rank Yes 10 (4.3) 47.25 108.55 62.95 No 219 (94) 119.81 117.79 118.93 Quit 4 (1.7) 137.50 94.88 117.75 Test/p KW: 11.47 p:0.003 2>1 3>1 KW: 0.62 p: 0.73 KW: 6.66 p: 0.03 2>1 Chronic Disease Mean (SD) Mean (SD) Mean (SD) Yes 53 (22.7) 129.20 (12.79) 9.81 (3.90) 76.54 (12.42) No 180 (77.3) 128.97 (13.29) 8.70 (3.95) 79.58 (13.24) Test/p t: 0.11 p: 0.91 t: 1.79 p: 0.07 t: -1.48 p: 0.13 SS: Standard Deviation. t: Independent Groups t Test. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale Table 5. Mean Scale Scores of Patients and Primary Caregivers and the Relationship Between Them Scales SWBS DAS ALSS Scale Scores of Patients Mean Scale Scores of Patients (SD) 131.12 (13.70) 8.09 (3.94) 80.33 (12.51) SWBS - r: -0.16** p: 0.01 r: 0.53* p: <0.001 DAS r: -0.16** p: 0.01 - r: -0.25* p: <0.001 ALSS r: 0.53* p: <0.001 r: -0.25* p: <0.001 - Scale Scores of Primary Caregivers Mean Scale Scores of Primary Caregivers (SD) 129.03 (13.15) 9.95 (3.96) 78.88 (13.09) SWBS - r: -0.11** p: 0.01 r: 0.53* p: <0.001 DAS r: -0.11** p: 0.01 - r: -0.23* p: <0.001 ALSS r: 0.53* p: <0.001 r: -0.23* p: <0.001 - Difference between Patient and Primary Caregiver Test t: 1.68 t: -2.35 t: 1.22 P 0.93 0.01 0.22 *Correlation is significant at p:0.01 level. **Correlation is significant at p:0.05 level. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale. t: Independent Groups t Test Table 6. The Effect of Being a Patient and Primary Caregiver and Scale Scores on the ALSS Dependent Variable Independent Variables B ß t P ALSS Fixed 21.33 3.98 <0.001 DAS -0.59 -0.18 -4.07 <0.001 SWBS 0.48 0.51 13.12 <0.001 Group 0.32 0.00 0.32 0.97 Model (p)<0.001 R 2 : 0.31 Additional Declarations No competing interests reported. Supplementary Files Appendix1.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Mar, 2026 Reviews received at journal 27 Mar, 2026 Reviewers agreed at journal 26 Mar, 2026 Reviewers agreed at journal 26 Mar, 2026 Reviewers agreed at journal 24 Mar, 2026 Reviews received at journal 17 Dec, 2025 Reviewers agreed at journal 02 Dec, 2025 Reviewers agreed at journal 02 Dec, 2025 Reviewers invited by journal 02 Dec, 2025 Editor assigned by journal 02 Dec, 2025 Editor invited by journal 02 Dec, 2025 Submission checks completed at journal 01 Dec, 2025 First submitted to journal 01 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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1","display":"","copyAsset":false,"role":"figure","size":75737,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eScatter Plot for testing the assumption of simple linear multiple regression analysis\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8126639/v1/4c627a3b70f5cd4b5d3856fc.png"},{"id":97893025,"identity":"557d3a17-a5f0-4c18-a2d7-04c7c69180b2","added_by":"auto","created_at":"2025-12-10 15:25:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2147688,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8126639/v1/4ad41646-71f0-4e17-b095-adc945e304a0.pdf"},{"id":97665496,"identity":"228bb633-7161-40b9-8581-6625f5aab032","added_by":"auto","created_at":"2025-12-08 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Introduction","content":"\u003cp\u003eCoronary artery disease (CAD) is a pathological condition that occurs when the myocardium is insufficiently nourished due to reduced or interrupted blood flow, often caused by the formation of atheromatous plaque in the coronary arteries. It progresses slowly and insidiously, and symptoms are usually observed in the advanced stage of the disease [1]. It is also called coronary heart disease [2]. As it accounts for approximately 7 million deaths annually worldwide, Coronary Artery Disease (CAD) ranks among the leading causes of mortality [3] and also contributes to the development of mental health problems [4]. Moreover, the fact that CAD is a serious condition that directly threatens life, and that individuals with CAD are at risk of experiencing sudden and potentially fatal events such as myocardial infarction, may lead them to confront the reality of death more concretely and imminently than others, thereby increasing their death anxiety. The perception of being close to death, having a life-threatening illness, or facing the death of loved ones or primary caregivers can evoke fear in these individuals. [5]. Primary caregivers of patients with CAD may experience intense anxiety, sadness, and helplessness when faced with the risk of their loved one's death. Spiritual well-being in chronic life-threatening illnesses can increase coping skills and help people cope more effectively with the physical and psychological stress they experience. In addition, spiritual well-being supports psychological resilience by reducing negative emotions such as depression, anxiety, and death anxiety [6]. Individuals with high life satisfaction adapt better to the treatment process by improving their coping skills with the disease and gain an advantage in maintaining their general mental health. Individuals with low life satisfaction have an 80 per cent higher risk of cardiovascular disease compared to those with high life satisfaction [7]. \u0026nbsp;Kasar et al. (2016) report that the presence of physical illness adversely affects death anxiety [8]. For these reasons, nurses need to determine the death anxiety levels of patients with CAD and their primary caregivers, as well as the factors influencing this anxiety, to preserve their psychosocial integrity. They should also incorporate interventions aimed at reducing death anxiety into the care process. Spiritual well-being is an essential component during the treatment process. Through interventions that draw patients’ attention to optimism and positive thinking, nurses can help maintain and enhance this dimension of Health [6].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBoehm et al. (2011) reported that life satisfaction may support cardiac health [9]. While high life satisfaction in patients promotes both physical and psychological recovery, the satisfaction of primary caregivers directly influences the quality of the care they provide. High life satisfaction in both patients and their primary caregivers strengthens the perception of social support and enhances resilience in coping with illness. Therefore, assessing and promoting life satisfaction within nursing care for patients with CAD and their primary caregivers may be a crucial factor in comprehensive and practical health management. In the literature, some studies examine the death anxiety, spiritual well-being, and life satisfaction of patients with CAD separately [10, 11, 12, 13, 14, 15]. However, no study has been found that examines these variables together or investigates their interrelationships. Moreover, no research has been identified in the literature that explores death anxiety, spiritual well-being, and life satisfaction among primary caregivers of patients diagnosed with CAD. In line with this information, the present study was conducted to determine and compare the relationship between spiritual well-being, death anxiety, and life satisfaction in patients diagnosed with CAD and their primary caregivers, thereby providing a meaningful contribution to the literature.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted to compare the relationship between spiritual well-being, death anxiety, and life satisfaction of coronary artery disease patients and their primary caregivers. \u003cstrong\u003eResearch Questions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study questions were:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1. What are the levels of spiritual well-being, death anxiety, and life satisfaction in patients with coronary artery disease and their primary caregivers?\u003c/p\u003e\n\u003cp\u003e2. What are the factors affecting the levels of spiritual well-being, death anxiety, and life satisfaction of coronary artery patients and their primary caregivers?\u003c/p\u003e\n\u003cp\u003e3. Is there a relationship between spiritual well-being levels, death anxiety, and life satisfaction of coronary artery patients and their primary caregivers?\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e4. Are spiritual well-being, death anxiety, and life satisfaction levels higher in coronary artery disease patients or primary caregivers?\u0026nbsp;\u003c/p\u003e"},{"header":"2.\tMethodology","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in a comparative, cross-sectional, and correlational design to examine the relationship between spiritual well-being, death anxiety, and life satisfaction of coronary artery disease patients and their primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSetting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted between November 9, 2024, and January 15, 2025, among patients hospitalized with a diagnosis of CAD in the cardiology clinic of an educational and research hospital, along with their primary caregivers. Patients diagnosed with coronary artery disease (myocardial infarction, acute coronary syndrome) and their primary caregivers were included in the study. The research population consisted of patients hospitalized in the clinic during the study period who met the inclusion criteria, as well as their primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants and sampling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the study, an attempt was made to reach the entire population, and participants who met the inclusion criteria and voluntarily agreed to participate were selected through convenience sampling. The data were collected through individual, face-to-face interviews conducted by the researcher (EAK), who is a nurse in the cardiology ward. Each interview lasted approximately 20\u0026ndash;30 minutes, and the questionnaire and scale items were read aloud to the patients diagnosed with coronary artery disease and their primary caregivers, with responses recorded accordingly. The reason for this was that some patients and primary caregivers in the study area were unable to read or write in Turkish, and they requested that the questions be read to them.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population consisted of patients hospitalized in the clinic and their primary caregivers who met the study criteria on the study dates. The adequacy of the sample size of the study was determined based on the statistical power level required by multiple linear regression analysis. G*Power 3.1 software was used by targeting a moderate effect size (f\u0026sup2; = 0.15), 95% confidence level (\u0026alpha; = 0.05), and 80% power (1-\u0026beta; = 0.80), and as a result of the analysis, it was calculated that a sample of at least 77 individuals would be sufficient [16]. Accordingly, the study included a total of 466 participants, comprising 233 individuals from each group (patients with coronary artery disease and their primary caregivers). This sample size is sufficient to enhance the reliability and generalizability of the analyses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Tools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were collected with the Participant Information Form, Spiritual Well-Being Scale (SWBS), Death Anxiety Scale (DEAS), and Adult Life Satisfaction Scale (ALSS).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eParticipant Information Form\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis form, which was prepared as a result of the literature review, includes the age, gender, place of residence, educational status, marital status, employment status, family type, cohabitants, smoking-alcohol use, presence of chronic disease, type of hospital admission, duration of hospitalisation, medical diagnosis, when the disease was diagnosed, current health perception, The study consisted of 20 questions about the presence of disease-related concerns and the nature of these concerns and 11 questions about the age, gender, place of residence, educational status, marital status, employment status, family type, cohabitants, smoking-alcohol use, and presence of chronic disease of the primary caregivers (Appendix-1) [11, 17, 18].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSpiritual Well-Being Scale (SWBS)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe validity and reliability studies of the scale developed by Ekşi and Karadaş in 2017, which was based on the opinions of 17 experts to measure the spiritual well-being of adults, were conducted using 865 adult participants. As a result of the analyses, a structure consisting of 29 items with a 5-point Likert-type response format was obtained. The scale comprises a three-factor structure, including transcendence, harmony with nature, and anomie. In the Likert scale, responses range from 1 to 5, where one means \u0026ldquo;Not at all suitable for me,\u0026rdquo; 2 means \u0026ldquo;Not suitable for me,\u0026rdquo; 3 means \u0026ldquo;Somewhat suitable for me,\u0026rdquo; 4 means \u0026ldquo;Quite suitable for me,\u0026rdquo; and five means \u0026ldquo;Completely suitable for me\u0026rdquo;. Scores obtained from the scale range from 29 to 145. In the case of a total score, the items under the anomie sub-dimension are calculated inversely. The total Cronbach\u0026apos;s Alpha value of the scale was found to be \u0026alpha;=0.886, \u0026alpha;=0.953 in the transcendence subscale, \u0026alpha;=0.864 in the harmony with nature subscale, and \u0026alpha;=0.853 in the anomie subscale [19]. In the present study, the Cronbach\u0026apos;s alpha coefficient of the SIOQ was found to be 0.95 in patients and 0.92 in primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDeath Anxiety Scale (DAS)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe scale, initially developed by Templer (1970), was adapted into Turkish by Ak\u0026ccedil;a and K\u0026ouml;se (2008). It consists of 15 items arranged in a proper- false format and is a dichotomous Likert-type scale. Correct responses are scored as 1 point, while incorrect responses are not included in the scoring. The total scores that can be obtained from the scale range from 0 to 15, and higher scores are interpreted as indicating that the individual has a higher level of death anxiety. The reliability coefficient of the scale, determined by the test-retest method, was 0.79, and the internal consistency coefficient, calculated using the Kuder-Richardson formula, was 0.75 [20, 21]. In this study, the Kuder Richardson 20 coefficient for the SCS was found to be 0.82 in patients and 0.84 in primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAdult Life Satisfaction Scale (ALSS)\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe ALSS is a 21-item, 5-point Likert-type self-report scale developed by Kaba, Erol, and G\u0026uuml;\u0026ccedil; to assess life satisfaction among adults in accordance with Turkish culture. The scale consists of five subdimensions: general life satisfaction, relationship satisfaction, self-satisfaction, social environment satisfaction, and job satisfaction. The total scores that can be obtained range from 21 to 105, and high scores indicate that the individual has positive perceptions about their life. As a result of the application for criterion validity, a positive and significant relationship was determined between ALSS and the General Satisfaction with Life Scale (Diener, Emmons, Laresen \u0026amp; Griffin, 1985) (r=.67, p \u0026lt;.01), and in the reliability study of ALSS, the cronbach alpha internal consistency coefficient of the 21 questions in the scale was calculated as 0.89 [22, 23]. In this study, the Cronbach alpha coefficient for ALSS was 0.90 in patients and 0.91 in primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research data were analyzed using SPSS version 25.00. Descriptive statistics, including frequency, percentage, standard deviation, and mean values, were calculated. The normality of scale scores and numerical variables was assessed using kurtosis and skewness values within the range of -1.96 to +1.96 [24], indicating that the scale score means were usually distributed. Therefore, relationships between total scale score means were evaluated using the Pearson correlation test. Since the length of hospital stay did not follow a normal distribution, its relationship with total scale scores was assessed using the Spearman correlation test. For groups with n = 30, the Kruskal-Wallis or Mann-Whitney U tests were applied. To analyze whether scale scores differed according to sociodemographic variables, the Student\u0026rsquo;s t-test was used for binary variables, and the ANOVA test was applied for variables with three or more groups. For variables found significant in the ANOVA test, Tukey\u0026rsquo;s post hoc test was conducted. Due to the small number of participants in certain groups (e.g., alcohol use, family type, employment status, and cohabitation), the Kruskal-Wallis test was used as a non-parametric alternative. To determine the effect of DAS and SWBS total scores, as well as the role of being a patient or a primary caregiver, on ALSS scores, multiple linear regression analysis was performed using the Enter method. Internal consistency of the SWBS and ALSS was assessed using Cronbach\u0026rsquo;s alpha coefficient, while the dichotomous nature of the DAS required the use of Kuder-Richardson 20 analysis. All findings were evaluated at a significance level of p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten permission was obtained from the Dicle University Social and Humanities Ethics Committee (06.09.2024/769033) and from the Provincial Health Directorate of Mardin Training and Research Hospital, where the study was conducted (30.10.2024/E-90410089-799-234236292). Before the commencement of the study, permission was obtained via email from the researchers who had established the validity and reliability of the scales used. Participants were first informed about the purpose of the study. Participation in the research process was based on the principle of voluntariness, in accordance with the Declaration of Helsinki, and informed consent was obtained through both verbal and written consent forms. For participants who declined to provide written consent, only verbal consent was obtained. \u0026ldquo;It does not require consent for publication.\u0026rdquo;\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003eComparison of sociodemographic characteristics and scale scores of patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe demographic variables of the patients who participated in the study are presented in Table 1. The mean age of the patients was 56.77 years (11.47), and 64.4% were male. When the education levels were analysed, it was determined that 25.8% were illiterate, 91% were married, and 43.8% lived in the district. It was found that 48.5% of the patients were not employed in an income-generating job, 76.5% had a nuclear family, and 81.5% lived with their spouses and children. Patients living with others were found to live only with their children, spouse, and grandchildren. A positive, weak, statistically significant relationship was found between age and SWBS. A significant difference was found in DAS total scores between genders, with male participants having higher death anxiety scores than females. Regarding family type, patients with a nuclear family structure had significantly higher SWBS total scores compared to those with an extended family structure. Additionally, the variable of cohabiting individuals revealed significant differences in both the total scores of SWBS and ALSS across groups. Accordingly, participants living with their spouse and children had significantly higher SWBS total scores compared to those living alone or with parents. Similarly, those living with others also had significantly higher SWBS scores than individuals living alone or with parents. In parallel, participants living with their spouse and children had significantly higher ALSS total scores than those living alone or with parents, and those living with others had significantly higher ALSS scores than those living alone. No statistically significant differences were found between groups for other variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of patients' physical health-related characteristics with scale scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe physical health-related characteristics of the patients are given in Table 2. 47.2% of the patients were smokers, and 2.6% were alcohol users. 60.1% of the patients had a chronic physical disease. The most common physical diseases were hypertension (HT), diabetes mellitus, and rheumatic diseases. Forty-eight point five per cent of the patients perceived their health at a moderate level, 43.8% had hopelessness, and 48.9% had anxiety about the disease. When the sources of concern were questioned, 26.2% stated that they had concerns about the treatment, 16.3% about feeling inadequate, and 14.2% about the caregiver. It was determined that the patients were hospitalised in the clinic for a mean of 1.82 (1.02) days, and 53.2% had a diagnosis of coronary artery disease (CAD) of less than 6 months. A statistically significant difference was found in DAS total scores based on smoking status. Participants who had quit smoking had significantly higher DAS scores compared to current smokers. Individuals with chronic illnesses had significantly higher SWBS total scores than those without chronic conditions. Regarding perceived health status, both SWBS and ALSS total scores varied significantly across groups. Participants who perceived their health as good had significantly higher SWBS scores than those with moderate or poor health perceptions. Similarly, ALSS scores were significantly higher among those with moderate health perceptions compared to those with poor perceptions, and among those with good health perceptions compared to those with poor perceptions. Participants who did not experience hopelessness related to their illness had significantly higher SWBS and ALSS total scores, and significantly lower DAS total scores, compared to those who did. Similarly, those who did not experience illness-related anxiety had significantly higher SWBS and ALSS scores and significantly lower DAS scores than those who did. Patients diagnosed with CAD for 1–2 years had significantly higher DAS scores compared to those diagnosed for 6 months to 1 year. No statistically significant differences were found between groups for other variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of primary caregivers' sociodemographic characteristics and scale scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sociodemographic variables of the primary caregivers who participated in the study are presented in Table 3. The mean age of primary caregivers was 39.31 years (SD = 13.68), and 56.7% were female. \u0026nbsp;When their educational level was analysed, it was found that 22.7% were high school graduates, 75.5% were married, and 46.4% lived in the district. It was found that 60.5% of the primary caregivers were gainfully employed, 75.1% had nuclear families, and 66.5% lived with their spouses and children. The comparison of sociodemographic characteristics among primary caregivers and their scale scores is presented in Table 3. The total DAS scores of male primary caregivers were statistically higher compared to those of female primary caregivers. A significant difference was found in the total ALSS scores in terms of educational level. The total ALSS scores of participants with a university degree or higher were statistically higher than those of individuals who were literate or illiterate. The total DAS scores of unemployed primary caregivers were significantly higher than those of employed primary caregivers. In terms of family structure, it was found that individuals living in nuclear families had statistically higher total SWBS and ALSS scores compared to those living in extended families.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of physical health-related characteristics of primary caregivers with scale scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe characteristics of primary caregivers related to physical health are shown in Table 4. It was found that 54.1% of primary caregivers did not smoke, 94% did not use alcohol, and 77.3% did not have a chronic physical disease. When chronic physical diseases were analysed, hypertension, diabetes, asthma, and thyroid dysfunction were frequently found. When the physical health status of the primary caregivers and the mean total scores of the SWBS and ALSS were compared between the groups, it was determined that the scores of the SWBS and ALSS changed statistically according to alcohol use. Non-alcohol users had statistically significantly higher scores on the SWBS and ALSS than alcohol users (p\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMean scale scores of patients and primary caregivers, and the relationship between them\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe scale scores of patients and primary caregivers are presented in Table 5. Group differences were analyzed using the independent samples t-test, and a statistically significant difference was found only in the DAS total scores between the two groups. Primary caregivers had significantly higher DAS scores compared to patients. According to Pearson correlation analysis, a statistically significant correlation was found between the scale scores of both patients and primary caregivers. A negative and very weak correlation was found between the mean total scores of the SWBS and the DAS scores of the patients, and a positive and moderately significant correlation was found between the mean total scores of the SWBS and the ALSS scores. \u0026nbsp;Similarly, a negative and statistically weak relationship was found between the mean total scores of the SWBS and DAS scores, and a positive and statistically significant relationship was found between the mean total scores of the SWBS and ALSS scores. A statistically weak and negative correlation was found between the mean scores of DAS and ALSS total scores for both patients and primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe effect of being a patient and primary caregiver and scale scores on the ALSS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn a simple linear multiple regression analysis conducted to determine the effect of being a patient or a primary caregiver on ALSS, along with total SWBS and DAS scores, the Enter method was used. The model was found to be statistically significant (F = 71.48, p \u0026lt; 0.001). Accordingly, as predictors of ALSS, total SWBS and DAS scores were found to be statistically significant rather than the status of being a patient or a primary caregiver (R² = 0.31). In this model, SWBS and DAS explained 31% of the variance in ALSS (Adjusted R² = 0.31) (Table 6).\u003c/p\u003e\n\u003cp\u003eA scatter plot was used to test the assumptions of the simple linear multiple regression analysis. ALSS was taken as the dependent variable, and DAS, SWBS, and group status were included as the standardized predictors in the regression. In the scatter plot, R² was depicted as 0.31 (Figure 1).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e\u003cstrong\u003eDiscussion of sociodemographic characteristics and scale scores of the patients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the patients who participated in the study, those of older age and those living in a nuclear family with their spouse and children were found to have higher levels of spiritual well-being. Additionally, individuals living with others had significantly better spiritual well-being compared to those living alone. In a study conducted by Eston Armond et al. (2022) examining the relationship between CAD and spiritual well-being, no significant association was found between age and spiritual well-being levels [11]. However, Amni and Akbar (2024) suggested that the increase in spiritual well-being among older patients with CAD may be attributed to a closer relationship with God or a Creator as age advances [25]. Age may not be a direct factor in enhancing spiritual well-being; instead, other elements such as life experiences, health status, and social support systems are believed to play a significant role [26]. In a study conducted by Seher and Çiftçi (2025) in Turkey, which examined the relationship between spiritual well-being and levels of hopelessness among 151 patients who had experienced myocardial infarction and undergone angiography, no significant association was found between patients’ age or family type and their spiritual well-being. However, married individuals scored significantly higher than single individuals in the transcendence subdimension of spiritual well-being.\u0026nbsp;Transcendence reflects the belief in a higher power that provides comfort, ease, and resilience. It has been suggested that this may be due to married individuals taking on more responsibilities compared to single individuals [10]. Additionally, in their study, Soleimani et al. (2018) found that social support significantly predicted spiritual well-being [17]. Spiritual well-being is a subdimension of overall well-being and is influenced by perceived social support [27]. It is thought that the spiritual well-being levels of patients living with others are higher than those living alone, due to the higher perceived social support these individuals receive. Accordingly, it can be said that social support is effective in increasing the spirituality of the individual.\u003c/p\u003e\n\u003cp\u003eAmong the patients who participated in the study, those who lived with someone had higher life satisfaction than those who lived alone. In a study on life satisfaction and healthy life behaviours in patients after MI, no significant difference was found between family type and life satisfaction [15]. In a study examining the mediating role of social support in the relationship between loneliness and life satisfaction among older adults, it was found that elderly individuals who were married and living with their spouse had higher levels of life satisfaction and perceived social support compared to those who were widowed and living alone. The same study also identified a significant relationship between loneliness and life satisfaction, indicating that loneliness has a negative impact on life satisfaction [28]. In a study conducted to determine loneliness, life satisfaction, and death anxiety among elderly individuals living at home, it was found that older adults living with their spouses had lower levels of loneliness and higher life satisfaction [29]. This finding demonstrates the enhancing effect of social support and cohabitation on life satisfaction. Individuals with greater social support tend to have higher levels of life satisfaction [30]. It is therefore suggested that the social support provided by cohabitation has a positive effect on life satisfaction.\u003c/p\u003e\n\u003cp\u003eIn this study, male patients were found to have higher levels of death anxiety compared to female patients. Contrary to these findings, studies conducted by Yiğitalp and Bürçün (2025), Yıldırım and Kocatepe (2023), and Turan Kavradım et al. (2022), involving patients diagnosed with CAD, did not identify any significant relationship between gender and death anxiety [5, 12, 13]. On the other hand, a study examining the relationship between death anxiety, life satisfaction, and psychological well-being among individuals aged 40–59 found that women experienced higher levels of death anxiety than men [31]. In a study conducted to examine the effects of status and gender on death anxiety, life orientation, and life satisfaction, it was found that women had higher levels of death anxiety compared to men [32]. Soleimani et al. (2018), in their study with patients who had experienced Acute Myocardial Infarction (AMI), reported that women experienced higher death anxiety than men [17]. In contrast, Buruntekin (2022), in a study with MI patients, found that male patients experienced higher levels of death anxiety [18]. The relationship between gender and death anxiety varies across studies. The observation that male patients report higher death anxiety than female patients may be attributed to men’s greater reluctance to express their fears and anxieties and their tendency to conceal these emotions [17]. In contrast, although women may have higher levels of anxiety [32, 33], they tend to express anxiety symptoms more openly. Consequently, men may verbalize death anxiety less frequently but internalize it, experiencing it more intensely and chronically.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion of patients' characteristics related to physical health with scale scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, patients who quit smoking had a higher fear of death than smokers. Patients with chronic disease had significantly higher spiritual well-being than patients without chronic disease. In this study, it was determined that those who perceived their health as good had higher spiritual well-being and life satisfaction. In a study conducted by Okutan et al. (2024) to examine the relationship between death anxiety and healthy lifestyle behaviors among individuals who underwent percutaneous coronary intervention, a negative correlation was found between healthy lifestyle behaviors and death anxiety [34]. The higher levels of death anxiety observed among individuals who have quit smoking may be associated with regret over past health behaviors and an increased perception of health threats. Moreover, it is possible that existing death anxiety played a role in their decision to quit smoking. There are also studies reporting that individuals with chronic illnesses exhibit high [35, 36] or moderate [37, 38] levels of spiritual well-being. The observation that individuals with additional chronic illnesses exhibit higher levels of spiritual well-being can be explained by their more frequent use of spiritual coping strategies in managing multiple health challenges. These individuals tend to experience spiritual concepts such as life meaning, patience, acceptance, and inner peace more intensely, which is thought to enhance their level of spiritual well-being.\u003c/p\u003e\n\u003cp\u003eIt was determined that those who did not experience hopelessness about the disease had higher spiritual well-being and life satisfaction and lower fear of death than those who experienced hopelessness. In a study conducted by Şolpan et al. (2023) involving patients with STEMI and hypertension, 60% of the participants reported fear of experiencing another myocardial infarction, and death anxiety was observed among the patients [39]. In another study examining the relationship between spiritual well-being, hope, and health anxiety in patients with advanced coronary artery disease, a significant and inverse relationship was found between hope levels and health anxiety among CAD patients. Hope is not only an emotional support factor for patients with CAD but also a practical psychological resource for coping with health-related concerns. It has the potential to reduce health anxiety by strengthening self-efficacy, optimism, and other positive psychological traits [40]. In a study examining the relationship between death anxiety, loneliness, and hope levels in patients treated in a cardiac intensive care unit, it was found that patients had moderate levels of hope and that there was no significant relationship between hope and death anxiety [41]. It is thought that feelings of hopelessness regarding their illness and concerns about disease recurrence may contribute to death anxiety in patients with CAD.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion of sociodemographic characteristics and scale scores of primary caregivers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, fear of death was higher in males and unemployed primary caregivers. Additionally, it was found that primary caregivers with a university degree or higher had higher life satisfaction than those with a lower level of education, including literate and illiterate caregivers. It was found that both spiritual well-being and life satisfaction were higher in those with nuclear families.\u0026nbsp;When examining the death anxiety levels of primary caregivers, Ying et al. (2024) found that female caregivers of cancer patients exhibited higher levels of death anxiety compared to their male counterparts [42]. Similarly, Soleimani et al. (2017) reported that female caregivers experienced significantly higher death anxiety than male caregivers [43]. In a study conducted by Beydag (2012) involving caregivers of cancer patients, a significant difference was found in death anxiety scores based on gender, with female caregivers scoring higher than males [44].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion of scale scores of physical health-related characteristics of primary caregivers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIt was found that both spiritual well-being and life satisfaction were higher in primary caregivers who did not use alcohol. In a study examining life satisfaction in cardiovascular diseases, it was determined that participants with moderate alcohol use had lower life satisfaction\u0026nbsp;[7]. Similarly, in a study conducted with individuals aged 60–80, occasional alcohol consumption was found to be associated with higher life satisfaction compared to daily consumption [45]. On the other hand, Och et al. (2022), in a study with randomly selected individuals from the general population, reported a relationship between high life satisfaction and high alcohol consumption [46]. In a study by Sezek et al. (2023) involving caregivers who provided home health services, alcohol consumption was not found to have a significant effect on caregivers’ life satisfaction [47]. This discrepancy is thought to be due to the low proportion of primary caregivers who consumed alcohol in our study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion of the mean scale scores of patients and primary caregivers and the relationship between them\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the mean DAS score for patients was 8.09 (SD = 3.94), while that for primary caregivers was 9.95 (SD = 3.96). It was also determined that primary caregivers experienced significantly higher levels of death anxiety compared to patients. In a study conducted by Turan Kavradım et al. (2022) involving patients with myocardial infarction (MI), more than half of the participants were reported to experience moderate levels of death anxiety [12]. In a study by Yıldırım and Kocatepe (2023) conducted with individuals who had previously experienced MI, it was found that the majority of patients experienced severe or panic-level death anxiety [13]. In Rahimi et al.’s (2021) study, the level of death anxiety in patients with MI was reported to be moderate to high [14]. Yiğitalp and Bürçün (2025), in their study examining death anxiety, psychological resilience, religious attitudes, and related factors in cardiology patients with and without Acute Myocardial Infarction, found that death anxiety was at a moderate level in both groups [5]. On the other hand, in a study conducted by Şolpan et al. (2023) involving patients with ST-segment elevation myocardial infarction (STEMI) and hypertension (HT), it was reported that hypertensive patients experienced moderate levels of death anxiety. In contrast, STEMI patients exhibited lower levels of death anxiety [39]. The variability in death anxiety among patients with coronary artery disease (CAD) across studies may be attributed to factors such as life satisfaction, personal beliefs, physical health, environment, and cultural values. To date, no studies have been identified in the literature that specifically examine death anxiety among primary caregivers of patients with CAD. However, studies on caregivers of cancer patients have shown that they tend to experience moderate to high levels of death anxiety [43, 44).\u0026nbsp;Consistent with the results of this study, research indicates that the mean DAS scores of caregivers are higher than those of patients [48]. Studies showing that death anxiety decreases with age suggest that this may be due to the higher average age of patients and the lower average age of primary caregivers [48, 49]. In addition, Yalom (2008) states that experiences of grief and loss can initiate a process of “awakening” in individuals [50].\u0026nbsp;In this context, the confrontation of primary caregivers with the illness of their loved ones and the reality of death may also trigger their own death anxiety. Although patients may not be able to eliminate their death anxiety entirely, directly facing their illness might help reduce it to some extent. In contrast, primary caregivers, confronted with the possibility of losing a loved one and facing their own mortality, may experience more intense anxiety and fear about the future. In this study, the higher levels of death anxiety observed among primary caregivers compared to patients may be associated with these processes.\u003c/p\u003e\n\u003cp\u003eIn this study, it was found that as spiritual well-being increased in both patients and primary caregivers, life satisfaction also increased, and death anxiety decreased. In a study conducted in Turkey to examine the effect of spiritual well-being on life satisfaction and hope among elderly individuals, a statistically positive and moderately significant relationship was found between spiritual well-being and life satisfaction [51]. In a study investigating the effect of spirituality on the quality of life and life satisfaction of elderly individuals after MI, no significant relationship was found between spiritual well-being and patients’ life satisfaction [52]. Soleimani et al. (2018), in their study involving patients who had experienced acute myocardial infarction (AMI), reported no direct relationship between spiritual well-being and death anxiety. However, they emphasized that spiritual well-being may play a significant role in reducing death anxiety among married patients. They suggested that it could serve as a fundamental psychosocial factor in coping with death anxiety [17]. In another study conducted during the COVID-19 pandemic to examine the role of spiritual well-being and coping strategies in death anxiety among patients with a history of coronary artery bypass graft (CABG) surgery, a negative correlation was found between spiritual well-being and its subdimensions and death anxiety, although this relationship was not statistically significant [53]. In a meta-analysis examining death anxiety and spiritual well-being in chronic illnesses, a negative relationship was found between spiritual well-being and death anxiety [54]. Studies show varying results regarding the relationship between patients’ spiritual well-being, life satisfaction, and death anxiety.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe effect of being a patient and primary caregiver and scale scores on the ALSS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, spiritual well-being and death anxiety were identified as predictors of life satisfaction. A study conducted in Turkey during the COVID-19 pandemic, examining the effect of nurses’ death anxiety on life satisfaction, showed that death anxiety negatively affected life satisfaction [55]. Similarly, a study by Bahçecioğlu Turan et al. (2024), conducted in Turkey to examine the effect of spiritual well-being on life satisfaction among hematological cancer patients aged 65 and older, found that spiritual well-being positively influences life satisfaction [56]. The literature shows that studies investigating the predictive role of spiritual well-being and death anxiety on life satisfaction are limited, and the existing studies are consistent with the findings of this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSince the study was conducted using a cross-sectional design, it is not possible to establish causal relationships. The fact that the study was carried out at a single center (Mardin Training and Research Hospital) may limit the generalizability of the findings to other populations. The use of self-report measures introduces the risk of social desirability bias and response errors. It should also be considered that psychosocial variables may be influenced by individuals’ cultural, religious, and socioeconomic backgrounds. The absence of longitudinal follow-up prevented the exploration of the dynamic nature of relationships between variables over time.\u003c/p\u003e"},{"header":"5. Conclusıon","content":"\u003cp\u003ePatients diagnosed with coronary artery disease and their primary caregivers were found to experience death anxiety, while also exhibiting high levels of life satisfaction and spiritual well-being. Among the total scores of SWBS, DAS, and ALSS, a statistically significant difference between the two groups was observed only in DAS scores, with primary caregivers scoring significantly higher than patients. It was found that, in patients, there was a negative and very weak relationship between the total SWBS scores and DAS scores, and a positive and moderately significant relationship between the total SWBS scores and ALSS scores. Similarly, in primary caregivers, there was a negative and very weak relationship between the total SWBS scores and DAS scores, and a positive and moderately significant relationship between the total SWBS scores and ALSS scores. For both patients and primary caregivers, a statistically significant negative and weak relationship was observed between DAS and ALSS total scores. Additionally, as a predictor of ALSS, total SWBS and DAS scores were found to be statistically significant, rather than the status of being a patient or a primary caregiver.\u003c/p\u003e\n\u003cp\u003eFurther studies with larger sample sizes are recommended to explore the relationship between spiritual well-being, death anxiety, and life satisfaction in patients with coronary artery disease (CAD) and their primary caregivers. Considering that death anxiety negatively affects life satisfaction, it is suggested that nurses provide both patients and their primary caregivers with group interventions or individual support programs aimed at coping with death anxiety. Given that both CAD patients and their primary caregivers experience death anxiety, it is recommended that nurses assess the level of death anxiety, identify the influencing factors, and incorporate interventions aimed at reducing death anxiety into the care process to help preserve the psychosocial well-being of both groups.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthorship Statement Confirming and Authors Contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, EAK, AA, FG; methodology, EAK, AA, FG; data collection; EK; data analysis: EAK, AA, FG; writing—original draft preparation, EAK, AA, FG; writing—review and editing, EAK, AA, FG.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data in this study were based on a part of Masters Thesis prepared by Ebru AYMAN KILIÇ under supervision by Dr. Abdullah ATLI and Funda GÜMÜŞ, Institute of Health Sciences, Dicle University, Turkey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive any financial support in conducting this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData of this study could be shared upon reasonable request from the corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEthics Approval We (all authors) confirm that the research presented in the paper has received permission from a stated Research Ethics Committee (REC), including adherence to the legal requirements of the study country.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent:\u0026nbsp;\u003c/strong\u003eInformed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u0026nbsp;\u003c/strong\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKnuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes: The task force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). 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Psychogeriatrics. 2024;24(5):1149\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1.\u0026nbsp;Comparison of Sociodemographic Characteristics and Scale Scores of Patients\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eSWBS\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eDAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eALSS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e56.77 (11.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003er: 0.18\u003c/p\u003e\n \u003cp\u003ep: 0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003er: -0.11\u003c/p\u003e\n \u003cp\u003ep: 0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003er: 0.04\u003c/p\u003e\n \u003cp\u003ep: 0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eMean (SS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eMean (SS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eMean(SS)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e83 (35.6)\u003c/p\u003e\n \u003cp\u003e150 (64.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e131.43(13.49)\u003c/p\u003e\n \u003cp\u003e130.95(13.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7.34 (3.76)\u003c/p\u003e\n \u003cp\u003e9.45 (3.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78.50 (13.45)\u003c/p\u003e\n \u003cp\u003e81.35 (11.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003et: -0.25\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ep: 0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003et: -4.05\u003c/p\u003e\n \u003cp\u003ep\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003et: 1.66\u003c/p\u003e\n \u003cp\u003ep: 0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eSingle/Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e212 (91)\u003c/p\u003e\n \u003cp\u003e21 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e131.74(12.86)\u003c/p\u003e\n \u003cp\u003e124.90(19.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.18 (3.93)\u003c/p\u003e\n \u003cp\u003e7.14 (3.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e80.96 (11.89)\u003c/p\u003e\n \u003cp\u003e74.00 (16.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eZ: -1.23\u003c/p\u003e\n \u003cp\u003ep: 0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eZ: -1.09\u003c/p\u003e\n \u003cp\u003ep: 0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eZ: -1.76\u003c/p\u003e\n \u003cp\u003ep: 0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003cp\u003eLiterate\u003c/p\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003cp\u003eMiddle School\u003c/p\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003cp\u003eUniversity +\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60 (25.8)\u003c/p\u003e\n \u003cp\u003e42 (18)\u003c/p\u003e\n \u003cp\u003e53 (22.7)\u003c/p\u003e\n \u003cp\u003e28 (12)\u003c/p\u003e\n \u003cp\u003e32 (13.7)\u003c/p\u003e\n \u003cp\u003e18 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e132.60(11.05)\u003c/p\u003e\n \u003cp\u003e130.64(13.61)\u003c/p\u003e\n \u003cp\u003e133.75(11.12)\u003c/p\u003e\n \u003cp\u003e129.14(16.84)\u003c/p\u003e\n \u003cp\u003e127.87(15.49)\u003c/p\u003e\n \u003cp\u003e128.44(18.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9.01 (4.26)\u003c/p\u003e\n \u003cp\u003e8.28 (4.15)\u003c/p\u003e\n \u003cp\u003e7.96 (3.78)\u003c/p\u003e\n \u003cp\u003e7.67 (3.45)\u003c/p\u003e\n \u003cp\u003e7.53 (3.80)\u003c/p\u003e\n \u003cp\u003e6.61 (3.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78.050(13.25)\u003c/p\u003e\n \u003cp\u003e82.00 (11.22)\u003c/p\u003e\n \u003cp\u003e82.16 (12.30)\u003c/p\u003e\n \u003cp\u003e77.21 (11.50)\u003c/p\u003e\n \u003cp\u003e81.75 (10.96)\u003c/p\u003e\n \u003cp\u003e81.05 (16.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 4.23\u003c/p\u003e\n \u003cp\u003ep: 0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 6.46\u003c/p\u003e\n \u003cp\u003ep: 0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 8.73\u003c/p\u003e\n \u003cp\u003ep: 0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Residence\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eCity\u003c/p\u003e\n \u003cp\u003eDistrict\u003c/p\u003e\n \u003cp\u003eVillage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e77 (33)\u003c/p\u003e\n \u003cp\u003e102 (43.8)\u003c/p\u003e\n \u003cp\u003e52 (22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e128.54(16.92)\u003c/p\u003e\n \u003cp\u003e132.42(12.26)\u003c/p\u003e\n \u003cp\u003e131.98(10.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.09 (3.96)\u003c/p\u003e\n \u003cp\u003e7.95 (3.96)\u003c/p\u003e\n \u003cp\u003e8.51 (3.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78.66 (14.18)\u003c/p\u003e\n \u003cp\u003e81.96 (10.99)\u003c/p\u003e\n \u003cp\u003e79.36 (12.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eF: 1.92\u003c/p\u003e\n \u003cp\u003ep: 0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eF: 0.36\u003c/p\u003e\n \u003cp\u003ep: 0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eF: 1.70\u003c/p\u003e\n \u003cp\u003ep: 0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eEmployment status\u003c/p\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e91 (39.1)\u003c/p\u003e\n \u003cp\u003e113 (48.5)\u003c/p\u003e\n \u003cp\u003e29 (12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e129.04(16.11)\u003c/p\u003e\n \u003cp\u003e131.69(12.03)\u003c/p\u003e\n \u003cp\u003e135.41(10.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.09 (3.97)\u003c/p\u003e\n \u003cp\u003e8.28 (4.01)\u003c/p\u003e\n \u003cp\u003e7.34 (3.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e80.85 (11.56)\u003c/p\u003e\n \u003cp\u003e78.65 (13.72)\u003c/p\u003e\n \u003cp\u003e85.27 (8.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 3.76\u003c/p\u003e\n \u003cp\u003ep: 0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 1.62\u003c/p\u003e\n \u003cp\u003ep: 0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e: 5.86\u003c/p\u003e\n \u003cp\u003ep: 0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eFamily Type\u003c/p\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003cp\u003eExtended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e179 (76.8)\u003c/p\u003e\n \u003cp\u003e54 (23.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e132.45(13.83)\u003c/p\u003e\n \u003cp\u003e126.70(12.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7.91 (3.86)\u003c/p\u003e\n \u003cp\u003e9.08 (4.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.64 (12.03)\u003c/p\u003e\n \u003cp\u003e76.01 (13.20)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003et: 2.74\u003c/p\u003e\n \u003cp\u003ep: 0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003et: -1.29\u003c/p\u003e\n \u003cp\u003ep: 0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003et: 2.94\u003c/p\u003e\n \u003cp\u003ep: 0.004\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eLiving Companions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003eSpouse and/or children\u003c/p\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e190 (81.5)\u003c/p\u003e\n \u003cp\u003e5 (2.1)\u003c/p\u003e\n \u003cp\u003e5 (2.1)\u003c/p\u003e\n \u003cp\u003e33 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e131.66(13.10)\u003c/p\u003e\n \u003cp\u003e114.20(27.86)\u003c/p\u003e\n \u003cp\u003e112.20(17.74)\u003c/p\u003e\n \u003cp\u003e133.48(10.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e8.24 (3.98)\u003c/p\u003e\n \u003cp\u003e6.00 (4.63)\u003c/p\u003e\n \u003cp\u003e9.20 (2.28)\u003c/p\u003e\n \u003cp\u003e7.39 (3.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e81.04 (12.03)\u003c/p\u003e\n \u003cp\u003e64.20 (17.62)\u003c/p\u003e\n \u003cp\u003e66.00 (13.96)\u003c/p\u003e\n \u003cp\u003e80.90 (11.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 109px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eKW:\u0026nbsp;8.84\u003c/p\u003e\n \u003cp\u003ep:0.03\u003c/p\u003e\n \u003cp\u003e1\u0026gt;2\u003c/p\u003e\n \u003cp\u003e1\u0026gt;3\u003c/p\u003e\n \u003cp\u003e4\u0026gt;2\u003c/p\u003e\n \u003cp\u003e4\u0026gt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eKW: 3.16\u003c/p\u003e\n \u003cp\u003ep: 0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003eKW:\u0026nbsp;10.35\u003c/p\u003e\n \u003cp\u003ep:0.01\u003c/p\u003e\n \u003cp\u003e1\u0026gt;2\u003c/p\u003e\n \u003cp\u003e1\u0026gt;3\u003c/p\u003e\n \u003cp\u003e4\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSD: Standard Deviation. t: Student t test. F: ANOVA. Z: Mann Whitney U Test. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Comparison of Patients\u0026apos; Physical Health Related Characteristics with Scale Scores\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"558\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSWBSS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDAS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eALSS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eYes\u0026sup1;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e110 (47.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e129,67 (14.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8,27 (3.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e79.86 (12.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eNo\u0026sup2;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e89 (38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e131.79 (12.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.40 (3.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e79.48 (13.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eQuit\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e34 (14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e134.05 (14.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.81 (3.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e84.11 (11.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF: 1.51\u003c/p\u003e\n \u003cp\u003ep: 0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF: 3.76\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep:0.02\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2\u0026gt;3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eF: 1.85\u003c/p\u003e\n \u003cp\u003ep: 0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e6 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e63.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e116.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e98.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e220 (94.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e119.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e116.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e116.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eQuit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e100.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e122.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e143.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eKW: 4.45\u003c/p\u003e\n \u003cp\u003ep: 0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eKW: 0.47\u003c/p\u003e\n \u003cp\u003ep: 0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eKW: 1.51\u003c/p\u003e\n \u003cp\u003ep: 0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e140 (60.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e132.67 (13.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.07 (3.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e80.52 (12.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e93 (39.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e128.79 (14.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.12 (4.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e80.06 (12.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: 2.13\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.03\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003et: -0.10\u003c/p\u003e\n \u003cp\u003ep: 0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003et: 0.27\u003c/p\u003e\n \u003cp\u003ep:0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived Health Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePoor\u0026sup1;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e22 (9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e124.27 (12.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.09 (4.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e69. 45 (11.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eModerate\u0026sup2;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e113 (48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e129.42 (13.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.50 (4.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e79.75 (11.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eGood\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e98 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e134.62 (13.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.39 (3.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e83.45 (12.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW: 21.28\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026gt;2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eKW: 5.32\u003c/p\u003e\n \u003cp\u003ep: 0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW: 23.24\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHopelessness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e102 (43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e127.30 (15.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.21 (4.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e76.18 (12.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e131 (56.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e134.09 (11.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.22 (3.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e83.57 (11.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: -3.75\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: 3.94\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: -4.66\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease-Related Concern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e114 (48.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e128.71 (14.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.85 (3.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e77.97 (12.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e119 (51.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e133.42 (12.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.36 (3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e82.06 (12.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: -2.65\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: 1.50\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: -2.86\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep:0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLength of Hospital Stay (days)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1.82 (1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003er: 0.22\u003c/p\u003e\n \u003cp\u003ep: 0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003er:-0.63\u003c/p\u003e\n \u003cp\u003ep: 0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003er: 0.05\u003c/p\u003e\n \u003cp\u003ep: 0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of CAD Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026lt; 6 months\u0026sup1;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e124 (53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e130.79 (14.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e7.67 (3.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e80.83 (12.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e6 months\u0026ndash;1 year\u0026sup2;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e21 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e128.52 (13.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e6.90 (4.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e81.04 (11.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1\u0026ndash;2 years\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e22 (9.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e128.13 (14.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e9.72 (4.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e75.36 (14.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026ge; 2 years⁴\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e66 (28.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e133.57 (13.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.71 (4.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e80.83 (12.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eKW: 4.91\u003c/p\u003e\n \u003cp\u003ep: 0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW: 8.07\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.04\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026gt;2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eKW: 4.32\u003c/p\u003e\n \u003cp\u003ep: 0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSS: Standard Deviation. t: Independent Groups t Test. F: ANOVA. KW: Kruskal Wallis Test. *Spearman Correlation test. p.0.01 level is significant. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale\u003c/em\u003e\u003c/p\u003e\n\u003cp id=\"_Toc199570554\"\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eComparison of primary caregivers\u0026apos; sociodemographic characteristics and scale scores\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSWBSS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDAS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eALSS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMean\u0026nbsp;(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e39.31 (13.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003er: 0.71\u003c/p\u003e\n \u003cp\u003ep: 0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003er: 0.06\u003c/p\u003e\n \u003cp\u003ep: 0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003er: -0.05\u003c/p\u003e\n \u003cp\u003ep: 0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e132 (56.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e127.82 (12.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e7.70 (4.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e77.96 (12.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e101 (43.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e130.60 (13.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.91 (3.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e80.07 (13.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: 1.66\u003c/p\u003e\n \u003cp\u003ep: 0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: -4.38\u003c/p\u003e\n \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: 1.21\u003c/p\u003e\n \u003cp\u003ep: 0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e176 (75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e129.46 (12.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.12 (3.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e79.29 (12.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eSingle/Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e57 (24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e127.70 (13.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e8.43 (4.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e77.64 (14.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: 0.87\u003c/p\u003e\n \u003cp\u003ep: 0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: 1.13\u003c/p\u003e\n \u003cp\u003ep: 0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003et: 0.82\u003c/p\u003e\n \u003cp\u003ep: 0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e26 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e131.07 (10.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e10.03 (4.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e74.76 (15.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eLiterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e44 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e123.20 815.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.56 (4.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e76.95 (11.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e29 (12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e133.62 (10.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.31 (4.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e81.67 (12.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eMiddle School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e30 (12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e131.80 (14.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e7.76 (4.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e79.93 (15.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e53 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e129.83 (12.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e8.90 (3.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e78.41 (12.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eUniversity and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e18 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e127.94 (12.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e8.43 (3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e81.00 (12.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 7.52\u003c/p\u003e\n \u003cp\u003ep: 0.18\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 7.44\u003c/p\u003e\n \u003cp\u003ep: 0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 13.18\u003c/p\u003e\n \u003cp\u003ep: 0.02\u003c/p\u003e\n \u003cp\u003e6\u0026gt;1\u003c/p\u003e\n \u003cp\u003e6\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of Residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eCity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e78 (33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e128.56 (12.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e8.58 (4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e78.81 (13.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eDistrict\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e108 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e129.12 (13.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.04 (4.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e79.97 (11.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eVillage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e47 (20.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e129.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9.36 (3.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e76.51 (15.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eF: 0.09\u003c/p\u003e\n \u003cp\u003ep: 0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eF: 0.60\u003c/p\u003e\n \u003cp\u003ep: 0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eF: 1.14\u003c/p\u003e\n \u003cp\u003ep: 0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eEmployment Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eEmployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e141 (60.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e116.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e102.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e120.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e84 (36.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e116.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e140.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e109.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e8 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e124.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e117.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e114.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 0.09\u003c/p\u003e\n \u003cp\u003ep: 0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 16.99\u003c/p\u003e\n \u003cp\u003ep\u0026lt;0.001\u003c/p\u003e\n \u003cp\u003e2\u0026gt;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 1.65\u003c/p\u003e\n \u003cp\u003ep: 0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eFamily Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eNuclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e175 (75.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e124.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e118.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e123.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eExtended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e56 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e93.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e111.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e98.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e2 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e117.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e120.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e46.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 8.67\u003c/p\u003e\n \u003cp\u003ep: 0.01\u003c/p\u003e\n \u003cp\u003e1\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 0.56\u003c/p\u003e\n \u003cp\u003ep: 0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 8.07\u003c/p\u003e\n \u003cp\u003ep: 0.01\u003c/p\u003e\n \u003cp\u003e1\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eLiving Companions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eMean Rank\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eSpouse and/or children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e155 (66.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e122.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e122.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e118.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e5 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e106.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e94.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e98.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e55 (23.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e103.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e111.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e117.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 161px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e18 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e110.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e97.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e98.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003eTest/p\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 3.61\u003c/p\u003e\n \u003cp\u003ep: 0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 3.73\u003c/p\u003e\n \u003cp\u003ep: 0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003eKW: 1.89\u003c/p\u003e\n \u003cp\u003ep: 0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSD: Standard Deviation. r: Pearson Correlation. t: Independent Groups t Test.. F: ANOVA. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS Adult Life Satisfaction Scale\u003c/em\u003e\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc199570555\"\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eComparison of Physical Health Related-Characteristics of Primary Caregivers with Scale Scores\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSWBS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDAS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eALSS\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eYes\u0026sup1;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e96 (41.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e109.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e105.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e109.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eNo\u0026sup2;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e126 (54.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e120.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e124.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e122.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eQuit\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e11 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e145.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e131.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e106.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eKW: 3.50\u003c/p\u003e\n \u003cp\u003ep: 0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eKW: 5.22\u003c/p\u003e\n \u003cp\u003ep: 0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eKW: 2.54\u003c/p\u003e\n \u003cp\u003ep: 0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Rank\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e10 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e47.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e108.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e62.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e219 (94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e119.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e117.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e118.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eQuit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e4 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e137.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e94.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e117.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW: 11.47\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep:0.003\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003eKW: 0.62\u003c/p\u003e\n \u003cp\u003ep: 0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKW: 6.66\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.03\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2\u0026gt;1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e53 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e129.20 (12.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e9.81 (3.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e76.54 (12.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e180 (77.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e128.97 (13.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e8.70 (3.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e79.58 (13.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest/p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003et: 0.11\u003c/p\u003e\n \u003cp\u003ep: 0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003et: 1.79\u003c/p\u003e\n \u003cp\u003ep: 0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003et: -1.48\u003c/p\u003e\n \u003cp\u003ep: 0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSS: Standard Deviation. t: Independent Groups t Test. KW: Kruskal Wallis Test. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale\u003c/em\u003e\u003c/p\u003e\n\u003cp id=\"_Toc199570556\"\u003e\u003cstrong\u003eTable 5.\u0026nbsp;\u003c/strong\u003eMean Scale Scores of Patients and Primary Caregivers and the Relationship Between Them\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScales\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSWBS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDAS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eALSS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScale Scores of Patients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Scale Scores of Patients (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e131.12 (13.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8.09 (3.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e80.33 (12.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eSWBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.16**\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: 0.53*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eDAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.16**\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.25*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eALSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: 0.53*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.25*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScale Scores of Primary Caregivers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean Scale Scores of Primary Caregivers (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e129.03 (13.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9.95 (3.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e78.88 (13.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eSWBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.11**\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: 0.53*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eDAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.11**\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: 0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.23*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003eALSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: 0.53*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er: -0.23*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ep: \u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDifference between Patient and Primary Caregiver\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eTest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003et: 1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et: -2.35\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003et: 1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp id=\"_Toc199570557\"\u003e\u003cem\u003e*Correlation is significant at p:0.01 level. **Correlation is significant at p:0.05 level. SWBS: Spiritual Well-Being Scale. DAS: Death Anxiety Scale. ALSS: Adult Life Satisfaction Scale. t: Independent Groups t Test\u003c/em\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6.\u0026nbsp;\u003c/strong\u003eThe Effect of Being a Patient and Primary Caregiver and Scale Scores on the ALSS\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"542\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDependent Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndependent Variables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026szlig;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eALSS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003eFixed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e21.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e3.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003eDAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e-0.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e-0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e-4.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003eSWBS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e13.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eModel (p)\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e: 0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Coronary Artery Disease, Death Anxiety, Spiritual Well-Being, Life Satisfaction","lastPublishedDoi":"10.21203/rs.3.rs-8126639/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8126639/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAim:\u003c/strong\u003e This study aims to compare the relationship between spiritual well-being, death anxiety, and life satisfaction among patients diagnosed with coronary artery disease and their primary caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eThis cross-sectional, correlational study was conducted with 233 patients diagnosed with Coronary Artery Disease (CAD) and 233 primary caregivers at the Cardiology Clinic of Mardin Training and Research Hospital between November 9, 2024, and January 15, 2025. Data were collected using the Spiritual Well-Being Scale (SWBS), the Death Anxiety Scale (DAS), and the Adult Life Satisfaction Scale (ALSS). Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to analyze the data. The normal distribution of scale scores and numerical variables was assessed using kurtosis and skewness values. Relationships between scale score means were evaluated using Pearson or Spearman correlation tests. Scale scores according to sociodemographic variables were analyzed using Student’s t-test, ANOVA, and Tukey’s post hoc test. In cases where normal distribution was not achieved, the Kruskal-Wallis test was applied. To determine the effect of DAS and SWBS total scores, as well as being a patient or a primary caregiver, on ALSS scores, multiple linear regression analysis was performed using the Enter method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe mean age of the patients was 56.77 (SD = 11.47), while that of the primary caregivers was 39.31 (SD = 13.68). A weak but statistically significant negative correlation was found between the total scores of the Death Anxiety Scale (DAS) and the Adult Life Satisfaction Scale (ALSS) in both patients (r = -0.25, p \u0026lt; 0.001) and primary caregivers (r = -0.23, p \u0026lt;0.001). Primary caregivers had significantly higher DAS scores compared to patients. Rather than the role of being a patient or a primary caregiver, the total scores of the Spiritual Well-Being Scale (SWBS) and the Death Anxiety Scale (DAS) were found to be statistically significant predictors of life satisfaction, accounting for 31% of the variance (R² = 0.31).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe findings of this study revealed that both patients diagnosed with Coronary Artery Disease (CAD) and their primary caregivers exhibited high levels of spiritual well-being and experienced death anxiety, with primary caregivers reporting significantly higher levels of death anxiety compared to patients. Considering the statistical significance of the total scores of the Spiritual Well-Being Scale (SWBS) and the Death Anxiety Scale (DAS) as predictors of life satisfaction (ALSS), it is recommended that the death anxiety and spiritual well-being of both patients and primary caregivers be assessed, and that appropriate interventions be planned and implemented accordingly.\u003c/p\u003e","manuscriptTitle":"Relationship between Spiritual Well-Being, Death Anxiety and Life Satisfaction in Coronary Artery Patients and Their Primary Caregivers: A Comparative Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-04 00:15:41","doi":"10.21203/rs.3.rs-8126639/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-30T06:21:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-27T07:02:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"231651177379720366897927529077249886654","date":"2026-03-26T06:34:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"207288665298064956018309306135924148426","date":"2026-03-26T05:51:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"157031581416190709160064538352646024061","date":"2026-03-24T22:47:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-17T15:10:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"328511005867986438388431197166411878800","date":"2025-12-02T08:28:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"80039179859708590059317372342262583657","date":"2025-12-02T07:41:48+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-02T06:40:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-02T06:31:21+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-02T06:23:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-01T13:13:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-12-01T11:46:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ad9877c2-e4fe-4696-8898-39dc4a4f4f5e","owner":[],"postedDate":"December 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-19T15:38:28+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-04 00:15:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8126639","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8126639","identity":"rs-8126639","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}