Document Type : Original Article


1 Master of Psychology, Department of clinical of Psychology, Faculty of Psychology and Educational Sciences, shahid Beheshti University, Tehran, Iran

2 Ph.D. in Psychology, Associate Professor, Department of clinical of Psychology, Faculty of Psychology and Educational Sciences, shahid Beheshti University, Tehran, Iran



Introduction: Diabetes, as the most common chronic metabolic disease, decreases the quality of life in patients. This disease causes a crisis in the physical, psychological, and spiritual aspects, which increases the use of the spiritual resource as a coping mechanism. Resilience is one of the variables that enhance the quality of life by coordinating different aspects of human life. it is considered necessary to adapt to the disease. This study aimed to investigate the effect of spiritual needs and resilience on quality of life in diabetics.
Methods: The study is a descriptive-correlational one. The participants were 165 patients with cancer diseases (female 105, male 60) from Sari city selected through convenience sampling. The data were collected using the quality-of-life scale (WHO), spiritual needs scale (Büssing), and resilience scale (Connor & Davidson). For data analysis, Stepwise regression analysis was carried out by means of SPSS 19.
Results: The data were analyzed using stepwise regression analysis. According to the results, there was a significant and positive correlation between scores on the components of Spiritual Needs and spiritual well- being. Moreover, subscales of the Spiritual Needs such as "Religious needs" (p < 0.001), "Existentialistic needs" (p < 0.001) "need for Inner peace" (p < 0.001) and "Actively Giving needs" (p < 0.001) had a positive correlation with the quality of life. And among all components of Spiritual Needs, Religious needs, Existentialistic needs, and Inner Peace needs had more predictive power in quality of life. And also there was a significant correlation between scores of resiliency and quality of life while the component of resiliency (p < 0.001) had more predictive power in quality of life.
Conclusion: It is concluded that components of Spiritual needs and resiliency, as two psychological constructs, can play a significant role in quality of life. Therefore, developing plans and approaches to address the patients' spiritual needs and resiliency can be beneficial since it promotes quality of life in diabetics.


  1. Sadri Damirchi E, Samadifard H. Predicting of Life Expectancy in Diabetic Patients Based on Self-efficacy, Self-esteem and Perceived Social Support. The Horizon of Medical Sciences. 2019: 25 (2): 85-92.
  2. Connell J, Carlton J, Grundy A, Buck ET, Keetharuth AD, Ricketts T, et al. The importance of content and face validity in instrument development: lessons learnt from service users when developing the Recovering Quality of Life measure (ReQoL). Quality of Life Research.2018: 27(7): 1893-902.
  3. Marzban A.  Relationship between Spiritual Health and Quality of Life in Type II Diabetic Patients: A cross-sectional study in Yazd. Journal of Diabetes Nursing. 2018: 6 (4):641-652.
  4. Badr H, Shen MJ. Pain intensity and dyadic adjustment influence patient and partner depression in metastatic breast cancer. The clinical journal of pain. 2010: 30(11):923-33.
  5. AlBuhairan F, Nasim M, Al Otaibi A, Shaheen NA, Al Jaser S, & Al Alwan I. Health related quality of life and family impact of type 1 diabetes among adolescents in Saudi Arabia. Diabetes research and clinical practice. 2016:114: 173-179.
  6. Costa WA, Giraldo PC, Gonçalves AK. Quality of life in breast cancer survivors.Revista da Associacao Medica Brasileira. 2017: 63(7): 583-89.
  7. Busch EL, Martin CH, DeWalt D, Sandler R. Functional health literacy, chemotherapy decisions and outcomes among a colorectal cancer cohort. Cancer Control. 2015:22: 95-101.
  8. Mousavi SH, Bagherian-Sararoudi R, Meschi F, Khalatbari J, Tajeri B.The Role of Mediating Resilience in the Relationship Between Health Literacy and Specific Quality of Life in Breast Cancer Patients. Quarterly Journal of Health Psychology. 2020:9(1):79-94.
  9. Khodavirdi T, Eskandari H, Borjali A, Farrokhi N. Explaining the spiritual needs of breast cancer patients: A qualitative study. mejds. 2019: 9:125-125.
  10. Ahangarkani M, Rahimian Boogar I, Makvand Hosseini Sh. The Relationship between Contextual Factors and Spiritual Needs with Spiritual Well-being in Patients with CancerDiseases. Sadra Medical Sciences Journal. 2019: 7(4): 335-356.
  11. Rohani C, Moosavi S, Borhani F, Akbari M. Consequences of Spiritual Care for Cancer Patients and Oncology Nurses: a Qualitative Study. Asia-Pacific Journal of Oncology Nursing. 2019:6(2):137. [Persian].
  12. Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, et al. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-Oncology. 2010:19(1):21–8.
  13. Büssing A, Balzat HJ, Heusser P. Spiritual needs of patients with chronic pain diseases and cancer Validation of the spiritual needs questionnaire. European Journal of Medicine Research 2010: 15:266–73.
  14. Seddigh R, Keshavarz-Akhlaghi A.A, Azarnik S. Questionnaires Measuring Patients’ Spiritual Needs: A Narrative Literature Review. Iran Journal of Psychiatry Behavioral Science 2016: 10(1): 232-244.
  15. Bussing A, Janko A, BaumannK, Christian N, Kopf A. Spiritual Needs among Patients with Chronic Pain Diseases and Cancer Living in a Secular Society .Pain Medicine 2013: 14: 1362–1373.
  16. Kiani J, Jahanpour F, Abbasi F, Darvishi SH, Gholizadeh B. Evaluation of effectiveness of spiritual therapy in mental health of cancer patients. Nursing Journal of the Vulnerable. 2016: 2 (5):40-51.
  17. Winkelman WD, Lauderdale K, Balboni MJ, Phelps AC, Peteet JR, Block SD, et al. The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: PreliminaryFindings. Journal of Palliative Medicine. 2011:14(9):1022–8.
  18. Chaar EA, Hallit S, Hajj A, Aaraj R, Kattan J, Jabbour H, Khabbaz LR. Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Supportive Care in Cancer. 2018:26(8):2581-2590.
  19. Flannelly KJ, Galek K, Bucchino J, Vane A. The Relative Prevalence of Various Spiritual Needs. Health and Social Care Chaplaincy. 2013:9 (2):25–30.
  20. Hodge DR, Bonifas RP, Chou RJA. Spirituality and older adults: Ethical guidelines to enhance service provision. Advances in Social Work 2010: 11(1): 1-16.
  21. Bussing A, Pilchowska I, Surzykiewicz J. Spiritual needs of polish patients with chronic diseases. Journal of Religion and Health.2015: 54:1524-42.
  22. Ahangarkani M, Rahimian Boogar I, Makvand Hosseini S. Prediction of Spiritual Wellbeing based on Contextual Factors and Spiritual Needs in Patients with Cardiovascular Diseases. Ilam University of medical sciences. 2019:27 (5):73-84.
  23. Abdi F, Banijamli S, Ahadi H, Koushki S. Psychometric properties of Resilience scale (CD-RISC) among women’s with breast cancer. Journal of Research in Psychological Health. 2019: 13 (2):81-99
  24. Markovitz SE, Schrooten W, Arntz A, Peters ML. Resilience as a predictor for emotional response to the diagnosis and surgery in breast cancer patients. Psycho-oncology. 2015: 24 (12):1639-1645.
  25. Dooley LN, Slavich GM, Moreno PI, Bower JE. Strength through adversity: Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress Health. 2017: 33(5): 549-557.
  26. Seiler A, Jenewein J. Resilience in Cancer Patients. Front. Psychiatry.2019:10(208): 1-35.
  27. Cole NN, Nonterah CW, Utsey SO, Hook JN, Hubbard RR, Opare- Henaku A, Fischer NL. Predictor and moderator effects of ego resilience and mindfulness on the relationship between academic stress and psychological well-being in a sample of Ghanaian College Students. Journal of Black Psychology. 2015: 41(4): 340-357.
  28. Habibi M, Salmani K, Amani O, Rafezi Z, Nematalahzadeh Mahani SS. The Comparison of Spiritual Experience and Resilience between Women with Breast Cancer and Healthy Women. Journal of research in behavioural scienes. 2016: 14(1): 50-5.
  29. Allen RC, & Palk G. Development of recommendations and guidelines for strengthening resilience in emergency department nurses. Traumatology. Advance online publication.2018.
  30. Axelsson U, Rydén L, Johnsson P, Edén P, Mهnsson J, Hallberg IR, Borrebaeck CAK. A multicenter study investigating the molecular fingerprint of psychological resilience in breast cancer patients: study protocol of the SCAN-B resilience study.BMC cancer. 2018: 18: 789.
  31. Ahangarkani  M ,  Rahimian Boogar  I,  Maboudi  M ,  FardAfshari  S,  Ismail Dukht R. The Relationship between Contextual Factors and Spiritual Needs with Spiritual Well - Being in Patients with Diabetic Diseases. Journal of Medical Ethics.2019:13(44): 22-33.
  32. Connor KM, Davidson J RT. Development of a new resilience scale: The connor- Davidson Resilience Scale (CD-RISC). Journal of Depression and Anxiety. 2003: 18: 76- 82.
  33. Jokar B, Shmani S, Sarahgard N. Resilience, mental Health, Satisfaction of Life٫٫ Journal of Psychiatry Clinical. 2008:13:290-295.
  34. Nejat S, Montazeri A, Holakouie Naieni K, Mohammad K, Majdzadeh S. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. School of public health and institute of public health research. 2006: 4 (4):1-12.
  35. Koenig H. Spirituality, wellness, and quality of life. Sexuality, Reproduction and Menopause. 2004:2(2):76–82.
  36. Wu LF, Koo M, Chenliao YCH, Chen YM, Yeh DCH. Development and validation of the spiritual care needs inventory for acute care hospital patients in Taiwan. Clinical Nursing Research.2016: 25: 590-606.
  37. Hekmatipour N, Hojjati H. The relationship between praying and life expectancy in cancerous patients. Journal of Medicine and Life. 2015: 8: 60 -64.
  38. Hassan J, Sheikhan R, Mahmoudzadeh A, Nikro M. The role of spiritual well-being and coping strategies in teenage High-risk behaviors. Thought and Behavior. 2014: 9 (33): 17-27
  39. Dale SK, Cohen MH, Kelso GA,
    Cruise RC, Weber KM, Watson C, et al. Resilience among women with HIV: Impact of silencing the self and socioeconomic factors. Sex Roles. 2014:70(5-6):221-31.
  40. 27.  Doustdar Tousi S A, Dabbaghi P. Evaluating Relation the Resiliency and Memory in Patients with Cardiovascular Diseases. Middle Eastern Journal of Disability Studies. 2016: 6:8-14
  41.  Hojjati H, ghsaran H. Relationship Between Resilience and Quality of Life in Parents with Thalassemia Major Children in Zahedan City. Iranian Journal of Rehabilitation Research in Nursing. 2018: 5 (1):36-43.