{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:46:45Z","timestamp":1782276405011,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005716","name":"Babol University of Medical Sciences","doi-asserted-by":"publisher","award":["724134907"],"award-info":[{"award-number":["724134907"]}],"id":[{"id":"10.13039\/501100005716","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Among the key protective factors identified in reducing such psychological complications are health literacy and spiritual well\u2010being. This study aimed to examine the relationship between health literacy and spiritual well\u2010being with symptoms of depression and anxiety in pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive\u2010analytical study was planned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted on a convenience sample of 200 third\u2010trimester pregnant women attending prenatal clinics at teaching hospitals affiliated with Babol University of Medical Sciences, Iran, between January 2024 and July 2024. Data collection tools included validated questionnaires on health literacy, spiritual well\u2010being and the Brief Symptom Inventory\u201018 (BSI\u201018) to assess symptoms of depression and anxiety during the third trimester. Multivariate logistic regression was used to analyze the associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Logistic regression analysis indicated that an \u2018excellent\u2019 level of health literacy was significantly associated with reduced odds of anxiety (OR\u2009=\u20090.209,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and depression (OR\u2009=\u20090.307,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Similarly, high spiritual well\u2010being showed a protective effect against both anxiety (OR\u2009=\u20090.296,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and depression (OR\u2009=\u20090.329,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Conversely, having a university\u2010level education was associated with increased likelihood of anxiety (OR\u2009=\u20094.512,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Based on the findings, it is recommended that nurses and health care providers implement educational programs to promote health literacy and strengthen spiritual health in prenatal care for women.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70625","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:50:44Z","timestamp":1780501844000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Health Literacy and Spiritual Well\u2010Being With Symptoms of Depression and Anxiety in Pregnant Women: A Descriptive\u2010Analytical Research"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-7267","authenticated-orcid":false,"given":"Shahnaz","family":"Barat","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazanin","family":"Teymourirad","sequence":"additional","affiliation":[{"name":"Student Research Committee, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4337-2096","authenticated-orcid":false,"given":"Mohammad Hadi","family":"Yadollahpour","sequence":"additional","affiliation":[{"name":"Islamic Education, Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2398-7560","authenticated-orcid":false,"given":"Soraya","family":"Khafri","sequence":"additional","affiliation":[{"name":"Biostatistics, Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4227-2998","authenticated-orcid":false,"given":"Shirin","family":"Shahrokhi","sequence":"additional","affiliation":[{"name":"Clinical Psychology, Clinical Research Development Unit of Rohani Hospital, Health Research, Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3568-7039","authenticated-orcid":false,"given":"Mahbobeh","family":"Faramarzi","sequence":"additional","affiliation":[{"name":"Psychology, Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","first-page":"242","article-title":"Nursing Students' 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