{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:32Z","timestamp":1790060492050,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients hospitalised in coronary intensive care units often experience heightened existential distress, including increased spiritual care needs and death anxiety. Spiritual well\u2010being has been suggested as a key protective factor that may alleviate death\u2010related anxiety in critically ill populations; however, the mechanisms underlying these relationships remain insufficiently explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study examined the relationships among spiritual care needs, spiritual well\u2010being and death anxiety in patients hospitalised in a coronary intensive care unit and tested whether spiritual well\u2010being mediates the relationship between spiritual care needs and death anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional design was employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included a convenience sample of patients hospitalised in a coronary intensive care unit in Eastern Turkey, between September and December 2024. Data were collected using a Sociodemographic and Clinical Variables Form, the Patients' Spiritual Needs Assessment Scale, the Functional Assessment of Chronic Illness Therapy\u2013Spiritual Well\u2010Being Scale and the Templer Death Anxiety Scale. Data analysis involved descriptive statistics, Pearson correlation analysis and mediation analysis using Hayes's PROCESS macro (Model 4), with age and gender included as control variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients reported moderate levels of spiritual care needs (3.04\u2009\u00b1\u20090.47), spiritual well\u2010being (30.53\u2009\u00b1\u20096.87) and death anxiety (8.04\u2009\u00b1\u20093.00). Spiritual care needs were positively associated with spiritual well\u2010being (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and its subdimensions (meaning, peace and faith). Death anxiety was negatively correlated with spiritual well\u2010being (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with the strongest association observed for the peace subdimension (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.39,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mediation analysis demonstrated a significant indirect effect of spiritual care needs on death anxiety through spiritual well\u2010being (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u2009\u22121.46, 95% CI [\u22122.28, \u22120.67]). Although higher spiritual care needs were directly associated with greater death anxiety, they were also associated with higher spiritual well\u2010being, which in turn was related to lower death anxiety, suggesting that spiritual well\u2010being may buffer the association between spiritual care needs and death anxiety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher spiritual care needs among coronary intensive care patients are associated with greater spiritual well\u2010being, which in turn relates to lower levels of death anxiety. The significant indirect effect suggests that spiritual well\u2010being plays a buffering role in the relationship between spiritual care needs and death anxiety. Given the cross\u2010sectional design, these findings should be interpreted as associative rather than causal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Assessing spiritual care needs and supporting spiritual well\u2010being in coronary intensive care settings may be critical for reducing death\u2010related anxiety. Integrating spiritual care interventions\u2014particularly those fostering inner peace and meaning\u2014into routine nursing care may enhance holistic patient support and psychological resilience in critically ill patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70659","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:30:12Z","timestamp":1788420612000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Mediating Role of Spiritual Well\u2010Being in the Relationship Between Spiritual Care Needs and Death Anxiety Among Coronary Intensive Care Patients"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-6094","authenticated-orcid":false,"given":"Ebubekir","family":"Kaplan","sequence":"first","affiliation":[{"name":"Department of Fundamentals of Nursing, Faculty of Health Science Van Yuzuncu Yil University  Van Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-2177","authenticated-orcid":false,"given":"Cemile H\u00fcrrem","family":"Ayhan","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Nursing, Faculty of Health Science Van Yuzuncu Yil University  Van Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-7486","authenticated-orcid":false,"given":"\u00c7a\u011flar","family":"\u015eim\u015fek","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Nursing, Faculty of Health Science Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6529-9766","authenticated-orcid":false,"given":"Mehmet Cihad","family":"Akta\u015f","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Nursing, Faculty of Health Science Van Yuzuncu Yil University  Van Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00fcrkan","family":"\u0130stek","sequence":"additional","affiliation":[{"name":"Department of Psychiatric and Mental Health Nursing, Institute of Health Science Van Yuzuncu Yil University  Van Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"WHO W \u201cThe Top 10 Causes of Death \u201d24 Maggio 2020."},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228231195103"},{"key":"e_1_2_14_4_1","first-page":"49","volume-title":"Dying: Facing the Facts","author":"Neimeyer R. A.","year":"1995"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.13007"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0191-8869(03)00045-X"},{"key":"e_1_2_14_7_1","first-page":"57","article-title":"Kardiyoloji Yo\u011fun Bak\u0131m \u00dcnitesindeki Hastalar\u0131n Maneviyat ve Anksiyete D\u00fczeyleri: Ne Kadar \u00d6nemli?","volume":"16","author":"Soylu A.","year":"2025","journal-title":"Kardiyovask\u00fcler Hem\u015firelik Dergisi"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57101066"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16067"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1334920"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-024-04076-7"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.30699\/ajnmc.27.1.1"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.12681\/healthresj.28190"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481180210146"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228231214128"},{"issue":"9596","key":"e_1_2_14_16_1","first-page":"1453","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"370","author":"Von Elm E.","year":"2007","journal-title":"Revista Espa\u00f1ola de Salud P\u00fablica"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004650-200503000-00006"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/HNP.0000000000000070"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.5455\/apd.5670"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/00221309.1970.9920634"},{"key":"e_1_2_14_21_1","first-page":"7","article-title":"Adaptation of Death Anxiety Scale (DAS): Validity and Reliability Studies","volume":"11","author":"Ak\u00e7a F.","year":"2008","journal-title":"Turkish Journal of Clinical Psychiatry"},{"key":"e_1_2_14_22_1","volume-title":"WMA Declaration of Helsinki: ethical principles for medical research involving human participants [Internet]","author":"World Medical Association","year":"2024"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/00846724241295779"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1116263"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.17079\/JKGN.2021.23.3.226"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-017-0554-2"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-025-02284-9"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2018.04.003"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0714980816000143"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010025\u201001726\u20101"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010022\u201006795\u2010z"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066617712677"},{"key":"e_1_2_14_33_1","first-page":"964","article-title":"The Effectiveness of Holistic Nursing Care in Enhancing Psychosocial Well\u2010Being and Quality of Life in Cardiovascular Patients","volume":"1","author":"Chintya Y.","year":"2024","journal-title":"Journal of Academic Science"},{"key":"e_1_2_14_34_1","first-page":"1","article-title":"Development of a Holistic Nursing Care Model to Improve the Psychological Well\u2010Being of Chronic Illness Patients","volume":"1","author":"Saputra R.","year":"2025","journal-title":"Journal of Sanitas et Salutem"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01258-6"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.70659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:03:52Z","timestamp":1790057032000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.70659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/nicc.70659"],"URL":"https:\/\/doi.org\/10.1111\/nicc.70659","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70659"}}