Psychological well-being among institutionalized older adults: The roles of mattering, alexithymia, and spirituality

Abstract

BACKGROUND: Institutionalized older adults often face emotional challenges, including a diminished sense of mattering and difficulties in identifying or expressing emotions (alexithymia), both of which can negatively affect their psychological well-being. OBJECTIVES: The study aimed to investigate the relationships among loss of mattering, alexithymia, spirituality, and psychological well-being among institutionalized older adults and to examine the mediating role of spirituality in these relationships. METHODS: A quantitative, cross-sectional, correlational study design was utilized. The study was conducted among a convenience sample of institutionalized older adults in Damietta Governorate. Four instruments were used for data collection: Ryff's Psychological Well-Being Scale, the Spiritual Perspective Scale, the Toronto Alexithymia Scale, and the Anti-Mattering Scale (AMS). RESULTS: The study revealed that loss of mattering and alexithymia were negatively associated with psychological well-being among institutionalized older adults, while spirituality showed a positive association. Spirituality also served as a mediator, reducing the negative effects of loss of mattering and alexithymia. These findings highlight the importance of fostering spirituality to promote psychological well-being among older adults. IMPLICATIONS: In clinical settings, the main implication of the study is the importance of implementing holistic, person-centered care approaches that integrate psychosocial and spiritual support to enhance the psychological well-being of institutionalized older adults. This involves designing structured programs that foster spiritual engagement, promote emotional expression, and reinforce a sense of mattering, while encouraging interdisciplinary collaboration among healthcare professionals. Educating caregivers to recognize psychological vulnerabilities, such as alexithymia and feelings of insignificance, can further improve care outcomes. Despite limitations in generalizability and cultural scope, these findings underscore the value of addressing both emotional and spiritual dimensions in long-term care environments. CONTROL TRAIL: Not applicable.

The authors' abstract, as published at the source. Geriatric Nursing, 2026 · DOI ↗