Iran Journal of Nursing

Introduction
Due to the increasing number of older women with anxiety sensitivity, it is necessary to pay attention to their conditions. Spiritual wellbeing promotes the mental health of the elderly, especially older women. On the other hand, since mental health plays an important role in ensuring the dynamic efficiency of any society, promoting the mental health of the elderly, especially older women, has been raised as a priority; however, it has been neglected in some countries, including Iran. The conducted studies on spiritual wellbeing have reported different levels in different countries. This study aims to investigate the relationship between spiritual wellbeing and anxiety sensitivity in older women in Ashtian, Iran. The results can be a basis for further interventions in this field. 
Materials and Methods
This is a descriptive-correlational study. The study population includes all older women referred to urban and rural health centers in Ashtian, Iran in 2019. Of these,160 eligible samples were selected by a continuous sampling method. Inclusion criteria were no use of anti-anxiety drugs according to the individual’s report, age ≥65 years, no visual or hearing impairments, and being literate. A demographic form, the Spiritual Wellbeing Scale and the Anxiety Sensitivity Index-Revised were used to collect information. The collected data were analyzed using descriptive and inferential statistics in SPSS v. 16 software. 
Results
The mean±sd total score of spiritual wellbeing was 96.1±19.86. The religious wellbeing of older women with a mean score of 48.22±10.52 was higher than their existential wellbeing with a mean score of 47.86 ±10.52. The mean total score of anxiety sensitivity was 48.25 ± 31.93. Dimension of “cardiovascular fears” had the highest score (1.47±1) while the fear of “fear of cognitive dyscontrol” had the lowest score (1.11±1.1). The results of Pearson correlation test showed negative and significant relationship between spiritual wellbeing and anxiety sensitivity (r= -0.734, P<0.001).Spiritual wellbeing and anxiety sensitivity had a significant relationship with age, marital status, educational level, employment status, number of family members, and age. In addition, among the demographic factors, marital status in older women (P<0.05).
Discussion
There is a negative and significant relationship between spiritual wellbeing and anxiety sensitivity in older women in Iran, such that their anxiety sensitivity decreases with the increase of their spiritual wellbeing. The results indicate the necessity to pay attention to the spiritual wellbeing of older women in Iran to reduce their anxiety sensitivity. It is recommended to include educational materials about spiritual wellbeing and anxiety sensitivity in the elderly care programs to create a positive attitude. It seems that Iranian older women with higher spiritual wellbeing can give meaning to the problems and losses that arise in their lives and reduce the psychological pressure caused by them. It is recommended to develop interventions based on spirituality to reduce the anxiety sensitivity and thus improve the mental health of older women in Iran. These interventions can be implemented in the form of education program for this vulnerable group.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.199). All ethical principles were considered in this article. The participants were informed about the study objectives and methods. They were also assured of the confidentiality of their information and were free to leave the study at any time. If desired, the research results would be available to them.

Funding
This study was extracted from the master thesis of the first author approved by Iran University of Medical Sciences, Tehran, Iran.

Authors' contributions
Conceptualization and Project administration: Fahime Mojiri, Marjan Mardani-Hamooleh; Investigation: Marjan Mardani-Hamooleh, Marhamat Farahani Nia; Data analysis: Shima Haghani; Editing and reviw: Marjan Mardani-Hamooleh.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all participants.

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