High Spiritual Needs and Associated Factors Among Older Adults in a Nigerian Primary Care: Relevance for Holistic Geriatric Practice

Background : Older adults often experience complex health challenges that heighten their spiritual needs, which are essential to holistic care yet, largely unaddressed in primary care. Method: This mixed-method convergent parallel study assessed spiritual needs and associated factors like depression, anxiety, chronic medical conditions, quality of life (QoL), and satisfaction with care among consenting adults aged 60 years and above attending the primary care clinics of the University of Ilorin Teaching Hospital,Nigeria. The quantitative component involved 280 participants selected through systematic random sampling, while 20 purposively selected participants took part in in-depth interviews. Data were collected using interviewer-administered semi-structured questionnaires: the Spiritual Needs Questionnaire, Hospital Anxiety and Depression Scale, Service Quality tool, and WHOQOL-BREF. Quantitative data were analysed using SPSS version 27, with chi-square tests and multivariate logistic regression at a significance level of p<0.05. Qualitative data were analysed thematically using Atlas.ti. Results: Prevalence of spiritual needs was 75.0%, especially in the religious domain. Statistically significant associations were found between spiritual needs and anxiety (p=0.045), health satisfaction (p=0.023), overall QoL (p<0.001), and geriatric syndromes (p=0.037). The predictors were age (OR=7.198), overall QoL (OR=1.835), presence of geriatric syndromes (OR=1.858), and satisfaction with usual care (OR=0.266). Qualitative findings revealed spirituality as a central coping resource linked to healing and resilience, yet unaddressed in clinical practice. Participants recommended integrating spiritual care into geriatric services. Conclusion: Primary care older adults have high prevalence of unmet spiritual needs and incorporating spiritual care into primary care practice may improve holistic outcomes and patient satisfaction.