Integrating Spirituality and Self-Transcendence in Chronic Kidney Disease Management: A Structural Equation Modeling Approach.
Journal of holistic nursing : official journal of the American Holistic Nurses' Association April 8, 2026 Siti Nurkholifah, Yurika Fauzia Wardhani, Minarti Minarti et al.
Among 140 adults with chronic kidney disease in Indonesia, a model called Spirituality-Based Self-Transcendence (STS) was tested and validated. Behavioral and external factors strongly predicted spiritual self-transcendence, which in turn strongly predicted psychological well-being. Spiritual self-transcendence also mediated the relationship between those factors and well-being. The model explained 68.6% of the variance in well-being and showed good overall fit. The findings extend Reed's Self-Transcendence Theory by confirming spirituality as a central pathway to psychological well-being in chronic kidney disease, offering a culturally grounded framework for designing spirituality-integrated nursing interventions.