Background/Aims <p>Research shows that low self-care ability and hopelessness are common in schizophrenia patients. Spirituality can be a key coping resource in managing mental illnesses. However, the mediating effect of spirituality on the relationship between self-care ability and hope in schizophrenia patients is unknown. This study aims to explore the mediating role of spiritual well-being in the relationship between self-care agency and hope in schizophrenia.</p> Method <p>This study is cross-sectional and correlational study with a descriptive design. The study was conducted with 116 schizophrenia patients who presented to the psychiatry outpatient clinic of a university hospital in eastern Turkey between 10.02. 2023 and 10.01. 2024. Descriptive Information Form, Self-Care Agency Scale, Herth Hope Index and Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale were used to collect the data. Structural equation modelling and bootstrapping method were used to analyse the data.</p> Results <p>In this study, the effect of self-care agency on hope (β = 0.12) was positive but not significant. However, self-care agency positively influenced spiritual well-being (β = 0.47), and spiritual well-being had a significant positive effect on hope (β = 0.83). Spiritual well-being fully mediated the relationship between self-care agency and hope, with the total mediated effect on hope being significant (β = 0.52). The model explained 23% of the variance in spiritual well-being and 80% of the variance in hope.</p> Conclusion <p>It was determined that self-care agency affected spiritual well-being positively and spiritual well-being affected hope positively in schizophrenia patients. It was also found that spiritual well-being mediated the relationship between self-care agency and hope. It is expected that this research model will be useful in formulating strategies to improve hope and self-care in schizophrenia patients.</p>