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Objective <p>Spiritual well-being (SWB) is a key health dimension crucial for quality of life. For university students facing significant academic pressures, SWB may be a vital resource associated with lower depression, healthier behaviors, and higher academic achievement. This study aimed to investigate the complex interrelationships among these variables in medical students.</p> Methods <p>This cross-sectional study enrolled 362 students from Khoy University of Medical Sciences via census sampling. The participants had a mean age of 21.67 ± 2.98 years. The majority of participants were female (55.5%) and single (88.7%). Validated self-report questionnaires were used to measure spiritual well-being (Paloutzian SWB scale), health behaviors (Ahmadi Questionnaire), depression (PHQ-9), and academic performance (GPA). Data were analyzed using Structural Equation Modeling (SEM) to test the direct and indirect pathways within the conceptual model.</p> Results <p>The final structural model demonstrated good fit (χ²/df = 2.34, RMSEA = 0.060, CFI = 0.91). Spiritual well-being had significant direct positive association with all health behaviors: physical activity (β = 0.35, <i>p</i> &lt; 0.001), healthy diet (β = 0.48, <i>p</i> &lt; 0.001), and no smoking (β = 0.58, <i>p</i> &lt; 0.001). SWB also had a significant direct negative association with depression (β=-0.50, <i>p</i> &lt; 0.001). Among health behaviors, only no smoking showed a significant direct association with lower depression (β=-0.18, <i>p</i> = 0.04). Depression showed a significant negative direct association with academic performance (β=-0.35, <i>p</i> = 0.007). Significant indirect effects revealed an association where SWB was related to better academic performance through its association with increased health behaviors and lower depression.</p> Conclusion <p>Spiritual well-being is a significant factor in comprehensive student health, with its associations with healthier behaviors and lower depression being subsequently linked to academic achievement. Integrating spiritual well-being into university support and educational programs is essential, underscoring the need for targeted interventions in this domain.</p>

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Investigating spiritual well-being and its relationship with health behaviors, depression, and academic achievement in medical students: a structural equation modeling study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月29日

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  • Mehrdad Karimi,
  • MoradAli Zareipour,
  • Esmayil Zeynali,
  • Rahim Sharafkhani

摘要

Objective

Spiritual well-being (SWB) is a key health dimension crucial for quality of life. For university students facing significant academic pressures, SWB may be a vital resource associated with lower depression, healthier behaviors, and higher academic achievement. This study aimed to investigate the complex interrelationships among these variables in medical students.

Methods

This cross-sectional study enrolled 362 students from Khoy University of Medical Sciences via census sampling. The participants had a mean age of 21.67 ± 2.98 years. The majority of participants were female (55.5%) and single (88.7%). Validated self-report questionnaires were used to measure spiritual well-being (Paloutzian SWB scale), health behaviors (Ahmadi Questionnaire), depression (PHQ-9), and academic performance (GPA). Data were analyzed using Structural Equation Modeling (SEM) to test the direct and indirect pathways within the conceptual model.

Results

The final structural model demonstrated good fit (χ²/df = 2.34, RMSEA = 0.060, CFI = 0.91). Spiritual well-being had significant direct positive association with all health behaviors: physical activity (β = 0.35, p < 0.001), healthy diet (β = 0.48, p < 0.001), and no smoking (β = 0.58, p < 0.001). SWB also had a significant direct negative association with depression (β=-0.50, p < 0.001). Among health behaviors, only no smoking showed a significant direct association with lower depression (β=-0.18, p = 0.04). Depression showed a significant negative direct association with academic performance (β=-0.35, p = 0.007). Significant indirect effects revealed an association where SWB was related to better academic performance through its association with increased health behaviors and lower depression.

Conclusion

Spiritual well-being is a significant factor in comprehensive student health, with its associations with healthier behaviors and lower depression being subsequently linked to academic achievement. Integrating spiritual well-being into university support and educational programs is essential, underscoring the need for targeted interventions in this domain.