en پرستاری پرستاری پژوهشی اصیل Original Article <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><b><i><span style="color:#003399">Background:</span></i></b> <span style="letter-spacing:-.5pt">Given the growing elderly population, the high prevalence of chronic diseases such as diabetes, and the critical importance of medication adherence for disease control, this study was conducted to determine the association between daily spiritual experiences and medication adherence among elderly patients with diabetes in Golestan Province, Iran, in 2023.</span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><span style="font-size:10.0pt"><span style="letter-spacing:-.5pt"></span></span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><b><i><span style="color:#003399">Methods:</span></i></b><span style="letter-spacing:-.5pt"> This descriptive-cross-sectional study included 200 elderly participants selected via a multi-stage cluster random sampling method based on the inclusion criteria. Sampling was conducted from clinics and endocrinology offices in various cities of Golestan Province. Data were collected using a demographic questionnaire (age, gender, marital status, education level, medication and smoking history, and diabetes history), the Compliance Questionnaire on Rheumatology (CQR) for medication adherence, and the Daily Spiritual Experience Scale (DSES). Data analysis was performed using SPSS software version 26, with a significance level of P < 0.05.</span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><span style="font-size:10.0pt"><span style="letter-spacing:-.5pt"></span></span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><b><i><span style="color:#003399">Results:</span></i></b><span style="letter-spacing:-.5pt"> A significant negative association was found between spiritual experiences and medication adherence (P < 0.001). Low adherence had the highest mean spiritual experience score (75.71 &plusmn; 9.88), while high adherence had the lowest (65.08 &plusmn; 10.61). Adherence was higher among those using 3&ndash;5 medications (P < 0.001) and those without hospitalization history (P = 0.001). Higher spiritual experiences were associated with re-employment, having four children, primary education, using 3&ndash;5 medications, hospitalization history, lower self-rated health vs peers, and disease duration of 6&ndash;10 years (P < 0.05).</span><span calibri="" dir="RTL" lang="FA" style="font-family:"><span style="letter-spacing:-.5pt"></span></span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><span style="font-size:10.0pt"><span style="letter-spacing:-.5pt"></span></span></span></span></span><br> <span style="font-size:11pt"><span chaparral="" pro="" style="font-family:"><span style="color:black"><b><i><span style="color:#003399">Conclusion:</span></i></b><span style="letter-spacing:-.5pt"> The results demonstrate a significant negative association between daily spiritual experiences and medication adherence among elderly patients with diabetes. This counterintuitive finding, potentially influenced by unmeasured confounders such as health literacy, socioeconomic status, or social support, suggests that higher spirituality may be associated with poorer adherence. Further qualitative and interventional research is warranted to clarify the underlying mechanisms.</span></span></span></span> Spirituality, Medication Adherence, Aged, Diabetes Mellitus, Type 2 1 10 http://crms.mubabol.ac.ir/browse.php?a_code=A-10-285-1&slc_lang=en&sid=1 Abouzar Dashteban Namaghi 10031947532846003000 10031947532846003000 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran Golbahar Akhoundzadeh G-akhoondzadeh@yahoo.com 10031947532846003001 10031947532846003001 Yes Department of Nursing, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran Sakineh Aghajani Azin Abadi 10031947532846003002 10031947532846003002 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran Ziba Talebzadeh 10031947532846003003 10031947532846003003 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran