Exploring spiritual health among South Korean older adults using the ICECAP-O measure: a cross-sectional study

Background Spiritual Health (SH) is regarded as a factor that influences an individual’s overall well-being. SH is about finding meaning, having a sense of purpose, and feeling inner peace. At the same time, the holistic health viewpoints stress their proximity to human capability and the entirety of life’s quality. Objective The present study sought to determine the relationship between capabilities and subjective well-being in older adults using the ICECAP-O (ICEpop CAPability measure for older people) instrument and also examined the role of the SH measured by PIL (Purpose in Life) as a moderator of the ICECAP-O capability outcomes. Methods This cross-sectional study was a paper-based questionnaire survey targeting 300 older adults aged 65 and over from Wonju and Yeoju, South Korea. The demographic characteristics, health perception, ICECAP-O result and PIL score were collected. Exploratory Factor Analysis (EFA) identified latent dimensions such as HP, IL and ELS. OLS and Pearson correlation were performed on the ICECAP-O tariff, EFA factors, and PIL scores. Stata 18 was used, with a significance level set at p < 0.05. Results The mean PIL score was 98.5 ± 15.6, which represents moderate well-being. Regression analyses revealed significant effects of the 3 from 5 EFA factors, including HP (β = -0.09, p < 0.001), IL (β = 0.03, p < 0.05), and ELS (β = -0.03, p < 0.05) on the ICECAP-O tariff. PIL scores significantly and positively correlated with ICECAP-O tariff ( r = 0.44, p < 0.001), with HP showing a noteworthy moderating effect (β = 0.05, p < 0.01). Conclusion The PIL score is a positive predictor of ICECAP-O among South Korea older adults, suggesting that a better sense of purpose improves capability and quality of life. Further research is needed to examine the applicability of this capability instrument across different countries and cultural contexts for spiritual health.