This descriptive sequential explanatory study, which forms part of a larger study, investigated the use of spiritual coping strategies by three cohort groups of Maltese older residents in three phases. The theoretical model of causal pathway for mental health based on monotheistic religions (Christianity, Judaism, and Islam) guided the study. Participants were recruited from four private homes: two in Australia (n=30), two in Malta (n=43) and two state residences also in Malta (n=64). The residents (n=137; men n=103, women n=34), mean (M) age 72.8 years, were all Roman Catholics, mobile and with a minimum residence of 6 months. The quantitative data (phase I) were collected by the Maltese version of the Spiritual Coping Strategies scale ( Baldacchino and Buhagiar, 2003 ). The qualitative findings in phase II derived from the face-to-face interviews and focus groups explain the use of spiritual coping strategies and how they contributed toward coping with institutionalisation. Significant differences were found in spiritual coping (F=11.434; p=0.001; degree of freedom (df)=2) whereby the cohort in Australia scored the highest scores in the total spiritual coping (M=48.60; standard deviation (SD)=6.251), religious coping (M=23.47; SD=2.145) and existential coping (M=25.13; SD=6.033). No significant differences were found in the total spiritual coping between subgroups of mobility and demographic characteristics except by gender (Student's t-test (t)=2.455; p=0.015) whereby women (M=22.09; SD=4.325) scored higher than the men (M=19.67; SD=4.508). Australian private homes reported the highest (significant) mean scores in total spiritual coping, religious coping and existential coping. Recommendations were set for clinical practice and management, nursing education, and further research.
Keywords: Causal pathway; Older people; Religious/existential coping; Spiritual coping.