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The primary purpose of this study was to explore the relationships among vulnerability, self-transcendence, and well-being in Japanese hospitalized elders. With their declining functional health and diminishing social network, elderly people are considered as a vulnerable population, which require special care and attention in the field of nursing. Self-Transcendence is identified as one of the developmental resources that promote well-being in later adulthood during increased vulnerability; however, applicability of the concept of self-transcendence as well as its theory has never been tested in Japanese population. Thus, the current study specifically tested and refined a theoretical model of self-transcendence in Japanese elders.In this study, a nonexperimental descriptive design was used to examine relationships among the variables. A total of 105 elderly patients were recruited from 4 hospitals in Sapporo, Japan. The respondents' level of vulnerability was assessed by three aspects: vulnerability in health status, vulnerability in resource availability, and past vulnerable experience. Well-being was examined from the level of depression and life satisfaction. Besides psychosocial self-transcendence, spiritual self-transcendence from Japanese perspective was conceptualized and evaluated.Reliability testing provided adequate supports for all the study instruments. Findings of multiple regression analyses indicated mediating effects of psychosocial self-transcendence on the relationship between vulnerability in resource availability and well-being variables. Psychosocial self-transcendence also demonstrated direct effects on well-being. Spiritual self-transcendence did not show any mediating and moderating effect in the relationship between vulnerability and well-being; however, it was found to be the strongest predictor for the level of life satisfaction. In addition, the findings revealed that vulnerability in health status had a direct effect on the level of depression, but past vulnerable experience had no effect on both self-transcendence and well-being.Findings of this study provided further evidence of universality of the concept of self-transcendence and applicability of its theory to Japanese hospitalized elders. This study not only contributes to Japanese nursing research by adding the body of knowledge about self-transcendence and spirituality but also can be a basis for formulating interventions that help enhance well-being in vulnerable elderly patients.
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