Barriers to Providing Spiritual Care from a Nurses’ Perspective: A Content Analysis Study

Ghodratollah Momeni, Maryam Sadat Hashemi, Zeinab Hemati


Background: Spirituality is an important dimension of holistic nursing, and spiritual care is essential to ensure the achievement of optimal care in nursing profession. The aim of this study was to explain the obstacles to providing spiritual care from the perspective of nurses.

Materials and Methods: The present qualitative study was conducted between November 2020 and June 2021 with a content analysis approach. Participants included 30 nurses, selected through purposive sampling, working in the general wards and intensive care units of Isfahan University hospitals. Data collection method was semi‑structured personal interviews. After recording and transcription word by word, all data were analyzed through qualitative content analysis. MAXQDA 11 was used for data analysis.

Results: Research findings included 323 primary codes and two main categories “individual barriers and organizational barriers” and eight subcategories “non‑compliance with human resources standards, lack of attention of organizational managers to the importance of holistic care, motivational barriers, training barriers, barriers to interprofessional collaboration, environmental barriers, barriers related to the nurses, and communication barriers.”

Conclusions: Using the results of the study, policymakers and nursing managers will be able to help facilitate spiritual care, and ultimately, improve the quality of nursing care by improving the infrastructure and removing existing barriers.


Care, nurses, qualitative study, spirituality

Full Text:



Handzo GF, Atkinson M‑M, Wintz SK. National consensus project’s clinical practice guidelines for quality palliative care: Why is this important to chaplains? J Health Care Chaplain 2020;26:58‑71.

Nouhi E, Zihaghi M, Abbaszadeh A, Jahani Y. Privacy in the elderly hospitalized in the internal wards of the Zahedan University of Medical Sciences and its relationship with the spiritual care of nursing workers. J Educ Ethics Nurs 2017;6:22‑30.

Merati‑Fashi F, Khaledi‑Paveh B, Mosafer H, Ebadi A. Validity and reliability of the Persian version of the nurse spiritual care therapeutics scale (NSCTS). BMC Palliat Care 2021;20:56.

Ghale TM, Musarezaie A, Moeini M, Esfahani HN. The effect of spiritual care program on ischemic heart disease patients’ anxiety, hospitalized in CCU: A clinical trial. J Behav Sci Res 2012;10:554‑64.

Mcsherry W, Jamieson S. The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. J clin Nurs 2013;22:21‑2.

Leeuwen Rv, Schep‑Akkerman A. Nurses’ perceptions of spirituality and spiritual care in different health care settings in the Netherlands. Religions 2015;6:1346‑57.

Hajiesmaeili MR, Abbasi M, Safaiepour L, Fani M, Abdoljabari M, Hosseini SM, et al. Spiritual health concept in Iranian society: Evolutionary concept analysis and narrative review. Med Ethics J 2016;10:77‑115.

Moeini M, Momeni T, Musarezaie A, Sharifi S. Nurses’ spiritual well‑being and their perspectives on barriers to providing spiritual care. Iran J Crit Care Nurs 2015;8:159‑66.

Abdollahyar A, Baniasadi H, Doustmohammadi MM, Sheikhbardesiri H, Yarmohammadian MH. Attitudes of Iranian nurses toward spirituality and spiritual care. J Christ Nurs 2019;36:E11‑16.

Memaryan N, Ghaempanah Z, Aghababaei N, Koenig HG. Integration of spiritual care in hospital care system in Iran. J Relig Health 2020;59:82‑95.

Farahani AS, Rassouli M, Salmani N, Mojen LK, Sajjadi M, Heidarzadeh M, et al. Evaluation of health‑care providers’ perception of spiritual care and the obstacles to its implementation. Asia Pac J Oncol Nurs 2019;6:122‑9.

Ramezani M, Ahmadi F, Mohammadi E, Kazemnejad A. Catalysts to spiritual care delivery: A content analysis. Iran Red Crescent Med J 2016;18:e22420.

Mahmoodishan G, Alhani F, Ahmadi F, Kazemnejad A. Iranian nurses’ perception of spirituality and spiritual care: A qualitative content analysis study. J Med Ethics Hist Med 2010;3:6.

Corbin J, Strauss A. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory: Sage Publications; 2014.

Chiu L, Emblen JD, Hofwegen LV, Sawatzky R, Meyerhoff H. An integrative review of the concept of spirituality in the health sciences. West J Nurs Res 2004;26:405‑28.

Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277‑88.

Glaser BG. The future of grounded theory. Qual Health Res 1999;9:836‑45.

Streubert H, Carpenter D. Qualitative Research in Nursing. 5th ed. Philadelphia: Lippincott Willams Wilkings; 2011.

McBrien B. Nurses’ provision of spiritual care in the emergency setting‑An Irish perspective. Int Emerg Nurs 2010;18:119‑26.

Wong KF, Yau SY. Nurses’ experiences in spirituality and spiritual care in Hong Kong. Appl Nurs Res 2010;23:242‑4.

Attia AK, Abd‑Elaziz WW, Kandeel NA. Critical care nurses’ perception of barriers and supportive behaviors in end‑of‑life care. Am J Hosp Palliat Med 2013;30:297‑304.

Adib‑Hajbaghery M, Zehtabchi S, Fini IA. Iranian nurses’ professional competence in spiritual care in 2014. Nurs Ethics 2017;24:462‑73.

Balboni MJ, Sullivan A, Enzinger AC, Peterson ZDE‑, Tseng YD, Mitchell C. Nurse and physician barriers to spiritual care provision at the end of life. J Pain Symptom Manage 2014;48:400‑10.

Alshmemri M, Shahwan‑Akl L, Maude P. Herzberg’s two‑factor theory. Life Sci J 2017;14:12‑6. 25. Mousazadeh S, Yektatalab S, Momennasab M, Parvizy S. Job satisfaction and related factors among Iranian intensive care unit nurses. BMC Res Notes 2018;11:823.


  • There are currently no refbacks.