title: Spirituality and spiritual care in Iran: nurses' perceptions and barriers.
abstract: OBJECTIVE
  This study aimed to explore the perception of Iranian nurses concerning spiritual care and to reveal any confronted barriers.
  
  
  BACKGROUND
  Although the context of spiritual care is a substantial aspect of holistic care, the delivery of spiritual care has been problematic due to lack of nurses' understanding of this concept.
  
  
  BACKGROUND
  Nurses' perceptions of spirituality and spiritual care directly influence their performance as well as their relationships with patients.
  
  
  METHODS
  This cross-sectional survey was conducted in 2013 with 259 nurses working in hospitals affiliated with Qazvin University of Medical Sciences, Iran. Data were collected using the Spirituality and Spiritual Care Rating Scale alongside qualitative open-ended questions. Descriptive and inferential statistics were used for the quantitative data and content analysis for the qualitative data.
  
  
  RESULTS
  The overall average for spirituality and spiritual care was 2.84 (score range: 1-4), indicating a moderate mean score. A significant relationship was found between education level and spiritual care. The majority of participants believed that they did not receive enough training in this aspect of care. The main obstacles regarding delivering spiritual care included busy working schedules, insufficient knowledge regarding spiritual care, low motivation, diversity of patients' spiritual needs and feeling 'unqualified' to provide spiritual cares.
  
  
  CONCLUSIONS
  Consistent with the previous studies, this study has demonstrated that nurses had low confidence to meet the spiritual needs of patients due to lack of knowledge and training in this regard.
  
  
  CONCLUSIONS
  Iranian nurses' perception of spirituality and spiritual care is moderate, reflecting that they do not receive sufficient training regarding spiritual care.
  
  
  CONCLUSIONS
  Despite the attention focused on spiritual care in clinical settings in Iran, there remains a significant gap in terms of meeting the spiritual needs of patients in nursing practice. This finding assists nursing clinicians, educators and policy makers to more effectively approach spiritual care as a beneficial component of holistic care. It is proposed that more emphasis is placed on integrating spirituality content into educational programmes to enable more effective clinical delivery. In addition, it would be beneficial to implement more widespread cultural assessment in order to further benefit spiritual care practices.
authors.affiliation: Social Determinants of Health Research Centre, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Zakaria Kiaei
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Salehi
authors.affiliation: Health Services Management, Department of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Moosazadeh Nasrabadi
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, SoNM, Flinders University, SA, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Whitehead
authors.affiliation: Department of Treatment Affairs, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Azmal
authors.affiliation: Social Determinants of Health Research Centre, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: R
authors.initials: R
authors.lastname: Kalhor
authors.affiliation: Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: E
authors.initials: E
authors.lastname: Shah Bahrami
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D057184:Practice Patterns, Nurses'; D012649:Self Concept; D012959:Socioeconomic Factors; D026443:Spiritual Therapies; D029181:Spirituality; D055815:Young Adult
keywords: Iran; Nursing; Perceptions; Spiritual care; Spirituality