Provision of spiritual care in the neonatal intensive care unit in Iran in healthcare providers’ perspective: a qualitative study

Document Type : Original Article


1 Department of Pediatrics, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Pediatrics, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran

3 Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran


Background: The provision of spiritual care along with holistic and comprehensive care is an important need for families with children hospitalized in an intensive care unit. This study aimed to explore the perceptions of healthcare providers regarding the spiritual care of parents with a newborn in a neonatal intensive care unit (NICU) in Iran.
Methods: This study was conducted using conventional qualitative content analysis, which adopts open coding, classification, and abstraction. A total of eight nurses and one doctor participated to be interviewed.
Results: Based on data analysis, three categories of nursing support needed for spiritual care as well as the necessity of changes in structural conditions were identified in this study.
Conclusion: Hospital administrators must undertake measures to change circumstances in NICUs. In addition, nurse managers should plan training courses on the importance of providing spiritual care to patients and their families.


  1. Martin CR, Brown YF, Ehrenkranz RA, O'Shea TM, Allred EN, Belfort MB, et al. Nutritional practices and growth velocity in the first month of life in extremely premature infants. Pediatrics. 2009; 124(2): 649-57.
  2. Jones L, Woodhouse D, Rowe J. Effective nurse parent communication: A study of parents’ perceptions in the NICU environment. Patient Educ Couns. 2007;69(1):206-12.
  3. Howland LC. Preterm birth: implications for family stress and coping. Newborn Infant Nurs Rev. 2007; 7(1): 14-9.
  4. Reid S, Bredemeyer S, van den Berg C, Cresp T, Martin T, Miara N, et al. Palliative care in the neonatal nursery. Neonatal Paediatr Child Health Nurs. 2011;14:2-8
  5. Taylor C, Lillis C, LeMone P, Lynn P. Fundamentals of Nursing: The Art and Science. Williams & Wilkins, Philadelphia, Pa, USA, 6th Ed; 2008.
  6. McSherry W. Making Sense of Spirituality in Nursing Practice: an interactive approach: WB Saunders Co; 2000.
  7. Mauk KL, Schmidt NA. Spiritual care in nursing practice: Wolters Kluwer Health; 2004.
  8. Schroeder J. Ethical issues for parents of extremely premature infants. J Paediatr Child Health. 2008; 44(5): 302-4.
  9. O'Brien ME. A nurse's handbook of spiritual care: standing on holy ground: Jones & Bartlett Learning; 2004.
  10. Franck LS, Cox S, Allen A, Winter I. Measuring neonatal intensive care unit-related parental stress. J Adv Nurs 2004; 49(6): 608-615.
  11. Seyyedfatemi N, Rezaie M, Givari A, Hosseini F. Prayer and spiritual well-being in cancer patients. Payesh. 2007;5(4):295-304. [in Persian]
  12. Elo S & Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008;62(1): 107–115.
  13. Graneheim UH & Lundman B. Qualitative content analysis in nursing research: Concepts, procedures, and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–112
  14. Chism LA & Magnan MA. The relationship of nursing students’ spiritual care perspectives to their expressions of spiritual empathy. J Nur Educ. 2009;48(11):597-605
  15. Dhamani K A, Paul P & Olson J K. Tanzanian nurses understanding and practice of spiritual care. ISRN NURS. 2011;2011:1-7.
  16. Dunn LL, Handley MC & Dunkin JW. The provision of spiritual care by registered nurses on a maternal-infant unit. J Holist Nurs. 2009;27: 1–28.
  17. O’Shea ER, Wallace M, Quinn Griffen M. & Fitzpatrick JJ. The effect of an educational session on pediatric nurses’ perspectives toward providing spiritual care. J Pediatr Nurs. 2011;26:34–43.
  18. Cleveland LM. Parenting in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs. 2008;37: 666–691.
  19. Obeidat, HM. Elaine A. Bond, E A. & Callister LC. The parental experience of having an infant in the newborn intensive care unit. J Perinat Educ. 2009;18(3):23–29.
  20. Heyland DK, Cook DJ, Rocker GM, et al. Defining priorities for improving end-of-life care in Canada. Can Med Assoc J. 2010;182: E747–E52.
  21. Astrow AB, Wexler A, Texeira K, et al. Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol. 2007;25:5753–7.
  22. Mansfield CJ, Mitchell J, King DE. The doctor as God’s mechanic? Beliefs in the Southeastern United States. Soc Sci Med. 2002; 54: 399-409.
  23. Rasinski KA, Kalad YG, Yoon JD, et al. An assessment of US physicians’ training in religion, spirituality, and medicine. Med Teach 2011; 33: 944–5.
  24. Caldeira S. & Hall J. Spiritual leadership and spiritual care in neonatology. J Nurs Manag. 2012;20:1069-1075.
  25. Feudtner Ch, Haney J, Dimmers M. Spiritual Care Needs of Hospitalized Children and Their Families: A National Survey of Pastoral Care Providers’ Perceptions. PEDIATRICS. 2003;111(1):67-72
  26. Heermann JA, Wilson ME, Wilhelm PA. Mothers in the NICU: Outsider to partner. Pediatr Nurs. 2005; 31(3): 176-81.
  27. Jackson K, Ternestedt B M & Schollin J. From alienation to familiarity: Experiences of mothers and fathers of preterm infants. J Advan Nurs. 2003; 43(2): 120-9.
  28. Hall E & Brinchmann BS. Mothers of preterm infants experience space, tone, and transfer in the neonatal care unit. J Neonatal Nursing. 2009;15: 129-36.