Intensive Care Unit Nurses' Perspectives and Experiences in Providing Spiritual Care: A Qualitative Meta-Synthesis

Patients in the intensive care unit (ICU) face severe psychological and spiritual stress, along with tough physical challenges. While the significance of spiritual care is widely acknowledged, systematic research on ICU nurses' practical experiences and perceptions in spiritual care is still lacking.

To examine and synthesise qualitative evidence about the ICU nurses' perspectives and experiences in providing spiritual care.

Databases including PubMed, Embase, Web of Science, Scopus, CINAHL, PsycINFO, ProQuest, Airiti Library and CNKI were searched up to December 2024. Additionally, grey literature and backward reference searches were also performed. Two independent reviewers assessed the methodological quality and extracted data; meta-aggregation was performed to synthesise the findings.

Ten studies were selected for inclusion, resulting in four synthesised findings: Developing an understanding of spiritual care, spiritual care has no fixed form, challenges in spiritual care practice among ICU nurses and spiritual care as a double-edged sword for ICU nurses.

ICU nurses' spiritual care experiences fall into four themes. Based on the ConQual certainty assessment, the synthesised finding 'challenges in spiritual care practice among ICU nurses' was rated as moderate certainty, the highest level achieved. Spiritual care is crucial in critical care. Effective implementation in intensive care medicine requires collaboration and support from policymakers, the medical community and society. Translating spiritual care from theory to practice can be facilitated through policy support, resource integration and capacity building.

Despite cultural differences, ICU nurses' practices in spiritual care reveal cross-cultural commonalities. The review gives specific advice for future ICU spiritual care, including creating standardised tools for spiritual needs assessment, forming multidisciplinary collaboration mechanisms and increasing ICU nurses' spiritual care training.

The protocol of this qualitative meta-synthesis has been registered at PROSPERO with the identifier CRD42025633933.