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Efficacy of structured spiritual care education program on nurses' spiritual well-being and clinical competence: a
Mehrvash Hemati1, Azita Jaberi1, Naval Heydari2
1Department of Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
Spiritual care is a key component of holistic nursing practice, yet many nurses feel insufficiently prepared to provide it effectively. This study aimed to evaluate the effect of a structured spiritual care education on nurses' spiritual well-being and clinical competence.
Methods:
This randomized controlled trial was conducted on 120 female nurses working in a specialized hospital in Iran from March 2024 to January 2025. Participants were randomly assigned in a 1:1 ratio to the intervention (n = 60) and control (n = 60) groups using block randomization with a block size of four and allocation concealment via sequentially numbered, opaque, sealed envelopes. The intervention group received a four-session structured spiritual care education program based on interactive lectures, scenario-based learning, and reflective discussions using the Gibbs reflective cycle, while the control group received routine training. Outcomes included spiritual well-being (measured by the Spiritual Well-Being Scale) and clinical competence (measured by the Clinical Competence Questionnaire), assessed at baseline, immediately post-intervention, and at two-month follow-up.
Results:
After the intervention, the intervention group showed significantly higher spiritual well-being scores compared to the control group, including both religious and existential dimensions (p < 0.001). Clinical competence scores were also significantly higher in the intervention group across most domains, including clinical care, interpersonal relationships, legal-ethical practice, professional development, and teaching-coaching (all p < 0.001). These improvements were sustained at the two-month follow-up. Effect sizes ranged from small to large, and mixed repeated-measures analysis confirmed a significant group × time interaction (p < 0.001), indicating greater improvement in the intervention group over time.
Conclusion:
Structured scenario-based spiritual care education can effectively improve nurses' spiritual well-being and clinical competence. We recommend integrating such programs into nursing education and continuing professional development.
Trial Registration:
Retrospectively registered in the Iranian Registry of Clinical Trials (IRCTID:IRCT20220927056047N2; https://en.irct.ir/trial/89352) on 2026-05-02.
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