فصلنامه اخلاق پزشکی
پیاپی 20 (تابستان 1391)

Various definitions have been provided on the concept of the spiritual health since its introduction by Moberg (1971) and there has been no agreement on its method of measurement either in the empirical research or in the common interpretations. The main purpose of this paper is to present a comprehensive definition of the spiritual health and the operational definition of the components and indices and the analysis of the measurement scales of the spiritual health based on the aboriginal culture of Iran. this study is based on a methodological approach. Data have been collected by a documental method. It is used of Walker and Avant (2005) method for conceptual analysis. The space of the literal concept of the spiritual health has been delineated and the corporal position of its components and indices has been determined after data collection. spirituality is a state of being, but the spiritual health is a state of having. What is today raised about the spiritual health in the scientific literature, rather deals with the influence of spiritual teachings and beliefs on the individual's health and the improvement process of their diseases that are discussed in a medical ground; but attitude on the spiritual health in Iran includes a broader and more comprehensive concept. the spiritual health of the humans must be defined based on a process of the interaction between man in the world of being and a superior and sovereign sacred power. In measuring the spiritual health of the individuals, our attitude toward the spiritual health should not be examined, rather, the, personal cognitions, actions emotions and outcomes of the individuals should be studied in this measurement.

Although it passes over five decades since the raise of the issue of the spiritual health, but the dimensions of this very important pillar have remained still unknown; for this reason, everybody, considering his sovereign paradigms based on his worldview has tried to provide a definition but no consensus has been reached yet. The main cause of the difficulty of definition returns to two main elements. The first element includes the type of sovereign worldview, attitude and paradigm that usually exists behind any view and judgment. Another element that plays a role in the second stage is non-agreement on the concepts of such words as health, spirituality, religion, spirit, soul, disease and other relevant items. The spiritual health in the medical terminology with a materialistic approach is a process by utilization of which, to the treatment of patients may be assisted. In non-medical terminology or the spiritualistic medicine, however, the spiritual health is a process that, in addition to be utilized in the corporal treatment of patients may be also useful in their spiritual and mental treatment and above it may provide situations in the society that would also raise the social health and finally would help the allover integrity and sublimity of the man and humanity.

Notwithstanding the acceptance of the spiritual dimension of health by the scientific circles and the WHO, the progress of the thought of the spiritual health has been very slow in the State health plans. Since, there are challenges in the concept of the spiritual health. The present study aims at identifying the indices of the spiritual health from the perspective of the revelatory teaching. The documental and conceptual analysis method has been used in this review research. For this purpose, necessary information has been collected and then analyzed by referring to first-hand sources such as Quranic index and interpretation books like Al-Mizan, and also searching in different internet databases and the papers and publications related to Quranic knowledge, psychology, medicine and religion. In the contemporary approaches, some ones have regarded spirituality as limited to a collection of correlated abilities and/or a kind of intelligence. Also a group considers spirituality as a flow and approach which leads to the intrinsic complacence. In the revelatory teaching, however, spirituality may not be mentioned without considering a reasonable meaning. Such a meaning cannot be anything else except God. The spiritual health includes cognitive, emotional, behavioral and consequential components. The spiritual man enjoys a special thought or thinking toward God, man, creation and their mutual relations. This thinking has torn the curtain of appearances and has attained the intrinsic truth. All his life finds a divine orientation. He enjoys special spiritual states such as love of God, altruism, reliance on God and tolerance; he benefits from more physical and mental health. Therefore, the indices of the spiritual health are not merely a kind of behaviors and/or psychological feelings such as the intrinsic complacence and/or the internal peace. Rather, the spiritual health deals with the all life of the spiritual man. Presenting such an image of spirituality is based on Quranic epistemology, anthropology and cosmology.

For years, humanities and in particular, the medical education and the health system have been regretting to answer the agony of their visitors in human, value and spiritual terms. Although some authorities-based, humanistic and existentialistic approaches have been able to lead education and services toward a modern sublimity, now that the achievement of the research in the field of spirituality in health has caused another hope in the medical education and humanities, it has been tried to answer these questions in this paper by reviewing different research: What is the spiritual health? What do the visitors expect from us? What do say the research evidences in this respect? What is the necessity for taking spiritual profile from the visitors? What measures should be taken after the spiritual evaluation by the authorities? What spiritual cares may be made by the therapist in his clinical working? What is the Islamic view on psychotherapy? It seems that answering these questions is the answer to the doubts, failures, and the necessities for applying the phrase and plans of the spiritual health in education and it is expected that thereafter, decision-makers of the health system and the Academy of Medical Science facilitate its resources and development requirements.

The impact of the spiritual attitude of physicians on the improvement of their patients is a title that today has attracted the attention of many experts and scholars. In recent research, it has been shown that the spiritual attitude may affect the process of the patient's treatment. The main aim of this study is to study the attitudes of physicians about the effects of spirituality quantity on the treatment process. Physicians constitute the statistical population of this study. Five Hundred physicians were chosen by the simple sampling method. A questionnaire was used in this study for assessment of physician's spiritual attitudes. According to the physicians, they were divided in two groups: religious and less religious and their opinions were compared. The effect of the Physician's attitudes on the health of patients were significantly different between religious and less religious Groups (P<0.0005). Namely, religious physicians attached for the religion or spirituality more impact on the patient's health in comparison with the opposite group. 68% of religious physicians believed that the impact of religion/spirituality on the health of patients was very much. In contrast, 70% of less religious physicians believed that this impact was little or to some extent. 18, 43, 34, and 4 percent of physicians respectively believed that the impact of spirituality on the patient's health was very high, high, somewhat and negligible. The result showed that a special attention must be made to the spiritual potentials of patients and physicians in the process of patient's treatment.

Spiritual care is an important component of nursing performance that has not been considered sufficiently in routine activities. Therefore, it seems for providing holistic care, the spiritual dimension should be noticed particularly as a prominent aspect of human being which affects individual's health. This research was done to compare nurse's and nursing student's views about spiritual care in kerman in 2011. This study is a descriptive and comparative study that. The sample consisted of 400 persons (320 nurses and 80 nursing students) that completed Spiritual Care Perspectives Scale (SCPS) questionnaire about spiritual care. For data analysis SPSS 18 and T,ANOVA, Regression, variance analysis were used. Average scores of views regarding the spiritual care was 46.91±4.97 in nursing students and 45.37±4.39 in nurses. There was a significant difference between two groups of nurses and nursing students (p<0.05). In both groups, scores of those who had participated in ethics workshops were high; moreover, a difference was also observed in nurses in respect of workplace hospitals (psychiatry or else) and position (nurse or nursing managers) (p<0.05). Students’ scores were higher than those of nurses that may be due to a special attention to spirituality and spiritual care in nursing education in recent years. Considering the importance of the issue, it is proposed that some educational plans to be prepared to promote nurse's and nursing student's qualifications in respect of spiritual care and acquisition of necessary capacities.

The consequence of the affection of a child by cancer on the distress of the parents and his family members is not less than of the same on the quality of his own life. The aim of this research is to study the effectiveness of spiritual intervention on reducing distress in mothers of children with cancer. This study is a kind of semi-trial projects. For examining the hypothesis of the research, twelve mothers of children with cancer whose children had been hospitalized in Imam Hussein hospital in Tehran, were selected randomly and were given psychotherapy based on spiritual intervention.The intervention was taught and carried out daily during six sessions of 90 minutes.Levels of distress of mothers in the first session before treatment and then in third and fifth sessions were evaluated with the assessment of distress questionnaire, Kessler(k10). Three weeks after the last session of the intervention, the level of distress of mothers was evaluated with the same questionnaire again; then the results were analyzed statistically. For analyzing data, the method of repeated measurement was used. The results showed that spiritual interventions were effective in reducing distress in mothers of children with cancer. Psychotherapy based on the spiritual intervention is deemed an important topic in respect of holistic planning in protection of mothers of children with cancer and need to be noticed more by the experts and concerned authorities and the psychology departments of the medical centers.