Volume 29, Issue 1 (Winter 2021)                   Avicenna J Nurs Midwifery Care 2021, 29(1): 45-52 | Back to browse issues page

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Radman E, Rezaee M, Baljani E. The Effect of Spiritual Counseling and Hope Therapy Training on Palliative Care Self-efficacy of Nursing Students of Urmia Azad University.. Avicenna J Nurs Midwifery Care 2021; 29 (1) :45-52
URL: http://nmj.umsha.ac.ir/article-1-2149-en.html
1- Department of Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran
2- Department of Midwifery, Urmia Branch, Islamic Azad University, Urmia, Iran , monir.rezaee@yahoo.co.uk
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✅ This study showed that the multidimensional measure of nurses’ personal resilience had appropriate psychometric properties and is a valid and reliable screening index to measure psychological resiliency of nurses. This index could facilitate the assessing of Well-Being in brief and practical way among nurses.

Extended Abstract:   (942 Views)

Palliative care is of great importance for improving the quality of life of chronic patients and providing palliative care education to nurses is one of the important ways in the development of such care. The purpose of this study was to determine the effect of spiritual counseling and hope therapy on self-efficacy of palliative care of nursing students.


Materials and Methods

This was an experimental study. The statistical population consisted of senior nursing students of Urmia Azad University, Urmia, Iran. The samples were selected from the complete list of students using census sampling and then divided into intervention and control groups. Data were collected using a two-part questionnaire including demographic information and clinical practice self-efficacy questionnaire. The intervention group received 9 sessions of training on hope and spiritual counseling but the intervention group did not receive training. The intervention results were re-evaluated after 9 sessions using the same questionnaire.



Independent-sample t-test showed that the mean scores of overall clinical self-efficacy scores of nursing students before spiritual counseling and hope therapy were not significantly different (P>0.05), while the same test showed that there was a significant difference between the mean scores of clinical self-efficacy between intervention and control groups after spiritual counseling and hope therapy program (t=63.6, P=0.02).

Table 1. Comparison of self-efficacy scores of palliative care of nursing students in the last year before the intervention
Clinical self-efficacy Group M SD t P
Patient examination Control 24.33 4.6 71.0
Intervention 32.48 7.10
Nursing diagnoses Control 18.25 35.5 36.1
Intervention 25.77 4.94
Implement a care plan Control 47.29 74.5 -4.034
Intervention 28.71 6.20
Care plan evaluation Control 26.17 60.4 2.63
Intervention 16.45 5.71
Table 2. Comparison of self-efficacy scores of palliative care of nursing students in the last year after the intervention
Clinical self-efficacy Group M SD t P
Patient examination Control 34.14 7.3 3.64 0.39
Intervention 35.42 6.18
Nursing diagnoses Control 26.15 6.33 2.34 0.042
Intervention 30.72 5.91
Implement a care plan Control 30.44 5.71 6.019 0.01
Intervention 35.49 7.23
Care plan evaluation Control 16.46 5.63 0.73 0.039
Intervention 23.35 6.41


The findings of this study showed that teaching spiritual counseling and hope therapy programs is effective on the self-efficacy of palliative care of nursing students. Although no study in Iran has examined the effect of spiritual counseling and hope therapy on the clinical self-efficacy of nursing students, in previous studies, the effect of spiritual counseling and hope therapy on variables of quality of life, hope and anxiety in patients and groups with mental health problems has already been examined which expresses how spiritual counseling affects health outcomes in different groups of clients. For example, the findings of Aghajani, Afaze and Morasai study indicate that spiritual counseling is effective on the hope of patients with chronic renal failure [12]. Martinez, Smith and Barlow also concluded that counseling with a spiritual approach has been effective in improving the quality of life of cancer patients [13]. Richards and Bergin in their study of complementary therapies in cancer patients concluded that spirituality and religion have the highest level of use of other complementary therapies in reducing anxiety and creating relaxation [14]. Hawks et al. stated that spiritual counseling helps a person not to focus on shortcomings and failures in life despite many illnesses and problems, but to seek hope and purpose in life and to connect with God and thus make their lives meaningful [15] ]. Therefore, it can be concluded that spiritual counseling and hope therapy in nursing students can increase their motivation to learn more in caring for and helping patients in difficult life situations such as illness by having meaning in life, purposefulness and belief in a better future.
In this study, the teaching of spiritual counseling and hope therapy in nursing students has further emphasized the fact that students can accept this type of training. In fact, it strengthened their beliefs to pay more attention to patients in need of care; because spiritual counseling contains important ethical points that strengthen professional ethical commitments and a high sensitivity to human health. Hence, the promotion of clinical self-efficacy of nursing students in this study can be attributed to the strengthening of professional ethics through the training of spiritual counseling and hope therapy.
Also in line with the effectiveness of spiritual counseling, Khorrami Markani et al. stated that spiritual counseling plays an important role in increasing the level of spiritual health of cancer patients. This highlights the need to pay attention to spirituality and develop spiritual counseling programs in specialized and public centers where cancer patients are admitted [16]. The findings of Rasouli, Bahramian and Zahrakar showed that group hope therapy affects the quality of life of these patients. Also, educational-counseling programs are better aligned with the inner and innate needs of human beings; consequently, this type of training is easy and low cost [11]. In this regard, the results of other studies confirm that the training of group hope therapy has been effective in increasing the self-efficacy of men with physical disabilities [17] and resilience and life expectancy of cancer patients [18].
It can be said that although palliative care has a high complexity and has a multidimensional meaning, in our country the existing knowledge in the field of palliative care is not well explained and in the context of the nursing curriculum, it has not been seriously considered [19]. The results of the present study emphasize that the implementation of spiritual counseling and hope therapy training program in nursing students can be used to teach the content of palliative care and model nursing to incurable patients.



The results of this study showed that spiritual counseling and hope therapy training is effective on self-efficacy of palliative care of nursing students and can be used in palliative care teaching and pattern-based nursing care for a variety of patients.



This study is taken from the dissertation of a student in the master's degree in nursing. The authors thank the Vice Chancellor for Research of the Islamic Azad University, Urmia Branch. We also express our gratitude to the nursing students participating in this study.


Conflicts of Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


Type of Study: Original Research | Subject: Nursing
Received: 2020/02/16 | Accepted: 2020/08/3 | Published: 2020/10/11

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