Journal of Religion and Health

, Volume 58, Issue 1, pp 180–194 | Cite as

An Exploratory Study of Spirituality and Spiritual Care Among Malaysian Nurses

  • Mohd Arif AtarhimEmail author
  • Susan Lee
  • Beverley Copnell
Original Paper


The increasing evidence that spirituality is a critical component for promoting health and well-being has made spirituality more significant to nursing practice. However, although nurses’ perceptions of spirituality have been studied in western countries, there has been little research on this topic in Southeast Asian countries where religions other than Christianity predominate. This study explores Malaysian nurses’ perceptions of spirituality and spiritual care and examines associations between socio-demographics and their perceptions. The Malaysian Nurse Forum Facebook closed group was used for data collection with 208 completed the online survey. The participants considered that spirituality is a fundamental aspect of nursing. Nonetheless, half of the respondents were uncertain regarding the use of the spiritual dimension for individuals with no religious affiliation. Significant differences were found between educational levels in mean scores for spirituality and spiritual care. There was also a positive relationship between perception of spirituality and spiritual care among the respondents. Despite the positive perceptions of nurses of spirituality in nursing care, the vast majority of nurses felt that they required more education and training relating to spiritual aspects of care, delivered within the appropriate cultural context.


Nurses Perceptions Spirituality Spiritual care Spiritual education Holistic care 


Compliance with Ethical Standards

Conflict of interest

No conflicts of interest to disclose.

Ethical Standards

The study was approved by the Monash University Human Research Ethics Committee (MUHREC) under the category of low-risk studies (Project Number: CF15/857-2015000383). Participation in this online survey was fully voluntary and anonymous with no explicit incentives provided for participation. Implied consent was applied for this study, in which the submission of the online survey indicated the participant’s consent to take part in the study. Participants were allowed not to answer any part of the survey without penalty. However, it was not possible to withdraw data, as the data provided by particular participants could not be identified once the online survey was submitted.

Supplementary material

10943_2018_624_MOESM1_ESM.doc (48 kb)
Supplementary material 1 (DOC 48 kb)


  1. Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., et al. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of Pain and Symptom Management, 48(3), 400–410. Scholar
  2. Baldacchino, D. R. (2006). Nursing competencies for spiritual care. Journal of Clinical Nursing, 15(7), 885–896. Scholar
  3. Baldacchino, D. R. (2011). Teaching on spiritual care: The perceived impact on qualified nurses. Nurse Education in Practice, 11(1), 47–53. Scholar
  4. Belcher, A., & Griffiths, M. (2005). The spiritual care perspectives and practices of hospice nurses. Journal of Hospice & Palliative Nursing, 7(5), 271–279. Scholar
  5. Burkhardt, M., & Nagai-Jacobson, M. (2013). Spirituality and health. In B. Dossey & I. Keegen (Eds.), Holistic nursing: A handbook for practice (6th ed., Vol. 721–749). Jones & Bartlett: Burlington, MA.Google Scholar
  6. Carr, T. J. (2010). Facing existential realities: Exploring barriers and challenges to spiritual nursing care. Qualitative Health Research, 20(10), 1379–1392. Scholar
  7. Carson, V. B., & Stoll, R. (2008). Defining the indefinable and reviewing its place in nursing. In V. B. Carson & H. G. Koenig (Eds.), Spiritual dimension of nursing practice (pp. 3–32). West Conshohocken, Pennsylvania: Templeton Foundation Press.Google Scholar
  8. Cetinkaya, B., Azak, A., & Dundar, S. (2013). Nurses’ perceptions of spirituality and spiritual care. Australian Journal of Advanced Nursing, 31(1). Retrieved from
  9. Chan, M. F. (2009). Factors affecting nursing staff in practising spiritual care. Journal of Clinical Nursing, 19(15–16), 2128–2136. Scholar
  10. Chan, M. F., Chung, L. Y. F., Lee, A. S. C., Wong, W. K., Lee, G. S. C., Lau, C. Y., et al. (2006). Investigating spiritual care perceptions and practice patterns in Hong Kong nurses: Results of a cluster analysis. Nurse Education Today, 26(2), 139–150. Scholar
  11. Christensen, K. H., & Turner, D. S. (2008). Spiritual care perspectives of danish registered nurses. Journal of Holistic Nursing, 26(1), 7–14. Scholar
  12. Clarke, J. (2009). A critical view of how nursing has defined spirituality. Journal of Clinical Nursing, 18(12), 1666–1673. Scholar
  13. Cooper, K. L., Chang, E., Sheehan, A., & Johnson, A. (2013). The impact of spiritual care education upon preparing undergraduate nursing students to provide spiritual care. Nurse Education Today, 33(9), 1057–1061. Scholar
  14. Ellis, H. K., & Narayanasamy, A. (2009). An investigation into the role of spirituality in nursing. British Journal of Nursing, 18(14), 886–890. Scholar
  15. Friedman, L. C., Barber, C. R., Chang, J., Tham, Y. L., Kalidas, M., Rimawi, M. F., et al. (2010). Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting. Journal of Cancer Education, 25(3), 343–348. Scholar
  16. Gallison, B. S., Xu, Y., Jurgens, C. Y., & Boyle, S. M. (2013). Acute care nurses’ spiritual care practices. Journal of Holistic Nursing, 31(2), 95–103. Scholar
  17. Gebhardt, M. C. (2008). Rehabilitation nurses’ experiences providing spiritual care. Spirituality and Health International, 9(4), 230–240. Scholar
  18. Han, J., & Richardson, V. E. (2010). The relationship between depression and loneliness among homebound older persons: Does spirituality moderate this relationship? Journal of Religion & Spirituality in Social Work: Social Thought, 29(3), 218–236. Scholar
  19. Haque, A., & Masuan, K. A. (2002). Perspective: Religious psychology in Malaysia. The International Journal for the Psychology of Religion, 12(4), 277–289. Scholar
  20. Hussey, T. (2009). Nursing and spirituality. Nursing Philosophy, 10(2), 71–80. Scholar
  21. IndexMundi. (2014). Malaysia demographics profile 2014. Retrived from
  22. Kasmo, M. A., Usman, A. H., Mohamad, Z., Yunos, N., & Wan Hassan, W. Z. (2015). Perception about God and religion within the Malaysian society. Mediterranean Journal of Social Sciences, 6(1), 246. Scholar
  23. Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of Clinical Nursing, 23(21–22), 3197–3205. Scholar
  24. Koenig, L. B., & Vaillant, G. E. (2009). A prospective study of church attendance and health over the lifespan. Health Psychology, 28(1), 117–124. Scholar
  25. Löfmark, A., & Wikblad, K. (2001). Facilitating and obstructing factors for development of learning in clinical practice: A student perspective. Journal of Advanced Nursing, 34(1), 43–50. Scholar
  26. Lundberg, P. C., & Kerdonfag, P. (2010). Spiritual care provided by Thai nurses in intensive care units. Journal of Clinical Nursing, 19(7–8), 1121–1128. Scholar
  27. McSherry, W., & Cash, K. (2004). The language of spirituality: An emerging taxonomy. International Journal of Nursing Studies, 41(2), 151–161. Scholar
  28. McSherry, W., Draper, P., & Kendrick, D. (2002). The construct validity of a rating scale designed to assess spirituality and spiritual care. International Journal of Nursing Studies, 39(7), 723–734. Scholar
  29. McSherry, W., & Jamieson, S. (2011). An online survey of nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(11–12), 1757–1767. Scholar
  30. McSherry, W., & Jamieson, S. (2013). The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 22(21–22), 3170–3182. Scholar
  31. Mitchell, M., & Hall, J. (2007). Teaching spirituality to student midwives: A creative approach. Nurse Education in Practice, 7(6), 416–424. Scholar
  32. Molzahn, A. E., & Sheilds, L.(2008). Why is it so hard to talk about Spirituality? The Canadian Nurse, 104(1), 25–29. Retrived from
  33. O’Shea, E. R., Wallace, M., Griffin, M. Q., & Fitzpatrick, J. J. (2011). The effect of an educational session on pediatric nurses’ perspectives toward providing spiritual care. Journal of Pediatric Nursing, 26(1), 34–43. Scholar
  34. Ozbasaran, F., Ergul, S., Temel, A. B., Aslan, G. G., & Coban, A. (2011). Turkish nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(21–22), 3102–3110. Scholar
  35. Penman, J., Oliver, M., & Harrington, A. (2009). Spirituality and spiritual engagement as perceived by palliative care clients and caregivers. Australian Journal of Advanced Nursing, 26, 29–35. Retrieved from:
  36. Pinto, S., March, P. D., & Pravikoff, D. (2008). Spiritual needs of hospitalised patients (Evidence-based care sheet). Retrieved from
  37. Plotnikoff, G. (2007). Integrating spiritual assessment and care. In D. Rakel (Ed.), Integrative medicine (2nd ed., pp. 1171–1175). Toronto, Ontario: Canada Saunders.CrossRefGoogle Scholar
  38. Pope, M., Musa, M., Singaravelu, H., Bringaze, T., & Russell, M. (2002). From colonialism to ultranationalism: History and development of career counseling in Malaysia. The Career Development Quarterly, 50(3), 264–276. Scholar
  39. Raosoft. (2004). Sample size calculator. From
  40. Rassool, G. H. (2000). The crescent and Islam: Healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. Journal of Advanced Nursing, 32(6), 1476–1484. Scholar
  41. Ronaldson, S., Hayes, L., Aggar, C., Green, J., & Carey, M. (2012). Spirituality and spiritual caring: Nurses’ perspectives and practice in palliative and acute care environments. Journal of Clinical Nursing, 21(15–16), 2126–2135. Scholar
  42. Ross, L., van Leeuwen, R., Baldacchino, D., Giske, T., McSherry, W., Narayanasamy, A., et al. (2014). Student nurses perceptions of spirituality and competence in delivering spiritual care: A European pilot study. Nurse Education Today, 34(5), 697–702. Scholar
  43. Sachedina, A. (2012). Islam. In M. Cobb, C. M. Puchalski, & B. Rumbold (Eds.), Oxford textbook of spirituality in healthcare practice. New York: Oxford University Press.Google Scholar
  44. Tavakol, S., Dennick, R., & Tavakol, M. (2011). Psychometric properties and confirmatory factor analysis of the Jefferson scale of physician empathy. BMC Medical Education, 11, 54. Scholar
  45. Tiew, L. H., Creedy, D. K., & Chan, M. F. (2013). Student nurses’ perspectives of spirituality and spiritual care. Nurse Education Today, 33(6), 574–579. Scholar
  46. Tiew, L. H., & Drury, V. (2012). Singapore nursing students’ perceptions and attitudes about spirituality and spiritual care in practice: A qualitative study. Journal of Holistic Nursing, 30(3), 160–169. Scholar
  47. Timmins, F. (2014). Spiritual dimensions of care: Developing an educational package for hospital nurses in the republic of ireland. Holistic Nursing Practice, 28(2), 106–123. Scholar
  48. Timmins, F., Murphy, M., Neill, F., Begley, T., & Sheaf, G. (2015). An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks. Nurse Education Today, 35(1), 277–282. Scholar
  49. Welch, J. L., Jeffries, P. R., Lyon, B. L., Boland, P, D. L., & Backer, J. H. (2001). Experiential learning: integrating theory and research into practice. Nurse Educator, 26(5), 240–243. Retrieved from
  50. Wong, K. F., Lee, L. Y. K., & Lee, J. K. L. (2008). Hong Kong enrolled nurses’ perceptions of spirituality and spiritual care. International Nursing Review, 55(3), 333–340. Scholar
  51. Wu, L.-F., & Lin, L.-Y. (2011). Exploration of clinical nurses’ perceptions of spirituality and spiritual care. Journal of Nursing Research, 19(4), 250–256. Scholar
  52. Young, C., & Koopsen, C. (2011). Spirituality, health, and healing: An integrative approach. Sudbury, Massachusetts: Jones and Bartle.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Nursing, 5th Floor, Kompleks Pendidikan Perubatan Canselor Tuanku Ja’afar, Universiti Kebangsaan Malaysia Medical Centre, Faculty of MedicineThe National University of MalaysiaKuala LumpurMalaysia
  2. 2.School of Nursing and MidwiferyMonash UniversityFrankstonAustralia
  3. 3.School of Nursing and Midwifery, College of Science, Health and EngineeringLa Trobe UniversityMelbourneAustralia

Personalised recommendations