The Effect of Spiritual Care on Perceived Stress and Mental Health Among the Elderlies Living in Nursing Home

  • Mohammad Heidari
  • Mansureh Ghodusi BorujeniEmail author
  • Shokouh Kabirian Abyaneh
  • Parvin Rezaei
Original Paper


The aim of this study was to investigate the effect of spiritual care on the perceived stress and mental health of the elderlies living in nursing home in Isfahan. This is a semi-experimental study with pretest and posttest design with control group. Ninety eligible elderlies living in the nursing home were divided into intervention and control groups through census and random allocation. The interventional spiritual care was conducted for the intervention group for 90 days. After conducting the spiritual care, the majority of the elderlies (62.22%) in the intervention group had a low perceived stress level and the majority of the subjects (64.44%) in the control group had a high perceived stress level. Therefore, after performing spiritual care, a significant difference was observed at the perceived stress level of the two groups (X2 = 3.22 and P = 0.001). The results of mental health level indicated that the mean score of the general health questionnaire was ranged between 10.95 and 27.2. After performing care, a significant difference was observed in mental health level of both groups, and 31.11% and 53.33% of the participants were suspected to general disorder in the intervention and control groups, respectively. Based on the results, there was a significant difference in the mental health level of both groups after the implementation of spiritual care (X2 = 6.56 and P = 0.001). Further, a significant negative correlation was found between the perceived stress and mental health (r = − 0.241 and P = 0.01). Considering the spiritual health as one of the health dimensions influencing the psychosocial variables of elderlies seems necessary. Policymakers and planners of health area contribute to the improvement of mental health level by using comprehensive care approach with an emphasis on the spiritual dimension of care for the elderly people.


Spiritual therapies Stress Mental health Elderly 



The authors want to express a special recognition to the elderlies living in nursing home in Isfahan who have participated in the data collection of this study, without whom the study could not be possible.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no potential conflicts of interest.

Ethical Approval

After selecting the eligible participant, the researcher was introduced to them and the objectives of the study were elaborated for the participants. The informed consent was obtained from the subjects, and they were assured that their information will remain confidential.


  1. Abolghasem Gorji, H., Bathaei, S. A., Shakeri, K., Heidari, M., & Asayesh, H. (2017). The effect of religiosity on quality of life in Muslim patients with heart failure: A study in Qom, the religious capital of Iran. Mental Health, Religion Culture, 20(3), 217–228.Google Scholar
  2. Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ® ). Washington, DC: American Psychiatric Pub.Google Scholar
  3. Bamdad, M., Fallahi Khoshknab, M., Dalvandi, A., Ardakani, K., & Reza, M. (2013). Impact of spiritual care on spiritual health of hospitalized amphetamin dependents. Iranian Journal of Psychiatric Nursing, 1(3), 10–18.Google Scholar
  4. Barati, M., Fathi, Y., Soltanian, A., & Moini, B. (2012). Health-promoting behaviors and health status of the elderly in the city of Hamadan. Journal of Hamadan Nursing & Midwifery Faculty, 20(2), 12–19.Google Scholar
  5. Bastani, F., Mohammadi Yeganeh, L., & Rahmatnejad, L. (2009). Evaluating the relationship of negative mood and perceived stress with demographic factors in women attending family planning clinics and applicant for contraceptive pills use. Journal of Urmia Nursing And Midwifery Faculty, 7(2), 82–88.Google Scholar
  6. Bekhet, A. K., & Zauszniewski, J. A. (2012). Mental health of elders in retirement communities: Is loneliness a key factor? Archives of Psychiatric Nursing, 26(3), 214–224.Google Scholar
  7. Bendixen, R. M., Elder, J. H., Donaldson, S., Kairalla, J. A., Valcante, G., & Ferdig, R. E. (2011). Effects of a father-based in-home intervention on perceived stress and family dynamics in parents of children with autism. American Journal of Occupational Therapy, 65(6), 679–687.Google Scholar
  8. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.Google Scholar
  9. Eshbaugh, E. M., Somervill, J. W., Kotek, J. H., Perez, E., Nalan, K. R., Wilson, C. E., et al. (2011). Brief report: Presence of a dog, pet attachment, and loneliness among elders. North American Journal of Psychology, 13(1), 1–4.Google Scholar
  10. Hadianfard, M., & Hadianfard, H. (2004). Mental status of geriatric patients with chronic locomotor diseases. Iranian Journal of Psychiatry and Clinical Psychology, 9(3), 75–83.Google Scholar
  11. Hammond, A. (2003). Substance misuse and serious mental illness: Spiritual care. Nursing Standard, 18(2), 33–38.Google Scholar
  12. Heidari, M., Borujeni, M. G., Ghafourifard, M., & Sheikhi, R. A. (2018). The evaluation of the awareness, attitude and practice of the elderly toward self-medication: A cross-sectional study. Drug Research, 68, 1–6.Google Scholar
  13. Heidari, M., Borujeni, M. G., & Rafiei, H. (2017). The assessment effect of spiritual care on hopelessness and depression in suicide attempts. Journal of Religion & Health. Scholar
  14. Heidari, M., Ghodusi Borujeni, M., & Naseh, L. (2016a). Comparison of self-efficacy and loneliness between community-dwelling & institutionalized older people. Iranian Journal of Ageing, 11(1), 142–151.Google Scholar
  15. Heidari, M., Ghodusi, M., & Shirvani, M. (2016b). Loneliness in elderly and non-elderly residents of nursing homes. International Journal of Nursing Education, 8, 71–76.Google Scholar
  16. Khoshknab, M. F., Mazaheri, M., Maddah, S. S., & Rahgozar, M. (2010). Validation and reliability test of persian version of the spirituality and spiritual care rating scale (SSCRS). Journal of Clinical Nursing, 19(19–20), 2939–2941.Google Scholar
  17. Kim, H. J., Shin, K. H., & Swanger, N. (2009). Burnout and engagement: A comparative analysis using the Big Five personality dimensions. International Journal of Hospitality Management, 28(1), 96–104.Google Scholar
  18. Kim, S. S., Reed, P. G., Kang, Y., & Oh, J. (2012). Translation and psychometric testing of the Korean versions of the spiritual perspective scale and the self-transcendence scale in Korean elders. Journal of Korean Academy of Nursing, 42(7), 974–983.Google Scholar
  19. Koenig, H. G., George, L. K., & Titus, P. (2004). Religion, spirituality, and health in medically ill hospitalized older patients. Journal of the American Geriatrics Society, 52(4), 554–562.Google Scholar
  20. Kuyper, L., & Fokkema, T. (2010). Loneliness among older lesbian, gay, and bisexual adults: The role of minority stress. Archives of Sexual Behavior, 39(5), 1171–1180.Google Scholar
  21. Malek, A., Poorafkary, N., Dadashzadeh, H., & Safaeeyan, A. (2008). Ranking of stressful life events in general population of Tabriz, Iran. Research Journal of Biological Sciences, 3(9), 993–998.Google Scholar
  22. Mansouri, T., Dehdari, T., Seyedfatemi, N., Gohari, M. R., & Barkhordari, M. (2014). The effect of communication skills training on perceived stress of caregivers of elderly with Alzheimer’s disease referral to Iranian Alzheimer Association in 2012. Razi Journal of Medical Sciences, 21(121), 52–62.Google Scholar
  23. Manzouri, L., Babak, A., & Merasi, M. (2010). The depression status of the elderly and it’s related factors in Isfahan in 2007. Iranian Journal of Ageing, 4(4), 27–33.Google Scholar
  24. Mohammadi, F., & Babaee, M. (2011). Effects of participation in support groups on Alzheimer’s family caregivers’ strain and spiritual wellbeing. Iranian Journal of Ageing, 6(1), 0–0.Google Scholar
  25. Mui, A. C., & Kang, S. Y. (2006). Acculturation stress and depression among Asian immigrant elders. Social Work, 51(3), 243–255.Google Scholar
  26. Mumford, D. B., Minhas, F. A., Akhtar, I., Akhter, S., & Mubbashar, M. H. (2000). Stress and psychiatric disorder in urban Rawalpindi: Community survey. The British Journal of Psychiatry, 177(6), 557–562.Google Scholar
  27. Muramatsu, N., Yin, H., & Hedeker, D. (2010). Functional declines, social support, and mental health in the elderly: Does living in a state supportive of home and community-based services make a difference? Social Science & Medicine, 70(7), 1050–1058.Google Scholar
  28. Nejati, V., Izadi-najafabadi, S., Shoja, O., Javadi, M., & Rezaei, F. (2013). Cognitive and general health status in elderly with and without history of falling. Iranian Journal of Ageing, 8(1), 7–15.Google Scholar
  29. Piazza, J. R., Almeida, D. M., Dmitrieva, N. O., & Klein, L. C. (2010). Frontiers in the use of biomarkers of health in research on stress and aging. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65(5), 513–525.Google Scholar
  30. Rejali, M., & Mostajeran, M. (2012). Investigation of religious status in students in health collage of Isfahan University of medical sciences. Journal of Health Research, 8(2), 314–318.Google Scholar
  31. Saberian, M., Haji, A. S., & Ghorbani, R. (2004). Study of the mental status of the elderly and its relationship with leisure time activities. Journal of Sabzevar University of Medical Sciences, 10(4), 53–60.Google Scholar
  32. Sartipzadeh, A., Ali-Akbari, M., & Tabaian, R. (2016). Effectiveness of spirituality therapy on the resiliency of the elderly in Isfahan, Iran. Journal of Research in Behavioural Sciences, 14(1), 56–63.Google Scholar
  33. Saydshohadai, M., Heshmat, S., Seidfatemi, N., Haghani, H., & Mehrdad, N. (2013). The spiritual health of seniors living in sanitarium and home residents. Iranian Journal of Nursing, 26(81), 11–20.Google Scholar
  34. Shoja, M., Rimaz, S., Asadi, L. M., Bagheri, Y. S. A., & Gohari, M. R. (2013). Mental health of older people and social capital. Payesh, 4, 345–353.Google Scholar
  35. Tehrani, H., Shojayizade, D., Hoseiny, S. M., & Alizadegan, S. (2012). Relationship between mental health, personality trait and life events in nurses working in tehran emergency medical service (Tehran 115). Iranian Journal of Nursing, 25(75), 52–59.Google Scholar
  36. Tsai, A. C., Chi, S.-H., & Wang, J. Y. (2013). The association of perceived stress with depressive symptoms in older Taiwanese—Result of a longitudinal national cohort study. Preventive Medicine, 57(5), 646–651.Google Scholar
  37. Wang, J. J., Snyder, M., & Kaas, M. (2001). Stress, loneliness, and depression in Taiwanese rural community-dwelling elders. International Journal of Nursing Studies, 38(3), 339–347.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Mohammad Heidari
    • 1
  • Mansureh Ghodusi Borujeni
    • 2
    Email author
  • Shokouh Kabirian Abyaneh
    • 3
  • Parvin Rezaei
    • 4
  1. 1.School of Nursing and MidwiferyShahrekord University of Medical SciencesShahrekordIran
  2. 2.Young Researchers and Elite Club, Abadeh BranchIslamic Azad UniversityAbadehIran
  3. 3.Shahid Beheshti University of Medical SciencesTehranIran
  4. 4.Shariati HospitalTehran University of Medical SciencesTehranIran

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