The present study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative part, the concept and dimensions of spiritual care after the corona pandemic were explained and in the quantitative part, the tool "spiritual care after the corona pandemic" was designed and psychometric. Qualitative data collection was performed using 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion. Sampling was started purposive and continued until data saturation. Inclusion criteria were interested in participating in the study, age over 18, mental ability to interview and answer questions, and ability to speak Persian. The interviews were typed face-to-face with permission to record (Sony VOR audio recording) and word-for-word. The guide to the interview questions was prepared by reviewing the texts and a preliminary study. In-depth semi-structured interviews began with a general question (What do you think is the meaning of spiritual care in Corona?). Each interview lasted between 60-45 minutes. Ethical obligations to protect the rights of participants were considered by the researcher, the purpose of the study was explained and the privacy of information, confidentiality, and the right to leave the study at any time was guaranteed. All participants participated in the study with written consent. Interviews were conducted and recorded at the specialist workplace. Software MAXQDA v.10 was used for data analysis. In order to examine the data of this study, the criteria of Cuba and Lincoln (1989) including validity, transferability 2, homogeneity, and validity were used (20). The tool was scored based on a 6-point Likert tool, scoring 1 to 6 for “Agree Very Strongly”, “Agree Strongly”,” Agree”,” Disagree”,” Disagree Strongly” and, “Disagree Very Strongly” respectively. The total score of the tool is determined by calculating the average scores of the total items.
In the quantitative part of the study, the validity and reliability of the tool were assessed. Content validity, face validity, construct validity (exploratory factor analysis) and criterion validity (simultaneous) were used to evaluate the validity of the health needs tool. To determine the face validity of the tool, two methods of qualitative and quantitative face validity were used. The qualitative face validity of the tool was determined through face-to-face interviews with 20 men and women and a review in terms of difficulty, appropriateness, and ambiguity in the items. Only questions were acceptable in terms of face validity and were found suitable for further analysis if their impact score was higher than 1.5.
To evaluate the content validity of the Health Needs Questionnaire, the opinions of 20 faculty members of the seminary and the university (specialists in the field of spiritual health, spiritual, jurisprudence and Islamic principles, health education and promotion specialists) were used to determine the content validity index (Content Validity Index) Waltz and Basel determine the relevance, clarity, and simplicity of each item in the questionnaire in the 4-point Likert tool (20). The content validity index score for each phrase is calculated by dividing the number of agreeing on experts for the Likert rank 3 and 4 by the total number of experts. Based on this index, all expressions are measured at the beginning. If the index obtained is 79% or higher, that phrase will be accepted (21). Content validity was assessed qualitatively and quantitatively with the participation of 20 experts with knowledge and experience in tool design. In the qualitative method, 20 toolmaking experts were asked to comment on the tool items in terms of grammar, use of appropriate words, placement of phrases, and appropriate scoring. "Content validity ratio" and "Content validity index" were used to evaluate the validity of quantitative content. The reliability of the tool was confirmed by two methods of determining internal consistency and retest test. The tool used the Exploratory Factor Analysis method, which examines the internal relationship between variables, in order to discover the classes of variables that were most related to each other. The validity of the criterion (simultaneously) was assessed using the spiritual care tool (SWBS). Ellison developed the spiritual care tool in 1983 (22). To determine the reliability of the Spiritual care tool after the Corona pandemic, two methods of internal consistency and reliability were tested. The internal consistency of this tool was assessed in two stages. First, before performing factor analysis and in a sample of 200 men and women, it was determined. In the second step, after performing factor analysis, Cronbach's alpha coefficient for each factor as well as the whole tool was calculated in a sample of 20 women and 20 men. Exploratory factor analysis, Cronbach's alpha calculation, intra-cluster correlation index, and Wilcoxon test were used for statistical analysis of the second part of the study.This study was approved by the University Ethics Committee with the number IR.GUMS.REC.1399.515.
Table 1 : Spiritual care tool after Corona Pandemic
|
Statements
|
Agree Very Strongly
|
Agree Strongly
|
Agree
|
Disagree
|
Disagree Strongly
|
Disagree Very Strongly
|
Outcomes of spiritual care
|
1
|
Patience
|
|
|
|
|
|
|
2
|
Trusting God
|
|
|
|
|
|
|
3
|
Hope
|
|
|
|
|
|
|
4
|
Peace
|
|
|
|
|
|
|
5
|
Reduce pain
|
|
|
|
|
|
|
6
|
God-seeking
|
|
|
|
|
|
|
7
|
Theology
|
|
|
|
|
|
|
8
|
God-centered
|
|
|
|
|
|
|
9
|
Knowing the purpose of creation and life
|
|
|
|
|
|
|
10
|
Striving for spiritual excellence
|
|
|
|
|
|
|
11
|
Improve the quality of life
|
|
|
|
|
|
|
The challenge of providing spiritual care
|
12
|
Weakness of religious beliefs
|
|
|
|
|
|
|
13
|
Failure to provide spiritual careservices
|
|
|
|
|
|
|
14
|
Low knowledge of health care providers
|
|
|
|
|
|
|
15
|
Resistance to religious issues
|
|
|
|
|
|
|
16
|
Lack of specialized team
|
|
|
|
|
|
|
17
|
Lack of access to quality services
|
|
|
|
|
|
|
Spiritual care provider characteristics
|
18
|
Positive attitude
|
|
|
|
|
|
|
19
|
Respect for human dignity
|
|
|
|
|
|
|
20
|
Understand and respect the religious values and beliefs of individuals
|
|
|
|
|
|
|
21
|
Verbal skills
|
|
|
|
|
|
|
22
|
scientific skills
|
|
|
|
|
|
|
23
|
Communication skills
|
|
|
|
|
|
|
Spiritual care needs
|
24
|
Facilitate spiritual growth
|
|
|
|
|
|
|
25
|
Spiritual support
|
|
|
|
|
|
|
26
|
Creating a positive attitude
|
|
|
|
|
|
|
27
|
Teaching spiritual self-care
|
|
|
|
|
|
|
28
|
Empowering health care providers
|
|
|
|
|
|
|
29
|
Provide spiritual care regardless of faith and religion
|
|
|
|
|
|
|
30
|
Continue spiritual care after discharge
|
|
|
|
|
|
|
31
|
Access to spiritual care services
|
|
|
|
|
|
|
32
|
Attract the support of health policy makers
|
|
|
|
|
|
|
33
|
Allocate resources
|
|
|
|
|
|
|
34
|
Give proper priority to spiritual care
|
|
|
|
|
|
|
35
|
Establish private centers providing spiritual care services
|
|
|
|
|
|
|
36
|
Training of spiritual care specialists
|
|
|
|
|
|
|
37
|
Integrating spiritual careinto care-treatment programs
|
|
|
|
|
|
|
38
|
Designing a spiritual care system
|
|
|
|
|
|
|