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Spiritual Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Abstract: (24 Views)
Abstract
Introduction: Trauma surgery prioritizes physiological stabilization and survival, however, severe trauma triggers spiritual distress, moral injury, and religious struggles. Holistic trauma care must address shattered beliefs and spiritual crisis by integrating structured spiritual healthcare frameworks into trauma systems. To address this gap, the present study introduces two trauma relevant constructs: (1) The Sound Heart Model (SHM) as a theistic and clinically adaptable spiritual care framework that emphasizes compassionate therapeutic communication by spiritual care providers as mentors and includes three core dimensions:- knowledge enhancement, -meaning making in the relationship with God, self, people, and nature, -and spiritual motivation; and (2) the Compassionate Spiritual Governance Theory, as a multi level system for organizing spiritual healthcare across clinical, familial, professional, and policy settings. This study aimed to develop a trauma oriented spiritual care framework through the Compassionate Spiritual Governance Theory based on the SHM using an Expanded Multi Grounded Theory (MGT Extended) approach.
Materials and Methods: An Expanded Multi Grounded Theory design incorporating with the Field informed Integrative Comparative Analysis (FICA) method was used. Empirical grounding was achieved through field observations, clinical notes, and expert interviews with trauma clinicians. Theoretical grounding incorporated scientific literature on trauma, spiritual distress, and coping, along with conceptual elements from Islamic and comparative spiritual traditions. Internal and rational grounding were performed through iterative model consolidation and the Rational Grounding Cycle. All analyses followed MGT procedures (open–axial–selective coding, conceptual integration, and multi layer triangulation). The validity of the framework was examined at the content level (expert confirmation), structural level (coherence and operationalizability), adaptive level (conformity with clinical evidence), and theoretical level (critical comparison with existing models). Reliability was also explained through inter rater agreement, stability of discourse analysis, and reproducibility of the inference pathway.
Results: Comprehensive trauma treatment requires cultural awareness. Social discourses framing suffering as divine punishment act as destructive social determinants of spiritual health (DSDSH), fostering negative images of God, insecure attachment to God, and shattered beliefs about God, self, others, and the world. Spiritual insecurity manifests as loneliness, helplessness, despair, and loss of meaning, leading to fear, grief, diminished self compassion, social withdrawal, and maladaptive coping. The proposed framework involves spiritual communication to build trust and security, reconstruct beliefs and restore meaning, develop secure attachment to God and supportive resources, and strengthen coping capacity and motivation for self care. It also allows culturally sensitive adaptation for patients and survivors with non religious worldviews.
Conclusion: This culturally informed, and clinically adaptable framework by strengthening meaning-making, spiritual security, and compassionate support can enhance spiritual health, coping capacity, and overall recovery in trauma settings.
Key words: Critical Care, Pastoral Care, Psychological Distress, Spirituality, Wounds and Injuries
Introduction: Trauma surgery prioritizes physiological stabilization and survival, however, severe trauma triggers spiritual distress, moral injury, and religious struggles. Holistic trauma care must address shattered beliefs and spiritual crisis by integrating structured spiritual healthcare frameworks into trauma systems. To address this gap, the present study introduces two trauma relevant constructs: (1) The Sound Heart Model (SHM) as a theistic and clinically adaptable spiritual care framework that emphasizes compassionate therapeutic communication by spiritual care providers as mentors and includes three core dimensions:- knowledge enhancement, -meaning making in the relationship with God, self, people, and nature, -and spiritual motivation; and (2) the Compassionate Spiritual Governance Theory, as a multi level system for organizing spiritual healthcare across clinical, familial, professional, and policy settings. This study aimed to develop a trauma oriented spiritual care framework through the Compassionate Spiritual Governance Theory based on the SHM using an Expanded Multi Grounded Theory (MGT Extended) approach.
Materials and Methods: An Expanded Multi Grounded Theory design incorporating with the Field informed Integrative Comparative Analysis (FICA) method was used. Empirical grounding was achieved through field observations, clinical notes, and expert interviews with trauma clinicians. Theoretical grounding incorporated scientific literature on trauma, spiritual distress, and coping, along with conceptual elements from Islamic and comparative spiritual traditions. Internal and rational grounding were performed through iterative model consolidation and the Rational Grounding Cycle. All analyses followed MGT procedures (open–axial–selective coding, conceptual integration, and multi layer triangulation). The validity of the framework was examined at the content level (expert confirmation), structural level (coherence and operationalizability), adaptive level (conformity with clinical evidence), and theoretical level (critical comparison with existing models). Reliability was also explained through inter rater agreement, stability of discourse analysis, and reproducibility of the inference pathway.
Results: Comprehensive trauma treatment requires cultural awareness. Social discourses framing suffering as divine punishment act as destructive social determinants of spiritual health (DSDSH), fostering negative images of God, insecure attachment to God, and shattered beliefs about God, self, others, and the world. Spiritual insecurity manifests as loneliness, helplessness, despair, and loss of meaning, leading to fear, grief, diminished self compassion, social withdrawal, and maladaptive coping. The proposed framework involves spiritual communication to build trust and security, reconstruct beliefs and restore meaning, develop secure attachment to God and supportive resources, and strengthen coping capacity and motivation for self care. It also allows culturally sensitive adaptation for patients and survivors with non religious worldviews.
Conclusion: This culturally informed, and clinically adaptable framework by strengthening meaning-making, spiritual security, and compassionate support can enhance spiritual health, coping capacity, and overall recovery in trauma settings.
Key words: Critical Care, Pastoral Care, Psychological Distress, Spirituality, Wounds and Injuries
Type of Study: Research |
Subject:
Trauma
Received: 2026/02/24 | Accepted: 2026/06/8 | ePublished ahead of print: 2026/07/13
Received: 2026/02/24 | Accepted: 2026/06/8 | ePublished ahead of print: 2026/07/13
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