Volume 14, Issue 3 (8-2026)                   J Surg Trauma 2026, 14(3): 128-143 | Back to browse issues page

Ethics code: IR.BMSU.REC.1404.162


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Seyed Kalal A, Asadzandi M. Developing a Trauma Oriented Spiritual Care Framework through the Compassionate Spiritual Governance Theory Based on the Sound Heart Model: An Expanded Multi Grounded Theory Study. J Surg Trauma 2026; 14 (3) :128-143
URL: http://jsurgery.bums.ac.ir/article-1-546-en.html
Spiritual Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Abstract:   (235 Views)
Introduction: Trauma surgery prioritizes physiological stabilization and survival, yet severe trauma triggers spiritual distress, moral injury, and religious struggles often unaddressed in conventional care. Holistic trauma care must address shattered beliefs and spiritual crisis through structured spiritual frameworks. This study is grounded in two constructs: (1) the Sound Heart Model (SHM), a theistic spiritual-care model emphasizing compassionate mentor communication for knowledge enhancement, meaning-making, and spiritual motivation; and (2) the Compassionate Spiritual Health Governance Theory(CSHG-T), a multi-level system organizing spiritual healthcare across individual, familial, professional, and policy settings. The aim was developing a trauma-oriented spiritual-care framework integrating the SHM within the CSHG-T, using an Expanded Multi-Grounded Theory (E-MGT) approach.
Methods: An E-MGT design incorporating Field-informed Integrative Comparative Analysis (FICA) was employed. Empirical grounding drew on field observations, clinical notes, and expert interviews with trauma clinicians. Theoretical grounding integrated literature on trauma, spiritual distress, and coping with elements from Islamic and comparative spiritual traditions. Internal and rational grounding proceeded through consolidation and the Rational Grounding Cycle (RGC). Analyses followed open, axial, and selective coding, conceptual integration, and triangulation. Validity was assessed at content, structural, adaptive, and theoretical levels; reliability was supported by inter-rater agreement and discourse stability.
Results: Comprehensive trauma care requires cultural awareness. Social discourses framing suffering as divine punishment function as destructive determinants of spiritual health, fostering negative God-images, 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, reduced self-compassion, withdrawal, and maladaptive coping. The proposed framework centers on spiritual communication that builds trust, reconstructs beliefs, restores meaning, cultivates secure attachment to God, and strengthens coping, permitting adaptation for non-religious worldviews.
Conclusion: This framework strengthens meaning-making, spiritual security, and compassionate support, enhancing spiritual health and overall recover
Keywords: Critical Care, Psychological Distress, Pastoral Care, Spirituality; Wounds and Injuries.
Full-Text [PDF 686 kb]   (122 Downloads) |   |   Full-Text (HTML)  (57 Views)  
Type of Study: Research | Subject: Trauma
Received: 2026/02/24 | Accepted: 2026/06/8 | ePublished ahead of print: 2026/07/13 | Published: 2026/08/1

References
1. 1. Nikdel R, Pakzad S, Mahmoudlo R. Examining the frequency of trauma types in patients referred to hospital emergency room. Stud Med Sci. 2021;34(6):353-60. [DOI: 10.61186/umj.34.6.353] [DOI:10.61186/umj.34.6.353]
2. Molen HF, Basnet P, Hoonakker PL, Lehtola MM, Lappalainen J, Frings‐Dresen MH, et al. Interventions to prevent injuries in construction workers. Cochrane Database Syst Rev. 2018; 52(2). [DOI: 10.1002/14651858.CD006251] [DOI:10.1002/14651858.CD006251]
3. Kafaeizad Tehrani P, Abed N, Shahrivar Z, Panaghi L. Play-based assessment for children with traumatic experiences: a meta-synthesis study. Iran J Psychiatry Clin Psychol. 2024;30(1):5006-1. [DOI:10.32598/ijpcp.30.5006.1] [DOI:10.32598/ijpcp.30.5006.1]
4. Kacker S, Bishai D, Mballa GA, Monono ME, Schneider EB, Ngamby MK, et al. Socioeconomic correlates of trauma: an analysis of emergency ward patients in yaoundé cameroon. Injury. 2016;47(3):658-64. [DOI: 10.1016/j.injury.2015.12.011] [PMID: 26763297] [DOI:10.1016/j.injury.2015.12.011] [PMID]
5. Dell'Osso L, Lorenzi P, Nardi B, Carmassi C, Carpita B. Post traumatic growth (PTG) in the frame of traumatic experiences. Clin Neuropsychiatr. 2022;19(6):390-3 [DOI: 10.36131/cnfioritieditore20220606] [PMID: 36627947]
6. Janoff-Bulman R. Assumptive worlds and the stress of traumatic events: applications of the schema construct. Social Cognition. 1989;7(2):113-36.[ DOI: 10.1521/soco.1989.7.2.113] [DOI:10.1521/soco.1989.7.2.113]
7. Hurst R, Kannangara C. Post-traumatic growth from grief-a narrative literature review. Ment Health Soc Incl. 2022;28(3):261-73.[DOI: 10.1108/MHSI-09-2022-0059] [DOI:10.1108/MHSI-09-2022-0059]
8. Belrose C, Duffaud AM, Dutheil F, Trichereau J, Trousselard M. Challenges associated with the civilian reintegration of soldiers with chronic PTSD: A new approach integrating psychological resources and values in action reappropriation. Front Psychiatry. 2019;9:737. [DOI: 10.3389/fpsyt.2018.00737] [PMID: 30670989] [DOI:10.3389/fpsyt.2018.00737] [PMID] [PMCID]
9. Salehabadi R, Roshanfekr M, Salehi Kian N, Salehi Kian H, Vejdani M, Yarelahi M. Post-traumatic stress disorder among covid-19 survivors at 1-month follow-up after vasei hospital of sabzevar discharge in 2019: a short report. J Rafsanjan Univ Med Sci. 2022;21(6):687-96. [DOI:10.52547/jrums.21.6.687] [DOI:10.52547/jrums.21.6.687]
10. Leo D, Izadikhah Z, Fein EC, Forooshani SA. The effect of trauma on religious beliefs: a structured literature review and meta-analysis. Trauma Violence Abuse. 2021;22(1):161-75. [DOI: 10.1177/1524838019834076] [PMID: 30862254] [DOI:10.1177/1524838019834076] [PMID]
11. Van Tongeren DR, Aten JD, Davis EB, Hook JN, Davis DE, DeBlaere C, et al.Meaning, religion, and spirituality in the aftermath of trauma: a review of the empirical literature.Psychol Trauma. 2023;15(5):879-95. [Link]
12. Tedeschi RG, Calhoun LG. " Posttraumatic growth: conceptual foundations and empirical evidence". Psychol Inquiry. 2004;15(1):1-8.[DOI: 10.1207/s15327965pli1501_01] [DOI:10.1207/s15327965pli1501_01]
13. Asgari Z, Naghavi A. Explaining post-traumatic growth: thematic synthesis of qualitative research. Iran J Psychiatry Clin Psychol. 2019;25(2):222-34. [DOI:10.32598/ijpcp.25.2.222] [DOI:10.32598/ijpcp.25.2.222]
14. Asadzandi M. Explaining the propositions of the sound heart model as spiritual health theory: research methodology. J Biomed Res Environ Sci. 2023;4(10):1507-21. [DOI:10.37871/jbres1824] [DOI:10.37871/jbres1824]
15. Zeligman M, Varney M, Grad RI, Huffstead M. Posttraumatic growth in individuals with chronic illness: The role of social support and meaning making. J Couns Dev. 2018;96(1):53-63. [DOI: 10.1002/jcad.12177] [DOI:10.1002/jcad.12177]
16. Asadzandi M, Lotfian L, Sepandi M. The effect of spiritual counseling based on the sound heart model on spiritual experience and spiritual intelligence of military commanders. J Mil Med. 2023;25(1):1701-9. [DOI: 10.30491/jmm.2023.1001200]
17. Ghalyanee B, Asadzandi M, Bahraynian S A, Karimi Zarchi A A. Comparing the effects of spiritual counseling based on the sound heart model with mindfulness training on the quality of life of women with breast cancer. 2021;14(3):34-45. [DOI: 10.30699/ijbd.14.3.34] [DOI:10.30699/ijbd.14.3.34]
18. Asadzandi M. An islamic religious spiritual health training model for patients. J Relig Health. 2020;59(1):173-87. [DOI: 10.1007/s10943-018-0709-9] [PMID: 30311051] [DOI:10.1007/s10943-018-0709-9] [PMID]
19. Asadzandi M, shahrabi farahany S, Abolghasemy H, Saberi M, Ebadi A. Effect of sound heart model- based spiritual counseling on stress, anxiety and depression of parents of children with cancer. Iran J Pediatr Hematol Oncol. 2020;10(2):96-106. [Link]
20. Seyed kalal A, Asadzandi M. The role of spiritual security in the spiritual fitness of military personnel in dealing with religious spiritual struggles: a comparative study of two theories. J Mil Med. 2025;27(4):2917 27. [DOI: 10.30491/jmm.2025.1006890.1351]
21. Asadzandi M, Seyed kalal A. Compassionate spiritual governance of those with a sound heart in the national educational-health-treatment system: a strategy for defending spiritual security and the spiritual and psychological health of society. Tehran: Resaneh T Publications. 2026. [Link]
22. Goldkuhl G, Cronholm S, Lind M. Multi-grounded action research. Information Systems and e-Business Management. 2020;18:121-56. [DOI: 10.1007/s10257-020-00469-1] [DOI:10.1007/s10257-020-00469-1]
23. Renjith V, Yesodharan R, Noronha JA, Ladd E, George A. Qualitative methods in health care research. Inter J Prevent Med. 2021;12(1):20. [DOI: 10.4103/ijpvm.IJPVM_321_19] [PMID: 34084317] [DOI:10.4103/ijpvm.IJPVM_321_19] [PMID] [PMCID]
24. Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches: Sage publications. 2017. [Link]
25. Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. 11th Edition, Lippincott Williams & Wilkins.2021. [Link]
26. Asadzandi M, Seyed Kalal A. The role of social customs in creating insecure attachment to god: based on the model of sound heart. Islam Res Spirituality. 2023;1(2):129-94. [DOI: 10.22081/jsr.2023.64855.1030]
27. Kalantar Neyestanaki M H, Asadzandi M, Hosseini S M. Perspectives of soft war officers on the social determinants of the spiritual health of iranian students: a grounded theory study at a military university. J Mil Med. 2025;26(6):2583-94. [DOI:. 10.30491/jmm.2025.1006756.1243]
28. Asadzandi M, Mazandarani HA, Saffari M, Khaghanizadeh M. Effect of spiritual care based on the sound heart model on spiritual experiences of hemodialysis patients. J Relig Health. 2022;61(3):2056-71. [DOI: 10.1007/s10943-021-01396-2] [PMID: 34427849] [DOI:10.1007/s10943-021-01396-2] [PMID]
29. Chan CS, Rhodes JE. Religious coping, posttraumatic stress, psychological distress, and posttraumatic growth among female survivors four years after hurricane katrina. J Traum Stress. 2013;26(2):257-65. [DOI: 10.1002/jts.21801] [PMID: 23529889] [DOI:10.1002/jts.21801] [PMID]
30. Asadzandi M. The role of military commanders as mentors in the spiritual health of society: based on the sound heart model. J Mil Med. 2023;25(4):1978-82 [Link]
31. Zoheiri M, Masuodi O, Asadzandi M, Khoshi A. Investigation the role of spiritual health in treatment of patients with covid-19: study of a military hospital. J Mil Med. 2022;24(3): 1201-9. [DOI: 10.30491/JMM.24.3.1201]
32. Parayil TJ. Integrating psycho-spiritual interventions for trauma-based counselling. Vinayasādhana. 2025;16(1):4-7. [Link]
33. Eames C, O'Connor D. The role of repetitive thinking and spirituality in the development of posttraumatic growth and symptoms of posttraumatic stress disorder. PloS One. 2022;17(8): e0272036. [DOI: 10.1371/journal.pone.0272036] [PMID: 35926059] [DOI:10.1371/journal.pone.0272036] [PMID] [PMCID]
34. Hansen DT. Trauma-informed spiritual care: Interventions for safety, meaning, reconnection, and justice. Augsburg Fortress Publ. 2024;74(3). [DOI: 10.1007/s11089-024-01197-w] [DOI:10.1007/s11089-024-01197-w]
35. Sadeghi A, Khodabakhshi-Koolaee A, Asadzandi M. The effect of spiritual counseling based on the sound heart model on resilience and parenting competence in mothers with intellectually disabled children. Prev Care Nurs Midwifery J. 2024;14(3):59-66. [DOI: 10.61186/pcnm.14.3.59] [DOI:10.61186/pcnm.14.3.59]
36. Resick PA, Schnicke MK. Cognitive processing therapy for sexual assault victims. J Cons Clin Psychol. 1992;60(5):748-56. [DOI: 10.1037//0022-006x.60.5.748] [PMID: 1401390] [DOI:10.1037//0022-006X.60.5.748] [PMID]
37. Pearce MJ, Haynes K, Rivera LR, Koenig HG. Spiritually integrated cognitive processing therapy: a new treatment for post traumatic stress disorder that targets moral injury. Glob Adv Health Med. 2018;7:1 7. [DOI: 10.1177/2164956118759939] [ PMID: 29497585] [DOI:10.1177/2164956118759939] [PMID] [PMCID]
38. Buhake L. Integrating faith based approaches into cognitive behavioral therapy (CBT) for mental health: a systematic review and meta analysis of existing studies [dissertation]. Virginia (VA): Regent University. 2025. [Link]
39. Mousavi S, Vatankhah H. Effectiveness of spiritual therapy on post traumatic growth in women with breast cancer. J Disabil Stud. 2023;12(1):113 20. [Link]
40. Asadzandi M, Farahany S, Abolghasemy H, Saberi M, Ebadi A. Effect of spiritual care on the care burden of families of children with cancer: a randomized controlled trial. Fam Med Prim Care Rev. 2021;23(3):279 83. [DOI: 10.5114/fmpcr.2021.108189] [DOI:10.5114/fmpcr.2021.108189]
41. Rahimi M, Heidarzadeh M. Presenting a post traumatic growth model based on positive psychology in cancer survivors: a meta synthesis. J Appl Psychol Res. 2022;13(4):85 98. [DOI:10.22059/japr.2022.326588.643896]

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