Journal of Surgery and Trauma

en 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 تروما Trauma پژوهشي Research <div class="WordSection1">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.</div> <div aria-label="Page Break" class="cke_pagebreak" contenteditable="false" data-cke-display-name="pagebreak" data-cke-pagebreak="1" style="page-break-after:always" title="Page Break"></div> Critical Care, Pastoral Care, Psychological Distress, Spirituality, Wounds and Injuries 128 143 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-553-1&slc_lang=en&sid=1 Ali Seyed Kalal ali.seyedkalal@gmail.com 100319475328460012951 100319475328460012951 No Department of Clinical Psychology, Faculty of Welfare and Health Social Sciences, Islamic Azad University of Medical Sciences, Tehran, Iran Minoo Asadzandi mazandi498@gmail.com 100319475328460012952 100319475328460012952 Yes Spiritual Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.