Introduction: Nurses’ spiritual wellbeing and their attitude toward spirituality and competence of nurses in providing of spiritual care can affect the quality of care in nursing. The aim of this study was to evaluate spiritual wellbeing, attitude toward spiritual care and its relationship with the spiritual care competence among nurses. Methods: This was a correlational descriptive study conducted on 109 nurses working in the Intensive Care Units of Imam Reza and Madani hospitals in 2015, Tabriz, Iran. Data collection tools were a demographic data form and three standard questionnaires including Spiritual Wellbeing Scale, Spirituality and Spiritual Results: The mean score of the spiritual wellbeing was 94.45 (14.84), the spiritual care perspective was 58.77 (8.67), and the spiritual care competence was 98.51 (15.44). The linear regression model showed 0.42 variance between the spiritual care competence scores which were explained by the two aspects of spiritual wellbeing (religious health, existential health) and three aspects of spiritual care perspective (spirituality, spiritual care, personalized care). The spiritual care competence had a positive relationship with spiritual wellbeing and spiritual care perspective. Conclusion: Because of the nature of nursing and importance of close interaction of nurses with patients in ICUs, the higher nurses’ SW and the more their positive attitude toward spiritual care, the more they can provide spiritual care to their patients.

BACKGROUND:Respiratory system, together with the cardiovascular and central nervous system, is responsible for all processes related to oxygenation and hemodynamics and the defect in the functioning of each of these systems, along with ageing, can have mutual effects on their performance and physiological symptoms. The use of Pursed-lips Breathing (PLB) training is an essential part of the treatment of patients with the obstructive pulmonary disease, PLB stimulates the autonomic nervous system and causes relaxation and improvement of physiological parameters.AIM:This study was conducted to evaluate the effect of PLB on cardiac, pulmonary and oxygenation level in patients with Chronic Obstructive Pulmonary Disease (COPD).METHODS:A three-group clinical trial study with experimental and control which was purposefully conducted with the participation of patients with COPD and healthy individuals referring to Madani hospital Khoy, in 2017. The sample size was selected to be 60 subjects. The patients were randomly allocated to two groups of intervention and control with 20 patients, and 20 healthy subjects were assigned to the healthy intervention group. The demographic, anthropometric information form and checklist recording changes in levels of oxygenation, respiration, temperature, heart rate and blood pressure with cardiopulmonary follow up in three stages before, during and after PLB were used for data collection. Data were analysed using descriptive statistics, repeated measure test, ANOVA, and Chi-square.RESULTS:On evaluation within the COPD patient intervention group in Saturation of Peripheral Oxygen (SPO2) index with the mean difference of 2.05 percent, Respiratory Rate(RR)-0.65 minute and Pulse Rate(PR)-1.6 bpm was significant (p ≤ 0.05), and systolic blood pressure index in healthy subjects was increased (3.35 mmHg).CONCLUSION:The results of this study indicated that using effective PLB as an easy, inexpensive, non- invasive and non-pharmacological method is considered as an important factor in improving the status of oxygenation and physiological indicators in patients with COPD and should be considered as an important part of rehabilitation programs for these patients.

Spirituality, as an essential part of holistic care, is concerned with faith and meaning, and is usually conceptualised as a 'higher' experience or a transcendence of oneself. A resurgence of interest in this area is evident in postmodern culture because of the effects that spirituality and religious beliefs may have on health. Up until the last two decades, spirituality and spiritual care, although vital, were invisible aspects of nursing. However, now that these concepts have made their way into the mainstream, literature in this area has burgeoned. In addition, modern nursing grew out of spiritual roots, and spiritual care is a component of holistic care. In the Islamic Republic of Iran, little information exists documenting the expressed spirituality of nurses in general and of oncology nurses in particular. This article presents spirituality as it is experienced by Muslim oncology nurses. The investigation involved a qualitative analysis of the spirituality of 24 participants, using semi-structured interviews. Participants were oncology nurses at 12 hospitals in two educational universities of medical sciences in Tehran. The main categories of spirituality as experienced by oncology nurses included religious and existential dimensions in an Iranian Muslim context. Findings are consistent with the holistic view of Islam, that considers all dimensions of personhood simultaneously. This study is important to transcultural nursing because of the benefits of increasing nursing knowledge through research that examines nurses' spirituality in diverse cultures.

Introduction: Oncology nurses should create a balance in their personal and professional life to provide holistic care to patients. The more the awareness of spirituality in oncology nurses develops, the more obviously it manifests itself in their attitudes toward spiritual care. This study aimed to assess the relationship between oncology nurses' spiritual wellbeing, and their attitudes toward spiritual care based on Neumann’s Systems Model. Methods: This descriptive correlational study tested the relationships of Neuman system-based model constructs, named oncology nurses antecedents, their spiritual wellbeing, and attitudes to spiritual care by using a causal model and path analysis. 130 oncology nurses from 12 Tehran hospitals completed the study questionnaires, having completed written informed consents. The study administration permission was approved by Urmia University of medical sciences ethical committee. The collected data were coded and entered to computer to be analyzed by SPSS 13. We used path analysis and multiple regressions for assessing the relationships among the variables of the hypothesized study model. Results: The model testing revealed, from four antecedents’ predictors’ variables, only age and spiritual wellbeing had a direct and meaningful relationship with oncology nurses’ attitudes towards spiritual care. The nurses’ antecedent and mediator variable, and spiritual wellbeing explained 32.5% of the variance in their attitudes towards spiritual care. Moreover, the nurses’ spiritual wellbeing was found to have a positive relationship with their attitude to spiritual care (β= 0.450). Conclusion: However, the study model and its constructs proved to be quite efficient in indicating oncology nurses’ attitudes to spiritual care-related factors, but it is not a comprehensive model and other studies are required for its empirical testing.

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