Spirituality and Spiritual Care in the Arab World

  • Mysoon Khalil Abu-El-Noor
  • Nasser Ibrahim Abu-El-NoorEmail author
Living reference work entry


Recent advancements in medical technology and pharmacological treatments have increased life spans and also the number of people living with chronic diseases. The growing number of people with chronic diseases will need frequent hospitalizations, subjecting them to stress, anxiety, and depression. Providing spiritual care to these patients benefits their health and improves their quality of life. Despite these benefits, health-care professionals, including health-care providers in the Arab countries, tend to provide inadequate spiritual care to their patents as they tend to focus on the physical needs of their patients.

Spirituality and spiritual care are deeply rooted in Arab countries as they are part of the Islamic practice which prevails in the area. The authors of this chapter explain the interwoven relationship between religion and spirituality and how a Muslim’s beliefs affect healthy behaviors. Based on their religious beliefs, Muslims use the Quran, prayer, Dua’a, and Ruqya as a means for spiritual care.

Research over the last decade suggests several barriers that impede spiritual care in the Arab countries and other parts of the world. Examples of these barriers include inadequate staff, lack of time, lack of training on provision of spiritual care, the ambiguity of spirituality, and the absence of spiritual care in the job descriptions for health-care professionals.

More attention has been paid recently to spirituality in health care, and the relationship between spirituality and illness is at the center of a growing body of literature in Western countries. As a result, many hospitals in the West have started to offer spiritual care to their patients and assigned clergy within the health-care team. Unfortunately, there is a dearth of literature on this topic in Arab countries, but there is recent emergence of literature in some Arab countries, particularly from Jordan, Saudi Arabia, and Palestine. To improve the level of spiritual care provided in Arab countries, new policies should be adopted. In this chapter, the authors propose several recommendations to improve the assessment and provision of spiritual care within Arab health-care systems. Examples include increasing the number of staff, providing training to staff on assessing and providing spiritual care, and adopting new polices to ensure spiritual care to Arab patients.


Spirituality Spiritual care Arab world Chronic diseases Islam 



Commission on Accreditation of Rehabilitation Facilities


Joint Commission on Accreditation of Healthcare Organizations


Peace be upon him


World Health Organization


  1. Abu-El-Noor M (2016a) Spiritual care for cardiac patients admitted to coronary care units in Gaza Strip: cardiac patients’ perception. IUG J Nat Stud 20(2):73–98Google Scholar
  2. Abu-El-Noor N (2016b) ICU nurses’ perceptions and practice of spiritual care at the end of life: implications for policy change. Online J Issues Nurs 21(1)Google Scholar
  3. Abu-El-Noor MK, Abu-El-Noor NI (2014a) Importance of spiritual Care for Cardiac Patients Admitted to coronary care units in the Gaza strip: patients’ perception. J Holist Nurs 32(2):104–115PubMedCrossRefGoogle Scholar
  4. Abu-El-Noor N, Abu-El-Noor M (2014b) End of life-decisions: an Islamic perspective. Online J Health Ethics 10(1):4Google Scholar
  5. Abu-El-Noor MK, Abu-El-Noor NI (2016) Mapping the road for a new spiritual care policy: identifying barriers and enhancing factors for providing spiritual care to cardiac patients. J Relig Spiritual Aging 28(3):184–199CrossRefGoogle Scholar
  6. Abu-El-Noor NI, Radwan AS (2015) Assessing spiritual Well-being of Arab Muslim prostate Cancer survivors: a reflection for a new spiritual health care policy. Int J Res Appl Nat Soc Sci 3(8):1–14Google Scholar
  7. Al Ghaferi H, Bond C, Matheson C (2017) Does the biopsychosocial-spiritual model of addiction apply in an Islamic context? A qualitative study of Jordanian addicts in treatment. Drug Alcohol Depend 172:14–20PubMedCrossRefGoogle Scholar
  8. Albaugh JA (2003) Spirituality and life-threatening illness: a phenomenologic study. Oncol Nurs Forum 30(4):593–598PubMedCrossRefGoogle Scholar
  9. Al-Jibaly M (1998) Sickness: regulations and exhortations (the inevitable journey – part 1). Al-Kitaab & as-Sunnah Publishing, ArlingtonGoogle Scholar
  10. Al-Natour A, Al Momani SM, Qandil AM (2017) The relationship between spirituality and quality of life of Jordanian women diagnosed with breast cancer. J Relig Health 56(6):2096–2108PubMedCrossRefGoogle Scholar
  11. Anandarajah G (2008) The 3 H and BMSEST models for spirituality in multicultural whole-person medicine. Ann. Fam. Med. 6(5):448–458PubMedPubMedCentralCrossRefGoogle Scholar
  12. Asadi-Lari M, Madjd Z, Goushegir SA (2008) Gaps in the provision of spiritual care for terminally ill patients in Islamic societies-a systematic review. Adv Palliat Med 7(2):73–80Google Scholar
  13. Athar S (1998) Information for health care providers when dealing with a Muslim patient. Islamic Medical Association of North America, Illinois, pp 1–3Google Scholar
  14. Balboni MJ, Sullivan A, Enzinger AC, Epstein-Peterson ZD, Tseng YD, Mitchell C, Niska J, Zollfrank A, VanderWeele TJ, Balboni TA (2014) Nurse and physician barriers to spiritual care provision at the end of life. J Pain Symptom Manage 48(3):400–410PubMedPubMedCentralCrossRefGoogle Scholar
  15. Bar-Sela G, Schultz M, Khader K, Rassouli M, Doumit M, Ghrayeb I, Kebudi R, Elshamy K, Al-Jadiry MF, Fahmi R (2016) Provision of spiritual care to advanced cancer patients by doctors and nurses in the Middle East. Ann Oncol 27(suppl_6):1312Google Scholar
  16. Bentur N, Resnitzky S, Sterne A (2010) Attitudes of stakeholders and policymakers in the healthcare system towards the provision of spiritual care in Israel. Health Policy 96(1):13–19PubMedCrossRefGoogle Scholar
  17. Burkhardt MA, Nagai-Jacobson MG (2002) Spirituality: living our connectedness. Cengage Learning, BostonGoogle Scholar
  18. Byrd RC (1988) Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Med J 81(7):826–829PubMedCrossRefGoogle Scholar
  19. Chan MF (2010) Factors affecting nursing staff in practising spiritual care. J Clin Nurs 19(15–16):2128–2136PubMedGoogle Scholar
  20. Chaturvedi SK (2007) Spiritual issues at end of life. Indian J Palliat Care 13(2):48CrossRefGoogle Scholar
  21. Chung LYF, Wong FKY, Chan MF (2007) Relationship of nurses’ spirituality to their understanding and practice of spiritual care. J Adv Nurs 58(2):158–170PubMedCrossRefGoogle Scholar
  22. Clark PA, Drain M, Malone MP (2003) Addressing patients’ emotional and spiritual needs. Jt Comm J Qual Saf 29(12):659–670PubMedGoogle Scholar
  23. Cromie WJ (1997) How your brain listen to music. Harvard University GazetteGoogle Scholar
  24. Cruz JP, Baldacchino DR, Alquwez N (2016) Validity and reliability of the spiritual coping strategies scale Arabic version in Saudi patients undergoing haemodialysis. J Ren Care 42(2):107–114PubMedCrossRefGoogle Scholar
  25. Cruz JP, Alshammari F, Alotaibi KA, Colet PC (2017a) Spirituality and spiritual care perspectives among baccalaureate nursing students in Saudi Arabia: a cross-sectional study. Nurse Educ Today 49:156–162PubMedCrossRefGoogle Scholar
  26. Cruz JP, Colet PC, Alquwez N, Inocian EP, Al-Otaibi RS, Islam SMS (2017b) Influence of religiosity and spiritual coping on health-related quality of life in Saudi haemodialysis patients. Hemodial Int 21(1):125–132PubMedCrossRefGoogle Scholar
  27. El-Kadi A (1993) Health and healing in the qur’an. In: Athar S (ed) Islamic perspectives in medicine. a survey of islamic medicine: achievements and contemporary issues. American Trust Publications, Indianapolis, pp. 117–118Google Scholar
  28. Errihani H, Mrabti H, Boutayeb S, El Ghissassi I, El Mesbahi O, Hammoudi M, Chergui H, Riadi A (2008) Impact of cancer on Moslem patients in Morocco. Psychooncology 17(1):98–100PubMedCrossRefGoogle Scholar
  29. Fadhil I, Lyons G, Payne S (2017) Barriers to, and opportunities for, palliative care development in the eastern Mediterranean region. Lancet Oncol 18(3):e176–e184PubMedCrossRefGoogle Scholar
  30. Feudtner C, Haney J, Dimmers MA (2003) Spiritual care needs of hospitalized children and their families: a national survey of pastoral care providers’ perceptions. Pediatrics 111(1):e67–e72PubMedCrossRefGoogle Scholar
  31. Forbis PA (1988) Meeting patients’ spiritual needs. Geriatr Nurs (New York) 9(3):158CrossRefGoogle Scholar
  32. Ghali H (2017) Cultural challenges in imple-menting palliative care services in Iraq. Palliat Med Hosp Care Open J SE 1:S19–S23CrossRefGoogle Scholar
  33. Golberg B (1998) Connection: an exploration of spirituality in nursing care. J Adv Nurs 27(4):836–842PubMedCrossRefGoogle Scholar
  34. Gray DP, Steele R, Sweeney K, Evans P (1994) Generalists in medicine 308:486–487Google Scholar
  35. Greenberg D (2003) Spirituality in medicine: does it fit. PennPulse 99:1–7Google Scholar
  36. Halm MA, Myers RN, Bennetts P (2000) Providing spiritual care to cardiac patients: assessment and implications for practice. Crit Care Nurse 20(4):54PubMedGoogle Scholar
  37. Handzo G, Koenig H (2004) Spiritual care: whose job is it anyway? South Med J 97(12):1242–1244PubMedCrossRefGoogle Scholar
  38. Highfield MF, Cason C (1983) Spiritual needs of patients: are they recognized? Cancer Nurs 6(3):187–192PubMedCrossRefGoogle Scholar
  39. Hills J, Paice JA, Cameron JR, Shott S (2005) Spirituality and distress in palliative care consultation. J Palliat Med 8(4):782–788PubMedCrossRefGoogle Scholar
  40. Isgandarova N (2005) Islamic spiritual care in a health care setting. In: Meier A, O'Connor TSJ, PL VK (eds) Spirituality and health: multidisciplinary explorations. Wilfrid Laurier University Press, Waterloo, pp 85–100Google Scholar
  41. Jafari N, Farajzadegan Z, Loghmani A, Majlesi M, Jafari N (2014a) Spiritual Well-being and quality of life of Iranian adults with type 2 diabetes. Evid Based Complement Alternat Med 2014:1–8CrossRefGoogle Scholar
  42. Jafari N, Loghmani A, Puchalski CM (2014b) Spirituality and health care in Iran: time to reconsider. J Relig Health 53(6):1918–1922PubMedCrossRefGoogle Scholar
  43. Joint Commission Resources (2003) Comprehensive accreditation manual for hospitals: The Official handbook. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare OrganizationsGoogle Scholar
  44. Keall R, Clayton JM, Butow P (2014) How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. J Clin Nurs 23(21–22):3197–3205PubMedCrossRefGoogle Scholar
  45. Koenig HG (1998) Religious attitudes and practices of hospitalized medically ill older adults. Int J Geriatr Psychiatry 13(4):213–224PubMedCrossRefGoogle Scholar
  46. Koenig HG (2009) Research on religion, spirituality, and mental health: a review. Can J Psychiatry 54(5):283–391PubMedCrossRefGoogle Scholar
  47. Kurtz S, Draper J, Silverman J (2016) Skills for communicating with patients. CRC Press, Boca RatonGoogle Scholar
  48. Kuuppelomäki M (2001) Spiritual support for terminally ill patients: nursing staff assessments. J Clin Nurs 10(5):660–670PubMedCrossRefGoogle Scholar
  49. Larson DB, Larson SS, Koenig HG (2002) Mortality and religion/spirituality: a brief review of the research. Ann Pharmacother 36(6):1090–1098PubMedCrossRefGoogle Scholar
  50. Lazenby M, Khatib J (2012) Associations among patient characteristics, health-related quality of life, and spiritual Well-being among Arab Muslim cancer patients. J Palliat Med 15(12):1321–1324PubMedCrossRefGoogle Scholar
  51. Lazenby M, Khatib J, Al-Khair F, Neamat M (2013) Psychometric properties of the functional assessment of chronic illness therapy—spiritual Well-being (facit-sp) in an Arabic-speaking, predominantly Muslim population. Psychooncology 22(1):220–227PubMedCrossRefGoogle Scholar
  52. Lemmer CM (2005) Recognizing and caring for spiritual needs of clients. J Holist Nurs 23(3):310–322PubMedCrossRefGoogle Scholar
  53. Levin J, Chatters LM, Taylor RJ (2005) Religion, health and medicine in African Americans: implications for physicians. J Natl Med Assoc 97(2):237PubMedPubMedCentralGoogle Scholar
  54. Lovering S (2008) Arab Muslim nurses experiences of the meaning of caring. The University of Sydney, SydneyGoogle Scholar
  55. Lovering S (2012) The crescent of care: a nursing model to guide the care of Arab Muslim patients. Divers Equ Health Care 9(3)Google Scholar
  56. Lunn JS (2004) Spiritual care in a multi-religious context. J Pain Palliat Care Pharmacother 17(3–4):153–166CrossRefGoogle Scholar
  57. Mako C, Galek K, Poppito SR (2006) Spiritual pain among patients with advanced cancer in palliative care. J Palliat Med 9(5):1106–1113PubMedCrossRefGoogle Scholar
  58. Mardiyono M, Songwathana P, Petpichetchian W (2011) Spirituality intervention and outcomes: corner stone of holistic nursing practice. Nurse Media J Nurs 1(1):117–127Google Scholar
  59. McSherry E (1983) The scientific basis of whole person medicine. J Am Sci Affilia 35(4):217–224Google Scholar
  60. McSherry W, Jamieson S (2011) An online survey of nurses’ perceptions of spirituality and spiritual care. J Clin Nurs 20(11–12):1757–1767PubMedCrossRefGoogle Scholar
  61. McSherry W, Ross L (2002) Dilemmas of spiritual assessment: considerations for nursing practice. J Adv Nurs 38(5):479–488PubMedCrossRefGoogle Scholar
  62. Melhem GAB, Zeilani RS, Zaqqout OA, Aljwad AI, Shawagfeh MQ, Al-Rahim MA (2016) Nurses’ perceptions of spirituality and spiritual care giving: a comparison study among all health care sectors in Jordan. Indian J Palliat Care 22(1):42PubMedPubMedCentralCrossRefGoogle Scholar
  63. Mueller PS, Plevak DJ, Rummans TA (2001) Religious involvement, spirituality, and medicine: implications for clinical practice. In: Mayo clinic proceedings, vol 12. Elsevier, pp 1225–1235Google Scholar
  64. Murray SA, Kendall M, Boyd K, Worth A, Benton TF (2003) General practitioners and their possible role in providing spiritual care: a qualitative study. Br J Gen Pract 53(497):957–959PubMedPubMedCentralGoogle Scholar
  65. Murray SA, Kendall M, Boyd K, Worth A, Benton TF (2004) Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med 18(1):39–45PubMedCrossRefGoogle Scholar
  66. Musa AS (2016) Factor structure of the spiritual Well-being scale: cross-cultural comparisons between Jordanian Arab and Malaysian Muslim university students in Jordan. J Transcult Nurs 27(2):117–125PubMedCrossRefGoogle Scholar
  67. Musa AS (2017) Spiritual care intervention and spiritual Well-being: Jordanian Muslim nurses’ perspectives. J Holist Nurs 35(1):53–61PubMedCrossRefGoogle Scholar
  68. Musa AS, Pevalin DJ (2012) An Arabic version of the spiritual Well-being scale. Int J Psychol Relig 22(2):119–134CrossRefGoogle Scholar
  69. Musa AS, Pevalin DJ (2014) Psychometric evaluation of the Arabic version of the spiritual Well-being scale on a sample of Jordanian Arab Christians. J Psychol Theol 42(3):293–301CrossRefGoogle Scholar
  70. Nabolsi MM, Carson AM (2011) Spirituality, illness and personal responsibility: the experience of Jordanian Muslim men with coronary artery disease. Scand J Caring Sci 25(4):716–724PubMedCrossRefGoogle Scholar
  71. Narayanasamy A (2004) The puzzle of spirituality for nursing: a guide to practical assessment. Br J Nurs 13(19):1140–1144PubMedCrossRefGoogle Scholar
  72. Narayanasamy A (2006) Spiritual care and transcultural care research. Quay Books Division, LondonGoogle Scholar
  73. National Cancer Institute (2015) Spirituality in cancer care. General information about spirituality. Accessed 12 Mar 2018
  74. Noble A, Jones C (2010) Getting it right: oncology nurses’ understanding of spirituality. Int J Palliat Nurs 16(11):565–569PubMedCrossRefGoogle Scholar
  75. Noguchi W, Morita S, Ohno T, Aihara O, Tsujii H, Shimozuma K, Matsushima E (2006) Spiritual needs in cancer patients and spiritual care based on logotherapy. Support Care Cancer 14(1):65–70. Scholar
  76. O’Connor M, Guilfoyle A, Breen L, Mukhardt F, Fisher C (2007) Relationships between quality of life, spiritual Well-being, and psychological adjustment styles for people living with leukaemia: an exploratory study. Ment Health Relig Cult 10(6):631–647CrossRefGoogle Scholar
  77. Oldnall A (1996) A critical analysis of nursing: meeting the spiritual needs of patients. J Adv Nurs 23(1):138–144PubMedCrossRefGoogle Scholar
  78. Omari FH, AbuAlRub R, Ayasreh IR (2013) Perceptions of patients and nurses towards nurse caring behaviors in coronary care units in Jordan. J Clin Nurs 22(21–22):3183–3191PubMedCrossRefGoogle Scholar
  79. Pembroke N (2008) Appropriate spiritual care by physicians: A theological perspective. J Relig Health 47:549–559PubMedCrossRefGoogle Scholar
  80. Powell LH, Shahabi L, Thoresen CE (2003) Religion and spirituality: linkages to physical health. Am Psychol 58(1):36PubMedCrossRefGoogle Scholar
  81. Pronk K (2005) Role of the doctor in relieving spiritual distress at the end of life. Am J Hosp Palliat Med 22(6):419–425CrossRefGoogle Scholar
  82. Rahman A (1980) Islam: ideology and the way of life. The Muslim Schools Trusts, LondonGoogle Scholar
  83. Rassool GH (2000) The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. J Adv Nurs 32(6):1476–1484. Scholar
  84. Ross L (2006) Spiritual care in nursing: an overview of the research to date. J Clin Nurs 15(7):852–862PubMedCrossRefGoogle Scholar
  85. Royal College of Nursing (2011) Spirituality and spiritual care in nursing practice. Author, LondonGoogle Scholar
  86. Rumbold BD (2003) Caring for the spirit: lessons from working with the dying. Med J Aust 179(6):S11PubMedGoogle Scholar
  87. Rushton L (2014) What are the barriers to spiritual care in a hospital setting? Br J Nurs 23(7):370–374PubMedCrossRefGoogle Scholar
  88. Saffari M, Pakpour AH, Naderi MK, Koenig HG, Baldacchino DR, Piper CN (2013) Spiritual coping, religiosity and quality of life: a study on Muslim patients undergoing haemodialysis. Nephrology 18(4):269–275PubMedCrossRefGoogle Scholar
  89. Sheikh A (2007) Head to head: should Muslims have faith based health services? BMJ 334(7584):74PubMedPubMedCentralCrossRefGoogle Scholar
  90. Shelly JA, Fish S (1988) Spiritual care: the nurse's role. InterVarsity press, Downers GroveGoogle Scholar
  91. Shukri R (2005) Status of nursing in the Arab world. Ethn Dis 15(1 Suppl 1):S1–S88PubMedGoogle Scholar
  92. Stacy A (2008) Health in Islam (part 3 of 4): diet and nutrition. How your brain listen to music. Harvard University Gazette. Retrieved from the Religion of Islam at
  93. Stoll R, Stoll I (1989) The essence of spirituality. In: Carson VB (ed) Spiritual dimensions of nursing practice. WB Saunders, PhiladelphiaGoogle Scholar
  94. Stranahan S (2001) Spiritual perception, attitudes about spiritual care, and spiritual care practices among nurse practitioners. West J Nurs Res 23(1):90–104PubMedCrossRefGoogle Scholar
  95. Sullivan MD, Newton K, Hecht J, Russo JE, Spertus JA (2004) Depression and health status in elderly patients with heart failure: a 6-month prospective study in primary care. Am J Geriatr Cardiol 13(5):252–260PubMedCrossRefGoogle Scholar
  96. Syed I (2009) Spiritual dimensions in healing in Islamic medicine. Accessed 27 Jan 2019
  97. Thoresen CE, Harris AH (2002) Spirituality and health: what’s the evidence and what’s needed? Ann Behav Med 24(1):3–13PubMedCrossRefGoogle Scholar
  98. Timby BK (2009) Fundamentals concepts and skills for nurses. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  99. Tuck I, McCain NL, Elswick RK Jr (2001) Spirituality and psychosocial factors in persons living with HIV. J Adv Nurs 33(6):776–783PubMedPubMedCentralCrossRefGoogle Scholar
  100. Van Leeuwen R, Tiesinga LJ, Post D, Jochemsen H (2006) Spiritual care: implications for nurses’ professional responsibility. J Clin Nurs 15(7):875–884PubMedCrossRefGoogle Scholar
  101. Westlake C, Dracup K (2001) Role of spirituality in adjustment of patients with advanced heart failure. Prog Cardiovasc Nurs 16(3):119–125PubMedCrossRefGoogle Scholar
  102. WHO (2006) Constitution of the World Health Organization.
  103. Williams E (2008) Spiritual agenda for doctors. Scott J Health Care Chaplain (New York) 11(1):2–8CrossRefGoogle Scholar
  104. World Health Organization (1946) Constitution of WHO: principles. Accessed 28 Jan 2019

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mysoon Khalil Abu-El-Noor
    • 1
  • Nasser Ibrahim Abu-El-Noor
    • 1
    Email author
  1. 1.Faculty of NursingIslamic University of GazaGazaPalestine

Section editors and affiliations

  • Ziad El- Khatib
    • 1
    • 2
  • Asmaa Alyaemni
    • 3
  1. 1.Department of Public Health SciencesKarolinska InstitutetStockholmSweden
  2. 2.Université du Québec en Abitibi-Témiscamingue (UQAT)World Health ProgrammeQuébecCanada
  3. care managementKing Saud UniversityRIYADHSaudi Arabia

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