{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:31:53Z","timestamp":1790346713855,"version":"4.1.0"},"reference-count":69,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to identify the spiritual responses of nurses providing direct patient care during the COVID pandemic and explore how religious\/spiritual struggles are associated with selected nurse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A quantitative, cross\u2010sectional observational study was conducted, based on the STROBE checklist, with 364 registered nurses recruited via convenience sampling between January 24 and March 12, 2022, in hospitals in Iran admitting COVID\u201019 patients. Data were collected through a self\u2010report questionnaire, including the Moral Injury Symptom Scale\u2013Health Professionals, Religious\/Spiritual Struggles Scale\u2010Short Form, Posttraumatic Growth Inventory, Job Satisfaction Scale, Copenhagen Burnout Inventory, Turnover Intention Scale, and Employee Engagement Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nurses reported high levels of moral injury during the pandemic, with an average score of 43.79\u2009\u00b1\u200915.20. Religious\/spiritual struggles were generally low, with demonic struggles scoring the lowest (0.36\u2009\u00b1\u20090.68) and ultimate meaning struggles the highest (1.54\u2009\u00b1\u20090.99). Posttraumatic growth scores for spiritual change were moderately high (26.17\u2009\u00b1\u20094.73). Work\u2010related burnout was moderate (64.31\u2009\u00b1\u2009100.00), intention to leave was low (8.84\u2009\u00b1\u20093.92), and job satisfaction was moderate (3.67\u2009\u00b1\u20091.75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study found that nurses experienced both positive and negative spiritual responses during the pandemic. While most nurses reported a high level of moral injury and moderate job satisfaction, they experienced low religious\/spiritual struggles and some spiritual growth. Incorporating spirituality into nursing practice may enhance professional fulfilment and nurse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.17632","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T02:49:18Z","timestamp":1734490158000},"page":"4223-4234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Spirituality and Work\u2010Related Outcomes Among Nurses During the <scp>COVID<\/scp> Pandemic: An Observational Study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6144-6001","authenticated-orcid":false,"given":"Foroozan","family":"Atashzadeh\u2010Shoorideh","sequence":"first","affiliation":[{"name":"Department of Psychiatric Nursing and Management, School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences  Tehran 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