Barriers of spiritual care in nursing: a scoping review

Spirituality is regarded as a fundamental aspect of humanity and is acknowledged by numerous healthcare professionals as a vital element in health and healing. Researchers have emphasized the importance of spiritual nursing care as a core aspect of nursing practice, highlighting the need to nurture the human spirit through the establishment of relationships and connections between nurses and patients. Nevertheless, despite the acknowledged significance of spiritual practices for health, there has been limited focus on spirituality within nursing practice and education in existing literature. This review aimed to identify the barriers that hinder the integration of spiritual care into nursing practice. Findings were organized using the Socio-Ecological Model (SEM) as a post-hoc analytical framework to systematically categorize barriers across multiple levels of influence. A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and the Arksey and O’Malley framework. A total of 26 studies were identified from the existing literature concerning the barriers to providing spiritual care in nursing. These barriers are categorized into five main themes using the Socio-Ecological Model (SEM) as a post-hoc analytical organizing framework. The scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist. Five primary themes were identified across the Socio-Ecological Model levels. Individual barriers enclosed nurses’ personal knowledge gaps, discomfort, and spiritual self-awareness deficits, as well as clients’ reluctance to engage. Interpersonal barriers included religious sensitivity, cultural competence challenges, and communication difficulties. Organizational, community, and policy-level barriers further hindered the integration of spiritual care into nursing practice. The primary barriers to providing spiritual care in nursing stem from the lack of visibility associated with this aspect of care within the profession. This review highlighted barriers faced by nursing professionals in delivering spiritual care to clients with concept of SEM, which need to be addressed in order to enhance the level and quality of spiritual care nursing. Future research should focus on developing and evaluating multilevel interventions targeting barriers at individual, interpersonal, organizational, community, and policy levels, with particular emphasis on integrating spiritual care education into nursing curricula and establishing supportive institutional policies across diverse cultural and healthcare contexts.