The Role of Spiritual Intelligence to Improving Quality of

Nursing Care: A Systematic Review

K N Beni1, N Dewanti1, I Yanriatuti1, MM Prakosa1, and S W Purwanza1

1
Master Student, Faculty of Nursing Airlangga University, Surabaya, Indonesia

E-mail: kornelis.namabeni-2018@fkp.unair.ac.id

Abstract. Poor quality of nursing care can be indicated by the lack of a sense of
responsibility, sincerity, self-awareness, and professionalism in serving the community
in the healthcare system. The aim of the systematic review was conducted to examined
the role of spiritual intelligence to improve the quality of nursing care. A systematic
search was conducted in PubMed, Science Direct, Researchgate, and Emerald Insight
data based. The search was identified 15 relevant original articles and full text
published between 2013 until 2018. The result showed that Spiritual Intelligence can
be improving the quality of nursing care. Nurse with high spiritual intelligence have
more competence, personal meaningful about caring, moral performance, personal
excellence and flexibility were effective in increasing the quality of care. The study
results show that spiritual intelligence was strengthened the beliefs and personality of
nurses and the desire to grow and learn, work more professionally in improving the
quality of nursing care. Because there was a lack in the reviewed studies used the
cross-sectional and correlation, well-designed such as randomized controlled trials or
queasy experiment should be conducted to more objectively evaluated the effect of
spiritual intelligence to improve the quality of nursing care

Keyword: Spiritual Intelligence, Quality of Nursing Care

1. Introduction

The quality of care has been proven to be a reason for increasing patient satisfaction and hospital
cost efficiency (1). The quality of nursing care is the biggest predictor of patient satisfaction in care.
But the fact is that nurses have low quality nursing care. Lack of sense of responsibility, sincerity, self-
awareness and professionalism is an indicator of the poor quality of nursing care in the health care
system (2). Major changes are taking place in health service goals, namely the quality of care where
nurses are needed to be more committed and have a cohesive working relationship that is better in
improving the quality of nursing care (1). Nurses must have goals and meanings in providing nursing
services. Nurses in providing services without purpose and meaning make people dissatisfied and
cause organizations to struggle to create something identity in the market and contribute to the
community they serve (3). Quality of Nursing Care is influenced by several factors including
spirituality, organizational commitment, and general health that result in greater commitment and
improvement in service quality or productivity (4). Therefore, organizations recognize the importance
of individual emotional and spiritual intelligence in improving the quality of nursing care (5). Spiritual
Intelligence facilitates interaction among logical thinking processes; emotional intelligence can lead to
personal growth and changes. Spiritual intelligence is one of the effective factors in improving the
quality of nursing services and can play a fundamental role in the observance of patient’s rights
because it provides nurses to deal with stressful situations and situations (4).
Spiritual intelligence is a combination of an individual's ability to solve problems effectively with
the adaptation of spiritual resources. Spiritual intelligence implies cognitive, moral, and interpersonal
development. With this intelligence it will help nurses to adjust to their environmental phenomena and
achieve internal and external integration. This intelligence provides a general view of life with
spiritual experience and resources that can be used in important decision making (6). Spiritual
intelligence as a compatible mental capacity based on aspects of indirect and transcendental reality.
Spiritual intelligence allows nurses to have meaning and purpose from all physical and mental
experiences, including the ability to create and dominate life goals, and produce individual meanings.
Spiritual intelligence also includes the highest levels of growth in various cognitive, ethical, emotional,
and interpersonal fields, and helps these people to coordinate with the phenomena around and achieve
internal and external integrity. Spiritual intelligence as a set of mental capacities that deal with
awareness, integration and application of transcendental and spiritual (immaterial) aspects of the
individual. Spiritual Intelligence have four main components forming the spiritual intelligence as
critical existential thinking, personal meaning production, transcendental awareness, and conscious
state expansion.
Nurses with high spiritual intelligence not only have the ability to respond appropriately in
special circumstances but also the ability to understand why he is in this position, how to use this
position and how to make this situation suitable. Spiritual intelligence is the ability of individuals to
behave through reason with compassion if they maintain their inner and outer calm in different
situations. Spiritual intelligence is a series of activities which, in addition to subtlety and flexibility in
behavior, lead to self-awareness and deep insight into life and make it a goal, such that goals are drawn
beyond the material world. This process leads to one's adaptation to the environment for the enjoyment
and satisfaction of others (7). The most important application of spiritual intelligence in the workplace
is to create peace of mind, mutual understanding, and understanding among colleagues and, as a result,
job satisfaction and job stress reduction.
Characteristic of high-quality nursing care are everything patient rights and responsibilities of all
treatments nurses and also communication competencies can be learned and by learning
communication skills, people can use various kinds communication approach to answer a different
needs and patients are different situation, patient safety, patient satisfaction, caring of nursing,
performance and fulfill patient needs (1). The quality of patient nursing care can be improved through
the personal characteristics and beliefs of nurses who help nurses in their effective role-playing, which
can affect the nursing process. Improving the quality of nursing care by nurses can be done both from
the mental, communication, and social aspects because a nurse has a holistic aspect of human life such
as biological, mental, social and spiritual aspects. The effects of the spirituality of nurses and nurses
who use spiritual intelligence make it possible to approach and resolve their problems with a spiritual
attitude approach that can achieve self-actualization and well-being (8). Based on the description of
the background, the aims of the article review to identify the role of spiritual intelligence in increasing
the quality of nursing care based on nursing service characteristics found in the article review.
2. Methods
2.1 Search Strategies
We search for articles published from 2013 to 2018 using the PubMed, Science Direct,
Researchgate, and Emerald Insight databases. We enter keywords by using the term Spiritual
Intelligence for the variables Spiritual Intelligence and (Nursing Care or Nursing Delivery) for Quality
Nursing Care Variables. With these terms, we also combine other keywords, such as (Nurse * OR
Nursing *) for Nursing so that they can retrieve all relevant articles. In addition, only studies written in
English were used for the current study. Search results in the form of titles and abstracts are the
responsibility of the author to read and select articles that are relevant to the criteria set by the author
2.2 Selection Criteria
The inclusion criteria of the articles sought are 1) including an increase in nursing services or a
system developed as part of nursing; 2) is original research; abstract and 3) The subjects of the study
are nurses, or employees, or leaders; 4) The location of the study is a hospital or education. Exclusion
criteria from the articles sought are 1) focusing on location in the community, 2) the research is a
thesis or part of the conference process.
2.3 Data Extraction
From the fifteen studies chosen, we extracted the types of research, research subjects, and
research data sources. Research subjects in fifteen of these studies could be nurses, leaders, and
employees. In addition, we extracted the results of articles that discussed the relationship between
spiritual intelligence and improving the quality of nursing care. Discussion of differences in research
results requires consideration from the author.

3. Result
3.1 Selection of Studies
Pubmed: 7 The initial search retrieved a total of
Science Direct: 27 1,058 studies: 7 from PubMed, 540 from
Emerald Insight: 484 Researchgate, 27 from ScienceDirect,
Researchgate: 540 and 484 from Emerald Insight. From this,
923 articles have been deleted. Based on
inclusion and exclusion criteria, author
reviewed each article and reached a
1.058 articles 923 Articles removed consensus regarding its exceptions. The
review process for selected articles
develops in three stages, including title
review, abstract review, and full text
135 Articles 51 articles excluded review. We extracted 84 studies from
screened at title and abstract titles and reviews and 69 studies
abstract review from full text review. Finally, a total of
fifteen articles were selected for this
69 articles excluded: study. The retrieval and screening
84 Full-text articles process is summarized in Figure 1.
Location not in
assessed for
hospital/education
eligibility
Subject not nurse,
leadership and
employee

15 articles included

Figure 1 Literature searching flow

3.2 Study Methods

Based on the research subject we found the number of respondents was 3218 respondent with
details of nurses as many as 2878 respondents, employees as many as 280 respondents, and leaders as
many as 100 respondents. Based on the location of the study we found 12 studies were conducted at
the hospital, 2 studies were conducted in the company and 1 study was conducted in the university.
Based on the research design, we found ten quantitative studies with the type of Descriptive
Correlation and five types of cross sectional. For data sources, the questionnaire is the instrument used
from the fifteen articles. We identified several instruments used to measure Spiritual Intelligence and
the components of nursing services. Spiritual Intelligence was measurement with questionnaire
developed by Badie et.al (2010) (1), (9), (10) , Integrated Spiritual Intelligence Scale (ISIS) (Amram
& Dryer, 2007) (3), (4) and (8), Abdullah Zadeh et al. questionnaires developed in 2008 which has 29
articles scored by Likert method (quite agree, agree, partly agree, opposite of, quite opposite of) (11),
King’s Spiritual Intelligence Questionnaire (5), (7), (12) and (13), Spiritual Intelligence has four
indicators that have been developed by Zohar and Marshall (2001) and Agustian (2003) (2), Spiritual
intelligence questionnaire contains 97 questions which evaluated the eight aspects (6), and Spiritual
Intelligence Self-Report Inventory (SISRI) (14). We identified characteristic of quality nursing Care
was measured by Kioalpak nursing care quality (1975), work satisfaction we used the Job Descriptive
Index (JDI) (Smith, Kendall, & Hulin, 1969), work satisfaction (Landy, Shankster, & Kohler, 1994),
questionnaire of made type about patient satisfaction, Peterson job performance questionnaire and a
demographic questionnaire, and Richard Walton’s Quality of Work Life, Quesioner of Organisational
performance have been developed by Mathis and Jackson (2011): output quality, output quantity,
output period, work attendance and cooperative attitude. Quesioner of Emotional intelligence has five
indicators that have been developed by Goleman (2006): self-awareness, self-adjustment, motivation,
empathy and social skills. Quesioner of integrity, wisdom, respect for life and courage. There are
three indicators related to organizational commitment described by Meyer and Allen (1984): affective,
continuance and normative. , Ethical performance questionnaire of Dehqani nurses was used to assess
the ethical performance, Quality of work life questionnaire, Quality of life questionnaires, The applied
Questionnaires included QUALPAC nurses’ quality of care, nurses’ ethical decision making was
assessed using the Nursing Dilemma Test (NDT), Nurse’s work performance was measured with
Schwirian Six-D Scale. We found Nursing care quality questionnaire includes two parts, part one
includes individual specifications and second part includes three social mental dimensions including
28 questions, physical dimension includes 24 questions and finally communicational dimension
includes 13 questions. The spiritual intelligence questionnaire and characteristic of the quality of
nursing care services quastionaire has been tested for reliability with Cronbach alpha and everything
has been declared reliable but there are some instruments that are not reported about the validity test.
From the fifteen journals we found that the analysis test used was Pearson correlation coefficient,
independent-samples t-test, SEM, ANOVA, t-test, Independent t-test, Mann–Whitney, Kruskal Wallis,
and Pearson and Spearman correlation coefficients and multivariate regression model , and multi-
variable linear regression tests. Table 1 Sumarry studies methods
 Table 1 Sumarry studies methods of The Role Of Spiritual Inteligence To Improving Quality Of
Nursing Care
No Title,Author, Year Study Sampel Measurement/Instrumen Reliability Validity Analysis
Design Cronbach
1 Determining the Descriptiv 80 nurses 42- Question Reliability Cronbach Pearson
Relation between e of with spiritual intelligence factors of alpha correlation
Nurses Spiritual correlatio bachelor and questionnaire of Badie spiritual coefficient
Intelligence and n with master's et.al (2010) and intelligenc
Nursing Pearson degree Kioalpak nursing care e scale
Care Quality in correlatio quality (1975) ranges
Estahban City Imam n from 0.8
Khomeini Hospital to 0.85
(the Relation of
Spiritual
Intelligence and
Nursing Care
Quality)
Alireza Faghihi,
Hossein Hosseini-
Fahraji 2016
2 The Relationship Correlatio Data were To measure spiritual ISIS was Nor Tested
between Spiritual n study collected in intelligence we used the 0.810 and Reported normality
Intelligence and one of the Integrated for JDI using the
Work Satisfaction largest metal Spiritual Intelligence was 0.946. Shapiro-
among Leaders manufacturi Scale (ISIS) (Amram &
Wilk test,
and Employees ng Dryer, 2007). To
companies measure the work
and
(Maja Koražija, independe
Simona Šarotar in Slovenia, satisfaction, we used the
which Job Descriptive nt-samples
Žižek, 2016) t-test
employs Index (JDI) (Smith,
1,150 Kendall, & Hulin, 1969),
people. which is
Surveys one of the most widely
were sent to used measures of work
a random satisfaction
sample of (Landy, Shankster, &
100 leaders Kohler, 1994)
and
100
employees
(a total of
200
questionnair
es)
3 Studying the Descriptiv 122 nurses Optional entry for Cronbach’ Not Pearson
relationship between e- working in nursing staff s alpha of Reported correlation
spiritual intelligence analytical different Questionnaires included 0.89 coefficients
of nurses and study that departments of Spiritual Intelligence , data were
patients’ satisfaction evaluates of three of Abdullah Zadeh et al. analyzed
with nursing care nursing hospitals in questionnaires developed by SPSS
(Fatemeh Merati staff and Kermanshah in 2008 which has 29 (Statistical
Fashi, 2017) patients province articles scored by Likert Package for
admitted with at least method (quite agree, Social
to a bachelor’s agree, partly agree, Science)
hospitals degree and opposite of, quite version 22.
in 122 opposite of). second
 Kermansh inpatients questionnaire was a
ah from three surveyor-made type
hospitals about patient satisfaction
prepared by the
personnel of Imam Reza
medical and training
hospital in Kermanshah.
4 Effect of spiritual Cross- Sample of Questionnaire that Reliability Validity Structural
intelligence, sectional 550 nurses captured five constructs. test was test was equation
emotional survey in practice Besides nurses, 348 performed performed modelling
intelligence, was used, from seven patients on the using (SEM)
and data public from seven hospitals five confirmat software,
psychological
were hospitals in participated in the study constructs ory factor LISREL,
ownership and analysed and around and recorded their using analysis student
burnout on caring using Kuala overall satisfaction with Cronbach’ (CFA) version
behaviour of descriptiv Lumpur the hospital and the s alpha 8.52
nurses: a cross- e statistics (Malaysia) services values, (Scientific
sectional study and provided by the nurses and the Software
(Kaur, D., structural values Internation
Sambasivan, M., equation were al, Inc.,
& Kumar, N. modelling. between Skokie, IL,
(2013) 0,75–0,92. USA)
5 Relationship Cross- Total of 197 Data collection was Spiritual Not ANOVA, t-
between Spiritual sectional nurses were conducted by three intelligenc Reported test,
Intelligence and Job study studied of questionnaires: Spiritual e 0,91 and Pearson
Performance: A whom intelligence job correlation
Case Study of 68.5% were questionnaire, Peterson performan coefficient,
Nurses and Nursing female job performance ce 0.93 and
Aids in the Main questionnaire and a Poisson
University Hospital demographic regression
of Qom, Iran ( questionnaire. Data in SPSS 20.
Mohammad analysis was conducted
Khandan, Zeinab by ANOVA, t-test,
Eyni, Alireza Pearson correlation
Koohpaei, 2017) coefficient
6 The Effect of Cross- Purposive Questionnaire survey Cronbach’ Average PLS-based
Emotional and sectional sample about emotional s alpha variance structural
Spiritual study among 172 intelligence, spiritual ranged extracted equation
Intelligence on nurses from intelligence, job burnout from (AVE) for modelling,
Nurses’ Burnout and two Islamic and caring 0.906 to variables SmartPLS
Caring Behavior Hospitals in 0.959 in model: Software.
(Hadi Sunaryo1), Malang, emotional
Nazief Nirwanto2), East Java, intelligenc
Abdul Manan, 2017) Indonesia. e, spiritual
intelligenc
e, job
burnout
and caring
behavior
were
0.859,
0.850,
0.842 and
0.835
7 The Relationship Descriptiv 95 nurses in King’s Spiritual Cronbach’ Formal Independe
 between Spiritual e the oncology Intelligence s alphas method to nt t-test,
Intelligence and correlatio departments Questionnaire and for the evaluate Mann–
Quality of Work nal study of Ahwaz Richard Walton’s spiritual the Whitney,
Life in Nurses in hospitals. Quality of Work Life, intelligenc validity of Kruskal–
Oncology e and Richard
Wallis,
Departments of quality of Walton’s
Ahwaz Hospitals work life quality of
and
(Mina questionn life Pearson
Mohsenimaram, aires were questionn and
Sayedali Naji, 9.33 and aire. Spearman
Kourosh Zarea, 0.93 correlation
2017) coefficient
s and
multivaria
te
regression
model
8 Effects of Emotional Quantitati Total Quesioner of 0,76-0,93 Confirmat Structural
and Spiritual ve respondents Organisational ory Factor Equation
Intelligence on Job research were performance Analysis Modeling
Performance among method- selected have been developed by (CFA) to (SEM)
Temporary Nurses cross purposely Mathis and test result technique
at Abdul Riva’i sectional among130 Jackson (2011) shown on utilising
Regional General temporary Quesioner of Emotional indicates AMOS
Hospital, Berau nurses who intelligence has five that the version
District, East work at indicators that value for 22.0
Kalimantan Abdul have been developed by loading software
Province, Riva’i Goleman (2006). factor in
Indonesia ( Siswoyo Regional Quesioner of Spiritual each
Haryono, Febry General Intelligence has four question
Rosady, Mohd Hospital, indicators that have been item was
Shamsuri MdSaad, Berau developed by Zohar and > .5 which
2018) District, and Marshall can
East (2001) and Agustian conclude
Kalimantan (2003) and three that all the
Province, indicators related to question
Indonesia. organisational items are
commitment described valid
by Meyer and Allen
(1984)
9 The Relationship Cross- 100 nurses The main instrument for Reliability Validity Data
Between Spiritual sectional were collecting data was two was by using analysis
Intelligence And study selected questionnaires; which obtained Ray Test was
Moral Function Of randomly were completed by 0.89 performed
among all nurses in anonymous using
Nurses In Jahrom
nurses who form after receiving SPSS19
University Of had at least written consent. Ethical software
Medical Sciences 24 months performance with one-
Jahrom (Hojat of clinical questionnaire of Dehqani variable
Mohsen M , work nurses was used to assess and multi-
Zeinijahromi experience, the ethical performance variable
Mojtaba, 2017) had a linear
bachelor's regression
degree and tests.
with no
 known
physical and
psychologic
al illness
10 The structural model Correlatio Population King and DeCicco Question Not Pearson
of relationship nal has (2009) spiritual naire SI Reported correlation
between spiritual descriptiv consisted of intelligence reliability coefficient
intelligence and e the questionnaire: with 24 was and
emotional employees structural
items, Emotional calculate
intelligence with in a number equation
intelligence, Bradberry d as 0.90, modelling
quality of of 340
and Greaves (2005) EI: 0,85. using SPSS
work life and persons,
28-item questionnaire, QoWL:
work engagement among ver. 19 and
which 180 Quality of work life, 0,78. LISREL
of employees Walton (1975) 35-item structural 8.5
(Zahra Karimi, people were
selected questionnaire. The model of software
Fariba Karimi, relations
Using structural model of
2016) simple relationship 285 hip: 0,84
random Schaufeli et al. (2006)
sampling 17-item
questionnaire .
11 The Correlation Descriptiv 100 nurses King spiritual 0,60-0,84 Not Statistical
between Cognitive e– working in intelligence and Quality reported analysis of
Emotion Regulation correlatio the private of life questionnaires. data the
and Spiritual nal hospitals. SPSS
Intelligence with research software
Quality of Life (version
among Emergency 16) and the
Department descriptive
statistics,
Nurses
linear
(Barghandan S. regression
PhD cand and
Khalatbari J. PhD, multiple
2017) stepwise
regression
12 Relation between Descriptiv 250 nurses Nurses’ clinical Reliability Not Analyzed
spiritual intelligence e– in Mashhad competency assessment of Reported by SPSS
and clinical correlatio educational tool contains 55 items questionn 11.5 using
competency of nal hospitals, and 7 domain. Spiritual aires was descriptive
nurses in Iran research selected by intelligence confirmed statistics;
(Hossein Karimi- multi-stage questionnaire contains using for
Moonaghi, Akram sampling 97 questions which Cronbach’ comparing
evaluated the eight s alpha means,
Gazerani, Saeed
aspects coefficient analysis of
Vaghee, Hassan 0,82-0,96 variance
Gholami, Amir
(ANOVA)
Reza
, Kruskal–
Salehmoghaddam,
Wallis,
Raheleh
t-test,
Gharibnavaz,
Mann–
2015) Whitney
test,
correlation
test and
 simple
linear
regression
13 The Relationship Descriptiv 200 nurses The applied The Not Pearson’s
Between Nurses’ e & patients Questionnaires included validity Reported correlation
Spiritual correlatio who were QUALPAC nurses’ and test.
Intelligence And nal study selected by quality of care, and reliability
Quality Of Nursing simple Badie’s 42-questions of
Care Based On sampling spiritual intelligence the test
Nurses' & Patients' were
Viewpoints (Miri verified
KH , Keshavarz by Alpha
A, SHirdelzadeh Cronbach’
s method
S, Parsa P, 2015)
which was
0.85 & 0.8
14 Relationship Cross- 376 nurses The questionnaires were Cronbach’ Validity Statistical
Between sectional who delivered to the subjects s alpha have been analyses
Spiritual study completed at their hospitals and values approved were
Intelligence and the Spiritual they were performed
Ethical Decision Intelligence were asked to complete 0.821 and using the
Making Self-Report them independently. To 0.74 for Minitab
in Iranian Nurses Inventory assess SI, we used the SISRI and software
(Shahram Arsang- (SISRI) and Spiritual Intelligence NDT version
Jang, Ashraf Nursing Self-Report Inventory 15. We
Khoramirad, Dilemma (SISRI) used
Davoud Pourmarzi, Test and the nurses’ ethical Pearson
and Marziyeh Raisi, decision making was correlation
2017) assessed using the coefficients
Nursing
Dilemma Test (NDT).
15 The impact of Descriptiv 506 nurses Amram & Dryer’s Spiritual Software Average
Spiritual e and of four Integrated Spiritual Intelligenc (AMOS Variance
Intelligence on Inferential government Intelligence Scale was e 0,50- 18) with Estimate
Work Perfomance: Research hospitals in chose in measuring 0,86 maximum (AVE) and
Case studies in East Coast nurse’s level of Spiritual likelihood Chi-Square
Government of Malaysia Intelligence due to its (ML) to
Hospitals of East comprehensive nature analyse
Coast of Malaysia and strong psychometric data and
(Anita Abdul Rani, properties. Nurse’s work CFA
Imaduddin Abidin, performance was
Mohd Rashid Ab measured with Schwirian
Hamid, 2013) Six-D Scale.

3.3 Outcomes Measure

From the results of a review of fifteen articles it was found that spiritual intelligence can directly
or indirectly improve the quality of care. Spiritual Intelligence can improve the quality of patient care
by mediating nurses' beliefs and personalities (1). Spiritual Intelligence with emotional intelligence
can improve the quality of nurse caring behavior. Spiritual intelligence, emotional intelligence,
psychological ownership and burnout of nurses play a significant role in effecting caring behaviour of
nurse (9). At the same time spiritual intelligence correlates significantly with decreasing burnout in
nurses (5). The results of our study found a significant positive relationship between spiritual
intelligence and job satisfaction for employees, patient satisfaction (11). Therefore, considering the
spiritual dimension in staff can improve the quality of care and patient satisfaction, Production of
Personal Meanings and Conscious Status The dimensions of SI expansion have a significant impact on
Respect for Others and Guaranteed Human Presence dimensions of caring for nurses. Spiritual
Intelligence leads to changes in patient attitudes, behavior, and support among nurses. Promotion of SI
can help improve nurses' mental health status to respond to patient needs and hence patient safety and
organizational efficiency. Significant corelation beetwen Spiritual intelligence and quality of work life
in nurses in oncology departments (7); psychological well-being (15). Emotional intelligence and
spiritual intelligence was found to have positive and significant effects toward organisational
commitment. Subsequently,organisational commitment haspositive and significant effects on
temporary nurses’ performance and positively mediates the relationship between emotional
intelligence and spiritual intelligence on temporary nurses’ performance (2). Moral performance has a
direct relationship with spiritual intelligence, so that individuals with a high spiritual intelligence have
the higher moral scores (16); Significant relationship between spiritual intelligence with quality of
work life and work engagement (13); significant correlation was found between spiritual intelligence
and clinical competency and quality of care (6); there was a positive significant correlation between
spiritual intelligence and nurses’ quality of care. Improving spiritual intelligence can help in increasing
patients’ quality of care due to encouraging nurses’ beliefs and personality (10); spiritual intelligence
plays a positive role in the ethical decision making of nurses (14); positive correlation found between
spiritual intelligence and work performance. The results show that nurses with higher spiritual
intelligence perform more in their work (8). Table 2 Outcomes of Role Spiritual Intelligence to
improve Quality of Nursing Care.

Table 2 Outcomes the Role Of Spiritual Intelligence To Improving Quality Of Nursing Care
No Title, Author , Year
1 Determining the Relation between Nurses
Spiritual Intelligence and Nursing Care
Quality in Estahban City Imam Khomeini
Hospital (the Relation of Spiritual
Intelligence and Nursing Care Quality)
(Alireza Faghihi, Hossein Hosseini-Fahraji,
2016)
2 The Relationship between Spiritual
Intelligence and Work Satisfaction
among Leaders and Employees (Maja
Koražija, Simona Šarotar Žižek, 2016)
3 Studying the relationship between
spiritual intelligence of nurses and
patients’ satisfaction with nursing care
(Fatemeh Merati Fashi, 2017)
4 Effect of spiritual intelligence,
emotional intelligence, psychological
ownership and burnout on caring
behaviour of nurses: a cross-sectional
study (Kaur, D., Sambasivan, M., &
Kumar, N. (2013)
5 Relationship between Spiritual Intelligence
and Job Performance: A Case Study of
Nurses and Nursing Aids in the Main
University Hospital of Qom, Iran (
Outcomes
Characteristic of Nursing Care
Spiritual intelligence in reinforcing beliefs and personality
and improving the quality of patients care.
Spiritual intelligence improving workplace satisfaction
for employees.
Spiritual dimensions such us meaningfull in nurse can
increase the quality of care and patient satisfaction.
Personal Meaning Production and Conscious State
Expansion dimensions of SI have significant impacts
on Respectful Deference
Assurance of Human Presence dimensions of caring
behavior of nurses.
Spiritual intelligence, emotional intelligence, psychological
ownership and burnout of nurses play a significant role in
effecting caring behaviour of nurses.
Impact of nurses' SI on their job performance
Promotion of SI can help to improve nurses' mental health
status to respond to patients’ needs and therefore patient
safety and organizational efficiency.
 Mohammad Khandan, Zeinab Eyni,
Alireza Koohpaei, 2017)
6 The Effect of Emotional and Spiritual
Intelligence on Nurses’ Burnout and Caring
Behavior (Hadi Sunaryo1), Nazief
Nirwanto2), Abdul Manan, 2017)
7 The Relationship between Spiritual
Intelligence and Quality of Work Life in
Nurses in Oncology Departments of Ahwaz
Hospitals (Mina Mohsenimaram, Sayedali
Naji, Kourosh Zarea, 2017)
8 Effects of Emotional and Spiritual
Intelligence on Job Performance among
Temporary Nurses at Abdul Riva’i Regional
General Hospital, Berau District, East
Kalimantan Province, Indonesia ( Siswoyo
Haryono, Febry Rosady, Mohd Shamsuri
MdSaad, 2018)
9 The Relationship Between Spiritual
Intelligence And Moral Function Of
Nurses In Jahrom University Of Medical
Sciences Jahrom (Hojat Mohsen M ,
Zeinijahromi Mojtaba, 2017)
10 The structural model of relationship
between spiritual intelligence and
emotional intelligence with quality of
work life and work engagement of
employees (Zahra Karimi, Fariba
Karimi, 2016)
11 The Correlation between Cognitive
Emotion Regulation and Spiritual
Intelligence with Quality of Life among
Emergency Department Nurses
(Barghandan S. PhD cand Khalatbari J.
PhD, 2017)
12 Relation between spiritual intelligence
and clinical competency of nurses in
Iran (Hossein Karimi-Moonaghi, Akram
Gazerani, Saeed Vaghee, Hassan
Gholami, Amir Reza Salehmoghaddam,
Raheleh Gharibnavaz, 2015)
13 The Relationship Between Nurses’
Spiritual Intelligence And Quality Of
Nursing Care Based On Nurses' &
Patients' Viewpoints (Miri KH ,
Keshavarz A, SHirdelzadeh S, Parsa P,
2015)
14 Relationship Between Spiritual Intelligence
and Ethical Decision Making in Iranian
The positive effect of emotional and spiritual intelligence on
caring behavior. It was indicated that the best predictors for
job burnout were spiritual intelligence, for caring behavior
were job burnout.
Spiritual intelligence increasing quality of work life
Spiritual intelligence was found to have positive and
significant effects toward organisational commitment.
Subsequently,organisational commitment haspositive
and significant effects on temporary nurses’
performance and positively mediates the relationship
between emotional intelligence and spiritual
intelligence on temporary nurses’ performance.
Moral performance has a direct relationship with spiritual
intelligence, so that individuals with a high spiritual
intelligence have the higher moral scores.
Significant relationship between spiritual intelligence with
quality of work life and work engagement, and between
emotional intelligence with quality of work life and work
engagement as well. Spiritual intelligence has a direct effect
on quality of work life and work engagement.
Significant positive correlation between the cognitive
emotion regulation compatible strategies and spiritual
intelligence with quality of life of nurses in emergency
department. Significant negative correlation between
cognitive emotion regulation incompatible strategies and
Spiritual intelligence with quality of life of the emergency
department nurses
Significant correlation was found between spiritual
intelligence and clinical competency. In this study, the
positive significant correlation between nurses’
spiritual intelligence and their clinical competency is
investigated. Because of the positive effects of
spiritual intelligence on nurses’ clinical competency
and quality of care, it is recommended to develop
nurses’ spiritual intelligence
There was a positive significant correlation between
spiritual intelligence and nurses’ quality of care. Improving
spiritual intelligence can help in increasing patients’ quality
of care due to encouraging nurses’ beliefs and personality
We have concluded that spiritual intelligence plays a
positive role in the ethical decision making of nurses.
 Nurses (Shahram Arsang-Jang, Ashraf
Khoramirad, Davoud Pourmarzi, and
Marziyeh Raisi, 2017)
15 The impact of Spiritual Intelligence on
Work Perfomance: Case studies in
Government Hospitals of East Coast of
Malaysia (Anita Abdul Rani, Imaduddin
Abidin, Mohd Rashid Ab Hamid, 2013)
There are positive correlation found between spiritual
intelligence and work performance. The results show that
nurses with higher spiritual intelligence perform more in
their work. In previous literature, Spiritual intelligence were
related with health, leadership, now with this study
confirming that Spiritual intelligence influence work
performance. There was a positive relationship between
Spiritual intelligence and work performance

4. Discussion

In conducting a systematic review of existing studies evaluating how the role of spiritual
intelligence is to improve the quality of nursing services. From this systematic review we are trying to
show that there is positive aspects of spiritual intelligence from these fifteen articles that met the
inclusion criteria from literature search. The study results show that spiritual intelligence was
strengthened the beliefs and personality of nurses and the desire to grow and learn, work more
professionally in improving the quality of nursing care. Spiritual intelligence in strengthening nurses'
beliefs and personality can help improve the quality of patient care. Therefore, with high spiritual
intelligence in the workplace, nurses can improve the quality of care in serving patients. The use of
spiritual intelligence in the workplace is to create peace, mutual understanding and understanding
between coworkers and as results, satisfaction and quality of nurse nursing care for patient care.
Because the nurse is dealing with community health and their functions besides their own health has a
direct impact on others public health also and improve nursing quality, then spiritual intelligence has
direct impact on the quality of nursing care (1). Spiritual intelligence is directly related to moral
performance. Nurses with high moral functions can improve the spiritual intelligence of personnel in
dimensions (communication with the source of life). One aspect of nursing care is communication. So
if the nurse has good communication it will have an impact on the quality of care. It can be said that
the more nurses adhere to spiritual values, the more they will show honesty towards patients. With the
presence of spiritual intelligence and good moral performance, nurses strive to improve the quality of
patient care at a higher level, reduce the incidence of disease problems and nurses will show good
ethics when carrying out nursing care for patients (16), spiritual intelligence affects performance but
must go through organizational commitment. This conditions indicate that someone who carries the
meaning of spirituality in his work will feel his own life and work, and will also have more meaning
that will form a strong organizational commitment. Establishing organizational commitment will
encourage and motivate individuals to make various efforts for the progress of the organization. This
shows a change in a person's performance when a business makes positive results. Spiritual
intelligence will create commitment because individuals will have skills in climbing stress so that it
will produce success in the organization. With the presence of spiritual intelligence, it will increase
critical thinking and creativity in finding the right solution in patient care (2), (14). Spiritual
intelligence can be regarded as a personality attribute such as personality characteristics, personal
meaning that builds character and identifies the purpose of all physical and mental experiences,
including the ability to create important goals and meanings for life, and other contemplation of
existence. Personal meaning describes transcendental quality which includes everything expressed in a
perceptive and effective way, contributing and conducive to creativity, self-development and
producing life goals and meaning. With the purpose and meaning of life for a nurse it will improve its
service in caring for patients as a purpose and meaning of life (17). Nursing care with a spiritual
intelligence approach to patients as multidimensional concepts where in practice nurses must respect,
maintain patient privacy, listen be careful to the patient and help the patient understand the treatment
procedures. Nursing care provided with a spiritual approach has an impact on human recovery and
enhancing creativity in nursing care services. Nurses in meeting the primary needs of patients must
build relationships, provide interventions and have the ability to work together in care tasks. If nurses
are able to build relationships that are appropriate to patients, the quality of nursing care will increase
and have an impact on increasing patient satisfaction (6).

5. Conclusion

The study results show that spiritual intelligence was strengthened the beliefs and personality of
nurses and the desire to grow and learn, work more professionally in improving the quality of nursing
care. Of the fifteen articles reviewed all showed positive results that spiritual intelligence can improve
service quality. From the articles reviewed also the relationship of spiritual intelligence to the quality
of nursing services was only analyzed by description correlation and cross-sectional well-designed
such as randomized controlled trials or queasy experiment should be conducted to more objectively
evaluated the effect of spiritual intelligence to improve the quality of nursing care (17). Increasing
spiritual intelligence can help improve the quality of care for patient care because it encourages nurses'
beliefs and personality. Then spiritual intelligence in the clinical environment can be applied to
improve the function and role of nurses in improving nursing. Due to the impact of nurses' SI on their
job performance, Spiritual Intelligence training courses should be incorporated into in-service training
for nurses and other healthcare workers. SI leads to changes in attitudes, behaviors, and patient support
among nurses. Spiritual intelligence in nurses increases nurses 'clinical competence and quality of
care, so it is advisable to develop nurses' spiritual intelligence during nursing education

6. References

1. Alireza Faghihi HH-F, Bafghi and MJA. Determining the Relation between Nurses Spiritual
Intelligence and Nursing Care Quality in Estahban City Imam Khomeini Hospital ( the Relation
of Spiritual Intelligence and Nursing ... Determining the Relation between Nurses Spiritual
Intelligence and Nur. M Sci. 2016;(November).
2. Haryono S, Rosady F, Mdsaad MS. Effects of Emotional and Spiritual Intelligence on Job
Performance among Temporary Nurses at Abdul Riva ’ i Regional General Hospital , Berau
District , East Kalimantan Province , Indonesia. WWWAIMIJOURNALCOM. 2018;4:42–54.
3. Koražija M. The Relationship between Spiritual Intelligence and Work Satisfaction among
Leaders and Employees. 2016;62(2).
4. Khandan M, Eyni Z, Koohpaei A. Original Article. 2017;4(3):8–13.
5. Sunaryo H, Nirwanto N, Manan A. The Effect of Emotional and Spiritual Intelligence on
Nurses ’ Burnout and Caring Behavior. Int J Acad Res Bus Soc Sci. 2017;7(September).
6. Karimi-moonaghi H, Gazerani A, Vaghee S, Gholami H, Salehmoghaddam AR, Gharibnavaz
R. Relation between spiritual intelligence and clinical competency of nurses in Iran.
2015;20(6):665–9.
7. Mohsenimaram M, Naji S, Zarea K. The Relationship between Spiritual. 2018;2018(2):1–5.
8. Rani AA, Abidin I, Rashid M, Hamid A. The Macrotheme Review. 2013;2(3):46–59.
9. Kaur D, Sambasivan M, Kumar N. Effect of spiritual intelligence , emotional intelligence ,
psychological ownership and burnout on caring behaviour of nurses : a cross-sectional study.
2013;3192–202.
10. Miri KH , Keshavarz A, SHirdelzadeh S PP. The Relationship Beetwen Nurses Spiritual
intelligence and Quality of nursing Care Based on Nurses and Patients Viewpoints. J Urmia
Nurs Midwifery Fac. 2015;13.
11. Fashi FM. Studying the relationship between spiritual intelligence of nurses and patients ’
satisfaction with nursing care. 2017;6(3):539–42.
12. Karimi ZK. The structural model of relationship between spiritual intelligence and emotional
intelligence with quality of work life and work engagement of employees. J Manaj.
2016;10(3):278–92.
13. Barghandan S. PhD Khalatbari J. PhD. The Corelation beetwen Cognitive Emotion Regulation
and Spiritual Intelligence with Quality of Life among Emergency Department Nurses. Iran J
Nurs. 2017;46–54.
14. Arsang-jang S, Khoramirad A, Pourmarzi D, Raisi M. Relationship Between Spiritual
Intelligence and Ethical Decision Making in Iranian Nurses. 2017;
15. Ahoei K, Faramarzi M, Hassanzadeh R. The Relationship Between Spiritual Intelligence and
Psychological Well-Being in Women with Breast Cancer. 2017;18(10):4–9.
16. M Hm, Mojtaba Z. The Relationship Between Spiritual Intelligence And Moral Function Of
Nurses In Jahrom University Of Medical Sciences Pharmacophore The Relationship Between
Spiritual Intelligence And Moral Function Of Nurses In Jahrom University Of Medical
Sciences Jahro. Pharmacophore,. 2018;(January 2017).
17. Shammout NA, Abu-eita JD. The relationship between spiritual intelligence and personality
traits among Jordanian university students. Psychol Res Behav Manag. 2015;89–97.