Silent Needs, Shared Stories: A Narrative Inquiry Into Spiritual Care in Paediatric Critical Care Settings

Abstract

Background: Spiritual health, as a fundamental component of holistic well-being, remains inadequately addressed in paediatric intensive care units (PICUs), despite its recognised impact on coping and quality of life for both children and their families. The World Health Organization's health framework omits the spiritual dimension, even as global evidence highlights the importance of spiritual care, especially in high-stress settings like PICUs where mothers and nurses face profound emotional and existential challenges.

Aim: This study aimed to explore and compare the lived experiences of mothers and nurses regarding spiritual care in PICUs, with a focus on understanding how storytelling can bridge the gap between caregiving and care-receiving perspectives.

Study design: A qualitative study utilising narrative inquiry and conventional content analysis, underpinned by Watson's Theory of Human Caring and phenomenological approaches. Semi-structured, narrative interviews were conducted with 14 mothers and 11 nurses from the PICU of Imam Hossein Hospital, Isfahan University of Medical Sciences, Iran. Participants were selected via purposive and convenience sampling. Interviews incorporated storytelling techniques to elicit deep, experiential narratives. Data were analysed using Graneheim and Lundman's content analysis framework, with iterative coding and thematic analysis until saturation was achieved.

Results: Two main themes emerged: (1) The Nurse as a Source of Spiritual Resilience and (2) The Need for Empathetic Support in Crisis. Nurses were perceived as facilitators of peace through empathic care and effective communication, while clinical competence blended with subtle sensitivity was crucial for building trust. Storytelling enabled mutual understanding and emotional anchoring, highlighting the therapeutic value of narrative in addressing spiritual needs.

Conclusions: Spiritual care is a vital yet often marginalised aspect of paediatric critical care. Nurses play a central role in providing spiritual resilience, but require better training and support. Storytelling serves as a powerful tool for fostering empathy, understanding and therapeutic engagement between mothers and nurses in the PICU.

Relevance to clinical practice: Integrating spiritual care and narrative approaches into PICU practice can enhance emotional support for families, improve coping and strengthen the nurse-family therapeutic alliance. These findings advocate for targeted education and policy changes to empower nurses in delivering holistic, spiritually sensitive care.

Keywords: adaptation; intensive care units; paediatric; psychological; spiritual therapies.