Effect of Spiritual Skills Training on Stress, Anxiety, and Depression Among Nurses Working in Baharan Psychiatric Hospital, Zahedan: A Quasi-Experimental Study

Abstract

Background: Nurses, especially those working in psychiatric settings, are exposed to high job demands, frequent contact with high-risk patients, and emotional burden, all of which increase the risk of stress, anxiety, and depression. In recent years, spiritually oriented interventions and spiritual skills training have been introduced as complementary approaches to promote nurses’ mental health. Objectives: This study aimed to determine the effect of spiritual skills training on stress, anxiety, and depression among nurses working in Baharan Psychiatric Hospital in Zahedan, Iran. Methods: This quasi-experimental study with a pretest–posttest design and control group was conducted in 2024 among 70 nurses working in Baharan Psychiatric Hospital. Sampling was carried out by census from all eligible nurses, who were then randomly allocated into an intervention group (n = 35) and a control group (n = 35). Data were collected using a demographic questionnaire and the 21-item Depression Anxiety Stress Scales (DASS-21). The intervention group participated in eight 30-minute group sessions of spiritual skills training, while the control group received only routine educational and clinical programs. The DASS-21 was completed by both groups before and immediately after the intervention. Data were analyzed using descriptive statistics, independent t-test, and chi-square test at a significance level of 0.05. Results: The two groups did not differ significantly at baseline in demographic characteristics or in mean scores of stress, anxiety, depression, and total DASS-21 (P > 0.05). After the intervention, the mean total DASS-21 score in the intervention group was significantly lower than in the control group (31.02 ± 5.08 vs. 41.96 ± 5.17; P < 0.001). Post-intervention mean scores of stress (10.57 ± 2.60 vs. 14.11 ± 1.02; P < 0.001), anxiety (9.80 ± 2.25 vs. 14.40 ± 2.77; P < 0.001), and depression (10.65 ± 2.68 vs. 13.45 ± 3.14; P = 0.004) were also significantly lower in the intervention group compared with the control group. Conclusions: Spiritual skills training significantly reduced stress, anxiety, and depression among nurses working in a psychiatric hospital. Incorporating structured spiritual skills training into in-service education programs may represent a low-cost, culturally congruent strategy for improving nurses’ mental health and care quality.