The Effect of a Spiritual Intervention Based on the Ghalbe Salim Model on Resilience and Anxiety Among Prehospital Emergency M.edical Services Personnel
Determining the effect of a healthy heart-based spiritual intervention on resilience and anxiety of prehospital emergency department (EMS) personnel at Larestan Faculty of Medical Sciences in 1405.
Design
This is a single-blind randomized clinical trial in which 70 qualified employees of the Larestan prehospital emergency department will be divided into two groups and a spiritual intervention based on the Healthy Heart will be implemented in 6 group sessions.
Settings and conduct
This study will be conducted on 70 qualified pre-hospital emergency staff in Larestan at the Larestan Faculty of Medical Sciences.
This clinical trial study is a single-blind, simple random sampling study, and the data from the groups will be sent to the statistical analyst in a blinded manner in the form of two names.
Participants/Inclusion and exclusion criteria
Employment in the Larestan Emergency Department; At least one year of work experience; Informed consent; No psychiatric disorders; No use of psychotropic drugs; No concurrent participation; BAI questionnaire score between 0 and 7.
Intervention groups
70 people were randomly divided into two groups of 35 people, and the intervention group received 6 90-minute sessions of Healthy Heart spiritual intervention, and the two groups completed the pre-test and post-test.
Main outcome variables
Anxiety: Spiritual interventions address existential and spiritual needs and challenges related to critical situations. Resilience: Described as the positive potential of individuals to cope with critical situations and is therefore considered a protective factor against future risks.
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20090304001742N15
Registration date:2026-08-22, 1405/05/31
Registration timing:registered_while_recruiting
Last update:2026-08-22, 1405/05/31
Update count:0
Registration date
2026-08-22, 1405/05/31
Registrant information
Name
mohammadrafi bazrafshan
Name of organization / entity
shiraz university medical science
Country
Iran (Islamic Republic of)
Phone
+98 917 382 1959
Email address
mrbazr@sums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2026-08-16, 1405/05/25
Expected recruitment end date
2026-09-16, 1405/06/25
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
The Effect of a Spiritual Intervention Based on the Ghalbe Salim Model on Resilience and Anxiety Among Prehospital Emergency M.edical Services Personnel
Public title
The Effect of a Spiritual Intervention Based on the Ghalbe Salim Model on Resilience and Anxiety Among Prehospital Emergency Medical Services
Purpose
Education/Guidance
Inclusion/Exclusion criteria
Inclusion criteria:
Formal or contractual employment in the prehospital emergency department of Larestan Faculty of Medical Sciences
At least one year of work experience in the prehospital emergency
Informed consent and willingness to participate in research
No diagnosed psychiatric disorders (based on self-report)
Not taking psychotropic drugs (based on the individual's statement)
Not participating in other similar intervention programs at the same time
The score obtained from the BAI questionnaire should be in the range of zero to 7.
Exclusion criteria:
Unwillingness to continue cooperation at any stage of the research
Absence from more than 1 intervention session (without attending the anticipated make-up session)
Occurrence of physical or mental conditions that prevent continued participation in the research
Age
No age limit
Gender
Male
Phase
N/A
Groups that have been masked
Data analyser
Sample size
Target sample size:
70
Randomization (investigator's opinion)
Randomized
Randomization description
The samples of this study will be selected from among the personnel working in the pre-hospital emergency department of Lar University of Medical Sciences who meet the inclusion criteria, using simple random sampling. To this end, after preparing a list of eligible individuals, a code will be assigned to each person, and the samples will be selected using random number generation/draw. After obtaining informed consent from the selected individuals, in order to reduce the effect of individual differences and control bias, the participants will be allocated to intervention and control groups using simple random allocation.
Blinding (investigator's opinion)
Single blinded
Blinding description
The raw data will be provided to the statistical analyst in coded form (under the headings of Group A and Group B), and he will be unaware of the true identity of the intervention and control groups until the end of the statistical analysis stages.
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Larestan University of Medical Sciences
Street address
, Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Approval date
2026-07-22, 1405/04/31
Ethics committee reference number
IR.LARUMS.REC.1405.017
Health conditions studied
1
Description of health condition studied
Anxiety
ICD-10 code
F06.4
ICD-10 code description
Anxiety disorder due to known physiological condition
Primary outcomes
1
Description
Anxiety disorder is one of the most common mental health problems worldwide, significantly affecting a person's mental health and functioning.
Timepoint
Before the intervention and after the end of the intervention
Method of measurement
Beck Anxiety and Connor-Davidson Resilience Questionnaires
Secondary outcomes
1
Description
Resilience
Timepoint
Before intervention and after intervention
Method of measurement
Beck Anxiety and Connor-Davidson Resilience Questionnaires
Intervention groups
1
Description
Intervention group: After sampling, individuals will be randomly assigned to two intervention and control groups. The intervention group consists of 35 individuals who will receive 6 90-minute sessions of the Healthy Heart-based spiritual intervention. Session 1: Introduction, spirituality, and self-awareness. In this session, participants are introduced to the research objectives, the intervention framework, and the concept of "Healthy Heart." Spirituality is introduced as an internal resource for coping with stress, and its role in reducing anxiety and increasing resilience is explained. Spiritual self-awareness is also addressed, and individuals are guided to identify their values, beliefs, and internal resources. In the practical part, a practice of focusing on breathing and paying attention to internal states (simple mindfulness based on paying attention to the heart) is performed, and participants are asked to record their daily experiences of stress and emotional reactions. Session 2: Recognizing and regulating emotions + positive thinking. This session is dedicated to integrating emotion recognition skills and cognitive restructuring. Participants learn to identify negative emotions (especially anxiety) in emergency situations and correct dysfunctional thoughts using simple cognitive techniques. Also, training in positive attitude, hope, and focusing on meaningful aspects of the job is provided. Practical practice includes recording negative thoughts and transforming them into adaptive thoughts and writing down daily positive points. Session Three: Acceptance, Patience, and Trust In this session, the key concepts of accepting reality, active patience, and trust are discussed as the main components of a healthy heart. Participants are taught how to reduce emotional resistance and achieve conscious acceptance when faced with uncontrollable circumstances (such as the death of a patient or severe events). The practical exercise involves reviewing a stressful experience, accepting it without judgment, and mentally practicing surrendering control to higher factors (in the form of trust), which helps reduce anxiety. Session Four: Empathy, Communication, and Spiritual Support This session emphasizes human relationships, empathy, and social support as sources of increased resilience. Participants are introduced to effective and empathetic communication skills and the role of positive communication in reducing stress and increasing a sense of meaning at work is examined. The practical exercise involves empathetic conversation, active listening, and providing positive feedback to colleagues, which strengthens a sense of belonging and reduces psychological stress. Session Five: Relaxation, Meaning-Seeking, and Heart Connection This session is a combination of relaxation and meaning-seeking techniques. Participants are introduced to physical and mental stress reduction techniques including deep breathing, muscle relaxation, and focusing on the heart. Next, the concept of meaning in emergency work is introduced and individuals are guided to redefine difficult experiences in terms of meaning and value. Practical exercises include guided breathing, focusing on the heart, and writing about a meaningful work experience. Session 6: Integration, consolidation, and future planning In the final session, all the skills and concepts taught are reviewed and integrated. Participants learn how to apply these skills in their daily lives and work environments. An individualized plan is designed to continue the exercises and participants share their experiences. This session aims to consolidate learning, increase self-efficacy, and sustain the effects of the intervention. The content of the spiritual intervention sessions is designed based on existing evidence on the impact of spirituality on mental health, and the duration of the course is approximately 45 days.
Category
Lifestyle
2
Description
Control Group: The control group consists of 35 participants who will only complete the pre-test and post-test and will not receive any intervention. Anxiety levels will be measured using the Beck Anxiety Inventory (BAI) in both the pre-test and post-test. Resilience will be measured using the Connor-Davidson Resilience Scale (CD-RISC) in both the pre-test and post-test.
Category
Lifestyle
Recruitment centers
1
Recruitment center
Name of recruitment center
Larestan Pre-Hospital Emergency Center
Full name of responsible person
Mohammad Rafi Bazrafshan
Street address
Research Management, Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Phone
+98 71 5225 5512
Email
mrbazr@sums.ac.ir
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Larestan University of Medical Sciences
Full name of responsible person
Dr Ruhollah Karimi
Street address
Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Phone
+98 71 5225 5512
Email
mrbazr@sums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Larestan University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Larestan University of Medical Sciences
Full name of responsible person
Dr. Mohammad Rafi Bazrafshan
Position
professor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Research Management, Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Phone
0098 52255512
Email
mrbazr@sums.ac.ir
Person responsible for scientific inquiries
Contact
Name of organization / entity
Larestan University of Medical Sciences
Full name of responsible person
Mohammad Rafi Bazrafshan
Position
professor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Research Management, Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Phone
+98 71 5255 5512
Email
mrbazr@sums.ac.ir
Person responsible for updating data
Contact
Name of organization / entity
Larestan University of Medical Sciences
Full name of responsible person
Mohammad Rafi Bazrafshan
Position
professor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Research Management, Larestan university of medical sciences, Velayat Boulevard, Imam Khomeini Square, larestan , Iran
City
Lar
Province
Fars
Postal code
7431895639
Phone
+98 71 5225 5512
Email
mrbazr@sums.ac.ir
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
The names of the participants are strictly confidential and cannot be published. However, the results of the study will be made public.
When the data will become available and for how long
2027
To whom data/document is available
public
Under which criteria data/document could be used
Referring to the name of the source and researcher
From where data/document is obtainable
Email
What processes are involved for a request to access data/document
Send request by email, wait for review and response, confirm and send in the same mail