Abstract
Background:
The role and effects of people’s spiritual well-being have received more attention in recent years. Knowing the factors related to spiritual well-being, especially in students as the educated class and future builders of society, is too important. The aim of this study was to investigate the effectiveness of education on spirituality through social media in the spirituality well-being of public health students of Isfahan University of medical science.
Methods:
A semi-experimental, pre-test, post-test study was conducted on 50 under- graduate public health students (3 men, 47 women; age range 18-30 years) of Isfahan University of Medical Sciences through convenience and purposive sampling. The educational content of spirituality education was used to promote and improve spiritual well-being, being sent by using one of the mobile phone applications. Using spiritual well-being questionnaire, the level of the individuals’ spiritual well-being before and after the educational was evaluated. To analyze the data in this study, descriptive statistics and t-test were use SPSS software was used to analyze the data and the significance level was considered lower than 0.05%.
Result:
In total, 50 students including 3 men and 47women participated in the study. The mean age of the participants was 22.02±3.78. About 68% of the students were single and the remaining were married. The score of the participants’ spiritual well-being was 96.5 before the intervention and it promoted to 103.3 after the intervention. The result of the analysis by t-test on the two groups showed that spirituality education can cause a significant increase in peoples’ spiritual well-being (P<0.001).
Conclusion:
After the educational intervention, the level of people’s spiritual well-being increased significantly. As a result, spirituality education causes conditions to improve the peoples’ spiritual well-being.
KEYWORDS: Spirituality, Students, Social media
INTRODUCTION
Spiritual is an important dimension of human well-being and is a unique power that creates a harmony between physical, psychological and social dimensions.1 It is a basic motivation and feeling to look for a long life in order to find a goal and meaning in life.2 Spirituality is often an intuitive and basic motivation in all people including beliefs in something greater or more than oneself which causes life to be positive. Also, it is one of the basic components of human experience and covers one’s belief in spirituality and experiences which do not focus only on corporeality.3
Spiritual well-being, as one of the dimensions of well-being, causes the integration of the other dimensions and it itself includes two existential and religious dimensions.4 Religious well-being focuses on the quality of well-being and on how one perceives it in spiritual life while connecting to a superior power, and existential well-being focuses on social and psychological worries and on how one relates to God, society, environment, and oneself.5
Spirituality and religion, which something are referred to as spiritual well-being and religious practices by people usually overlap. It means that both of them present some frames through which one can understand the meaning, purpose and transcendent values of one’s life. A lot of people can achieve spirituality through religious. Considering people’s differences, something which may provide somebody with comfort and well-being may be ineffective for others.6 Today, religion and spirituality play important roles in people’s lives and are important predictors of the comfort of these persons who believe in religion and its concepts.
Based on the result of researchers, the role of spiritual well-being and religion has been effective in treatment and recovery of diabetes patients.7 The results of a study entitled “the relationship between spiritual well-being, religion and hope in cancer patients” confirm the importance of the spiritual well-being and religion as effective variables for cancer patients’ hope.8
Considering the role of religion and religious orientation in health and prompting psychological well-being, the importance of spirituality and human’s spiritual growth has increasingly attracted the attention of the psychologists and mental health experts since the past decades.9
Apart from paying attention to the role of the religion and spirituality in the field of treatment and health, what is attractive at the global level is attention to spirituality and transcendent values in education about health sciences and specially education about life skills, spiritual life skills and healthy lifestyle for patients’ family, especially young people and students.10
Although spirituality has played a key role in civilization evolution and human society, education about spiritual skills in the field of psychology and behavioral sciences does not have a long history.10 Since care based on spirituality is among the main practices of health authorities, education based on spirituality and spirituality education seem essential and indispensable.11 Some researchers have reported that practicing spirituality and religion has an effective and positive relationship with health habits in the study population it also has beneficial effects on the health of students in developing countries.2
Spirituality is a set of beliefs and attitudes of people and spirituality education leads to important effects on people’s psychological health.12 In spite of all theoretical improvements in the area of health health dimensions in the majority of health promotion programs has been neglected. Desired improvement in spiritual well-being is very slow and its development in the field of health and disease prevention has been postponed.
Many studies on spirituality have referred to spiritual well-being as one of the forgotten reasons in the concerns in physical health. In this regard, the importance of spirituality in human’s physical life has increasingly attracted the attention of health experts.13
Concerning how to teach spirituality, many scientists, researchers and teachers believe that spirituality can improve through new teaching methods, one of the newest of which is using social media.
In the powerful internal connection with internet tools, such a Facebook Twitter, etc. a new technology has developed named social media. It is a massive network which covers the World Wide Web and applications which people use to chat, share information, offer and get information in different fields.3 Social media are a perfect, comprehensive and attractive means of communication which are used widely all around the world.14
The result of the study in Tanzania showed 65% of people use social media to chat and connect to others, 22% use it to get and read the latest news, 15% use it to see videos and photos, 17% use it to do their daily homework, and just 10% of the subjects use it to play internet games.15 Social media are a new technology which allows the users to provide and take part in different internet connections such as communication, transferring information, sharing information, enjoying presence in a virtual space.
The result of another study revealed that students are interested in and have more positive ideas about using social media as a method for learning in comparison with traditional and old methods. They prefer learning by Facebook and weblogs to old and traditional methods.16
One important tool which can provide health information faster than before is social media.15 This tool helps better prospect of health issues and elimination of related worries. Transferring information and expressing ideas about the subjects related to health, developing online health communications and exchanging information about health are among the approaches followed by access to more information and social progress.17 This educational method has been used for various courses for example, in 2014 nutritional subjects in which people get nutritional information and methods through social media.18
Medicine is another subject which has a lot of benefits in this field (using social media); using internet tools to monitor patients and provide medical students with educational digital equipment is an example. Also, there is a new method that uses social media in the field of physician-patient, i.e. the physicians impart information about the disease and prescribe medicine for their patients by technology and web services.3 The mutual effects of social media have been proved as an important aspect of education in order to increase educational experiences and access to better and faster education for learners. In the past, education was provided face to face or by means of mobile phones. Today it has been changed to social media and video conferencing which causes the learners to learn more and change their attitudes.19
According to several studies, using social media, and increase in across to information about health, and using online services can increase health cases and individual self-control in people.17,20 Another study showed 60% of students benefit from group education through social media.20
According to a study conducted on Iranian students, web-based education and social media had some effects on improving traffic behaviors of students.21
Education through social media enables the learners to access educational content in online environment from anywhere and anytime they tend to. So it seems that online approaches to providing the interventions can be effective in learning outcome in comparison with traditional and face to face educational approaches.
With regards to the increasingly importance of the spiritual well-being as one of the health dimensions and considering the fact that in our Iranian and Islamic society, most of behaviors of the individuals and social lives are directly or indirectly influenced by religious doctrine and beliefs and also considering the increasing development and use of social media and the significant role of the media in people’s lives this study conducted to investigate the effects of education on spirituality through virtual networks on the spiritual well-being of public health students of Isfahan University of Medical Sciences.
MATERIALS AND METHODS
This is a semi-experimental, pre-test, post-test study done on the public health students (including: first, second, third, fourth- year public health students) of Isfahan University of Medical Sciences in March 2015 and it continued for 1 month. Considering the situation, convenience sampling was used. The sample size was determined using the following formula and the previous studies.22
The sample size of this study:
Z1=Confidence coefficient 95%=1.96
Z2=Ability test 80%=0.84
D=The lowest mean difference in spirituality health score=0.4S.
S= the estimated standard deviation of spirituality health score.
Considering the sample size and after receiving a letter from the Faculty Vice-chancellor for Research, 100 students were selected as the samples among public health students in health faculty. They studied in BS degree. Considering the inclusion criteria, 75students were selected. 25 students withdrew from the intervention during the study, so we continued the intervention with 50 students. After introducing and providing them with the required information about the study, the researcher gave the questionnaires and consent form in a packet to the students and asked them to complete the questionnaires.
To collect the information in this study, we used a questionnaire consisting of two parts: the first part includes the students’ demographic information (age, marital status, employment, residential status) and the second part includes the standard Ellison- Palutzion Spiritual well-being questionnaire.23
Ellison-Palutzion spiritual well-being questionnaire includes 20 items, out of which 10 items measure religious well-being and the other 10 measure existential well-being. The range of the spiritual well-being for each sub-group of religious and existential well-being is separately 10-60. There is no classification for religious and existential well-being sub-groups and the judgment is made based on the obtained scores. The higher the scores, the better the religious and existential well-being. The responses to the items are classified based on 6-item Likert scale from strongly disagree to strongly agree. Spiritual well-being is divided into three levels of low (20-40) moderate (41-99) and higher (100 120). Ellison-Palutzion Well-being scale is a standard questionnaire and was evaluated In IRAN by Abbasi in 2005. Reliability was estimated 82% and the Cronbach’s Alpha coefficient of validity was 0.75 and both of them have been read and confirmed.24
Plan on Execution of the Study Method
To implement the study, we used pre-test, post-test design that is, after necessary explanations about the purpose of the study and encouraging participation in the study the participants filled out the questionnaire once before the intervention and once after the intervention. Inclusive criteria included the participants’ interest in taking part in the intervention, studying public health, and having access to the Internet and having mobile phone. Exclusion criteria were absence in more than three intervention sessions those with incomplete questionnaire, and lack of interest in studying in the virtual social network. After doing the pre-test, the considered intervention was made during 10 educational sessions in spirituality education.
To do the study, first a survey was conducted on the kind of mobile phone applications the students use more. According to result of the survey, what’s app application was used more by the students. So, this mobile phone application was selected as the educational channel and the educational sessions were held through this channel. Since some students did not have the considered what’s application and had limited access to the Internet and also the low speed of this application during some hours during the day, the participants were divided into two groups based on two different periods of time.
Every day, 5 subjects related to the considered topics were sent to the participants in each group in the form of massage, pictures, and also, according to the topic of some subjects, in the form of video clips audio files. The participants were asked to be exposed to the other participants in the group, to their positive and negative ideas and also their recommendations on the subjects which were sent to the group.
Education through using religious doctrine included the patience, trust, mercifulness, adoration, proper thanks giving to God, theology, self- reflection and presence of God in life. The post-test was done four weeks after the pre-test and this interval was considered with respect to similar studies.11
The present study was approved by the Ethics Committee of Isfahan University of Medical Sciences (Grant no. 3938488), Iran. Before data collection, the researcher obtained an oral and written informed consent to ensure anonymity, privacy and confidentiality and emphasized their voluntary enrollment.
RESULTS
In total, 50 people participated in the intervention; their mean age was 22.02±3.78. The majority of the participants were females (94%). About 32% of them were married. Also, 44% were residents in dormitories (table 1).
Table 1.
Demographic information of the participants in the study
| Variables | Mean±SD | |
|---|---|---|
| Age (years) | 22.02±3.78 | |
| Sex | Number | Percent |
| Female | 47 | 94% |
| Male | 3 | 6% |
| Marital status | Number | Percent |
| Single | 34 | 68% |
| Married | 16 | 32% |
The results of t-test indicated that the mean post-test score (M=103.3, SD=13.2) was significantly higher than mean pre-test scores (M=96.5, SD=11.6.), P<0.001. The effect size was 6.8, indicating a substantially large effect (table 2).
Table 2.
Average, mean, and standard deviation of spirituality well-being and its sub-area scores between 2 groups of students. (Before and after the intervention)
| Spirituality well-being dimensions | Before intervention Mean±SD | Four weeks after intervention Mean±SD | P value | Effect Size |
|---|---|---|---|---|
| Religious well-being | 51.7±6.3 | 63.6±6.5 | 0.03 | 11.9 |
| Existential well-being | 44.8±6.8 | 49.7±7.9 | <0.001 | 4.9 |
| Spiritual well-being total | 96.5±11.6 | 103.3±13.2 | <0.001 | 6.8 |
DISCUSSION
Spiritual well-being is one of the important dimensions which has wonderful effects on people’s lives and is involved in many personal and social performances of people. To improve this important health dimension, various approaches have been suggested. One of the important ways to promote spiritual well-being is educating people on spirituality. Based on searches performed, since no study has been conducted in Iran on the effects of spirituality education through social media, to explain the findings, there was an attempt to point to the studies most similar to the present study.
In this study, hypothesis testing showed that spirituality education can significantly affect the people’s spiritual well-being and cause a significant difference between the average scores of two groups before and after the intervention.
The result of study which was conducted on the older adults showed that religion and spiritual well-being play an important role in people’s lives.25 In most of the previous studies, spirituality and religion cause the individuals’ mental health to promote.26 Another study showed that spirituality and spiritual therapy take special notice of the quality and well-being of people’s lives.27
The results are approximately consistent with those of another study on this subject.28 Paying attention to spiritual dimension provides humans with power and helps them to tolerate life problems. One of the main reasons for the fact that young people avoid religion and spirituality is inappropriate education they receive under the name of religion. If people receive appropriate spirituality education, perceive spirituality correctly, and learn that they can live a healthy and normal life in the light of spirituality, they will undoubtedly be interested in religious and spiritual values.
According to the findings of the present study, it can be said that spirituality education, to a significant extent, has been able to cause an increase in spirituality well-being this positive result may have resulted from cultural and religious conditions of Iran’s society because Iran is a religious country and Iranian people believe in GOD. Investigating the qualitative results of educational sessions has confirmed the above results as well.
Positive results of the studies conducted on the people with mental problems have revealed an increase in mental well-being of those who had participated in group discussion.29 In the present study, a new channel, i.e. Social media, was used to provide education the results showed positive effects of using it on the increase in spirituality well-being. Various studies have shown the positive roles of using social media, such as Facebook, which can cause great interest in learning.20 Using social media has a lot of benefits for students and education theory and can effectively help to hold educational courses.30 Regarding the finding of a study social media was used as a new mechanism in order to cause their target group to get the latest and the most up-to-date nutritional information.18 The present study investigated the effects of spiritual education through virtual social media on the spirituality well-being of public health students studying at Isfahan University of Medical Sciences in 2015. As the results of data analysis showed, spirituality education through the new channel, called social media, has significant effects on the promotion of students’ spiritual well-being.
Among the limitation of this study was the lack of a control group. Therefore, the changing in spirituality well-being scores cannot be attributed only to the intervention; they may simply represent developmental or cultural/historical changes, or may be due to experimenter effects. Thus, the findings should be interpreted with caution and further studies on the effect of intervention in 2 groups are recommended to be conducted. The second limitation is the lack of background in using social media for education and this imposes limitation on enough time to discuss the obtained results. Considering the limited number of samples and limitation of the study to one special course, it is suggested that further studies be performed on this subject with more samples which are more various and also by comparing the effects of education in two separate sexes, courses and other demographic information.
CONCLUSION
As a conclusion, spiritual education has a positive role in promoting people’s spiritual well-being. In this study, the results showed that spirituality education is on effective intervention in promoting people’s spiritual well-being and finally in their mental well-being; moreover, education through social media channel, as an attractive channel, can cause continuous participation of people in the intervention and finally promotion of the participant’s’ spiritual well-being.
Considering these results, due to the strong presence of spiritual/religious culture in Iran’s society, it is suggested that experts and authorities should pay more attention to spiritual category especially in universities.
Also considering the results of this study, the usefulness of social media as a channel for education could be mentioned. Due to its advantages such as attraction, innovation, low cost, easy access, possible group discussion, social media can facilitate and speed up educational conditions and methods in comparison with usual old methods.
ACKNOWLEDGEMENT
The researcher appreciates all the students who took part in this study and took the trouble to answer the questionnaire of the study. This article is extracted from the Master Thesis of Maryam Hasanshahi with the code number of 3938488, which was approved by Isfahan University of Medical Sciences.
Conflict of Interest: None declared.
REFERENCES
- 1.Zeighami Mohamadi Sh, Tajvidi M. Relationship between spirituall well-being whit hopelesness and social skills in beta-thalasemia major adolescents. Modern Care Journal. 2011;8:116–24. [In Persian] [Google Scholar]
- 2.Hillary LT. On Spirituality, Religiosity and Health among College Students In Mumbai, India [Thesis] New York: Yeshiva University; 2012. [Google Scholar]
- 3.Popoiu MC, Grosseck G, Holotescu C. What do We Know about the Use of Social Media in Medical Education? Procedia - Social and Behavioral Sciences. 2012;46:2262–6. [Google Scholar]
- 4.Rezaee AM, Ghaleghasem Momeni T, Ebrahimi A, Karimian J. The Relationship between Spiritual Wellbeing with Stress, Anxiety, and Some Demographic Variables in Women with Breast Cancer Referring to the Specialized Cancer Treatment Center in Isfahan, Iran. JHSR. 2012;8:104–13. [In Persian] [Google Scholar]
- 5.Asaroudi A, Jalilvand MR, Oudi D, Akaberi A. The relationship between spirituality well-being and life satisification in the nursing staff of mashhad hasheminejad hospital. Modern Care Journal. 2012;9:156–62. [In Persian] [Google Scholar]
- 6.Anand V, Jones J, Gill P. The Relationship Between Spirituality, Health and Life Satisfaction of Undergraduate Students in the UK: An Online Questionnaire Study. J Relig Health. 2015;54:160–72. doi: 10.1007/s10943-013-9792-0. [DOI] [PubMed] [Google Scholar]
- 7.Necula R, Damian S, Caras A, et al. The Role of Spirituality in the Construction of the Autonomy and Responsibility of Chronic Diabetic Patients. An Orthodox Priests’ Perspective. Procedia - Social and Behavioral Sciences. 2013;92:617–26. [Google Scholar]
- 8.Balenjani E, Khashabi J, Amanpor E, Azimi N. Relationship between spiritual well-being, religion and hope among patient with cancer. Hayat. 2011;17:27–37. [In Persian] [Google Scholar]
- 9.Gholami A, Beshlideh K. The effect of spirituality care on the mental health of divorced woman. Journal of family Consulting and psychotherapy. 2012;1:331–48. [In Persian] [Google Scholar]
- 10.Jalali D. The effect of preventing short message servicse on the attitude and self- efficacy of students towards to use drug use. Information and Communication Technology in Education. 2011;1(3) [In Persian] [Google Scholar]
- 11.Akbari M, Yazdani Sh, Makarem A, et al. Spirituality and Epistemological and behavioral Excellence in the education. Med Ethics. 2013;7:115–34. [In Persian] [Google Scholar]
- 12.Mhaske RS. Spiritual Beliefs and Mental Healt among Institutionalized Aged. Psychosoc Res. 2013;8:71–8. [Google Scholar]
- 13.Abbasi M, Azizi F, Shamsi Goushki E, et al. Conceptual Definition of spiriyually health. Med Ethics. 2012;6:11–44. [In Persian] [Google Scholar]
- 14.Kostka-Rokosz MD, Camiel LD, McCloskey WW. Pharmacy students’ perception of the impact of a Facebook-delivered health news service-Two-year analysis. Currents in Pharmacy Teaching and Learning. 2014;6:471–7. [Google Scholar]
- 15.Pfeiffer C, Kleeb M, Mbelwa A, Ahorlu C. The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania. Reproductive Health Matters. 2014;22:178–86. doi: 10.1016/S0968-8080(14)43756-X. [DOI] [PubMed] [Google Scholar]
- 16.Mao J. Social media for learning: A mixed methods study on high school students’ technology affordances and perspectives. Computers in Human Behavior. 2014;33:213–23. [Google Scholar]
- 17.Mano RS. Social media and online health services: A health empowerment perspective to online health information. Computers in Human Behavior. 2014;39:404–12. [Google Scholar]
- 18.Tobey LN, Manore MM. Social media and nutrition education: the food hero experience. Journal of nutrition education and behavior. 2013;46:128–33. doi: 10.1016/j.jneb.2013.09.013. [DOI] [PubMed] [Google Scholar]
- 19.Vollum MJ. The potential for social media use in K-12 physical and health education. Computers in Human Behavior. 2014;35:560–4. [Google Scholar]
- 20.V. Rasiah RR. Transformative Higher Education Teaching and Learning: Using Social Media in a Team-based Learning Environment. Procedia - Social and Behavioral Sciences. 2014;123:369–79. [Google Scholar]
- 21.Jalilian M, Mostafavi F, Delpisheh A, et al. Impact of useing electronic device on road crossing behaviors among medical college students. Life Science Journal. 2014;11:391–5. [Google Scholar]
- 22.Azhdari fard PS, Ghazi Gh, Nourani pour R. The effect of spirituality education on the mental health of students. Journal of Modern Thoughts in Education. 2010:5105–27. [In Persian] [Google Scholar]
- 23.Bufford RK, Paloutzian RF, Ellison CW. Norms for the spiritual well-being scale. Journal of Psychology and Theology. 1991;19:56–70. [Google Scholar]
- 24.Farahaninia M, Abbasi M, Givari A, Haghani H. Nursing Students’ Spiritual Well-Being and Their Perspectives Towards Spirituality and Spiritual Care Perspectives. IJN. 2006;18:7–14. [In Persian] [Google Scholar]
- 25.Noronha KJ. Impact of Religion and Spirituality on Older Adulthood. Journal of Religion, Spirituality & Aging. 2014;27:16–33. [Google Scholar]
- 26.Hefti R. Integrating Religion and Spirituality into Mental Health Care, Psychiatry and Psychotherapy. Religions. 2011;2:611–27. [Google Scholar]
- 27.Crowther S, Hall J. Spirituality and spiritual care in and around childbirth. Women and Birth. 2015;28:173–8. doi: 10.1016/j.wombi.2015.01.001. [DOI] [PubMed] [Google Scholar]
- 28.Lotfi kashani F, Vaziri Sh, Gheisar Sh, et al. Evaluation of effectiveness of spiritual intervention on promoting quality of life among mothers of children with cancer. Medical Figh Quarterly. 2012;4:25–149. [In Persian] [Google Scholar]
- 29.Bahrami Dashtaki H, Alizade H, Ghobari B, Karami A. The effect of group spirituality education on the decrees of depression in students. Counseling Research & Developments. 2005;5:49–72. [In Persian] [Google Scholar]
- 30.Elitaş T. Social Media Usage by Open Education Faculties: Atatürk University Case. Procedia - Social and Behavioral Sciences. 2015;176:243–50. [Google Scholar]