The World Health Organization (WHO) (1998) has proclaimed that the definition of health includes four Domains of well-being: physical, mental, social and spiritual. It is therefore suggested that nurses should prepare themselves to assist individuals and families, not only to cope with spiritual distress of illness and suffering but also to explore the meaning in these experiences. The purpose of this investigation is to explore the antecedents of spiritual distress experienced by Iranian Muslim patients in the context of Islam.

qualitative descriptive research was conducted using unstructured interviews with twenty-one patients and three relatives. The data analyzed using content analysis method.

three main categories were found: failure in communication, non-holistic care and inability to worship

The results showed that the patient's spiritual well-being could be enhanced by communication, listening and giving information. Finally, it is clear that staff members have a great deal of responsibility for the patient's well-being, facilitating the relatives’ involvement based on their wishes and limiting the stress and difficulties experienced by the family.