Coronaviruses can infect animals and humans and cause respiratory distress. These discomforts may be as mild as common cold, or as severe as pneumonia. In some cases, coronaviruses can be transmitted from animals to humans, and infected healthy people such as SARS (Acute Respiratory Symptoms) in 2002 to 2003 or MERS (Respiratory Symptoms of the Middle East) in 2012, which was transmitted from camels to humans. The new coronavirus (COVID-19) with symptoms of fever, cough, and dyspnea can lead to acute respiratory failure and death. It usually spread through coughing and sneezing, contaminated hands, contact with an infected person or touching contaminated surfaces. Due to the contagious power and high mortality of the disease, this biological crisis, in addition to socio-economic consequences, has caused psycho- spiritual problems for people around the world 123456 because in acute life-threatening illnesses, the perceived threat of the disease increases due to the severity of the patient's situation 7. In COVID-19 disease, some of the patients should be admitted to the intensive care unit (ICU) due to the respiratory failure and multi- failure organs (MFO) 8. Severe physical symptoms and rapid spread of the disease among family members, causes psychological problems such as (fear, panic attacks, death anxiety, depression, etc.) and spiritual distress (disappointment with God's Mercy, dissatisfaction with fate, resentment, and revenge...) 9. These problems threaten the people’s spiritual health and requires spiritual care 10.

Due to the effectiveness of religious spirituality, on reducing stress 1112 the World Health Organization (WHO) introduces a health-promoting lifestyle combined with six dimensions of: -Spiritually and believing in God for mental health,-Sense of responsibility for health promotion,- Maintaining interpersonal relationships to promote the social health,-Stress management for prevention of physical and mental illness,- Physical activity and healthy diet 13. The encouraging healthy behavior and creating a healthy environment were the two goals of the WHO in 2020 for Healthy People Program 14. Health promotion as an important pillar of society's progress has been considered in WHO policy 15. Today, health services and treatment team, are focusing on promoting health, preventing disease, and eliminating factors that have a negative impact on the health of societies. 16. Considering the bio- psycho-socio-spiritual health problems caused by COVID-19 pandemic, the importance of surveying health services in countries around the world is important. Due to the fact that in Iran, health system personnel and health science students do not learn the method of spiritual care or spiritual counseling in the academic course this research was conducted to answer these two questions: 1- Were spiritual health services provided in Pandemic COVID-19 in Iran? 2- What was the basis of providing spiritual health services in this biological crisis? This study aims to investigate the spiritual health services in the face of the COVID-19 pandemic in Iran.

This qualitative study was conducted from March 1, 2020 to the end of May 2020 in Tehran, by using the concept analysis method of Schwartz and Kim hybrid model, which is a strong methodology for concept development with deductive / inductive analysis approach. Research was implemented in three stages: 1- Theoretical review, 2- Work in the field (field research) 3- Final analysis 17. The main emphasis in the theoretical review was to identify the essential components of the concept definition, how to measure it, which were included the following steps: concept selection, text search, discussion of the meaning and method of measurement, and finally, the selection of the working definition. Inclusion criteria were: - Religious evidence related to sound heart, Islamic health instructions in infectious diseases, from the books of Shiite Hadith. Scientific evidence related to COVID-19 disease, physical, psychosocial and spiritual consequences of the disease. - access to the full text of the article, -during the outbreak of the disease 2019-2021, -available in reputable databases (PubMed, Web of Science, SID, Scopus, and Magi ran). Exclusion criteria: - Lack of full text or lack of valid sources.

In the field research phase, after obtaining informed written consent, semi-structured individual interviews were conducted by target-based sampling. Samples were selected from the medical staff of Baqiyatallah Hospital. Interviews continued until data saturation. In order to get acquainted with possible and unforeseen issues and to form a combination of questions, a few initial interviews were conducted. The questions were based on the interview process and included the following: 1- Do your patients, their family or your colleagues face spiritual problems? 2- What do you do to help alleviate their spiritual suffering? In order to increase the accuracy and robustness of the research as well as the accuracy and comprehensiveness of the collected information, notes were taken on the people's behaviors in the face of biological crisis in social networks (national media, WhatsApp, Instagram). Work in the field, with the aim of confirming and consolidating the concept through the analysis of collected data, to examine the components of the concept at a practical level, coincided with the first stage of research. In the final analysis stage, the findings of the initial theoretical analysis were compared with the data in the field 18.

The Shiite religion has been the official religion in Iran since the 16th century. After the Islamic Revolution of Iran (1978), the government was established according to the rules of jurisprudence 4243 as a divine law that expresses the duty that God expects from His servants in every verbal and non-verbal behavior 44. Imams’ jurisprudence is one of the most important sources of law in Iran 45. The various social laws are inferred from the Qur'an and hadiths 46. Religious orders have shaped the normative beliefs and cultural norms of the Muslims people 34. The Islamic spirituality as a valuable resource for reducing health problems, promoting health, adapting to stressful events and improving the quality of life 47 is in harmony with the World Health Organization perspective about health promotion as empowerment programs for increasing people control over their health 48 and responsibility for their own health and adopt a healthy lifestyle 49. On the other hand the religious spirituality of Islam and the "rule of no harm" governs all aspects of the relationship between individuals in society (such as Articles 11 and 12 of the Civil Liability Law and Articles 140 to 145 of the Islamic Penal Code]34. These laws also govern the provision of health services 50. According to these laws, people who cause harm to themselves or others will be dealt with legally and criminally if they violate the relevant regulations. So all people have a responsibility to repel potential harm from themselves and others 51.

The participation of the people in the face of national crises, are blessings that can be seen among the followers of the Abrahamic religions and Muslims 52. Given that the crisis of manpower shortages, rising treatment costs, disease beyond geographical boundaries, bioterrorism, has affected the health systems of countries 53, this partnership and empathy reinforces the self-care and home care approach, family members' participation in the treatment and care process 54. The religious beliefs, also facilitates the interdisciplinary collaboration of health science graduates with unique cultural contexts and educational approaches and provides inter-professional services to address the health needs of society 55. It provides the holistic care, community-based health services according to the beliefs and cultural values ​​ of the community and respecting the opinions of patients / clients / families in crisis situations 56.The inter-professional spiritual health services based on the Islamic culture 57, led the provision of health services at various levels of prevention, for healthy people /clients / patients 58 by a team work approach to combat the disease 59.