From Burden to Blessing: Maternal Guilt as a Spiritual Compass for Resilience Among Muslim Intensive Care Unit Nurses in Indonesia
DOI:
https://doi.org/10.25217/002026929800Keywords:
Islamic psychology, interpretative phenomenological analysis, maternal guilt, Muslim women, ICU nursesAbstract
Maternal guilt is common among working mothers in caregiving professions, and Muslim Intensive Care Unit (ICU) nurses in Indonesia have been shown to report elevated levels; however, existing research has treated religiosity primarily as a buffer that mitigates such distress rather than examining how guilt itself may be reinterpreted as a spiritually meaningful process. This gap is most consequential in ICU nursing, where the compression of professional moral distress and maternal obligation is most acute, yet this population has received little empirical attention within Islamic psychology. This study examined how Muslim ICU nurses in Indonesia interpret and transform maternal guilt through an Islamic spiritual lens. Interpretative Phenomenological Analysis was employed, with two in-depth semi-structured interviews conducted with each of eight Muslim ICU nurse-mothers recruited through purposive sampling from three regional public hospitals in Banjarmasin, South Kalimantan. Interviews were conducted in Bahasa Indonesia interwoven with Bahasa Banjar and analysed following Smith and colleagues' six-step Interpretative Phenomenological Analysis (IPA) procedure. Three group experiential themes emerged: guilt was experienced as a divine moral compass anchored in the body and read through daily exposure to patient mortality; it was transformed through Islamic vocabulary (sabr, ikhlas, tawakkul, amanah) and embodied ritual practices (wudu, niyyah) from perfectionist standards to the standard of cukup (enough); and it ultimately reinforced a unified identity in which mothering and nursing were held together as dual sacred trusts. These findings contribute to culturally grounded models of maternal well-being in Muslim-majority caregiving contexts and inform faith-integrated approaches to Islamic guidance and counselling for women in high-demand healthcare professions.
References
Aarntzen, L., Derks, B., van Steenbergen, E., Ryan, M., & van der Lippe, T. (2019). Work-family guilt as a straightjacket: An interview and diary study on consequences of mothers' work-family guilt. Journal of Vocational Behavior, 115, 103336. https://doi.org/10.1016/j.jvb.2019.103336
Aarntzen, L., Derks, B., van Steenbergen, E., & van der Lippe, T. (2023). When work–family guilt becomes a women's issue: Internalized gender stereotypes predict high guilt in working mothers but low guilt in working fathers. British Journal of Social Psychology, 62(1), 12–29. https://doi.org/10.1111/bjso.12575
Achour, M., Bensaid, B., & Nor, M. R. B. M. (2016). An Islamic perspective on coping with life stressors. Applied Research in Quality of Life, 11(3), 663–685. https://doi.org/10.1007/s11482-015-9389-8
Al Eid, N. A., Alqahtani, M. M., Marwa, K., Arnout, B. A., Alswailem, H. S., & Al Toaimi, A. A. (2020). Religiosity, psychological resilience, and mental health among breast cancer patients in Kingdom of Saudi Arabia. Breast Cancer: Basic and Clinical Research, 14, 1–13. https://doi.org/10.1177/1178223420903054
Aydın, A., Bingöl, H., Kebudi, R., Savaş, E. H., Koç, B., Büyükkapu Bay, S., Yıldırım, Ü. M., & Zülfikar, B. (2025). Religious coping strategies of mothers who lost their children to cancer in Türkiye: A qualitative study. Journal of Religion and Health, 64(3), 2152–2164. https://doi.org/10.1007/s10943-025-02256-z
Basley, S. A., Ferszt, G. G., & DeSanto-Madeya, S. (2024). The experiences of nurses as double-duty caregivers for a family member at the end of life. Journal of Hospice & Palliative Nursing, 26(3), 132–139. https://doi.org/10.1097/NJH.0000000000001009
Constantinou, G., Varela, S., & Buckby, B. (2021). Reviewing the experiences of maternal guilt: The "Motherhood Myth" influence. Health Care for Women International, 42(4–6), 852–876. https://doi.org/10.1080/07399332.2020.1835917
Cottingham, M. D., Chapman, J. J., & Erickson, R. J. (2020). The constant caregiver: Work–family spillover among men and women in nursing. Work, Employment and Society, 34(2), 281–298. https://doi.org/10.1177/0950017019885084
Daulay, N., Daulay, H., & Rohman, F. (2025). Religious coping of Muslim mothers of children with autism spectrum disorder in Indonesia. Journal of Disability & Religion, 29(1), 33–50. https://doi.org/10.1080/23312521.2024.2372021
Dolcos, F., Hohl, K., Hu, Y., & Dolcos, S. (2021). Religiosity and resilience: Cognitive reappraisal and coping self-efficacy mediate the link between religious coping and well-being. Journal of Religion and Health, 60(4), 2892–2905. https://doi.org/10.1007/s10943-020-01160-y
Eatough, V., & Smith, J. A. (2008). Interpretative phenomenological analysis. In C. Willig & W. Stainton-Rogers (Eds.), The SAGE handbook of qualitative research in psychology (pp. 179–194). SAGE Publications. https://doi.org/10.4135/9781848607927.n11
Eltaiba, N. (2024). Religion, spirituality, and responding to guilt among Muslim women. Journal of Religion & Spirituality in Social Work: Social Thought, 43(3), 404–420. https://doi.org/10.1080/15426432.2024.2363309
Englander, M. (2012). The interview: Data collection in descriptive phenomenological human scientific research. Journal of Phenomenological Psychology, 43(1), 13–35. https://doi.org/10.1163/156916212X632943
Febriyani, Amna, Z., Mirza, & Iskandar. (2025). Religious coping and parental burnout among mothers working as nurses in Aceh province, Indonesia: A cross-sectional study. Journal of Community Mental Health and Public Policy, 8(1), 47–58. https://doi.org/10.51602/cmhp.v8i1.262
Ha, E. (2016). Attitudes toward child rearing in female clinical nurses working in three shifts. Nursing & Health Sciences, 18(4), 416–424. https://doi.org/10.1111/nhs.12284
Hairina, Y., Hartini, N., Nursalam, & Imadduddin. (2024). Descriptive profile of maternal guilt levels on female ICU nurses in South Borneo. Nusantara Science and Technology Proceedings, 2024(44), 11–18. https://doi.org/10.11594/nstp.2024.4403
Henderson, A., Harmon, S., & Newman, H. (2016). The price mothers pay, even when they are not buying it: Mental health consequences of idealized motherhood. Sex Roles, 74(11–12), 512–526. https://doi.org/10.1007/s11199-015-0534-5
Henrich, N. J., Dodek, P. M., Gladstone, E., Alden, L., Keenan, S. P., Reynolds, S., & Rodney, P. (2017). Consequences of moral distress in the intensive care unit: A qualitative study. American Journal of Critical Care, 26(4), e48–e57. https://doi.org/10.4037/ajcc2017786
Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94(3), 319–340. https://doi.org/10.1037/0033-295X.94.3.319
Ibrahim, M. A., Isa, K. Q., Haji-Idris, H.-A., Nawi, S.-H., Teo, Y. C., Abdul Rahman, H., & Abdul-Mumin, K. H. (2020). Spiritual coping with stress among emergency and critical care nurses: A cross-sectional study. Community Mental Health Journal, 56(2), 287–293. https://doi.org/10.1007/s10597-019-00486-6
Khosravi, Z. (2018). Guilt and shame in religious education. Talim: Journal of Education in Muslim Societies and Communities. https://doi.org/10.12738/talim.2018.1.0100
Komariah, M., Hatthakit, U., & Boonyoung, N. (2020). Impact of Islam-based caring intervention on spiritual well-being in Muslim women with breast cancer undergoing chemotherapy. Religions, 11(7), 361. https://doi.org/10.3390/rel11070361
Matheson, A., O'Brien, L., & Reid, J. (2019). Women's experience of shiftwork in nursing whilst caring for children: A juggling act. Journal of Clinical Nursing, 28(21–22), 3817–3826. https://doi.org/10.1111/jocn.15017
Mazruei, N., Alivandi Vafa, M., & Moheb, N. (2024). Effectiveness of Islamic spiritual-religious group training on psychological disturbance and guilt of mothers with mentally retarded students. Spirituality Research in Health Sciences, 2(1), 90–99. https://doi.org/10.34172/srhs.2024.008
Moreno-Ávila, I. del M., Martínez-Linares, J. M., Mimun-Navarro, K., & Pozo-Muñoz, C. (2023). Muslim and Christian women's perceptions of the influence of spirituality and religious beliefs on motherhood and child-rearing: A phenomenological study. Healthcare, 11(22), 2932. https://doi.org/10.3390/healthcare11222932
Nor, M. (2023). Review literature about influence prayer and dhikr in improving mental health based on the Qur'an Surah Ar-Ra'd Verse 28. Bulletin of Islamic Research, 1(1), 103–124. https://doi.org/10.69526/bir.v1i1.335
Öke Karakaya, P., Sönmez, S., & Aşık, E. (2021). A phenomenological study of nurses' experiences with maternal guilt in Turkey. Journal of Nursing Management, 29(8), 2515–2522. https://doi.org/10.1111/jonm.13401
Pietkiewicz, I., & Smith, J. A. (2014). A practical guide to using interpretative phenomenological analysis in qualitative research psychology. Czasopismo Psychologiczne / Psychological Journal, 20(1), 361–369. https://doi.org/10.14691/cppj.20.1.7
Primadona, F., & Lenggogeni, S. (2024). "Kepala Putik" on women: Perspectives and challenges in balancing the dual role as mother and worker in Indonesia. Sawwa: Jurnal Studi Gender, 19(1), 75–98. https://doi.org/10.21580/sa.v19i1.22521
Ramírez-Elvira, S., Romero-Béjar, J. L., Suleiman-Martos, N., Gómez-Urquiza, J. L., Monsalve-Reyes, C., Cañadas-De la Fuente, G. A., & Albendín-García, L. (2021). Prevalence, risk factors and burnout levels in intensive care unit nurses: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(21), 11432. https://doi.org/10.3390/ijerph182111432
Sánchez-Rodríguez, R., Orsini, É., Laflaquière, E., Callahan, S., & Séjourné, N. (2019). Depression, anxiety, and guilt in mothers with burnout of preschool and school-aged children: Insight from a cluster analysis. Journal of Affective Disorders, 259, 244–250. https://doi.org/10.1016/j.jad.2019.08.031
Saniotis, A. (2018). Understanding mind/body medicine from Muslim religious practices of salat and dhikr. Journal of Religion and Health, 57(3), 849–857. https://doi.org/10.1007/s10943-014-9992-2
Schwalm, F. D., Zandavalli, R. B., de Castro Filho, E. D., & Lucchetti, G. (2022). Is there a relationship between spirituality/religiosity and resilience? A systematic review and meta-analysis of observational studies. Journal of Health Psychology, 27(5), 1218–1232. https://doi.org/10.1177/1359105320984537
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. Sage Publications.
Smith, J. A., & Osborn, M. (2015). Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. British Journal of Pain, 9(1), 41–42. https://doi.org/10.1177/2049463714541642
Wu, H.-C., Peng, Y.-C., & Wang, H.-H. (2022). Intensive care unit nurses' perceptions of and coping strategies for motherhood experiences: A qualitative study. Healthcare, 10(9), 1660. https://doi.org/10.3390/healthcare10091660
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