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Spirituality and qulity of life in hemodialysis patients White, Rita Yim Fong

Abstract

The accuracy and efficacy of the diagnosis and the renal replacement modalities for end stage renal disease are becoming increasingly sophisticated, but the psychospiritual impact of the disease is still unclear. Although there were studies supporting the relationship of spirituality and quality of life in various chronic conditions, little information regarding this relationship is known for chronic hemodialysis patients. This descriptive correlational study was done to describe the spirituality and health-related quality of life of adult long-term hemodialysis patients, and to examine the relationship between spirituality and health-related quality of life in these patients. The stress, appraisal, and coping theory developed by Lazarus and Folkman (1984) served as the theoretical framework. A convenience sample of 88 subjects who received hemodialysis for over three months completed the Kidney Disease Quality of Life Short Form (KDQOL-SF™) questionnaire and the revised Spiritual Involvement and Beliefs Scale (SD3S-R) during one hemodialysis treatment session. Overall, these long-term hemodialysis patients perceived a moderately low level of spirituality. The low spirituality appeared to be related to the persistence of health problems over time and that the subjects were concerned with physiological needs rather than being focused on their spiritual life. The subjects perceived a moderately low level of health-related quality of life and were worse in physical than in mental and emotional dimensions. There was no statistical correlation between the perception of spirituality and health-related quality of life (r = . 14, p_ < .05). Patients with high scores of spirituality appeared to perceive better general health and higher energy level. The lack of correlation between spirituality and quality of life appeared to be related to the nature of the sample and the psychometric quality of the tool used to measure spirituality. Based on the findings, suggestions are made for new directions for the provision of effective health care for hemodialysis patients. It is recommended that the tool used to measure spirituality be strengthened, a random selection from a larger population in multiple hemodialysis centers be used, and the data collection be done between, rather than during dialysis treatments. A longitudinal approach would lead to a more comprehensive understanding of the relationship between spirituality and quality of life over the course of patients' experiences with chronic kidney disease.

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