THE EFFECT OF THE SPIRITUAL STATES OF HEMODIALYSIS PATIENTS ON THEIR LEVELS OF HOPELESSNESS

Abstract

Aim: This study was conducted descriptively to determine the effects of the spiritual orientation of hemodialysis patients on their levels of hopelessness. Method: The study sample consisted of 100 hemodialysis patients treated at Ondokuz Mayıs University Health Application and Research Center (OMUHARC) hemodialysis unit, nephrology service and City Health Center affiliated to OMUHARC between July 2017 and May 2018. The data were collected using patient introductory information forms, Spiritual Orientation Scale (SOS) and Beck Hopelessness Scale (BHS). The compliance of the data to normal distribution was examined using the Shapiro Wilk test. Kruskal Wallis and Mann Whitney U tests were used to compare data that did not conform to normal distribution. Spearman correlation analysis was used to examine the relationship between the sub-dimensions of the scales. Result: The patients' average age was 56.7±14.4, 59% were male, 80% were married, 53% were diagnosed with chronic renal failure 1-5 years ago, 75% had been receiving hemodialysis treatment for 1-5 years and 63% had another chronic disease. The mean total score of SOS was 99.57±15.51. The mean BHS total score was 5.68 ± 4.43; while the emotions and expectations about the future sub-dimension mean total score was 1.2 ± 1.29, that of the motivation loss sub-dimension was 2.56±1.89, whereas that of the hope sub-dimension was 1.91±1.82. A moderately negative significant correlation was found between SOS and BHS (r: -0.385, p<0.001). Conclusion and Suggestions: We found a moderate relationship between spiritual orientation and hopelessness and that as spiritual orientation increased, hopelessness decreased. To strengthen the patient against hopelessness, we recommend establishing spiritual practices for Hemodialysis (HD) patients and a spiritual support team.

Keywords

• Hemodialysis
• Hopelessness
• Nursing
• Spiritual Orientation.

Hemodiyaliz Hastalarının Manevi Durumlarının Umutsuzluk Düzeylerine Etkisi

Abstract

Amaç: Bu araştırma hemodiyaliz hastalarının manevi yönelimlerinin umutsuzluk düzeylerine etkisini belirlemek amacıyla tanımlayıcı olarak yürütülmüştür. Materyal ve Metot: Araştırmanın örneklemini Temmuz-2017 ve Mayıs 2018 tarihleri arasında Ondokuz Mayıs Üniversitesi Sağlık Uygulama ve Araştırma Merkezi (OMÜ SUVAM) hemodiyaliz ünitesi, nefroloji servisi ve OMÜ SUVAM’a bağlı Şehir Sağlık Merkezi’nde tedavi gören 100 hemodiyaliz hastası oluşturmuştur. Veriler hasta tanıtıcı bilgi formu, Manevi Yönelim Ölçeği (MYÖ) ve Beck Umutsuzluk Ölçeği (BUÖ) kullanılarak toplanmıştır. Verilerin normal dağılıma uygunluğu Shapiro Wilk testi ile incelenmiştir. Normal dağılıma uymayan verilerin karşılaştırılmasında Kruskal Wallis ve Mann Whitney U testi kullanılmıştır. Ölçeklerin alt boyutları arasındaki ilişkinin incelenmesinde ise Spearman korelasyon analizinden yararlanılmıştır. Bulgular: Hastaların yaş ortalamasının 56.7±14.4 olduğu, %59’unun erkek, % 80’inin evli, % 53’ünün 1-5 yıl önce kronik böbrek yetmezliği tanısı aldığı, % 75’inin 1-5 yıldır hemodiyaliz tedavisi aldığı, % 63’ünün başka bir kronik hastalığı olduğu tespit edilmiştir. Bu araştırmada MYÖ toplam puan ortalaması 99.57±15.51 olarak saptanmıştır. BUÖ toplam puan ortalaması ise 5.68±4.43; gelecek ile ilgili duygular ve beklentiler alt boyutu toplam puan ortalaması 1.2±1.29 iken motivasyon kaybı alt boyutu toplam puan ortalaması 2.56±1.89 ve umut alt boyutu toplam puan ortalaması 1.91±1.82 olarak belirlenmiştir. MYÖ ve BUÖ arasında orta düzeyde negatif yönde anlamlı korelasyon belirlenmiştir (r: -0.385, p<0.001). Sonuç ve Önerler: Manevi yönelim ve umutsuzluk arasında orta düzeyde ilişki olduğu ve manevi yönelim arttıkça umutsuzluğun azaldığı belirlenmiştir. Hastanın umutsuzluğa karşı güçlendirilmesi için Hemodiyaliz (HD) hastalarına yönelik manevi uygulamalarının oluşturulması ve manevi destek ekibinin kurulması önerilmektedir.

Keywords

• Hemodiyaliz
• Manevi Yönelim
• Umutsuzluk
• Hemşirelik

References

1. Al-Ghabeesh, S.H., Alshraifeen, A.A., Saifan, A.R., Bashayreh, I.H., Alnuaimi, K.M. & Masalha, H.A. (2018). Spirituality in the Lives of Patients with End-Stage Renal Disease: A Systematic Review. J Relig Health, 57(6):2461-2477. https://doi.org/10.1007/s10943-018-0622-2.
2. Andrade, S.V., Sesso, R. & Diniz, D.H. (2015). Hopelessness, Suicide Ideation, And Depression In Chronic Kidney Disease Patients on Hemodialysis or Transplant Recipients. J Bras Nefrol, 37(1):55-63. https://doi.org/10.5935/0101-2800.20150009.
3. Arslantaş, H., Adana, F., Kaya, F. & Turan, D. (2010). Hopelessness and Social Support Level in The Inpatients and Factors Affecting Them. Florence Nightingale Journal of Nursing, 18(2): 87-97
4. Atan, G., Özer, Z. & Bahçecioğlu, Turan, G . (2020). Assessment of Hopelessness and Spiritual Care Perception in Cancer Patients. J Contemp Med, 10(2): 266-274. https://doi.org/10.16899/jcm.649645
5. Ayık, Ü. & Yılmaz, Karabulutlu, E . (2020). Examination of Acceptance of Illness and Religious Coping Styles of Patients Undergoing Hemodialysis Treatment. Journal of Nephrology Nursing, 15(2): 45-55. https://doi.org/10.47565/ndthdt.2020.17
6. Başaran, D., Şahin, Altun, Ö., Kaban, F. & Ecder, T. (2016). Assessment of the Hopelessness Levels of Hemodialysis Patients. Journal of Nephrology Nursing, 1: 9-16
7. Boztilki, M. & Ardıç, E. (2017). Spirituality and Health. Journal of Academic Research in Nursing. 3(1): 39-45. https://doi.org/10.5222/jaren.2017.1008
8. Cengiz, D.U. & Çıtlık Sarıtaş, S. (2019). The Effect of Illness Perception on Hopelessness Level of Patients Receiving Hemodialysis. Turk J Nephrol. 28(4): 257-62. https://doi.org/10.5152/turkjnephrol.2019.3477

9. Cheawchanwattana, A., Chunlertrith, D., Saisunantararom, W. & Johns, N.P. (2015). Does the Spiritual Well-Being of Chronic Hemodialysis Patients Differ from that of Pre-dialysis Chronic Kidney Disease Patients? Religions, 6(1):14-23. https://doi.org/10.3390/rel6010014
10. Cruz, J.P., Colet, P.C., Alquwez, N., Inocian, E.P., Al-Otaibi, R.S. & Islam SM. (2017). Influence of religiosity and spiritual coping on health-related quality of life in Saudi haemodialysis patients. Hemodial Int, 21(1):125-132. https://doi.org/10.1111/hdi.12441.
11. Daştan, N,B. & Buzlu, S. (2010) The effects of spirituality in breast cancer patients and spiritual care. Maltepe University Nursing Science and Art Journal. 3(1): 73-79.
12. Duran, S., Avci, D.& Esim, F. (2020). Association Between Spiritual Well-Being and Resilience Among Turkish Hemodialysis Patients. J Relig Health, 59(6):3097-3109. https://doi.org/10.1007/s10943-020-01000-z
13. Fradelos, E.C., Alikari, V., Tsaras, K., Papathanasiou, I.V., Tzavella, F., Papagiannis, D. & Zyga, S. (2021). The Effect of Spirituality in Quality of Life of Hemodialysis Patients. J Relig Health, 7. https://doi.org/10.1007/s10943-020-01153-x.
14. Gao, Y., Zhou, Y., Guo, C.X. & Zhao, J.F. (2016). The relationship among hope, symptom distress, social support, coping style and monthly income in maintenance hemodialysis patients: a structural equation model. Int J Clin Exp Med. 9(10):19717–19724.
15. Kasapoğlu F. (2015). Development of Spiritual Orientation Scale: The Study Of Validity and Reliability. İnönü University Journal of the Faculty of Education, 16(3):51-68. https://doi.org/10.17679/iuefd.16360640
16. McSherry, W. (2000) Education issues surrounding the teaching of spirituality. Nursing Standard (through 2013), 14(42):40-3
17. McSherry, W & Ross, L. (2010).editors. Spiritual Assessment in Healthcare Practice. M&K Publishing. p:5
18. Mollaoglu, M., Candan, F. & Mollaoglu, M. (2016). Illness perception and hopelessness in hemodialysis. Archives Clinical Nephrology, 2(1):44-48.
19. Mukhtar, S. (2020). Mental health and emotional impact of Covid-19: Applying health belief model for medical staff to general public of Pakistan. Brain, Behavior and Immunity, 87,28-29. https://doi.org/10.1016/j.bbi.2020.04.012.
20. Musa, A.S., Pevalin, D.J. & Al Khalaileh, M.A.A. (2018). Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan. J Holist Nurs, 36(4):354-365. https://doi.org/10.1177/0898010117736686.
21. Ok, E. & Kutlu, F.Y. (2019). Hopelessness, anxiety, depression and treatment adherence in chronic hemodialysis patients. International Journal of Caring Sciences. 12(1):423-429.
22. Oshvandi, K., Amini, S., Moghimbeigi, A. & Sadeghian, E. (2020). The Effect of a Spiritual Care on Hope in Patients Undergoing Hemodialysis: A Randomized Controlled Trial. Current Psychiatry Research and Reviews, 16 (1): 68. doi:10.2174/2666082216666200316142803
23. Ottaviani, A.C., Souza, É.N. Drago, N., de Mendiondo, M.S., Pavarini, S.C. & Orlandi, F. (2014). Hope and spirituality among patients with chronic kidney disease undergoing hemodialysis: a correlational study. Revista latino-americana de enfermagem, 22(2): 248–254. https://doi.org/10.1590/0104-1169.3323.2409
24. Peters, F.S. (2008). “When Prayer Fails: Faith Healing, Children and the Law”. Oxford University Press, Inc. p:27
25. Pilger, C., Santos, R.O.P., Lentsck, M.H., Marques, S.& Kusumota, L. (2017) Spiritual wellbeing and quality of life of older adults in hemodialysis. Rev Bras Enferm,70:689-96.
26. Rambod, M., Pasyar, N. & Mokhtarizadeh M. (2020). Psychosocial, Spiritual, and Biomedical Predictors of Hope in Hemodialysis Patients. Int J Nephrol Renovasc Dis. 13:163-169 https://doi.org/10.2147/IJNRD.S255045
27. Reig-Ferrer, A., Arenas, M.D., Ferrer-Cascales, R., Fernández-Pascual, M.D., Albaladejo-Blázquez, N., Gil, M.T. & de la Fuente, V. (2012). Evaluation of spiritual well-being in haemodialysis patients. Nefrologia, 32(6):731-42. https://doi.org/10.3265/Nefrologia.pre2012.Apr.11384.
28. Seber, G., Dilbaz, N., Kaptanoğlu, C. & Tekin, D. (1993). Hopelessness Scale: reliability and validity. Kriz Dergisi, 1(3):139-142. Available at https://toad.halileksi.net/sites/default/files/pdf/beck-umutsuzluk-olcegi-toad_0.pdf
29. Seyahi N., Ateş K., Süleymanlar G. (2021) Current Status of Renal Replacement Therapy in Turkey: A Summary of the 2019 Turkish Society of Nephrology Registry Report Turkish J Nephrol 30: 105-111 DOI: 10.5152/turkjnephrol.2021.21436
30. Srivastava, J., Shukla, H., Kaushik, S, & Tewari, M. (2016). Assessment of distress (depression, anxiety and stress) in Indian women with breast cancer: Predictive role of spiritual well being. Annals of Oncology 2016;27:161-162
31. Tavassoli, N., Darvishpour, A., Mansour-Ghanaei, R. & Atrkarroushan, Z. (2019). A correlational study of hope and its relationship with spiritual health on hemodialysis patients. Journal of education and health promotion, 8, 146. https://doi.org/ 10.4103/jehp.jehp_461_18
32. Turkey Republic Ministry of Health, General Directorate of Public Health. (2021). Available at https://hsgm.saglik.gov.tr/depo/birimler/kronik-hastaliklar-engelli-db/hastaliklar/bobrek_hastaliklari/kitap_ve_makaleler/Turkiye_Bobrek_Hastaliklari_Onleme_ve_Kontrol_Programi_2018-2023.pdf Yılmaz, F.T., Sert, H., Kumsar, A.K., Aygin, D., Sipahi, S. & Genç, A.B. (2020). Evaluatıon of hope, symptom control, and medication compliance/adherence ın hemodialysis patients. Acıbadem University Health Sciences Journal. 11(1):35-43. https://doi.org/ 10.31067/0.2019.197