The Relationship Between Spiritual Well-Being and Anxiety and Depression in Hemodialysis Patients

Abstract

Abstract: The aim of this study is to determine the relationship between spiritual well-being, anxiety and depression levels of patients receiving hemodialysis treatment.The type of this research is descriptive and correlational. The research was carried out at Gaziantep University Şahinbey Research and Training Hospital’s Hemodialysis Unit between Septem-ber 26 and December 16, 2020. The sample of the study consisted of 83 patients receiving hemodialysis treatment, who met the inclusion criteria and agreed to participate in the study between the specified dates. The data were collected by using an information form, the Spir-itual Well-Being Scale (FACIT-SP), Beck Anxiety and Beck Depression Inventory. The cod-ing and evaluation of the data were carried out with SPSS 25 statistical analysis software. Number, percentile distributions, mean, independent groups t-test, Pearson Correlation and One Way Anova Variance analyses were used to evaluate the data. It was determined that the spiritual well-being levels of the participants and the subscales of the spiritual well-being scale, meaning, peace and belief levels were moderate. It was determined that the anxiety levels of the patients receiving hemodialysis treatment were moderate, and the depression levels were mild. A negative significant relationship was found between the levels of mean-ing, peace, faith, and spiritual well-being of the patients receiving hemodialysis treatment and anxiety and depression. It was determined that as the spirituality of the individuals in-creased, their anxiety and depression levels decreased.

Keywords

• Spiritual well-being
• Anxiety
• Depression
• Hemodialysis

Hemodiyaliz Hastalarında Manevi İyi Oluş ile Anksiyete ve Depresyon Arasındaki İlişki

Abstract

Özet: Bu araştırmanın amacı, hemodiyaliz tedavisi alan hastaların manevi iyi oluş, ank-siyete ve depresyon düzeyleri arasındaki ilişkiyi belirlemektir. Araştırma tanımlayıcı ve ilişki arayıcı türde yapıldı. Araştırma Gaziantep Üniversitesi Şahinbey Araştırma ve Uygu-lama Hastanesi Hemodiyaliz Ünitesinde 26 Eylül- 16 Aralık 2020 tarihleri arasında yürütüldü. Araştırmanın örneklemini belirtilen tarihler arasında araştırmaya alınma ölçütler-ine uyan ve çalışmaya katılmayı kabul eden hemodiyaliz tedavisi alan 83 hasta oluşturdu. Veriler, bilgi formu, Manevi İyi Oluş Ölçeği (FACIT-SP), Beck Anksiyete ve Beck Depre-syon Ölçeği kullanılarak toplandı. Verilerin değerlendirilmesi ve kodlanması bilgisayar or-tamında SPSS 24 paket programı aracılığıyla gerçekleştirilmiştir. Verilerin değerlendirilme-sinde; sayı, yüzdelik dağılımlar, ortalama, bağımsız gruplarda t testi, Pearson Korelasyon ve One Way Anova Varyans analizleri kullanılmıştır. Katılımcıların manevi iyi oluş ölçeği alt boyutlarından anlamda 7.73±2.38, barışta 7.42±2.74, inançta 8.86±3.84 ve toplam puan ortalamasının 24.02±8.22 olduğu belirlenmiştir. Hemodiyaliz tedavisi gören hastaların anksiyetede 17.12±11.96, depresyonda 15.60±11.44 toplam puan ortalamasının olduğu saptanmıştır. Bireylerin anlam, barış, inanç, manevi iyi oluş ve anksiyete düzeylerinin orta düzeyde, depresyon seviyelerinin ise hafif düzeyde olduğu belirlendi. Hemodiyaliz tedavisi gören hastaların maneviyat boyutlarında bulunan anlam, barış, inanç ve manevi iyi oluş düzeyleri ile anksiyete ve depresyon arasında negatif yönde anlamlı bir ilişki bulunmuştur. Bireylerin maneviyatları arttıkça anksiyete ve depresyon düzeylerinin azaldığı saptanmıştır.

Keywords

• Manevi iyi oluş
• Anksiyete
• Depresyon
• Hemodiyaliz

References

1. Akça, N. K., & Doğan, A. (2011). Post-Dialysis problems and home care needs of hemodialysis patients. Bozok Medical Jour-nal, 1(1),15-22
2. Alradaydeh, M. F., & Khalil, A. A. (2018). The association of spiritual well‐being and depression among patients receiving hemodialysis. Perspectives in Psychiatric Care, 54(3), 341-347. https://doi.org/10.1111/ppc.12249
3. Alshogran, O. Y., Khalil, A. A., Oweis, A. O., Altawalbeh, S. M., & Alqudah, M. A. (2018). association of brain-derived neurotrophic factor and interleukin-6 serum levels with depressive and anxiety symptoms in hemodialysis patients. General Hospital Psychiatry, 53, 25-31. https://doi.org/10.1016/j.genhosppsych.2018.04.003
4. Alshraifeen, A., Alnuaimi, K., Al-Rawashdeh, S., Ashour, A., Al-Ghabeesh, S., & Al-Smadi, A. (2020). Spirituality, anxiety and depression among people receiving hemodialysis treatment in Jordan: A Cross-sectional Study. Journal of Religion and Health, 59(5), 2414-2429. https://doi.org/10.1007/s10943-020-00988-8
5. Aydemir, Ç., Kasım, İ., Cebeci, S., Göka, E., & Tüzer, V. (2002). Quality of life and psychiatric symptoms in relatives of chro-nic kidney failure patients. Journal of Chrisis, 10(2): 29-39.
6. Bahar, A., Savaş, A. H., Yıldızgördü, E., Barlıoğlu, H. (2007). Anxiety, depression and sexual life of hemodialysis pa-tients. Anatolian Journal of Psychiatry, 8(4), 287.
7. Bahar, A. (2023). Depression And Spiritual Well-Being Of Hemodialysis Patients: A Sectional Study. Journal of Contempo-rary Medicine, 13(4), 593-598.
8. Baktıroğlu, G. (2010). Comparison of depression and anxiety levels of patients with chronic kidney disease undergoing and not undergoing hemodialysis (Master’s thesis, Maltepe University, Social Sciences Institute). Beck, A. T., Epstein, N., Brown, G., Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric proper-ties. Journal of Consulting and Clinical Psychology, 56(6), 893. https://doi.org/10.1037/0022-006X.56.6.893

9. Bolhari, J., Naziri, G. H., Zamanian, S. (2012). Effectiveness of spiritual group therapy in reducing depression, anxiety, and stress of women with breast cancer. Quarterly Journal of Women and Society, 3(9), 87-117.
10. Büssing, A., & Koenig, H. G. (2010). Spiritual needs of patients with chronic diseases. Religions, 1(1), 18-27. https://doi.org/10.3390/rel1010018
11. Chen, C. K., Tsai, Y. C., Hsu, H. J., Wu, I. W., Sun, C. Y., Chou, C. C., Lee, C.C, Tsai, C.R., Wu, M.D, & Wang, L. J. (2010). Depression and suicide risk in hemodialysis patients with chronic renal failure. Psychosomatics, 51(6),528-528. https://doi.org/10.1016/S0033-3182(10)70747-7
12. Coresh, J., Selvin, E., Stevens, L. A., Manzi, J., Kusek, J. W., Eggers, P., Van Lente, F., & Levey, A.S (2007). Prevalence of chronic kidney disease in the United States. Jama, 298(17), 2038-2047. https://doi.org/10.1001/jama.298.17.2038
13. Çetinkaya, S., Nur, N., Ayvaz, A., & Özdemir, D. (2008). Depression, anxiety levels and coping strategies with stress in con-tinuous ambulatory peritoneal dialysis and hemodialysis patients in a University Hospital. Archives of Neuropsychiatry 45(3), 78-84.
14. Çınar, S. (2009). Determining of effective factors on psychosocial adjustment in hemodialysis patients. Journal of Nephrology Nursing, 6(1-2), 22-28.
15. Duran, S., Avci, D., & Esim, F. (2020). Association between spiritual well-being and resilience among turkish hemodialysis patients. Journal of Religion and Health, 1-13. https://doi.org/10.1007/s10943-020-01000-z
16. Durmuş, M., & Ekinci, M. (2021). The effect of spiritual care on anxiety and depression level in patients receiving hemodialysis treatment: a randomized controlled trial. Journal of Religion and Health, 1-15. https://doi.org/10.1007/s10943-021-01386-4
17. Erdem, N., Karabulutlu, E., Okanlı, A., & Tan, M. (2004). Hopelessness and life satisfaction in hemodialysis patients. Interna-tional Journal of Human Sciences, 1(1), 1-14.
18. Gürbüz, S., & Şahin, F. (2014). Sosyal bilimlerde araştırma yöntemleri. Seçkin Yayıncılık
19. Haghighat, N., Rajabi, S., & Mohammadsahahi, M. (2021). Effect of synbiotic and probiotic supplementation on serum brain-derived neurotrophic factor level, depression and anxiety symptoms in hemodialysis patients : a randomized, double-blinded, clinical trial. Nutritional neuroscience, 24(6),490-499. https://doi.org/10.1080/1028415X.2019.1646975
20. Hisli, N. (1989). A reliability and validity study of Beck Depression Inventory in a university student sample. J. Psychol., 7, 3-13.
21. Kara, B. (2007). Treatment adaptation in hemodialysis patients: A versatile approach. Gülhane Medical Journal, 49(2), 132-136.
22. Kılıç, H. F., Alpar, S. E. (2016). The effect of group training implemented on hemodialysis patients for their stress management, psychosocial adjustment and self care strengh. Journal of Human Sciences, 13(1), 754-767. https://doi.org/10.14687/ijhs.v13i1.3422
23. Ma, T. K. W., & Li, P. K. T. (2016). Depression in dialysis patients. Nephrology, 21(8), 639-646. https://doi.org/10.1111/nep.12742
24. Küçük, L. (2005). Mental problems frequently encountered in dialysis patients. Turkish Journal of Nephrology Dialysis and Transplantation, 14(4),166-170. 20
25. Loureiro, A., de Rezende Coelho, M. C., Coutinho, F. B., Borges, L. H., & Lucchetti, G. (2018). The influence of spirituality and religiousness on suicide risk and mental health of patients undergoing hemodialysis. Comprehensive psychiatry,80,39–45. https://doi.org/10.1016/j.comppsych.2017.08.004
26. Luchetti, G., Almeida, L. G. C. D., Granero, A. L. (2010). Spirituality for dialysis patients: Should the nephrologist address?. Brazilian Journal of Nephrology (Jornal Brasileiro de Nefrologia), 32(1),128–132. https://doi.org/10.1590/S0101-28002010000100020
27. Marthoenis, M., Syukri, M. Abdullah, A. Tandi, T.M.R., Putra, N., Laura, H., Setiawan, S., Sofyan, H., & Schouler-Ocak, M. (2021). Quality of life, depression and anxiety of patients undergoing hemodialysis: Significant role of acceptance of the illness. The International Journal of Psychiatry in Medicine, 56 (1), 40-50. https://doi.org/10.1177/0091217420913382
28. Martínez, B. B., & Custódio, R. P. (2014). Relationship between mental health and spiritual wellbeing among hemodialysis patients: a correlation study. Sao Paulo Medical Journal, 132(1), 23-27. https://doi.org/10.1590/1516-3180.2014.1321606
29. Musa, A. S., Pevalin, D. J., & Al Khalaileh, M. A. (2018). Spiritual well-being, depression, and stress among hemodialysis patients in Jordan. Journal of Holistic Nursing, 36(4), 354-365. https://doi.org/10.1177/0898010117736686
30. Özcan, Y., Utaş, C., Oymak, O., Baştürk, M., & Aslan, S. S. (1999). 9(2), 109-111. The Effect of Erythropoietin use on de-pression, anxiety and quality of life in patients on hemodialysis. Bulletin of Clinical Psychopharmacology, 9(2), 109-111.
31. Özdemir, Ü., & Taşçı, S. (2013). Psychosocial problems and care in chronic diseases. Journal of ERU Faculty of Health Scien-ces. 1(1), 57-72.
32. Özgür, B., Kürşat, S., & Aydemir, Ö. (2003). Quality of life and evaluation in terms of anxiety and depression levels in hemo-dialysis patients. Turkish Journal of Nephrology Dialysis and Transplantation, 12(2), 113-116.
33. Palmer, S., Vecchio, M., Craig, J. C., Tonelli, M., Johnson, D. W., Nicolucci, A., Pellegrini, F., Saglimbene, V., Logroscino, G., Fishbane, S., & Strippoli, G. F. (2013). Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney international, 84(1), 179-191. https://doi.org/10.1038/ki.2013.77
34. Patel, S. S., Shah, V. S., Peterson, R. A., & Kimmel, P. L. (2002). Psychosocial variables, qua-lity of life, and religious beliefs in esrd patients treated with hemodialysis. American Journal of Kidney Diseases, 40(5), 1013-1022. https://doi.org/10.1053/ajkd.2002.36336
35. Pehlivan, S., Ovayolu, N., Uçan, Ö. (2008). Relationship between perceived social support from family and depression level in hemodialysis patients. Journal of Nephrology Nursing, 5(1-2), 50-54.
36. Pilger, C., Santos, R. O. P. D., Lentsck, M. H., Marques, S., & Kusumota, L. (2017). Spiritual well-being and quality of life of older adults in hemodialysis. Revista Brasileira de Enfermagem, 70(4), 689-696. https://doi.org/10.1590/0034-7167-2017-0006
37. Puchalski, C. M. (2001). The role of spirituality in health care. Baylor University Medical Center Proceedings 14(4), 352-357. https://doi.org/10.1080/08998280.2001.11927788
38. Rahnama, P., Javidan, A. N., Saberi, H., Montazeri, A., Tavakkoli, S., Pakpour, A. H., & Hajiagha-babaei, M. (2015). Does religious coping and spirituality have a moderating role on depression and anxiety in patients with spinal cord injury? A Study from Iran. Spinal Cord, 53(12), 870-874. https://doi.org/10.1038/sc.2015.102
39. Rayani, A. M., Smart, M. W., Alreshidi, S. M., Al-Mrayat, Y. D., Fawaz, M., Alodhailah, A. M., ... & Rababa, M. (2025). Correlations Between Spirituality, Anxiety, and Depression in Hemodialysis Patients in Saudi Arabia: A Cross-Sectional Study. Journal of Religion and Health, 1-18. https://doi.org/10.1007/s10943-024-02239-6
40. Reig-Ferrer, A., & Arenas, M. D, Ferrer-Cascales, R., Fernández-Pascual, M. D, Albaladejo-Blázquez, N., Fuente, V. (2012).Evalution of spiritual well-being in hemodialysis patients. Nefrología (English Edition), 32(6),731-742. https://doi.org/10.3265/Nefrologia.pre2012.Apr.11384
41. Saffari, M., Pakpour, A. H., Naderi, M. K., Koenig, H. G., Baldacchino, D. R., & Piper, C. N. (2013). Spiritual coping, religio-sity and quality of Life: A study on muslim patients undergoing hemodialysis. Nephrology, 18(4), 269-275. https://doi.org/10.1111/nep.12041
42. Sağduyu, A., Şentürk, V., Sezer, S., Emiroğlu, R., & Özel, S. (2006). Psychiatric problems, life quality and compliance in patients treated with hemodialysis and renal transplantation. Turkish Journal of Psychiatry, 17(1), 22-31. Sarı, Ö. (2015). Chronic renal failure with social dimensions. Bitlis Eren University Journal of Social Sciences Institute, 4, 72–80.
43. Sohrabi, Z., Eftekhari, M. H., Eskandari, M. H., Rezaeianzadeh, A., & Sagheb, M. M. (2015). Malnutrition-inflammation score and quality of life in hemodialysis patients: is there any correlation?. Nephro-urology monthly, 7(3), e27445. https:/7doi.org/10.5812/numonthly. 7(3)2015.27445
44. Süleymanlar, G., Utaş, C., Arinsoy, T., Ateş, K., Altun, B., Altiparmak, M. R., Ecder, T., Yilmaz, M. E., Çamsari, T., Başçi, A., & Serdengeçti, K. (2011). A population-based survey of chronic renal disease in Turkey—the CREDIT study. Nephrology Dialysis Transplantation, 26(6), 1862-1871. https://doi.org/10.1093/ndt/gfq656
45. Şanli, M. E., Dinç, M., Öner, U., Buluş, M., Çiçek, İ., & Doğan, İ. (2023). The role of spirituality in anxiety and psychological resilience of hemodialysis patients in Turkey. Journal of religion and health, 62(6), 4297-4315. 21
46. Şentürk, A., Levent, B. A., & Tamam, L. (2005). The Psychopathology in patients with chronic renal failure treated with hemo-dialysis. Journal of Experimental and Clinical Medicine, 17(3),163-172.
47. T.C. Ministry of Health and Turkish Nephrology Association Joint Report. (2024) Turkish Nephrology Society Registration System 2020 Summary Report. https://nefroloji.org.tr/uploads/pdf/REGISTRY2023_web.pdf
48. Turgay, G., Tutal, E. & Sezer, S. (2017). Evaluation of Hemodialysis Patients in Terms of Activities of Daily Living, Disability, Depression and Comorbidity. Turkish Journal of Nephrology Dialysis and Transplantation, 26(3),311-316. https://doi.org/10.5262/tndt.2017.1003.11
49. Yavuz, R., Yavuz, D., Altunoglu, A., Canoz, M.B., Sezer, S., Yalcın, B. M., & Demirağ, M. (2015). Depression, inflamma-tion, and social support in hemodialysis patients. Journal of Clinical and Analytical Medicine, 6, 801-805. https://doi.org/10.4328/JCAM.3679
50. Yıldırım, N. K., Okanlı, A., Karabulutlu, Y. E., Karahisar, F., & Özkan, S. (2013). Effects of illness perception on anxiety and depressive symptoms in hemodialysis patients: a multi-center study. Anatolian Journal of Psychiatry. 14(3), 252. https://doi.org/10.5455/apd.40629
51. Zazzeroni, L., Pasquinelli, G., Nanni, E., Cremonini, V., & Rubbi, I. (2017). Comparison of quality of life in patients undergo-ing hemodialysis and peritoneal dialysis: a systematic review and meta-analysis. Kidney and Blood Pressure Research, 42(4), 717-727. https://doi.org/10.1159/000484115