The Effect of Spirituality Counseling on Anxiety and Depression in Hemodialysis Patients

Document Type: Original Quantitative and Qualitative Research Paper

Authors

1 Instructor of Nursing, Department of Psychiatric Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran

2 Instructor of nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran

3 MS in Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran

Abstract

Background: In attention of increasing prevalence psychological problems, complications and consequences of hemodialies and important role of nurses in psychological support of patients, application of complementary therapies such as spirituality counseling is very important.
Aim: This study investigates the effect of spirituality counseling on anxiety and depression in hemodialysis patient.
Methods: This randomized clinical trial study included 90 patients with chronic renal failure undergoing hemodialysis in Amin Hospital, Isfahan (2013), which were randomly assigned into two groups. The experimental group received 8 sessions of spiritual counseling and the control group took routine care. Data were collected with the Hospital Anxiety and Depression Scale (HADS) and were analyzed using independent and paired t-test and exact fisher test in SPSS software version 11.5.
Results: Statistical results showed no significant difference in demographic variables between intervention and control groups (p>0/05). In addition, independent t-test showed no significant difference between the mean anxiety and depression scores in the intervention and control groups (p>0/05). However, after applying spiritual counseling, average scores of anxiety and depression decreased in intervention group in comparison with the control group. Paired t-test showed significant differences between average scores of anxiety and depression scores before and after the spiritual counseling in an intervention group (p<0/05), while in the control group, this difference did not reach statistical significance (p>0/05).
Conclusion: Spiritual counseling could decrease the anxiety and depression in dialysis patients; therefore it is recommended that this approach performed as a complementary, effective, non-invasive, low cost nursing intervention to decrease the psychological problems of these patients.

Keywords

Main Subjects


  1.  Hagren B, Pettersen IM, Severinsson E, Clyne N, Lutzen K. Maintain Hemodialysis Patients Experiences of Their Life Situation. Clin J Nurse 2005; 14: 294-300.
  2. Davison SN. End of Life Care Preferences and Needs Perception of Patients with Chronic Kidney Disease. ‍Clin J Am Soc Nephrology 2010;5: 195-204.
  3. Ko B ،Khurana A, Spancen J, Scott B, Hahn M. Religious Belief and Quality of Life an American Inner-City Hemodialysis. Oxford J medicine Nephrology Dialysis Transplantation 2005; 22: 2985-90.
  4. Gilbar O, Or-Han K, Plivazky N. Mental Adjustment، Coping Strategy and Psychological Distress among End-Stage Renal Disease Patients. J of psychosom Res 2005; 58(6):471-6.
  5. Koo j, Yoon J, Kim s, Lee Y. Association of Depression with Malnutrition in Chronic Hemodialysis Patient. Am J Kidney Dis 2003; 41(5):1037-42.
  6. Marvi A, Bayazi M ,Rahmani M, Kazemi A. Studying the Effect of Cognitive Behavioral Group Training on Depression In Hemodialysis Patients. Science direct j 2011; 30: 1831-6.
  7. Cukor D, Coplan J, Brown C, The Associations Between Depression, Health Related Quality of Life, Social Support, Life Satisfaction and Disability In Community - Dwelling Us Adults. J Nerve Ment Dis 2009; 197: 61-4.
  8. Rebecca A, Drayer M, Piraino B, Reynolds C, Houck P, Mazumdar S and et al. Characteristics of Depression in Hemodialysis Patients: Symptoms, Quality of Life and Mortality Risk. General Hospital Psychiatry 2006; 28: 306-12.
  9. Kimmel Pl, Weishes K, Peterson R. Survival in Hemodialysis Patients the Role of Depression. J Am soci- Nephrol 1993; 4: 12-27.
  10. Drayer R ,Piraino B, Reynolds C, Houck P, Mazumdar S, Bernardini J and et all. Charactristics of Depression in Hemodialysis Patients: Symptom, Quality of Life and Mortality Risk. J General Hosp Psychiatry 2006; 28(4): 306-12.
  11. Tavallaie S, Ebrahimnia M, Shamspour N, Assari S .Effect of Depression on Health Care Utilization in Patients With End – Stage Renal Disease Treated With Hemodialysis. Euro J of internal med 2009; 20: 411-4. (Persian)
  12. Farsi Z, Salsali M. Metaparadaim Conceptual and Nursing Care in Islam 2008; 1(66-68):8-21. (Persian)
  13. Rezaie M, Fatemi N, Hoseini F. Spiritual Wellbeing in Cancer Patients Who Undergo Chemotherapy. Hayat J 2008; 14(3-4):33-9. (Persian)
  14. Davison S, Simpson C. Hope and Advance Care Planning in Patients With End Stage Renal Disease. British Med J 2006; 333(757): 886.
  15. Hematimaslak M, Ahmadi F, Anoosheh M. Spiritual Beliefs and Quality of life: A Qualitative Research about Diabetic Adolescent Girl's Perception. Koomesh J Golestan medical University 2011; 12(2):144-51. (Persian)
  16. Bolhari J, Naziry y, Zamaniyan S. Effective Spiritual Healing Therapy for Decrease Depression, Anxiety, Stress Woman with Breast Cancer. J of socialliaty2012; 3(1):85-116. (Persian)
  17. Richards P, Hrdman K, beret M. Spiritual Approaches in Treatment of Women with Eating Disorders Washington. American Psychological Association 2006;304
  18. Moghimian M, Salmani F. The Study of Correlation between Spiritual Well-Being and Hope in Cancer Patients Referring to Training – Therapy Center of Isfahan University Medical Sciences. J Qom Med Univer 2012; 6(3):40-5. (Persian)
  19. Eatemadi A. Faith Spirituality in Counseling and Psychotherapy. Quarterly J Psychotherapy 2005; 10(36،35):131-146. (Persian)
  20. Moritz S, Kelly M, Xu T, Towes J, Rickhi D. Teaching Spirituality in Depression. Commentary Therapies in Med J 2011;19:201-7
  21. Boscaglia N, Clarke D, Jobling T, Quinn M. The Contribution of Spirituality and Spirituality Coping to Anxiety and Depression in Women with a Recent Diagnosis of Gynecological Cancer 2005. Int J Gynecol cancer;15:755-761
  22. Taylor E, Outlaw F. Use of Prayer among Persons with Cancer. J Holistic Nurse 2002;16(3): 46-60
  23. Thuneboyle I, Stygall J, Keshtgar M, Newman S. Do Religious/ Spiritual Coping Strategies Affect Illness Adjustment in Patients with Cancer? A Systematic Review of the Literature. J Socia& scie Med 2006;63: 151-64
  24. Ironson G, Stuetzle R, Fletcher M. An Increase in Religiousness/ Spirituality Occurs after HIV Diagnosis and Predicts Slower Disease Progression over 4 Years in People with HIV2006. J Gen intern Med;21:62-8
  25. Hojjati H, Taheri N, Akhundzadeh G. Resorting to Pray Rate in Hemodialysis Patients of Goldstone Province. Iranian J of critic care Nursing 2010; 3(2):75-9. (Persian)
  26. Akhbardeh M. Role of Spiritual Beliefs and Prayer in Health Promotion of Chronic Patients: A Qualitative Study .Quart J of Quran Med 2011; 1(1):1-9. (Persian)
  27. Wink P, Dillon M. Religiousness, Spirituality and Psychosocial Functioning in Late Adulthood Finding from a Longitude Study. Psych and aging J 2003; 18:916-24.
  28. Piedmont L, Ciarrochi W, Wlliams J. The Empirical and Conceptual Value of The Spiritual Transcendences Religious Involvement Scales for Personality Research. Psycholog Relig Spiritual 2009; 1(3):162-79.
  29. Bahrami H, Tashk A. Relation between Religious Orientation and Mental health and Evaluation of Religious Orientation Scales. J of Psychology and Educa2005; 34(2): 41-63. (Persian)
  30. Miller W, Thoresen E. spirituality, Religious and Health. An Emerging Research Field. Am Psychol J2003; 58:24-35.
  31. Kao T, Lai M, Tsai T. Economic, Social and Psychology Factors Associated with Health – Related quality of life Chronic Hemodialysis Patient in Northern Taiwan. J Art Organs2009; 33(1):61-8.
  32. Breitbart W, Rosenfeld B, Pessin H. Depression, Hopelessness and Desire for Hastened Death in Terminally Ill Patients with Cancer. JAMA 2000; 284(22): 2907-11.
  33. Shirmohamadi M.The Effect of Consultation on the Symptom of PMS. (Thesis Msc Midwifery), Tehran Uni of Med Sci; 2009. (Persian)
  34. Kermanshahi S, Hoseynzadeh SH, Alhani F. The Effect of the Group Counseling Program on the Status of Primary Dysmenorrheal, Dietary Condition and Exercise in Shahreyar Girl’s High School. J Zanjan Uni Med Sci. 2008; 16(65): 49-59. (Persian)
  35. Mcshery W, Cash K, Ross L. Meaning of Spirituality: Implications for Nursing Practice. J of Clin Nurs 2004;13: 934-41
  36. Ahmadvand A, Saie R, Sepehrmanesh Z, Ghanbari A. Effect of Cognitive Behavioral on Anxiety and Depression in Hemodialysis Patients. Qom med Sci Uni 2010; 6(1):35-9. (Persian)
  37. Moarefzadeh S, Sodani M, Shafiabadi A. The Study of the Effect of Teaching of Contrastivetraining Skills Originated of Quran on Reducing Anxiety Among High School Girl Student in Ahwaz. Quart J of Edu Psychol Islamic Azad Uni Tonekabon Branch 2010;1(3):19-26(Persian)
  38. Drayer R, Piraino B, Reynolds S, Houck P, Mazumdar S, Bernardini J and et al. Charactristics Depression Hemodialysis Patient. Psych-Med J 2006; 4(24):306-12.
  39. Ebadi A, Moradian T, Feyzi F, Asiabani M. Comparison of Hospital Anxiety and Depression among Patients with Coronary Artery Disease on Proposed Treatment. Iranian J of Crit Care Nursing 2011;2(4):97-103.(Persian)
  40. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): Translation and Validation Study of the Iranian Version. Health Quality Life Outcomes.2003; 28(1):14. (Persian)
  41. Davis T, Kerr B, Kurpius S. Meaning, Purpose and Religiosity in At- Risk Youth. The Relationship between Anxiety and Spirituality. J of Psychol 2003; 6:132-40.
  42. Yagoubih, Sohrabi F, Mohammadzadeh A. The Comparison of Cognitive Behavior Therapy and Islamic Based Spiritual Religion Psychotherapy on Reducing of Student's Overt Anxiety. Behav Res J2011; 10(2): 99-107. (Persian)
  43. Stanley M, Bush A, Jameson , Philips L, Barber C and et al. J Aging and Ment health 2011;5(3): 334-43.
  44. Wachholtz A, Pargament K. Is Spirituality A Critical Ingredient of Meditation? J of Med Behav 2005; 28(4): 369-84.
  45. Moritz S, Kelly M, Xu T, Towes J, Rickhi D. Teaching Spirituality in Depression. J Commentary Therap in Med 2011; 19:201-7.
  46. Bormann J, Aschbacher K, Wetherell J, Roesch S and Redwine L. Effect of Faith Assurance on Cortisol Levels are enhanced by a Spiritual Mantram. Intervention in Adults with HIV: A Randomized Trial. J of Psychosom Res 2009; 66(2): 161- 71.
  47. Rahmati M, Ghanbari V, Khaledi P, Mohammadi B. Effective Spirituality-Religious Healing intervention on Depression Schizophrenic Patients. J Nurs and Midwif Tabriz 2011. (Persian)
  48. Mcclain C, Rosenfeld B, Breitbart W. Effect of Spiritual Wellbeing on End of Life Despair in Terminally- Ill Cancer Patients. Lancet j 2003; 361:1603-07.
  49. Mirbagher N, Aghajani M, Shahshahani M. The Effect of Music and Holy Quran on Patient Anxiety and Vital Sign before Abdominal Surgery. J Mashhad  Evidence Based Medical 2010:1(1):65-76.(Persian)
  50. Asayesh H, Heidary F .Prayer like Spirituality Approach in Psychological Intervention Sajjadieh Sahifeh. Gorgan Nurse and midwifery J 2006;4(2):50-5.(Persian)
  51. Bussing A, Michalsen A, Grunther R. Are Spirituality and Religiosity Resources for Patients With Chronic Pain Condition? J Pain Medicine 2009; 10(2): 327-39.
  52. Ando M, Morita T, Akechi T, Okamoto T. Efficacy of Short Term Life Review Interviews on Spiritual Well-Being of Terminally Ill Cancer Family Patients. J of pain and symptom Management 2010; 39(6):993-1002.
  53. Hojat M, Zehadatpour Z, Nasr Esfahani M. The Effect Quran Sound with Normal, Quiet, Arabic Music and Irani Music on dialysis Efficacy. Iranian j of Criti Care Nurs 2010; 3(2): 69-74. (Persian)
  54. KO B ،Khurana A, Spancen J, Scott B, Hahn M. Religious Beliefe and Quality of Life an American Inner_City Haemodialysis. oxford J medicine Nphrology Dialysis Transplantation 2005;22: 2985-90
  55. Breitbart W, Rosenfeld B, Pessin H. Depression, Hopelessnsee and Desire for Hastened Death in Terminally Ill Patients with Cancer. JAMA 2000;284(22): 2907-11
  56. Momeni T, Musarezaie A, Karimian J, Ebrahimi A. Relationship between Spiritual Well-Being And Depression in Iranian Breast Cancer Patient. Health Inf Manag J 2012; 8(8):1007-16.
  57. Norwati M, Nur Syahidah K. Spiritual Well-Being of INSTED, IIUM Students and Its Relationship with College Adjustment. Procedia Soc Behav Sci2012; 1314– 23.
  58. Nur Syahidah KhalidKarren KJ, Hafen BQ, Smith NL, FrandsenKJ. Mind-Body Health: The Effects of Attitudes, Emotions and Relationship. 3th Ed, Pearson: Sanfrancisco, 2006.
  59. Fehring RJ, Miller JF, Shaw C. Spiritual Wellbeing, Religiosity, Hope, Depression, and Other Mood-States in Elderly People Coping with Cancer. Oncol Nurs Forum1997; 24: 663-71.
  60. Asayesh H, Heidary F .Prayer like Spirituality Approach in Psychological Intervention Sajjadieh sahifeh. Gorgan Nurse and midwifery J2006; 4(2):50-5. (Persian)