Relationship between mental health and spiritual wellbeing among hemodialysis patients: a correlation study

The Relationship Between Preparedness for Caregiving and Spiritual Well-Being in the Carers of Stroke Patients: A Case Study in Türkiye

This study was conducted to determine the relationship between preparedness for caregiving and spiritual well-being in the carers of stroke patients. This descriptive and cross-sectional study was conducted with 130 primary carers of patients hospitalized with the diagnosis of stroke at the neurology clinic of a hospital. It was determined that the participants had moderate levels of preparedness for caregiving, they had high levels of spiritual well-being, and there was a positive significant relationship between these two variables. According to the regression analysis results, the spiritual well-being level of the participants was a predictor of their preparedness for caregiving (B: 0.144, p < 0.001). The results of this study demonstrated that the spiritual well-being of the carers of stroke patients is important in increasing preparedness for caregiving. In this context, to ensure that the carers of all stroke patients feel prepared for the caregiving process, it is recommended to evaluate their preparedness levels, support them in their preparation for their caregiving roles, and identify their spiritual needs.

The Effect of Spiritual Group Therapy on the Quality of Life and Empowerment of Women with Breast Cancer: A Randomized Clinical Trial in Iran

This randomized clinical trial was carried out on 74 women with breast cancer between May 2015 and April 2016 in the south of Iran. The patients were selected using a simple sampling method and randomly divided into an intervention (n = 30) and a control (n = 37) group. Five spiritual therapy sessions were conducted for the intervention group. Each session lasted one hour. The quality of life and empowerment of the patients were measured before and one month after the intervention. To collect data, four instruments were used, including a demographic information form, the European Organization for Research and Treatment of Cancer QOL questionnaire Cancer-30 (EORTC QLQ C-30), EORTC QLQ Breast-23 (EORTC QLQ-BR23), and the Cancer Empowerment Questionnaire (CEQ). After the intervention, a difference was observed between the groups concerning the mean score of general health (P = 0.016) and emotional function (P = 0.029), but there was no significant difference between the groups concerning the mean score of empowerment (P = 0.62). Thus, it appears that spiritual group therapy can improve the quality of life of this group of patients.IRCT registration number: IRCT 2014050417546N2.

Supporting elderly patients in strengthening their personal and spiritual health resources

Care for the sick, including spiritual support is sometimes called holistic medicine. The term bio-psycho-social-spiritual model is sometimes used to describe this type of therapeutic approach patient-oriented medicine. This report indicates the importance of taking into account the spiritual aspect of life due to its beneficial impact on the coping resources activated and the patient's well-being. Existential and spiritual issues are on the verge of new clinical and research interest in medicine, especially in gerontology, oncology, and palliative care. Clinicians focus not only on symptom control but also on spiritual and existential issues such as spirituality, hope, and meaning. This paper reviews the topic of spirituality in the context of illness and end-of-life care trying to define spirituality within the context of health resources of the subject. Spirituality is perceived in two of its main components: faith/religious beliefs and spiritual well-being. Especially this second construct is reviewed and described as a health resource.

Spiritual Wellbeing and Quality of Life among Hemodialysis Patients in Jordan: A Cross-Sectional Correlational Study

Purpose: Nursing research studies investigating the relationship between spiritual wellbeing and health-related quality of life are lacking among Arab hemodialysis patients in Jordan or any other Arab country. The purpose of this study was to explore the associations between spiritual wellbeing, its religious and existential wellbeing dimensions, and health-related quality of life among Jordanian Muslim hemodialysis patients. Design: A cross sectional, quantitative correlational study. Methods: A convenience sample of 150 Jordanian hemodialysis patients completed a structured, self-administered questionnaire. Descriptive, bivariate, and multivariate regression models were used. Findings: The Jordanian hemodialysis patients had a moderate level of spiritual wellbeing and religious wellbeing, a low level of existential wellbeing, and a poor health-related quality of life. The findings revealed a significant moderate positive correlation between the spiritual wellbeing and its dimensions, and health-related quality of life. The existential wellbeing was the strongest predictor, with a large, positive, and significant effect after controlling for other spiritual, demographic and medical-related variables. Conclusion: Overall, the study suggests Jordanian hemodialysis patients use their religious and spiritual beliefs and practices as a coping mechanism, especially as sources of satisfaction, peace, comfort, strength and support, to help improve their health-related quality of life.

The Effect of Spiritual Well-being on Hope in Immobile Patients Suffering From Paralysis Due to Spinal Cord Injuries

This study aimed to determine the effect of spiritual well-being on hope in immobile patients suffering from paralysis due to spinal cord injuries. The sample size of this cross-sectional study was determined to be 100 immobile patients suffering from paralysis due to spinal cord injuries via power analysis. "Descriptive Characteristics Form," "Spiritual Well-being Scale," and "Dispositional Hope Scales" were used to collect the data. It was determined that participants' spiritual well-being scores were 22.25 ± 9.62 and their hope scores were 29.53 ± 9.83. There was a weak but positive correlation between the total scores on the hope scale and the spiritual well-being scale (p = 0.001, r = 0.477). Among immobile patients suffering from paralysis due to spinal cord injury, spiritual well-being levels accounted for 22% of the variance in hope levels (p = 0.001, R² = 0.22). This study showed that as patients' spiritual well-being levels increased, their hope levels also increased.

The Effect of Spiritual Care on Anxiety and Depression Level in Patients Receiving Hemodialysis Treatment: a Randomized Controlled Trial

The present study was conducted to determine the effect of spiritual care on the anxiety and depression levels of patients receiving hemodialysis treatment. The research was carried out between January and May 2019 in a training and research hospital hemodialysis unit in the Eastern Anatolian Region of Turkey. The research was completed with a total of 71 patients (33 experiments, 38 controls) who received hemodialysis treatment. Regarding in-group comparison, the difference between the mean scores of pre-test and post-test of the patients concerning the anxiety and depression in the experimental group was found to be statistically significant (p ˂ 0.05). It was determined that training for strengthening spirituality was effective in reducing the anxiety and depression levels of patients receiving hemodialysis treatment. It can be suggested that spiritual care should be used as a complementary method in health care practices to increase the effectiveness of the treatment.

The Effect of Spirituality in Quality of Life of Hemodialysis Patients

This study aimed to assess the effect of spirituality on quality of life of end-stage renal disease patients undergoing hemodialysis (HD). A cross-sectional study was carried out in six HD Units. The sample consisted of 367 patients averaging 61.8 years of age. For the measuring of spirituality and the quality of life, the FACIT-Sp-12 and the Missoula Vitas Quality of Life Index-15, respectively, were completed. Social and demographic data were, also, collected. Spirituality and its dimensions such as Meaning in Life and Peace had a positive effect on Global QoL, Symptoms, Interpersonal and in Well-being. Spirituality can have a positive effect on the QoL of HD patients. Therefore, in the context of the holistic approach of the individual, health systems can include spiritual evaluation and care of HD patients.

The Resilience Scale in Portuguese Adults under Assisted Reproductive Techniques

Assessing resilience response to an adverse event such as infertility requires measuring the same construct adequately and accurately by nurses. The objective of this study was to explore the validity and reliability of the Portuguese version of the Resilience Scale for adults. A cross-sectional and methodological design was used, and factor analyses were performed. The sample comprised 140 adult Portuguese individuals under fertility treatment recruited from health-related websites. The findings yielded a bad fit of the hypothesized Resilience Scale structure with the observed data. Instead, a 21-item tool with a four-factor structure revealed high internal consistency (0.94). The tool correlated positively and significantly to the Portuguese version of the Spiritual Well-Being Questionnaire and was negatively associated and lacked correlation with the Fertility Adjustment Scale. The 21-item Resilience Scale is a reliable tool suitable to measure resilience in Portuguese adults under assisted reproductive techniques. This tool offers the opportunity of early recognition by health professionals aiming to enhance patients’ coping skills effectively and promote positive psychological and mental health outcomes.

Self-Participation Experiences among Well-Adapted Hemodialysis Patients

A successful self-participation experience empowers patients to adapt to living with hemodialysis. However, few studies regarding the subjective experiences of such patient participation have been conducted. This study’s purpose was to describe hemodialysis patients’ perspectives on integrating hemodialysis into a new life regarding self-participation experience. A qualitative study using the grounded theory method was applied. Thirty-two well-adaptive hemodialysis Taiwanese patients attended in-depth interviews. “Integrating hemodialysis into a new life journey” was identified as the core category guiding the entire self-participation experience of hemodialysis patients. The three antecedent themes were “Sense of worthlessness”, “Life is still worth living”, and “Friendly and joyful atmosphere of the hemodialysis room”. Once the patients went through the three antecedent themes, they gradually began making efforts to participate more fully in their hemodialysis. Within this participation experience, the hemodialysis patients exhibited these four interactive themes: “Overcoming one’s predicament”, “Integrating self-care skills into my life”, “Resuming previous roles and tasks”, and “Adapting to independent living”. Finally, most adaptive patients master the hemodialysis life. Encouraging patients to discover that their life is worth living and providing a friendly and joyful atmosphere in hemodialysis units are the keys to facilitating patients’ self-participation more fully.

The relationship between anxiety, stress, spiritual health, and mindfulness among patients undergoing hemodialysis: A survey during the COVID-19 outbreak in Southeast Iran

BACKGROUND AND AIMS

Hemodialysis patients are prone to high stress and anxiety related to the acute coronavirus epidemic. Mindfulness and spiritual health are among the factors associated with stressful and anxious situations. The current study aimed to investigate the relationship between mindfulness, spiritual health, and coronavirus stress/anxiety in patients undergoing hemodialysis.

METHODS

One hundred and forty-four patients underwent hemodialysis participated in this cross-sectional study. Patients completed the Demographic and Clinical Characteristics Form, Corona Disease Anxiety Scale (CDAS), stress subscale of DASS-21, The Freiburg Mindfulness Inventory- Short Form (FMI-SF), and Spiritual Health Scale.

RESULTS

The results showed that 28.5% of the participants had moderate to severe anxiety. According to the psychological symptom subscale (CDAS), 54.2% of the participants had moderate to severe anxiety. According to the physical symptom subscale, 41.7% of the participants had moderate to severe anxiety. Sixteen percent of the patients believed that the coronavirus disease 2019 (COVID-19) outbreak and lockdown influenced their course of treatment. A significant association was found between coronavirus disease anxiety and mindfulness (r = -0.20, P < .05). No significant association was found between stress and mindfulness/spiritual health (P > .05).

CONCLUSION

The results of this study showed that coronavirus anxiety and stress are common in hemodialysis patients. Mindfulness may be effective in reducing coronavirus anxiety in hemodialysis patients. Therefore, interventions are suggested to increase the level of mindfulness and empower hemodialysis patients to cope with anxiety caused by crises such as the coronavirus outbreak.

Assessment of psychological distress in end stage renal disease: is it spirituality related?

Introduction

Patients undergoing hemodialysis (HD) are faced with bearing this burden and report poor mental health. Spirituality can be a key factor in managing these problems among HD patients.

Aim

This cross-sectional study aimed at exploring possible factors that are associated with psychological distress among HD patients and testing its relation to spirituality.

Methods

HD patients were recruited from six dialysis units in Greece. Psychological distress was assessed using the scale Symptom Check List 90-R and spirituality using the Facit Sp-12 questionnaire. In addition, a special design questionnaire regarding demographic, social, and clinical characteristic was administrated.

Results

According to the results, factors such age, gender, marital status and area of residence are associated with psychological distress, while dimensions of spirituality such Meaning in Life and Peace can have a positive influence on psychological distress.

Conclusion

This study highlights the vital role of spirituality, which can act as a mechanism for managing stressful situations. In particular, this study highlights the positive effect of the meaning and purpose of life, as well as the role of peace and harmony.

Association Between Spiritual Well-Being and Resilience Among Turkish Hemodialysis Patients

This study aimed to determine the association between spiritual well-being and resilience among Turkish hemodialysis patients. This cross-sectional study was conducted with 134 hemodialysis patients treated at two state hospitals' hemodialysis units between February 2019 and July 2019. The data were collected with a Personal Information Form, the Spiritual Well-Being Scale and the Resilience Scale for Adults with the face-to-face interview technique. To analyze the data, descriptive statistics, t tests, ANOVA, Pearson's correlation and multivariate linear regression analysis were used. The patients' spiritual well-being levels were high, while their psychological resilience levels were medium. There was a moderate positive correlation between spiritual well-being and resilience (p < 0.01). Education level, economic level, duration of disease and spiritual well-being were determined to be statistically significant predictive factors of the patients' resilience (p < 0.001). In this context, nurses may provide psychosocial and spiritual care, education and counseling services that will increase patient's resilience.

Psychological Symptoms in Patients on Dialysis and Their Relationship with Spiritual Well-Being

AIM

This study was examined the prevalence of psychological symptoms in patients on dialysis and their relationship with spiritual well-being.

METHOD

This descriptive study was conducted in Iran, and the sample consisted of 150 patients on hemodialysis. The data were collected using a checklist for demographic variables; Depression, Anxiety and Stress Scales 21; and Palutzian & Ellison Spiritual Well-being Scale.

RESULTS

Among the 150 participants in this study, 57.3% were female, and the others were male. The mean age of the participants was 44.6 years. The mean scores of depression, anxiety, and stress in the studied patients were 17.3, 17.6, and 19.3, respectively. The mean of the total score of spiritual well-being was 75.02±9.1. The results showed that there was a reverse and significant correlation between the total score of spiritual well-being and the levels of stress (r= -0.265, p<0.001), anxiety (r= -0.243, p<0.003), and depression (r -0.281, p<0.001).

CONCLUSION

Depression, anxiety, and stress were highly prevalent in patients undergoing hemodialysis; all three had a strong relationship with the patients' level of spiritual well-being. In other words, patients with higher levels of spiritual well-being showed lower psychological symptoms.

Spiritual Well-Being in Cancer Patients Undergoing Chemotherapy in an Outpatient Setting: A Cross-Sectional Study

Purpose: To assess the spiritual well-being (SWB) of cancer patients undergoing chemotherapy in an outpatient setting. Method: Quantitative, cross-sectional, and descriptive study. A convenience sample of 150 participants was obtained. Data collection instrument was a self-reported questionnaire that included the SWB Questionnaire (SWBQ), whose scores range from 20 to 100. SPSS software, version 21, was used in data analysis. The study was approved by the institutional ethics committee. Results: Patients’ ages ranged between 35 and 83 years; most were female (64.7%), married (68.0%), Catholic (86.7%), and with breast cancer (35.3%) and colorectal cancer (25.3%). The average SWBQ total score was 65.91 ( SD = 12.177). The highest score of the SWBQ was obtained in females, widows and singles, Evangelic and Catholic, and with lower educational level and professional occupation. The Cronbach α was 0.89, and the subscales αs ranged between 0.78 and 0.94. Conclusion: The SWBQ scores were reasonable. These results can guide nurses’ clinical reasoning, as the assessment of SWB may precede the diagnosis of risk for spiritual distress, readiness for enhanced SWB, or spiritual distress. Thus, the use of this instrument may facilitate spirituality being effectively implemented in clinical practice, favoring holistic health care.

Religiousness and Symptoms of Depression in Native and Immigrant Chronic Dialysis Patients in the Netherlands

For immigrant chronic dialysis patients, religious behavior and religious coping may have a different impact on depressive symptoms compared to native patients. This study aims to describe both cross-sectional and longitudinal associations between religious behavior and coping with symptoms of depression for 281 native and 277 immigrant dialysis patients in the Netherlands. A higher prevalence of depressive symptoms was found in immigrant compared to native patients (49% vs. 36%). No significant cross-sectional or longitudinal associations were found in both groups between religious behavior and positive religious coping with depressive symptoms. Strong significant cross-sectional associations were found between negative religious coping items and depressive symptoms in both groups, while no longitudinal associations were found. So, similar impact of religiousness on the presence of depressive symptoms was found for both native and immigrant dialysis patients. Therefore, these results do not explain the higher prevalence of depressive symptoms found in immigrant chronic dialysis patients compared to native patients.

Benefits of spirituality and/or religiosity in patients with Chronic Kidney Disease: an integrative review

ABSTRACT Objective: Identify and analyze existing evidence regarding the benefits of spirituality and / or religiosity in patients with Chronic Kidney Disease. Method: Integrative review carried out through consultation of databases: Latin American and Caribbean Literature in Health Sciences, Scientific Electronic Library Online, US National Library of Medicine and Scopus. The following descriptors were used: chronic kidney disease, spirituality and religion. Primary articles published by December 2017 were included. Results: Twenty-six articles were selected, from which four thematic categories emerged: benefits as a modality of coping, perception of quality of life, mental health and improvement of renal function after transplantation. Conclusion: Benefits included those related to situational coping modalities, such as the strengthening of hope, social support and coping with pain; those related to mental health, such as the lower risk of suicide and fewer depressive symptoms; improvement in the perception of quality of life and in renal function after transplantation.

Religiosity, spirituality and quality of life of dialysis patients: a systematic review

PURPOSE

End-stage renal disease (ESRD) patients often report a combination of disturbing physical symptoms and psychological distress which result in significantly reduced quality of life (QoL). Coping with a chronic disease is a complex matter involving also the family and a multi-disciplinary team. Recently, observational studies suggested that spirituality (S) and religiosity (R) are two important determinants in coping with a chronic/terminal disease. Both concepts were studied in various settings, involving ESRD and QoL. This systematic review aims to synthesize all instruments used to assess R/S, to examine the strategies evaluating QoL of dialysis patients and to analyse their correlations.

METHODS

In accordance with the PRISMA, a systematic search was conducted in PubMed and SCOPUS (between Jan 1980-Dec 2018, PROSPERO number CRD42019116837). Eligible studies included patients on dialysis therapy, religiously/spiritually assessed and contained QoL evaluation.

RESULTS

Of the initial 311 studies, 261 papers were excluded. Consequently, 50 papers with a total 9265 patients were available for inclusion. From a list of 177 R/S scales available worldwide, we identified 24 tools. We organized all QoL parameters into 10 classes. In all studies, R/S variables were positively correlated with at least one QoL variable.

CONCLUSIONS

In this systematic review, we synthesized the studies involving R/S assessment in dialysis patients and their benefit on QoL. R/S has a positive impact on most QoL parameters in 5D-CKD. We suggest that nephrology guidelines on palliative care and/or elderly should include specific recommendations on R/S support and opportunities for integrated specific therapies.

Spirituality in the Lives of Patients with End-Stage Renal Disease: A Systematic Review

The aim of this systematic review was to answer these questions: What does spirituality means to patients with end-stage renal disease (ESRD)? And are there associations between spirituality and the health outcomes and general well-being of patients with ESRD? Thirty-three studies met the review criteria. Meaning of spirituality for patients with ESRD and spirituality in the lives of patients with ESRD were the main themes emerged. There is growing evidence that suggests a positive relationship between spirituality and the health outcomes and well-being of ESRD patients. However, the evidence is incomplete and there is a need for further research to enhance our understanding of the role of spirituality in improving the health outcomes and well-being of ESRD patients.

The association of spiritual well-being and depression among patients receiving hemodialysis

PURPOSE

The purpose of this study was to identify the relationship between spiritual well-being (meaning/peace, and faith) and depression among Jordanian patients receiving hemodialysis.

METHODS

Cross-sectional descriptive correlation design was used to carry out on a nationally representative convenience sample of 158 patients receiving hemodialysis at five different hospitals in Jordan.

RESULTS

The mean total score of the depression was 17.8 of the 40. While the mean total score of the spiritual well-being was 36.9 of the 48. The Pearson's correlation coefficient test showed significant negative correlation between spiritual well-being and depression (r = -.64, p < .005).

CONCLUSION

Healthcare providers should consider spiritual well-being in their assessment and interventions by helping the patients to establish meaning, peace, and faith to reduce patients' depression.

Percepções, significados e adaptações à hemodiálise como um espaço liminar: a perspectiva do paciente

Este trabalho apresenta um olhar etnográfico sobre a experiência das pessoas que dependem da hemodiálise para continuar vivendo. Neste artigo, o foco é o paciente, apresentamos suas percepções e experiências, tomando como base seu convívio com a doença e suas estratégias de enfrentamento, pois as características bastante peculiares desse tratamento geram uma relação complexa, acompanhada de contradições e ambiguidades. Os entrevistados, com idades entre 18 e setenta anos, estavam há mais de um ano nesse tratamento e revelaram vidas marcadas pela experiência da doença, além de depoimentos que nos levam a analisar a hemodiálise como espaço de liminaridade. Interpretamos, aqui, à luz da teoria antropológica e a partir de alguns depoimentos dos 117 entrevistados, que todo paciente com insuficiência renal crônica, dependente da hemodiálise, vive em um espaço liminar que pode durar meses ou anos.

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August-October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer's Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is non-significant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences.

Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan

Purpose: The spiritual dimension of a patient’s life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress. Design: A quantitative, cross-sectional correlational study. Method: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models. Findings: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables. Conclusions: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored.

Body Sanctification and Sleep in Adolescents with Cystic Fibrosis: A Pilot Study

Imbuing one's body with divine significance is associated with health-protective behaviors. The purpose of this study was to determine whether adolescents with a life-shortening, chronic disease (cystic fibrosis) who sanctified their bodies also received adequate sleep. Data from Daily Phone Diaries and questionnaire replies from 45 adolescents with cystic fibrosis (ages 11-19 years) were analyzed. A significant relationship between body sanctification and sleep was found, with between-gender differences. Body sanctification is an understudied construct which is associated with healthy behaviors.

Spirituality in Renal Supportive Care: A Thematic Review

Chronic kidney disease is marked by a reduced life expectancy and a high symptom burden. For those who reach end-stage renal disease, the prognosis is poor, and this combined with the growing prevalence of the disease necessitates supportive and palliative care programmes that will address people's psychosocial, cultural and spiritual needs. While there is variation between countries, research reveals that many renal specialist nurses and doctors are reluctant to address spirituality, initiate end-of-life conversations or implement conservative treatment plans early. Yet, other studies indicate that the provision of palliative care services, which includes the spiritual dimension, can reduce symptom burden, assist patients in making advanced directives/plans and improve health-related quality of life. This review brings together the current literature related to renal supportive care and spirituality under the following sections and themes. The introduction and background sections situate spirituality in both healthcare generally and chronic kidney disease. Gaps in the provision of chronic kidney disease spiritual care are then considered, followed by a discussion of the palliative care model related to chronic kidney disease and spirituality. Chronic kidney disease spiritual needs and care approaches are discussed with reference to advanced care planning, hope, grief and relationships. A particular focus on quality of life is developed, with spirituality named as a key dimension. Finally, further challenges, such as culture, training and limitations, are explicated.

Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: a randomized, double-blind, placebo-controlled, pilot clinical trial

OBJECTIVE

Herbal remedies play an important role in treatment of psychiatric disorders. The aim of this study was to assess the efficacy of crocin, the main active constituent of saffron, as an adjunctive treatment in major depressive disorder (MDD).

METHOD

This study was a randomized, double-blind, placebo-controlled, pilot clinical trial. It was carried out during 4 weeks in two groups (placebo and treatment) on 40 MDD patients between 24 and 50 years old in Ibn-e-Sina psychiatric hospital, Mashhad, Iran, from March 2013 to December 2013. The crocin group (n=20) was given one selective serotonin reuptake inhibitor (SSRI) drug (fluoxetine 20mg/day or sertraline 50mg/day or citalopram 20mg/day) plus crocin tablets (30mg/day; 15mg BID) and placebo group (n=20) was administered one SSRI (fluoxetine 20mg/day or sertraline 50mg/day or citalopram 20mg/day) plus placebo (two placebo tablets per day) for 4 weeks. Both groups filled beck depression inventory (BDI), beck anxiety inventory (BAI), general health questionnaire (GHQ), the mood disorder questionnaire (MDQ), side effect evaluation questionnaire, and demographic questionnaire before and after one month intervention.

RESULTS

The crocin group showed significantly improved scores on BDI, BAI and GHQ compared to placebo group (Pvalue<0.0001). The averages of decrease in BDI, BAI and GHQ scores in placebo group were 6.15, 2.6 and 10.3 respectively, whereas the values in crocin group were 17.6, 12.7 and 17.2 after 4 weeks trial.

LIMITATIONS

Poor patient compliance with medications and short trial period, small sample size and self-report assessments were the major limitations of this study.

CONCLUSION

These results demonstrated the effect of crocin in depression and could be administered in treatment of MDD patients.

Evaluation of psychological distress using the K6 in patients on chronic hemodialysis

OBJECTIVE

The aim of this study was to evaluate psychological distress in patients on chronic hemodialysis.

SUBJECTS AND METHODS

A total of 72 patients on chronic hemodialysis were enrolled in this study. We evaluated psychological distress by using the K6 questionnaire, health-related quality of life (HRQOL) by using the EQ-5D questionnaire, and clinical parameters. Among the 72 patients, we also evaluated changes in K6 scores in 58 patients at 1-year follow-up.

RESULTS

The mean K6 score was 3.7 ± 3.7 and 2 subjects (2.8%) were defined as having psychological distress. K6 scores were significantly correlated with body fat percentage, albumin level, and EQ-5D scores in total subjects. K6 scores were also significantly and negatively correlated with EQ-5D scores in men and women. In the 1-year follow-up group, changes in K6 scores were weakly and negatively correlated with changes in EQ-5D scores.

CONCLUSION

Psychological distress was closely associated with HRQOL in patients on chronic hemodialysis. Coping strategies for psychological distress might be useful in improving HRQOL in patients on hemodialysis.