Spirituality-oriented psychological counseling may reduce fear of death among hemodialysis patients

1. In patients receiving the intervention of spirituality-oriented psychological counseling, the fear of death was significantly less compared to the control group.

2. Patients in the control group had no significant difference on their fear of death following the intervention.

Evidence Rating Level: 2 (Good)

Studies have shown that the majority of patients treated with hemodialysis suffer from psychiatric disorders which may have an effect on their spiritual needs. Many of these patients may be preoccupied with the fear of death (FOD) which drastically reduces their quality of life. Little is known with respect to how spirituality-oriented psychological counseling (SOPC) can influence FOD in these patients. As a result, the present single blind randomized controlled trial (RCT) sought to examine the effects of SOPC on FOD among hemodialysis patients in Iran.

The present single blind RCT included 66 patients who were randomly assigned to an intervention group (n=33) or to a control group (n=33) from May 2019 to January 2020. Patients were included if they had been diagnosed with end stage renal disease. Patients were excluded if they used antipsychotic medications. Both groups received routine spiritual care; however, the intervention group received additional psychological counseling (SOPC). FOD was measured using the Collett-Lester Fear of Death Scale (CL-FODS). There was no significant difference between both groups on FOD before the intervention.

The results showed that in patients receiving the intervention of SOPC , the fear of death was significantly less compared to the control group. Furthermore, patients in the control group had no significant difference on their fear of death following the intervention. However, the study was limited by its inclusion of only Shia Muslims which limited the generalizability of the results. Nonetheless, these results present early evidence suggesting that SOPC may help reduce FOD in patients undergoing hemodialysis.

Click to read the study in European Journal of Integrative Medicine

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