Effect of a Spiritual Care Program on Treatment Adherence and Sleep Quality in Hemodialysis Patients: A...

Declining sleep quality is common among hemodialysis patients, adversely affecting their quality of life and treatment adherence. Improving sleep is a nursing priority, and targeted interventions might be beneficial. This study aimed to evaluate the effect of a spiritual care program on treatment adherence and sleep quality in hemodialysis patients.

This study was a parallel, two-group, cluster-randomized clinical trial with a pretest-posttest design. In 2023, 80 hemodialysis patients from two teaching hospitals in Urmia, Iran, were enrolled via convenience sampling and cluster-randomized by hospital unit to intervention (n = 39) or control (n = 37 completers) groups. The intervention involved four 1 h spiritual care sessions twice weekly post-dialysis. Outcomes were measured using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) and Pittsburgh Sleep Quality Index (PSQI) at baseline and 1 month post-intervention. Data were analyzed in SPSS v26.0. Normality was checked with Kolmogorov-Smirnov, between-group differences with independent t-tests, and within-group changes with paired t-tests.

The mean age of the 76 participants was 52.09 years (range: 20-84 years); 65 participants (85.5%) were male, and 11 (14.5%) were female. Baseline scores showed no significant between-group differences (adherence: p = 0.848; sleep quality: p = 0.891). Post-intervention, the intervention group had significantly higher adherence (mean difference: 219.60 [95% CI: 159.51-279.69]; p < 0.001; Cohen's d = 1.92) and better sleep quality (mean difference: -2.67 [95% CI: -1.46 to -3.88]; p = 0.006; Cohen's d = 0.68) compared to the control group. Within the intervention group, adherence improved (p < 0.001; Cohen's d = 2.15) and sleep quality enhanced (p < 0.001; Cohen's d = 0.79); no changes were observed in the control group (p > 0.05).

A spiritual care program improves treatment adherence and sleep quality in hemodialysis patients. Hospital administrators should integrate spiritual interventions like meditation and counseling, considering barriers such as staffing. Future studies should include diverse populations and longer follow-ups.

The CONSORT 2010 checklist was used.