Design, implementation and evaluation of a comprehensive spiritual care package in self-care and the meaning of life for hemodialysis patients: a mixed method study

The aim of this study was to design, implement and evaluate a comprehensive spiritual care package in self-care and the meaning of life for hemodialysis patients. A mixed-sequential-exploratory study was performed in 2020-2021 in the population of hemodialysis patients referred to hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. First, in-depth, semi-structured interviews were performed with 18 patients undergoing hemodialysis with purposive sampling, and then based on these interviews, the patients' needs were extracted. In the quantitative phase, 60 patients with inclusion criteria were included in the study. Intervention The intervention was performed every week for 8 weeks. The findings of the qualitative section included the two main categories of mortality with the subcategories of death anxiety, pessimism about life, spiritual pain, and feelings of abandonment. The second subclass of resilience with the subclasses of the joiner ring with the divine essence was a reflection on creation, purpose-making, and the harmony of the soul. In the quantitative ward, self-care performance with an average of 120.86 (19.00) and meaning of life with an average of 40.06 (10.45) after intervention in hemodialysis patients had increased. The results of this study showed that although there are negative thoughts and anxiety of death and annihilation in hemodialysis patients, but spirituality and spiritual beliefs can be an effective aid in accepting the disease and a good support for promoting physical, mental and social health in Hemodialysis patients..