Spiritual needs of patients undergoing haemodialysis : a mixed method approach

Abstract

Spirituality is complex and forms part of an essential feature of holistic care for the patients undergoing haemodialysis (HD). Haemodialysis affects patients’ daily lives including the psychosocial, spiritual, religious and physical aspects. The theoretical framework based on Maslow’s hierarchy of needs (1943; 1954; 1971) guided this study in order to explore the spiritual needs of patients who are undergoing HD treatment. A descriptive explanatory sequential design using a mixed method approach was used. The ‘Spiritual Needs Assessment for Patients’ (SNAP; Sharma, Astrow, Texeira & Sulmasy, 2012) questionnaire was used on 60 continuous ambulatory peritoneal dialysis (CAPD) patients for psychometric testing of the questionnaire with a response rate of 79% and later on 85 HD patients, obtaining a respone rate of 81%. Following this, interviews with 8 patients and 2 separate focus groups with 8 nurses and 8 spiritual leaders were conducted to further explain the questionnaire findings. Descriptive and inferential statistics were used to analyse quantitative findings and presented into tables and figures, while the Thematic Analysis Framework (Burnard, 1991) was used to analyse qualitative findings. There were no significant differences in the spiritual needs and the demographic subgroups apart from the religious score in which female participants scored higher than the male participants. Spiritual needs were identified in this study with the highest need score obtained was ‘visits from a hospital chaplain’ (mean=3.74), while the lowest need score obtained was ‘relaxation or stress management’ (mean 1.36). Themes emerged from the qualitative data collected include the impact, living and coping with renal failure, finding meaning and purpose in illness, religious services, the role of spiritual leaders, nursing the patient with renal failure and spiritual care. Identifying and acknowledging spiritual needs is important, setting recommendations for the healthcare sector, education and future research. Conducting longitudinal studies on patients on HD with different cultures and faiths was suggested in order to investigate the spiritual needs of these patients along their journey of illness.