A study on Symptom Experience, Spiritual Well-Being, and Depression in Patients Undergoing Hemodialysis

This cross-sectional descriptive investigation attempted to identify the relationship among the symptoms, spiritual well-being, and depression experienced by patients undergoing hemodialysis. Data were collected from 146 patients at 6 hemodialysis clinics from October 15th, 2014 to January 15th, 2015. The Dialysis Symptom Index (DSI) was used to measure symptom experience, spiritual well-being was measured using the Spiritual Well-being Scale, and depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The data were analyzed using ANOVA, the t-test, Scheffe's test, Pearson correlation, and hierarchical regression analysis. The mean score of the symptom experience was 26.43 (range: 0∼85), the mean spiritual well-being score was 47.79 (range: 20∼80), and the mean depression score was 10.56 (range: 0∼35). It was found that greater existential well-being leads to lower depression (r=-.23, p=.004) and symptom experience (r=-.17, p=.045). Greater physical (B=.09) and emotional (B=.64) symptom experience leads to higher depression and the explanatory power of these factors was 52.1% (F=18.54, p<.001). Therefore, a comprehensive nursing intervention that can help reduce the symptom experience and increase the existential well-being in hemodialysis patients is needed to reduce their depression.