FACTORS EXPLAINING SPIRITUAL WELL-BEING IN PERSONS WITH END STAGE RENAL DISEASE RECEIVING HEMODIALYSIS

Abstract

Spiritual well-being is vital for persons with chronic illness and life-threatening situation, such as End Stage Renal Disease [ESRD]. It could enhance their positive attitude and emotion as well as enable them to live more meaningfully in the midst of suffering and to accept those ailments. A model-testing, cross-sectional study was conducted to test a causal model of spiritual well-being in persons with ESRD. A multi-stage random sampling was used to recruit a sample of 270 persons with ESRD who received hemodialysis in Chon Buri Province. Data collection was carried out from March to August 2019. Research instruments included six self-report questionnaires of the Spiritual Well-being, the Memorial Symptom Assessment, the Barthel’s Activities of Daily Living Index, the Perception of Palliative Care, the Duke University Religion Index, and the Multidimensional Scale of Perceived Social Support. Their consistency reliability ranged from .71-.95. Data were analyzed by using descriptive statistics and Structural Equation Modeling.

The results revealed that the modification of the hypothesized model fit the data well (c2 = 97.495, p = .301, df = 91, CMIN/ df = 1.132, GFI = .965, AGFI = .920, and RMSEA =. 016). Symptom experience, social support, activities of daily living, receiving palliative care and religiosity had direct effects on spiritual well-being (β = -0.109, β = 0.299, β = 0.186, 0.272 and β = 0.01, respectively). Symptom experience mediated the link between social support and spiritual well-being. Symptom experience, activities of daily living, social support, religiosity, and receiving of palliative care together accounted for 60.90 percent of variance in prediction of spiritual well-being in persons with ESRD. These findings suggest that this causal model of spiritual well-being is appropriated. It would suggest a new direction for the nursing profession to enhance spiritual well-being of persons with ESRD receiving through providing social support and religiosity, reducing perceived symptom experience and improving their activities daily living.

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