People with high resilience evaluate stressful events as more positive and controllable than people with low resilience. The aim of this study was to determine the effect of spirituality therapy on resilience of patients undergoing hemodialysis.

 

The present study is a quasi-experimental study with two experimental and control groups. The statistical population of the study consisted of all patients undergoing hemodialysis referred to Imam Reza (AS) Hospital and Imam Ali (AS) Hospital in Amol, Iran. The participants of the present study included 80 patients undergoing hemodialysis who were divided into experimental (n = 40) and control (n = 40) groups. The research instruments were demographic information self-report questionnaires, Connor and Davidson Resilience Scale. Patients in the intervention group participated in 12 sessions of spiritual therapy and therapy individually and with respect to patient privacy for 6 weeks. Data analysis was performed using SPSS 24 software.
 

The aim of this study was to determine the effect of spiritual therapy on the resilience of patients undergoing hemodialysis in Amol. The statistical results of assessing the impact of spiritual therapy training on resilience showed that the mean resilience score of the two groups before and after the intervention had a statistically significant difference. These results indicated that the resilience score increased after spiritual therapy increased, indicating the positive effect of spiritual therapy training in patients undergoing hemodialysis in this study. Sartipzadeh, Golparvar and Aghaei showed the effectiveness of spiritualism-oriented existentialism treatment and spirituality-Islamic therapy on resilience and emotional capital in older female adults. According to their findings, spirituality-based existentialism treatment is a good way to increase resilience in women [24]. Poorakbaran, Mohammadi Ghare Ghozlou, and Mosavi also examined the effect of group spirituality therapy on resilience in women with breast cancer and showed that 76% of the difference in postoperative resilience scores was related to the spiritual therapy group [25]. Examining the effect of spiritual therapy with an emphasis on the teachings of Islam on self-esteem and resilience in addicts, Nemati Sogoli Tape has reported the positive impact of spirituality therapy on increasing resilience [26]. According to the results of Salmani et al., there is a significant difference between the spiritual experiences and resilience of women with breast cancer and healthy women [27]; their results are consistent with the present study. In their research, Davis et al. concluded that the domain of spirituality, in particular, evokes a positive feeling in the individual. According to this study, spiritual therapy can promote hope and increase resilience in patients [28]; Therefore, according to the results of these two studies, despite the differences in the method of research, like the type of spiritual therapy sessions, the number of sessions and how to do it, as well as the study population can be said that these two studies are in line and compatible with each other. Other studies have confirmed the positive effects of spiritual therapy, including the studies of Kiani and Jahanpour [31], Oshvandi et al. [32], Rahmanian, Moein Samadani, and Oraki [21], Borjali et al. [33]. Patel et al. evaluated the effects of spiritual therapy on breast cancer experience. The experience of living with spirituality and seeking one's existential meaning was one of the topics discussed in this study. The results showed that spiritual beliefs and religious experiences have been effective in growing and strengthening hope for the future [29]. Despite the differences in spiritual therapy sessions and the type of it and also the study population, it can be said that these two studies are consistent with the results.

There have also been studies on hemodialysis patients that are consistent with the present study due to the difference in the independent variable of the results; among them were Aghajani and Morasei, who studied the effect of spiritual therapy regarding hope of patients with chronic renal failure. According to the results of their research, there was a significant difference between the scores of hope before and after counseling in the experimental group and before and after in the control group. In this study, they found that counseling with a spiritual approach raises hope in patients with chronic renal failure [30].

Explaining the findings, it can be said that it is the spirituality of man that shows his connection and integration with the science of existence. Communication and integration give meaning to man and push him beyond the limits of time and place and material interests [35]. Since meaningfulness, purposefulness, and hope in life are inseparable components of spirituality-healing approaches [36], spiritual people try to maintain these factors by relying on their existential dimensions. For this reason, they have more purpose in their lives, and the degree of resilience to their lives is higher [37]. Proper practice of nurses in spiritual counseling creates a sense of purpose in the life of the individual and encourages him/her to communicate with God and others, and ultimately leads to interpersonal communication and hope in the individual's life [39, 38]. Individual and group spiritual therapy seek to maintain and promote the patient's spirituality and spiritual well-being.

The purpose of designing this treatment is to work with despair, anxiety, loss of the patient's spiritual well-being, change the quality of life, and helplessness. This treatment helps patients regarding spirituality, reconnecting with it, maintaining and even promoting it in life, facilitating a complete understanding of spirituality and its resources, and promoting a supportive environment. Given that the type of spiritual therapy interventions in the present study was performed for the first time in patients undergoing hemodialysis, the results of the present study can help planners and clinical nurses to use in the development of policies and spiritual interventions in medical centers. It is also effective in spreading spirituality-based interventions in patients with chronic diseases and their families. In addition, due to the fact that nurses have a significant role in patient care and education, managers, officials, and policymakers in the field of education are recommended to prioritize spiritual therapy in university centers and postgraduate education for nurses.
 

The results of this study indicated that spiritual therapy could effectively increase the resilience of patients undergoing hemodialysis.
 

The present research has been registered with the ethics code IR.IAU.CHALUS.REC.1398.032 on 20/08/1398. The researchers would like to express their gratitude to the officials of the Islamic Azad University of Chalous Branch and the staff of the mentioned centers. In the end, they would like to express their gratitude to the participants in the study.
 

The authors declared no conflict of interest.