Religious coping methods predict depression and quality of life among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study.
BACKGROUND
Poor quality of life (QOL) and a high prevalence of depression have been identified among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We aimed to evaluate the associations between religious/spiritual (R/S) coping methods and both QOL and depression among ESRD patients undergoing hemodialysis (HD).


METHODS
The sample included 161 ESRD patients over 18 years of age who had been undergoing HD for more than 3 months. R/S coping methods were assessed using the Religious Coping Questionnaire (RCOPE). The RCOPE generates scores (from 1 to 5) for positive and negative R/S coping methods. The higher the score, the more frequent the use of that coping method. Depression was evaluated using the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Scores on the CES-D range from 0 to 60. A cutoff of 18 was used to define depression. QOL was evaluated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); this survey was used to generate scores for the eight dimensions of QOL, which can vary from 0 (worst) to 100 (best).


RESULTS
We identified a depression prevalence of 27.3%. Positive R/S coping scores were higher among non-depressed than depressed patients (2.98 vs. 2.77; p = 0.037). Positive R/S coping scores were negatively correlated with depression scores (r = -0.200; p = 0.012) and were an independent protective factor for depression (OR = 0.13; CI 95% = 0.02-0.91; p = 0.039). Regarding QOL, a positive correlation was identified between positive R/S coping scores and scores related to general health (r = 0.171; p = 0.030) and vitality (r = 0.183; p = 0.019), and an inverse correlation was identified between negative R/S coping scores and scores in the social functioning (r = -0.191; p = 0.015) and mental health (r = -0.214; p = 0.006) dimensions. In addition, positive R/S coping scores were an independent predictor of higher scores in the bodily pain (β = 14.401; p = 0.048) and vitality (β = 12.580; p = 0.022) dimensions. In contrast, negative R/S coping scores independently predicted lower social functioning scores (β = -21.158; p = 0.017).


CONCLUSIONS
Our results provide further evidence suggesting that R/S coping methods may be associated with QOL and depression among HD patients. In our opinion, the use of religious resources should be encouraged among HD patients, and psycho-spiritual interventions should be attempted to target religious struggles (negative R/S coping) in patients undergoing HD.
['Santos|Paulo Roberto|PR|http://orcid.org/0000-0002-3092-4808', 'Capote Júnior|José Roberto Frota Gomes|JRFG|', 'Cavalcante Filho|José Renan Miranda|JRM|', 'Ferreira|Ticianne Pinto|TP|', 'Dos Santos Filho|José Nilson Gadelha|JNG|', 'da Silva Oliveira|Stênio|S|']
D000223:Adaptation, Psychological D000328:Adult D000368:Aged D003430:Cross-Sectional Studies D003863:Depression D005260:Female D006306:Health Surveys D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011788:Quality of Life D012067:Religion D012069:Religion and Psychology D006435:Renal Dialysis
Depression Quality of life Spirituality Religion and medicine Renal dialysis