Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey
Background: Long-term haemodialysis patients often experience physical symptom distress (PSD) and varying levels of demoralization. Spirituality and self-compassion can help patients to cope these challenges. However, the interrelations between these variables remain underexplored, necessitating fur...
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Elsevier
2025-06-01
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| Series: | International Journal of Nursing Studies Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666142X24001152 |
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| author | Chia-Hui Lin Yi-Chien Chiang Wen-Yi Li Tsung-Lan Chu Ya-Chu Hsiao |
| author_facet | Chia-Hui Lin Yi-Chien Chiang Wen-Yi Li Tsung-Lan Chu Ya-Chu Hsiao |
| author_sort | Chia-Hui Lin |
| collection | DOAJ |
| description | Background: Long-term haemodialysis patients often experience physical symptom distress (PSD) and varying levels of demoralization. Spirituality and self-compassion can help patients to cope these challenges. However, the interrelations between these variables remain underexplored, necessitating further investigation. Objectives: To examine the effect of PSD on demoralization among haemodialysis patients and to determine whether spirituality and self-compassion mediate these relationships. Design: A cross-sectional correlational study. Settings: A convenience sample was used to recruit from two haemodialysis clinics. Methods: Self-report questionnaires were the Physical Symptom Distress Scale, Demoralization Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12, and Self-Compassion Scale. Relationships and mediators were examined with Pearson's correlations and multiple linear regression analysis, respectively. Results: A total of 156 participants participated. Mean age of participants was 61.3 years (SD = 11.3). Most participants were male (66 %) and had received dialysis for ≥ 5 years (61.5 %). Pearson's correlation indicated higher scores for PSD were significantly associated with lower levels of spirituality and self-compassion and higher levels of demoralization. There was a significant total and direct effect of PSD on demoralization. Mediation analysis indicated that the relationship between PSD and demoralization was partially and significantly mediated by spirituality and self-compassion. Demoralization can be explained by 46.83 % variance accounted by these predictors in the mediation model. Conclusion: Long-term haemodialysis can cause chronic symptom distress and feelings of demoralization. The mediating effects of spirituality and self-compassion on PSD and demoralization suggest that these qualities may act as emotional regulators that enable haemodialysis patients to be more accepting of symptom distress, which results in lower levels of demoralization. Our findings imply that developing strategies to increase spirituality and self-compassion could help patients manage chronic symptom distress associated with haemodialysis, reduce demoralization, and ultimately improve their quality of life. |
| format | Article |
| id | doaj-art-b4b96bb3396a48768a2926ffb04209b4 |
| institution | DOAJ |
| issn | 2666-142X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Nursing Studies Advances |
| spelling | doaj-art-b4b96bb3396a48768a2926ffb04209b42025-08-20T03:11:14ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810028810.1016/j.ijnsa.2024.100288Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire surveyChia-Hui Lin0Yi-Chien Chiang1Wen-Yi Li2Tsung-Lan Chu3Ya-Chu Hsiao4Nurse practitioner in the Hemodialysis, Department of National Taiwan University Hospital Yunlin Branch, Yunlin, TaiwanDepartment of Nursing, Chang Gung University of Science and Technology, Division of Pediatric Hematology and Oncology, Chang Gung Memorial Hospital Linkou Main Branch, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan; College of Medicine, National Taiwan University, Taipei, TaiwanAdministration Center of Quality Management Department, Chang Gung Medical Foundation, TaiwanDepartment of Nursing, Chang Gung University of Science and Technology, Administration Center of Quality Management Department, Chang Gung Medical Foundation, Taiwan; Corresponding author at: Department of Nursing, Chang Gung University of Science and Technology, No.261, Wenhua 1st Rd., Guishan District, Taoyuan City, 333 03 Taiwan.Background: Long-term haemodialysis patients often experience physical symptom distress (PSD) and varying levels of demoralization. Spirituality and self-compassion can help patients to cope these challenges. However, the interrelations between these variables remain underexplored, necessitating further investigation. Objectives: To examine the effect of PSD on demoralization among haemodialysis patients and to determine whether spirituality and self-compassion mediate these relationships. Design: A cross-sectional correlational study. Settings: A convenience sample was used to recruit from two haemodialysis clinics. Methods: Self-report questionnaires were the Physical Symptom Distress Scale, Demoralization Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12, and Self-Compassion Scale. Relationships and mediators were examined with Pearson's correlations and multiple linear regression analysis, respectively. Results: A total of 156 participants participated. Mean age of participants was 61.3 years (SD = 11.3). Most participants were male (66 %) and had received dialysis for ≥ 5 years (61.5 %). Pearson's correlation indicated higher scores for PSD were significantly associated with lower levels of spirituality and self-compassion and higher levels of demoralization. There was a significant total and direct effect of PSD on demoralization. Mediation analysis indicated that the relationship between PSD and demoralization was partially and significantly mediated by spirituality and self-compassion. Demoralization can be explained by 46.83 % variance accounted by these predictors in the mediation model. Conclusion: Long-term haemodialysis can cause chronic symptom distress and feelings of demoralization. The mediating effects of spirituality and self-compassion on PSD and demoralization suggest that these qualities may act as emotional regulators that enable haemodialysis patients to be more accepting of symptom distress, which results in lower levels of demoralization. Our findings imply that developing strategies to increase spirituality and self-compassion could help patients manage chronic symptom distress associated with haemodialysis, reduce demoralization, and ultimately improve their quality of life.http://www.sciencedirect.com/science/article/pii/S2666142X24001152SpiritualitySelf-compassionDemoralizationHaemodialysisSymptom distress |
| spellingShingle | Chia-Hui Lin Yi-Chien Chiang Wen-Yi Li Tsung-Lan Chu Ya-Chu Hsiao Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey International Journal of Nursing Studies Advances Spirituality Self-compassion Demoralization Haemodialysis Symptom distress |
| title | Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey |
| title_full | Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey |
| title_fullStr | Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey |
| title_full_unstemmed | Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey |
| title_short | Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey |
| title_sort | physical symptoms distress and demoralization among haemodialysis patients the mediating effect of spirituality and self compassion a cross sectional questionnaire survey |
| topic | Spirituality Self-compassion Demoralization Haemodialysis Symptom distress |
| url | http://www.sciencedirect.com/science/article/pii/S2666142X24001152 |
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