Coping and Spirituality in Relation to Quality of Life Among Patients Undergoing Hemodialysis

Abstract

Background: Hemodialysis imposes substantial physical and psychosocial demands that may affect patients' quality of life. Objectives: To examine associations between coping mechanisms, spirituality, and quality of life among patients with chronic kidney disease at Sekarwangi Regional General Hospital, Sukabumi Regency. Methods: This quantitative cross sectional study recruited 100 patients through accidental sampling. Data were collected using the Brief COPE, Daily Spiritual Experience Scale, and Kidney Disease Quality of Life instruments. Descriptive statistics and exact contingency tests were applied, with approximate 95% confidence intervals for differences in proportions. Results: Adaptive coping was reported in 91 patients, high spirituality in 59, and good quality of life in 60. Good quality of life occurred in 60 of 91 patients with adaptive coping versus none of nine with maladaptive coping (difference 65.9 percentage points; 95% confidence interval 34.3–74.8; Fisher exact p < 0.001). Corresponding counts were 59/59 for high spirituality, 1/28 for medium spirituality, and 0/13 for low spirituality (overall exact p < 0.001). Conclusions: Coping mechanisms and spirituality were significantly associated with quality of life. Individualized nursing assessment and further evaluation of psychosocial and spiritual interventions are warranted, although causal relationships cannot be established.