Spiritual Interventions on Physical and Psychological Outcomes in Adults Receiving Haemodialysis: a Systematic Review and Meta-Analysis of Randomized Controlled Studies

Abstract

Background: Adults receiving haemodialysis experience several physical and psychological problems. Recently, spiritual interventions have been commonly performed for haemodialysis, but evidence of their effectiveness is lacking. Aim: To synthesize the effects of spiritual interventions on physical and psychological problems in haemodialysis. Methods: The study protocol was registered with PROSPERO. We searched 11 electronic databases from inception to August 2024. Participants included: 1) adults 18 years and older receiving haemodialysis for at least three months; 2) studies implementing spiritual interventions; 3) studies evaluating spiritual interventions' effects on physical and psychological outcomes. Data synthesis was undertaken using Comprehensive Meta-analysis version 3. Random-effects meta-analysis was conducted to pool effects of interventions. The Grading of Recommendations, Assessment, Development, and Evaluations assessed evidence certainty. Results: Twelve trials with 869 participants were included. Only one trial assessed physical outcomes, so they weren't included in the meta-analysis. For psychological outcomes, this intervention was not effective for anxiety and depression symptoms, with low-quality evidence. This intervention showed a medium positive effect on improving hope, with high-quality evidence. Subgroup analysis demonstrated that spiritual intervention, with or without prayer, was effective, and there was no difference between these variables in improving hope. Additionally, eight spiritual intervention sessions were more effective than fewer than eight sessions in improving hope for haemodialysis population. Conclusions: This meta-analysis shows that spiritual interventions moderately improve hope with high-quality evidence but do not affect anxiety and depression symptoms in haemodialysis. Nurses and health professionals can use these interventions to enhance hope as evidence-based practice in haemodialysis.