Restricted accessResearch articleFirst published online 2025
Quality of life and its association with spiritual well-being among Jordanian Muslim patients with chronic kidney disease undergoing hemodialysis: A cross-sectional study
This research aimed to assess the spiritual well-being and quality of life (QOL) among patients with chronic kidney disease who are undergoing hemodialysis in Jordan. A cross-sectional, descriptive correlational study was employed. A convenience sample of 238 Jordanian adult patients with chronic kidney disease undergoing hemodialysis in governmental hospitals was selected. Findings revealed that the response rate was 93.7%. and the participants had moderate spiritual well-being and low QOL. A significant positive correlation was shown between QOL and spiritual well-being, educational level, marital status, and monthly income (p < 0.001), while a negative correlation was shown with age (p < 0.001). Spiritual well-being, educational level, and monthly income were predictors of QOL. Thus, patients with chronic kidney disease undergoing hemodialysis need to enhance their spiritual well-being and improve their QOL. Counseling programs should be provided to patients with chronic kidney disease undergoing hemodialysis to promote spiritual well-being and improve their QOL.
AbdulqaderSAliB (2023) Quality of life of patients in end-stage renal disease patients undergoing hemodialysis in Sulaimani City/Iraq. Mosul Journal of Nursing11: 227–239.
2.
AdwanLAl-SadiTShawakhaS, et al. (2023) Clinical outcomes of COVID-19 in hemodialysis patients. Frontiers of Medicine10: 1281594.
3.
AiniNCahyaning WahyuA (2020) The correlation between family support and psychological well-being in patients with end-stage renal disease. Kontakt22(4): 291–296.
4.
Al-GhabeeshSHAlshraifeenAASaifanAR, et al. (2018) Spirituality in the lives of patients with end-stage renal disease: a systematic review. Journal of Religion and Health57(6): 2461–2477.
5.
AlghamdiAHAlaryniAAAlmathamKI, et al. (2023) Quality of life of end-stage kidney disease patients undergoing dialysis: a multi-center study from Saudi Arabia. Saudi Journal of Medicine and Medical Sciences11(1): 81–88.
6.
AlhajimSA (2018) Assessment of the quality of life in patients on haemodialysis in Iraq. Eastern Mediterranean Health Journal23(12): 815–820.
7.
AlmarabhehASalahABAlghamdiM, et al. (2023) Validity and reliability of the WHOQOL-BREF in the measurement of the quality of life of Sickle disease patients in Bahrain. Frontiers in Psychology14: 1219576.
8.
AlnaeemMMShehadehANashwanAJ (2024) The experience of patients with hematological malignancy in their terminal stage: A phenomenological study from Jordan’s perspective. BMC Palliative Care23: 36.
9.
Al SalmiIKamblePLazarusER, et al. (2021) Kidney disease-specific quality of life among patients on hemodialysis. International Journal of Nephrology2021: 8876559.
10.
AlshellehSAlhawariHAlhouriA, et al. (2023) Level of depression and anxiety on quality of life among patients undergoing hemodialysis. International Journal of General Medicine16: 1783–1795.
11.
AlshogranOYShatnawiEAAltawalbehSM, et al. (2021) Predictors of poor health-related quality of life among hemodialysis patients with anemia in Jordan. Health and Quality of Life Outcomes19(1): 272.
12.
AlshraifeenAAl-RawashdehSRababaM (2022) Quality of life and general well-being in people receiving hemodialysis treatment: A cross-sectional study. Jordan Journal of Nursing Research2: 45–54.
13.
AmaryaSSinghKSabharwalM (2018) Ageing Process and Physiological Changes. InTech.
14.
BakkerWMTheunissenMÖztürkE, et al. (2024) Educational level and gender are associated with emotional well-being in a cohort of Dutch dialysis patients. BMC Nephrology25(1): 179.
15.
BelloAKOkpechiIGOsmanMA, et al. (2022) Epidemiology of haemodialysis outcomes. Nature Reviews Nephrology18(6): 378–395.
BoukhiraIJidaneSBelyamaniL (2022) Associations of socio-demographic, clinical, and biochemical parameters with quality of life among hemodialysis patients in Morocco. Middle East Journal of Rehabilitation and Health Studies9(3): e122559.
18.
DoumitMAARahiACSaabR, et al. (2019) Spirituality among parents of children with cancer in a Middle Eastern country. European Journal of Oncology Nursing39: 21–27.
19.
EbrahimiHAshrafiZEslampanahG, et al. (2015) Relationship between spiritual well-being and quality of life in hemodialysis patients. Journal of Nursing and Midwifery Sciences1(3): e141397.
20.
El-HabashiAFEl-AgroudyAEJaradatA, et al. (2020) Quality of life and its determinants among hemodialysis patients: A single-center study. Saudi Journal of Kidney Diseases and Transplantation31(2): 460–472.
21.
ElsodanyAYMAbdelhamedZLAdamSS (2022) Quality of life among patients with hemodialysis. Egyptian Journal of Health Care13: 735–748.
22.
EmtairAElhamadiMBuniH (2021) Quality of life of patients with end stage renal disease at Tripoli, Libya. IOSR Journal of Dental and Medical Sciences20(1): 35–41.
23.
FanoodiAAramjooHMoosavian KhorasaniSH, et al. (2021) Relationship between spiritual health and stress, depression, and anxiety in hemodialysis patients. Health Technology Assessment in Action4(4): 1–6.
24.
FaulFErdfelderEBuchnerA, et al. (2009) Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods41: 1149–1160.
25.
FlanaganJBeckCTPolitDF (2025) Polit and Beck’s Nursing Research: Generating and Assessing Evidence for Nursing Practice, 12th ed. Wolters Kluwer.
26.
FradelosECAlikariVTsarasK, et al. (2021) Assessment of psychological distress in end stage renal disease: Is it spirituality related?Medicine and pharmacy reports94(1): 79–87.
27.
GadiaPAwasthiAJainS, et al. (2020) Depression and anxiety in patients of chronic kidney disease undergoing haemodialysis: A study from western Rajasthan. Journal of Family Medicine and Primary Care9(8): 4282–4286.
28.
Ganeshkumar RajaNCSivakumarKSeenivasanP (2023) Effect of perceived social support and level of hope on quality of life among chronic kidney disease patients in a tertiary care center in Chennai - a cross-sectional study. Asian Journal of Medical Sciences14(4): 68–73.
29.
GebrieMHAsfawHMBilchutWH, et al. (2023) Health-related quality of life among patients with end-stage renal disease undergoing hemodialysis in Ethiopia: A cross-sectional survey. Health and Quality of Life Outcomes21(1): 36.
30.
GerogianniGPolikandriotiMBabatsikouF, et al. (2019) Anxiety-depression of dialysis patients and their caregivers. Medicinar55(5): 168.
31.
Gonzalez-BedatMCRosa-DiezGFerreiro-FuentesA, et al. (2020) Burden of disease: Closing the gaps in the burden of end-stage kidney disease in Latin America. Clinical Nephrology93(1): 55–59.
32.
HairJF (ed.) (2019) Multivariate data analysis, 8th edn. Cengage.
33.
HimmelfarbJVanholderRMehrotraR, et al. (2020) The current and future landscape of dialysis. Nature Reviews Nephrology16(10): 573–585.
IqbalMSKassabYWAl-SaikhanFI, et al. (2020) Assessing quality of life using WHOQOL-BREF: A cross-sectional insight among patients on warfarin in Malaysia. Saudi Pharmaceutical Journal28(8): 936–942.
36.
IshtawiSJomaaDNizarA, et al. (2023) Vitamin D level, pain severity and quality of life among hemodialysis patients: A cross-sectional study. Scientific Reports13(1): 1182.
37.
JafaripoorrHSafarabadiMPourandishY, et al. (2019) The elders’ spiritual well-being and their quality of life: A cross-sectional study. Journal of Client-Centered Nursing Care4: 145–154.
38.
JardineTWongESteenkampR, et al. (2020) Survival of South African patients on renal replacement therapy. Clinical Kidney Journal13(5): 782–790.
39.
KimSNigatuYArayaT, et al. (2021) Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: A cross-sectional study. BMC Nephrology22(1): 280.
40.
KnegteringHBruggemanRSpoelstraSK (2024) Spirituality as a therapeutic approach for severe mental illness: Insights from neural networks. Religion15(4): 489.
41.
KrägelohCUHenningMAHawkenSJ, et al. (2011) Validation of the WHOQOL-BREF Quality of Life Questionnaire for use with medical students. Education for Health24(2): 545.
42.
LakensD (2013) Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Frontiers in Psychology4: 863.
43.
LazarusER (2019) Effectiveness of education and exercise on quality of life among patients undergoing hemodialysis. Clinical Epidemiology and Global Health7(3): 402–408.
44.
LeeTFlytheJEAllonM (2021) Dialysis care around the world: a global perspectives series. Kidney3602(4): 604–607.
45.
LegrandKSpeyerEStengelB, et al. (2020) Perceived health and quality of life in patients with CKD, including those with kidney failure: Findings from national surveys in France. American Journal of Kidney Diseases75(6): 868–878.
46.
LimaSTeixeiraLEstevesR, et al. (2020) Spirituality and quality of life in older adults: A path analysis model. BMC Geriatrics20(1): 259.
47.
MafiMHZeabadiSMMafiM, et al. (2018) Relationship between stressors and coping strategies in Iranian patients undergoing hemodialysis. Jundishapur Journal of Chronic Disease Care8(1): e84508.
48.
MalakMZTawalbehLIAbu SharourLM (2018) Predictors of quality of life among older patients with cancer during treatment. Journal of Research in Nursing23: 598–611.
49.
Masià-PlanaAJuvinyà-CanalDSuñer-SolerR, et al. (2022) Pain, anxiety, and depression in patients undergoing chronic hemodialysis treatment: A multicentre cohort study. Pain Management Nursing23(5): 632–639.
50.
McConnachieDJStowJLMallettAJ (2021) Ciliopathies and the kidney: A review. American Journal of Kidney Diseases77(3): 410–419.
51.
MegariK (2013) Quality of life in chronic disease patients. Health Psychology Research1(3): e27.
Mohd ShahrinFILimZYOmarN, et al. (2019) Association of socio-demographic characteristics, nutritional status, risk of malnutrition and depression with quality of life among elderly haemodialysis patients. Malaysian Journal of Nutrition25(1): 1–11.
54.
MollaogluMBaşerE (2021) Investigation of effect on activities of daily living and symptoms in hemodilaysis patients. Nigerian Journal of Clinical Practice24(9): 1332–1337.
55.
MoonsPLuyckxKDezutterJ, et al. (2019) Religion and spirituality as predictors of patient-reported outcomes in adults with congenital heart disease around the globe. International Journal of Cardiology274: 93–99.
MusaASElbqowmOAlBashtawyM, et al. (2023) Spiritual Wellbeing and quality of life among hemodialysis patients in Jordan: A cross-sectional correlational study. Journal of Holistic Nursing41(3): 220–232.
58.
MusaASPevalinDJ (2012) An Arabic version of the spiritual well-being scale. International Journal for the Psychology of Religion22: 119–134.
59.
MusaASPevalinDJAl KhalailehMAA (2018) Spiritual well-being, depression, and stress among hemodialysis patients in Jordan. Journal of Holistic Nursing36(4): 354–365.
60.
NajafiKKhoshabHRahimiN, et al. (2022) Relationship between spiritual health with stress, anxiety and depression in patients with chronic diseases. International Journal of Africa Nursing Sciences17: 100463.
61.
NaseefHHHaj AliNArafatA, et al. (2023) Quality of life of Palestinian patients on hemodialysis: Cross-sectional observational study. Science World Journal2023: 4898202.
62.
NgMSNChanDNSChengQ, et al. (2021) Association between financial hardship and symptom burden in patients receiving maintenance dialysis: A systematic review. International Journal of Environmental Research and Public Health18(18): 9541.
63.
PaloutzianRFEllisonCW (1982) Loneliness, spiritual well-being and the quality of life. Wiley, pp.224–237.
64.
PilgerCSantosROPDLentsckMH, et al. (2017) Spiritual well-being and quality of life of older adults in hemodialysis. Revista Brasileira de Enfermagem70(4): 689–696.
65.
PompeyCSRidwanMNZahraAN, et al. (2019) Illness acceptance and quality of life among end state renal disease patients undergoing hemodialysis. Enfermería Clínica29: 128–133.
66.
PuchalskiCMVitilloRHullSK, et al. (2009) Improving the spiritual dimension of whole person care: Reaching national and international consensus. Journal of Palliative Medicine12(10): 885–904.
67.
QaddumiJASAl-TellMAlmahmoudO, et al. (2020) Physiological and psychosocial stressors among Palestinian hemodialysis patients: A cross-sectional study. Saudi Journal for Health Sciences9: 50–55.
68.
QueeleyGLCampbellES (2018) Comparing treatment modalities for end-stage renal disease: A meta-analysis. American Health & Drug Benefits11(3): 118–127.
69.
RabittiECavutoSIaniL, et al. (2020) The assessment of spiritual well-being in cancer patients with advanced disease: Which are its meaningful dimensions?BMC Palliative Care19(1): 26.
70.
RaghupathiVRaghupathiW (2020) The influence of education on health: An empirical assessment of OECD countries for the period 1995-2015. Archives of Public Health78: 20.
71.
RavindranASunnyAKunnathRP, et al. (2020) Assessment of quality of life among End-Stage renal disease patients undergoing maintenance hemodialysis. Indian Journal of Palliative Care26(1): 47–53.
72.
RayaniAMSmartMWAlreshidiSM, et al. (2025) Correlations between spirituality, anxiety, and depression in hemodialysis patients in Saudi Arabia: A cross-sectional study. Journal of Religion and Health64: 2558–2575.
73.
RehmanIULaiPSKunLS, et al. (2020) Chronic kidney disease-associated pruritus and quality of life in Malaysian patients undergoing hemodialysis. Therapeutic Apheresis and Dialysis24(1): 17–25.
74.
RikosNKassotakiAFrantzeskakiC, et al. (2023) Investigation of perception of quality of life and psychological burden of patients undergoing hemodialysis-quality of life of hemodialysis patients. Nursing Reports13(3): 1331–1341.
75.
SaediFDehghanMMohammadrafieN, et al. (2024) Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. BMC Nephrology25(1): 326.
76.
SantiniZIJosePEYork CornwellE, et al. (2020) Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): A longitudinal mediation analysis. Lancet Public Health5(1): e62–e70.
77.
SenmarMRazaghpoorAMousaviAS, et al. (2020) Psychological symptoms in patients on dialysis and their relationship with spiritual well-being. Florence Nightingale Journal of Nursing28(3): 243–249.
78.
TooleJKohansiehMKhanU, et al. (2020) Does your patient understand their treatment plan? Factors affecting patient understanding of their medical care treatment plan in the inpatient setting. Journal of Patient Experience7(6): 1151–1157.
79.
VahednasiriAValadkhaniM (2022) Assessment of quality of life and its determinants among hemodialysis patients: Dialysis units of East Azerbaijan Province in Iran in 2021. Nephro-Urology Monthly14(4): e128468.
80.
Valsa JoseJSusan GeorgeJJosephR, et al. (2022) Out-of-pocket expenditures, catastrophic household finances, and quality of life among hemodialysis patients in Kerala, India. Hemodialysis International26(4): 569–574.
81.
WarnerRM (2008) Applied Statistics: From Bivariate Through Multivariate Techniques. Sage Publications.
82.
WebsterACNaglerEVMortonRL, et al. (2017) Chronic kidney disease. Lancet389(10075): 1238–1252.
83.
WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF Quality of life assessment. Psychological Medicine28: 551–558.
84.
World Health Organization, Quality of Life Group (1996) What quality of life? World Health Organisation quality of life assessment. World Health Forum17(4): 354–435.
