A Causal Model of Spiritual Well-being in Persons with End Stage Renal Disease Receiving Hemodialysis
Keywords:Spiritual well-being, End stage renal disease, Hemodialysis
A model-testing, cross-sectional study was conducted to test a causal model of spiritual well-being in persons with ESRD. A multi-stage random sampling was used to recruit a sample of 270 persons with ESRD who received hemodialysis in Chon Buri Province. Research instruments included six scales of the Spiritual Well-Being, the Memorial Symptom Assessment, the Barthel’s Activities of Daily Living Index, the Perception of Palliative Care, the Duke University Religion Index, and the Multidimensional Scale of Perceived Social Support. Data were analyzed by using descriptive statistics and Structural Equation Modeling.
The results revealed that the modification of the hypothesized model fit the data well ( = 97.495, p = .301, df = 91, CMIN/df = 1.132, GFI = .965, AGFI = .920, and RMSEA =. 016) accounted for 50 – 60.9 percent of variance in prediction of spiritual well-being in persons with ESRD. Symptom experience, social support, activities of daily living, receiving palliative care and religiosity had direct effects on spiritual well-being (β = -0.109, 0.299, 0.186, 0.272 and 0.01, respectively). Symptom experience mediated the link between social support and spiritual well-being. These findings indicate that this causal model is appropriated. It would suggest a direction for the nursing profession to enhance spiritual well-being of persons with ESRD receiving hemodialysis through providing social support, palliative care and religiosity, reducing symptom experience and improving activities daily living.
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