The effectiveness of spiritual education on the uncertainty of illness in hemodialysis patients
DOI:
https://doi.org/10.53713/nhsj.v5i3.548Keywords:
spiritual, uncertainty, illness, hemodialysisAbstract
Chronic kidney disease is a progressive condition that requires long-term treatment with hemodialysis. Routine and invasive hemodialysis not only has an impact on the physical aspects of the patient, but also causes psychological, social, and spiritual uncertainty of illness. Uncertainty of illness related to health conditions requires adaptation to changes during the hemodialysis process, including negative psychosocial impacts. Spiritual education consisted of belief and the power of prayer, dzikir (remembrance of Allah) therapy, and enhancing healing motivation. This study aimed to examine the effectiveness of spiritual education in reducing the uncertainty of illness among hemodialysis patients. A quasi-experimental design with a pretest-posttest control group design was employed. The sample comprised 68 respondents divided equally into an intervention and a control group, with 34 respondents/group. The instrument used to measure uncertainty of illness was the Mishel Uncertainty of Illness Scale (MUIS-C, comprising 22 items in a five-point Likert scale. Data analyzed using an independent t-test and a Mann-Whitney U-test. The study results showed a significant difference in the score uncertainty of illness by using spiritual education in hemodialysis patients between the intervention and control groups, with mean ranks of 45.76 and 23.24 (p<0.001), respectively. Interventional spiritual education through an Islamic-based approach showed a significant effect in reducing the uncertainty of illness in hemodialysis patients. These findings suggest that spiritual education may be implemented in nursing interventions to reduce the uncertainty of illness among patients undergoing hemodialysis and may serve as a valuable component in the holistic care of chronic illness.
References
Abdurachman, Luqman Hakim Andira, Andira, D. ., Alkaff, F. F. ., Weinheimer, A. Z. ., & Dewanti, A. T. . (2025). The great potential of dhikr as prevention of coronary heart disease: A review. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 16(1), 117–129. https://doi.org/10.20885/JKKI.Vol16.Iss1.art12
Alkhaqani, A. L. (2022). Psychological impact of chronic kidney disease and Hemodialysis: Narrative review. Psychosom Med Res, 4(2), 1-5. https://doi.org/10.53388/202209
Anda, R., & Surbakti, A. (2025). The Role of Social Support in Enhancing Psychological Well-Being : The Mediating Effect of Self-Esteem in First-Year University Students Education Islamic Education Islamic education Learning Learning Media Learning. 25–28. https://doi.org/10.35445/alishlah.v17i1.5824
Bedrov, A., & Gable, S. L. (2023). Thriving together: the benefits of women’s social ties for physical, psychological and relationship health. Philosophical Transactions of the Royal Society B: Biological Sciences, 378(1868). https://doi.org/10.1098/rstb.2021.0441
Borges, C. C., Dos Santos, P. R., Alves, P. M., Borges, R. C. M., Lucchetti, G., Barbosa, M. A., ... & Fernandes, M. R. (2021). Association between spirituality/religiousness and quality of life among healthy adults: a systematic review. Health and Quality of Life Outcomes, 19(1), 246. https://doi.org/10.1186/s12955-021-01878-7
Cheng, L., Liu, Y., Chen, Q., & Zhang, F. (2025). Exploring the spiritual experiences of older adults with chronic diseases: a qualitative study in a multicultural context. BMC psychology, 13(1), 632. https://doi.org/10.1186/s40359-025-02710-3
Chidarikire, S., Makaza, M., Popoola, T., Yu, F., & Molloy, L. (2025). Bridging the gap: Normalising spiritual care in undergraduate nursing education: A review of qualitative research. Nurse Education in Practice, 85(February). https://doi.org/10.1016/j.nepr.2025.104359
Clarke, S. T., Murphy, B. M., Hester, R., & Jackson, A. C. (2022). How does illness uncertainty impact recovery among patients with cardiac conditions?. British Journal of Cardiac Nursing, 17(10), 1-8. https://doi.org/10.12968/bjca.2022.0102
Diao, K., Wang, J., Huang, Y., Zhang, Y., Guo, D., Zhang, L., & Shan, Y. (2025). The experience of social isolation in patients receiving peritoneal dialysis: A qualitative study. BMC psychology, 13(1), 1-8. https://doi.org/10.1186/s40359-025-02367-y
Filho, Trezza, Comassetto, silva, Lopes, S. and P. (2023). Spirituality in the uncertainty of illness: the perspective of oncology patients. Revista Brasileira de Enfermagem, 76(4), 1–9. https://doi.org/10.1590/0034-7167-2022-0712
Garza, V., Graf, N., Lerma, P., & Herold, M. (2021). Social Support and Companionship Among People With End-Stage Renal Disease. Journal of Applied Rehabilitation Counseling, 52(3). http://dx.doi.org/10.1891/JARC-D-20-00024
Hafil, A. S., & Ningrum, U. P. (2023). The Effectiveness of Therapy Zikir in Reducing Anxiety Levels in Patients at RSU Lirboyo Kediri. JOUSIP Journal of Sufism and Psychotherapy, 3(1), 1–16. https://doi.org/10.28918/jousip.v3i1.859
Hai, A. H., Wigmore, B., Franklin, C., Shorkey, C., & DiNitto, D. M. (2021). Efficacy of Two-Way Prayer Meditation in Improving the Psychospiritual Well-Being of People with Substance use Disorders: A Pilot Randomized Controlled Trial. Substance Abuse. https://doi.org/10.1080/08897077.2020.1865244
Husna, C., Kamil, H., Yahya, M., & Tahlil, T. (2021). Exploring the perspective of Muslim scholars on the roles of nurses’ response to disaster: a qualitative study. Mental Health, Religion & Culture, 24(5), 478–492. https://doi.org/10.1080/13674676.2021.1876004
Iovino, P., Vellone, E., Cedrone, N., & Riegel, B. (2022). A Middle-Range Theory of Social Isolation in Chronic Illness. International Journal of Environmental Research and Public Health, 20(6), 4940. https://doi.org/10.3390/ijerph20064940
Komarudin, K., Bukhori, B., Karim, A., Haqqi, M. F. H., & Yulikhah, S. (2022). Examining social support, spirituality, gratitude, and their associations with happiness through self-acceptance. Psikohumaniora: Jurnal Penelitian Psikologi, 7(2), 263–278. https://doi.org/10.21580/pjpp.v7i2.13371
Li, X., & Luo, J. K. (2023). Perceptions and attitudes of kidney supportive care among elderly patients with advanced chronic kidney disease and dialysis healthcare professionals in China: a qualitative study. BMC nephrology, 24(1), 316. https://doi.org/10.1186/s12882-023-03372-2
Lockwood, M. B., Rhee, C. M., Tantisattamo, E., Andreoli, S., Balducci, A., Laffin, P., Harris, T., Knight, R., Kumaraswami, L., Liakopoulos, V., Lui, S., Kumar, S., Ng, M., Saadi, G., Ulasi, I., Tong, A., & Li, P. K. (2022). Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nature Reviews Nephrology, 18(3), 185-198. https://doi.org/10.1038/s41581-021-00518-z
Manalu, LO., et al. (2021). Effectiveness of Administrationhealth Education of the Level of Anxiety of Chronic Kidney Failure Patients who are demonstrated at RSKG Ny. Ra Habibie Bandung. Risenology, 6(1a), 70–75. https://doi.org/10.47028/j.risenologi.2021.61a.215
Maurya, N. K. (2025). Navigating Post-Dialysis Challenges: A Review of Common Symptomatology and Clinical Management Approaches. Archives of Clinical and Experimental Pathology, 4(1). http://dx.doi.org/10.31579/2834-8508/041
Nair, D., Bonnet, K., Wild, M. G., Umeukeje, E. M., Fissell, R. B., Faulkner, M. L., Bahri, N. S., Bruce, M. A., Schlundt, D. G., Wallston, K. A., & Cavanaugh, K. L. (2020). Psychological Adaptation to Serious Illness: A Qualitative Study of Culturally Diverse Patients With Advanced Chronic Kidney Disease. Journal of Pain and Symptom Management, 61(1), 32-41.e2. https://doi.org/10.1016/j.jpainsymman.2020.07.014
Phetrnui, S., Suwanno, J., Chiaranai, C., Bunsuk, C., Koson, N., Kumanjan, W., Phonphet, C., & Thiamwong, L. (2025). Cross-cultural adaptation and psychometric evaluation of the Thai version of the Enhancing Recovery in Coronary Heart Disease Social Support Inventory in individuals with chronic illnesses. International Journal of Nursing Sciences, 12(1), 65-73. https://doi.org/10.1016/j.ijnss.2024.12.013
Rafiee-Vardanjani, L., Arsalani, N., Mohammadi-Shahbolaghi, F., & Tabrizi, K. N. (2025). Self-Management in Hemodialysis Patients: A Concept Analysis. Journal of Nursing and Midwifery Sciences, 12(12). https://doi.org/10.5812/jnms-158696
Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015. Archives of public health, 78(1), 20. https://doi.org/10.1186/s13690-020-00402-5
Rassoulian, A., Gaiger, A., & Loeffler-Stastka, H. (2021). Gender differences in psychosocial, religious, and spiritual aspects in coping: a cross-sectional study with cancer patients. Women's health reports, 2(1), 464-472. https://doi.org/10.1089/whr.2021.0012
Rykkje, L., Søvik, M. B., Ross, L., McSherry, W., Cone, P., & Giske, T. (2022). Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review. Journal of Clinical Nursing, 31(11-12), 1440-1464. https://doi.org/10.1111/jocn.16067
Sarmila & Ridfah, A. (2022). Provision of Islamic Intervention as an Effort to Increase the Spirituality of Mental Disorders in RSKD Dadi Makassar. Abdikan: Journal of Community Service in the Field of Science and Technology, 149–153. https://doi.org/10.55123/abdikan.v1i2.269
Schielea, SE, & Emerya, C. (2020). The role of illness uncertainty in the relationship between disease knowledge and patient-reported outcomes among adults and adolescents with congenital heart disease. National Institutes of Health. https://doi.org/10.1016/j.hrtlng.2018.10.026.The
Sharkey, CM, et al. (2018). Exploratory Factor Analysisof the Mishel Uncertainty of illness Scale Among Adolescents and Young Adults With Chronic Medical Conditions. 1–9. https://doi.org/https://doi.org/10.1016/j.pedhc.2018.08.002
Sholehah, A. (2022). Implementation of reading Asmaul Husna: An effort to increase spiritual intelligence. JOUSIP: Journal of Sufism and Psychotherapy, 2(1), 1-16. https://doi.org/10.28918/jousip.v2i1.5610
Supriati, L., Sunarto, M., Ulya, I., Rodli, M., Saputra, R. Y., Nova, R., & Hidaayah, N. (2024). The role of peer social support on family psychological resilience in caring for Chronic Kidney Disease patients receiving hemodialysis. Healthcare in Low-resource Settings, 12(s1). https://doi.org/10.4081/hls.2024.13048
Syafi, F. J. H., & Winahyu Sari, I. W. (2022). A picture of spiritual welfare of chronic kidney failers patient undergoing hemodialysis. Journal of Clinical Nursing and Community, 6, 1–12. https://doi.org/10.22146/jkkk.49490
Zainal Badri, S. K., & Zulkarnain, N. Z. (2024). Spirituality and personal growth of muslim working women: The moderating role of family supportive supervision. Social Sciences and Humanities Open, 10(March), 101201. https://doi.org/10.1016/j.ssaho.2024.101201
Zheng, X., Yang, Z., Xu, L., & Wang, A. (2025). Insights into the complexities of symptom management for hemodialysis patients: a systematic review of qualitative studies. Health Psychology Review, 1–44. https://doi.org/10.1080/17437199.2025.2496230
Zhou, L., Kang, L., Wang, D., Li, Q., Wei, J., Li, M., … Li, H. (2025). Experiences of Dietary Management and Social Adaptation in Young End-Stage Renal Disease Maintenance Hemodialysis Patients: A Qualitative Study. Patient Preference and Adherence, 19, 1731–1745. https://doi.org/10.2147/PPA.S526917
Zumstein-Shaha, M., Ferrell, B., & Economou, D. (2020). Nurses’ response to spiritual needs of cancer patients. European Journal of Oncology Nursing, 48(June), 101792. https://doi.org/10.1016/j.ejon.2020.101792
