Exploration of the spiritual expectations of patients in a Swiss hemodialysis center

Abstract

Background Previous American studies suggest that dialysis patients want caregivers to discuss spirituality and mobilize appropriate spiritual resources. Whether this also applies to the Swiss dialysis population, and whether patients' spiritual experiences contribute to their coping mechanisms is unknown. The goal of this pilot study is therefore to explore the spiritual expectations of hemodialysis patients in a Swiss dialysis center. Methods A qualitative study was conducted. Semi-structured interviews were performed by an experienced sociologist with dialysis patients in the ambulatory chronic dialysis unit of the University Hospital of Lausanne, Switzerland. The interviews included a set of pre-defined, open questions based on SPIR and HOPE, two validated tools to assess spirituality. The questions included three themes: the role that spirituality plays in patients’ life, in (coping with) their illness and in the recent COVID-19 epidemic. All interviews were recorded, transcribed, and then coded and analyzed following the approach of content analysis. Results Interviews took place between February and June 2022. The mean age of the 20 participants was 62.5 years (min 30-max 86), 40% were female. In total 14/20 (70%) patients practiced some form of religion (believers), 4 were agnostics, and 2 defined themselves as atheist. The majority of participants of this study (75%) consider that spirituality can play a positive role to preserve hope and to manage the difficulties caused by the disease and its treatment. The need for spiritual guidance is however not among the patients’ most urgent needs. Although some of them are open to the possibility of spiritual guidance within the hemodialysis unit, none of them expressed this as a formal expectation. Research participants’ level of spirituality and spiritual practice have generally not been significantly impacted by their changing health status, or the recent COVID-19 pandemic. The most frequently mentioned needs are related to social dimensions (isolation, loneliness, need to talk, financial problems). Conclusions In this pilot study, the majority of Swiss dialysis patients did not express the wish to discuss more often spiritual issues with dialysis caregivers, but they would appreciate more attention for social and socio-economic difficulties.