Document Type : Original Article
Authors
1 Nursing and Midwifery Care Research Center
2 Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Although 25‑33% of patients with non‑hematological malignancies suffer from
depression disorder, some studies have reported the rate among patients with leukemia as
high as 50%. Furthermore, based on studies chronic disease such as leukemia increases the
patients’ spiritual needs and may accelerate the patient problems. Therefore, spirituality has
a significant role in adapting to leukemia and coping with its consequent mental disorders
such as depression. Owing to the spirituality aspect importance and contradictory results of
previous research, this study was hence performed to determine the effects of a spiritual care
program on depression of patients with leukemia. Materials and Methods: This randomized
clinical trial was conducted in specialized cancer treatment center affiliated to Isfahan
University of Medical Sciences (Isfahan, Iran). A total of 64 adult patients with leukemia were
randomly divided into experiment and control groups. The spiritual care program including
supportive presence and support for religious rituals was implemented for 3 days. Depression
sub‑scale of 42‑item depression, anxiety and stress scale‑42 was completed before and after
the intervention for both groups. Data was analyzed using ANCOVA, Mann‑Whitney U‑test,
Chi‑square, in SPSS statistical software (version 18, SPSS Inc., Chicago, IL). Results: After
the intervention, mean score of depression was significantly lower in the experiment group
than in the control group (P < 0.01). Comparison the mean score of depression in two groups,
revealed the decrees in mean score of depression 11.09 (8.47) after spiritual care program
that it was significant (P < 0.001). Conclusion: Our spiritual care program could successfully
decrease depression level in patients with leukemia and nurses have to apply a holistic care
approach with emphasis on spiritual care to decrease depression, so paid attention to spiritual
aspect of patients accompanying with physical aspects in therapy process is recommended.
Keywords
Annual report to the nation on the status of cancer, 1975‑2005,
featuring trends in lung cancer, tobacco use, and tobacco control.
J Natl Cancer Inst 2008;100:1672‑94.
2. Sheibani KH, Mortazavi SH, Azadeh P. The trend of cancer during
the past 58 years in Iran. Iran J Surg 2004;12:25‑30.
3. American Cancer Society. Cancer Facts and Figures 2014. Atlanta,
GA: American Cancer Society; 2014. Available from: http://www.
cancer.org/cancer/leukemia-acutemyeloidaml/detailedguide/
leukemia-acute-myeloid-myelogenous-key-statistics.
4. Vice Chancellor of Health. National Report on Registered Cases of
Cancer, Iran, 2010. Tehran, Iran: Office for Cancer, Department of
Non‑Communicable Diseases, Center for Disease Control; Javan
Publication; 2012.
5. Smeltzer SC, Bare BG, Hinkle J. Brunner and Suddarth’s Textbook
of Medical Surgical Nursing. 11th ed. Philadelphia: Williams and
Wilkins; 2008.
6. Akechi T, Okuyama T, Akizuki N, Azuma H, Sagawa R, Furukawa TA,
et al. Course of psychological distress and its predictors in
advanced non‑small cell lung cancer patients. Psychooncology
2006;15:463‑73.
7. Akechi T, Nakano T, Okamura H, Ueda S, Akizuki N, Nakanishi T,
et al. Psychiatric disorders in cancer patients: Descriptive analysis of
1721 psychiatric referrals at two Japanese cancer center hospitals.
Jpn J Clin Oncol 2001;31:188‑94.
8. Jois B, Havex JH. Nursing internal medicine, surgery, cardiology,
and hematology. In: Eghbali M, Khalifezadeh A, Shahgholian N,
Shahriary M, Sabouhi F, Zargham A, et al., editors. 1st ed. Isfahan,
Iran: Isfahan University of Medical Sciences; 2006.
9. Montgomery C, Pocock M, Titley K, Lloyd K. Predicting psychological
distress in patients with leukaemia and lymphoma. J Psychosom
Res 2003;54:289‑92.
10. Malekian A, Alizadeh A, Ahmadzadeh GH. Anxiety and depression
in cancer patients. J Res Behav Sci 2007;5:115‑9.
11. Palmer JL, Fisch MJ. Association between symptom distress and
survival in outpatients seen in a palliative care cancer center. J Pain
Symptom Manage 2005;29:565‑71.
12. Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L.
Assessment of anxiety and depression in advanced cancer
patients and their relationship with quality of life. Qual Life Res
2005;14:1825‑33.
13. O’Brien ME. Spirituality in Nursing: Standing on Holy Ground.
Massachussett: Jones and Bartlett Publications; 2003. p. 96, 182,
183, 176.
14. Rezaei M, Seyedfatemi N, Hosseini F. Spiritual well‑being in
cancer patients who undergo chemotherapy. J Fac Nurs Midwifery
2009;14:33‑9.
15. Mauk K, Scnemidt N. Spirituality Care in Nursing Practice. 2th ed.
Philadelphia: Lippincott Company; 2004. p. 60‑199.
16. Delaney C, Barrere C. Blessings: The influence of a spirituality‑based
intervention on psychospiritual outcomes in a cardiac population.
Holist Nurs Pract 2008;22:210‑9.
17. Kennedy JE, Abbott RA, Rosenberg BS. Changes in spirituality and
well‑being in a retreat program for cardiac patients. Altern Ther
Health Med 2002;8:64‑6, 68.
18. Yousefi H. Needs of admitted patients in an interpretive
phenomenology study. PhD Thesis in Nursing. Isfahan: Isfahan
University of Medical Sciences; 2009.
19. Omidvari S. Spiritual health; concepts and challenges. J Interdiscip
Quranic Res 2008;1:5-17.
20. Cole BS, Hopkins CM, Spiegel JT, Agarwala S, Kirkwood JM.
A randomised clinical trial of the effects of spiritually focused
meditation for people with metastatic melanoma. Ment Health Relig
Cult 2012;15:161‑74.
21. Koszycki D, Raab K, Aldosary F, Bradwejn J. A multifaith spiritually
based intervention for generalized anxiety disorder: A pilot
randomized trial. J Clin Psychol 2010;66:430‑41.
22. Mueller PS, Plevak DJ, Rummans TA. Religious involvement,
spirituality, and medicine: Implications for clinical practice,
foundation for medical education add research. Mayo Clin Proc
2001;76:1225‑35.23. Afzali A, Delavar A, Borjali A, Mirzamani M. Psychometric properties
of DASS‑42 as assessed in a sample of Kermanshah High School
students. J Res Behav Sci 2007;5:81‑92.
24. Asgharimoghadam MA, Saed F, Dibajnia P, Zangeneh J.
A preliminary study of the reliability and validity of the depression,
anxiety, and stress scale on non‑clinical samples. Daneshvar‑e‑Raftar
2009;31:23‑38.
25. Kashani F. The effect of massage therapy and relaxation, depression,
anxiety and stress mastectomy patients in Seyed‑Al‑Shohada
Hospital, Isfahan University of Medical Sciences 2010. [MSc Thesis].
Isfahan, Iran: Isfahan University of Medical Sciences; 2011.
26. Musarezaie A. Effect of a spiritual care program on levels of
stress, anxiety and depression in patients with leukemia in
Seyed‑Al‑Shohada Hospital, Isfahan University of Medical Sciences
2012. [MSc Thesis]. Isfahan, Iran: Isfahan University of Medical
Sciences; 2013.
27. Moeini M, Momeni Ghale Ghasemi T, Yousefi H, Abedi. The effect
of spiritual care on spiritual health of patients with cardiac ischemia.
Iran J Nurs Midwifery Res 2012;17:195‑9.
28. Potter PA, Perry AG. Fundamental of Nursing. 7th ed. Canada, Ottava:
Mosby Elsevier; 2009.
29. Balouchestani Asl E. Effects of two methods of prayer on quality
of life of patients with cancer, Seyed‑Al‑Shohada Hospital, Isfahan
University of Medical Sciences, 2009. [MSc Thesis]. Isfahan, Iran:
Isfahan University of Medical Sciences; 2010.
30. Elahi MK. Designing a spiritual nursing care model in Iran. [PhD
Thesis]. Isfahan, Iran: Isfahan University of Medical Sciences; 2007.
31. Momeni Ghale Ghasemi T. Reviewing the effect of spiritual care on
spiritual health of patients with cardiac ischemia admitted in CCU
of Al‑Zahra Hospital in 2010, [MSc Thesis]. Isfahan, Iran: Isfahan
University of Medical Sciences; 2011.
32. Bolhari J, Naziri GH, Zamanian S. Spiritual approach to treatment
efficacy in reducing depression, anxiety and stress in women with
breast cancer. J Woman Soc 2012;3:85‑115.
33. Liu CJ, Hsiung PC, Chang KJ, Liu YF, Wang KC, Hsiao FH, et al.
A study on the efficacy of body‑mind‑spirit group therapy for
patients with breast cancer. J Clin Nurs 2008;17:2539‑49.
34. Rajagopal D, Mackenzie E, Bailey C, Lavizzo‑Mourey R. The
effectiveness of a spiritually‑based intervention to alleviate
subsyndromal anxiety and minor depression among older adults.
J Relig Health 2002;41:153‑66.
35. Musarezaie A, Naji Esfahani H, Momeni Ghaleghasemi T, Ebrahimi A,
Karimian J. The relationship between spiritual wellbeing and stress,
anxiety, and depression in patients with breast cancer. J Isfahan
Med Sch 1st week 2012;30:922‑31.
36. DelaneyC, BarrereC, Helming M. The influence of a spirituality‑based
intervention on quality of life, depression, and anxiety in
community‑dwelling adults with cardiovascular disease: A pilot
study. J Holist Nurs 2011;29:21‑32.
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