Hospital Practices and Research

Abstract Background: Patients undergoing hemodialysis often experience significant suffering, encompassing various psychological and existential components that negatively impact their quality of life.
Objectives: This study aimed to compare the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Spiritual Self-Care Training (SSCT) in reducing the components of suffering—physical, psychological, and existential—among patients undergoing hemodialysis.
Methods: This study utilized a three-group quasi-experimental design, employing a pre-test, post-test, and follow-up protocol with MBCT, SSCT, and control groups. The target population comprised hemodialysis patients residing in Isfahan, Iran, during the autumn of 2024. A convenience sample of 60 participants was drawn from this population and subsequently randomly allocated to three distinct groups (n = 20 per group). The Life Suffering Questionnaire served as the instrument for measuring the dependent variable across all three assessment time points. The experimental groups received 10 weekly therapeutic sessions each lasting for 90 minutes, with MBCT and SSCT administered, while the control group was a waitlist control receiving no intervention during the study period. Data were analyzed using repeated-measures analysis of variance (ANOVA), supplemented by Bonferroni post-hoc tests, via SPSS version 26.
Results: The findings revealed statistically significant differences across three domains of suffering—physical, psychological, and existential—when comparing MBCT, SSCT, and the control group (P<0.01). Notably, SSCT exhibited superior efficacy relative to MBCT in alleviating both physical and psychological suffering (P<0.05). Conversely, no significant difference in effectiveness was observed between the two intervention groups with respect to existential suffering.
Conclusion: SSCT outperformed MBCT in reducing physical and psychological suffering in hemodialysis patients, while both interventions equally mitigated existential suffering. These findings highlight the need for tailored interventions, specifically by integrating spiritual components into cognitive therapies, to address the multifaceted suffering of chronically ill patients. Clinically, incorporating such integrated interventions into hemodialysis care could enhance patient well-being and quality of life.