Spiritual Well-Being Emerges as a Powerful Predictor of Hope in Hemodialysis Patients

For the millions of people worldwide who depend on hemodialysis to stay alive, the treatment itself is only half the battle. Sitting attached to a dialysis machine for hours several times a week, week after week, year after year, takes a profound psychological toll that clinicians have long struggled to quantify — and to treat. Now, a new cross-sectional study published in Current Psychology offers a striking piece of the puzzle: a patient’s spiritual well-being may be one of the strongest measurable predictors of how much hope they can hold onto during one of medicine’s most grueling chronic therapies.

The study, conducted by Hatice Oltuluoğlu of the Department of Fundamentals of Nursing at İnönü University’s Nursing Faculty in Malatya, Turkey, examined 123 patients undergoing hemodialysis at two hospitals — a university hospital and a private hospital — between mid-July and the end of August 2023. Rather than drawing a random sample, the researcher aimed to reach the entire eligible population of 145 patients registered in the participating hemodialysis units, ultimately collecting complete data from 123 individuals. The work was approved by an ethics committee (Decision No. 2023/4388) and conducted in line with the Declaration of Helsinki, with verbal informed consent obtained from every participant.

The central question was deceptively simple: does the way patients experience meaning, purpose, and spiritual connection relate to the hope they carry into their treatment? To answer it, the study deployed two well-validated psychometric instruments alongside a standard patient introduction form. Spiritual well-being was measured with the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Short Form 12, known as FACIT-Sp-12, a tool widely used in chronic illness research that captures a person’s sense of meaning, peace, and faith in the face of disease. Hope was assessed with the Adult Hope Scale, which measures both the willpower to pursue goals and the perceived pathways for reaching them.

The numbers tell a compelling story. Patients in the study scored an average of 31.34 ± 8.92 on spiritual well-being — a level the author characterizes as moderate but approaching the high-level threshold — and an average of 45.95 ± 8.68 on hope, which falls into the high range. More importantly, the two variables moved together. Pearson correlation analysis revealed a moderate positive association between spiritual well-being and hope, with a correlation coefficient of r = 0.576 and a p-value below 0.001, meaning the relationship is extremely unlikely to be a statistical fluke.

But the study went beyond correlation. Using simple linear regression, Oltuluoğlu tested whether spiritual well-being could actually predict hope scores — and it could, decisively. Spiritual well-being accounted for 33.2 percent of the variance in hope among the hemodialysis patients. In psychological research, where dozens of competing factors — depression, social support, income, symptom burden — typically dilute any single predictor’s explanatory power, one variable explaining a third of the variance in a core psychological resource is a result that demands attention.

The finding fits into a growing international literature. Previous studies have linked spiritual well-being to lower depression and stress in hemodialysis patients in Jordan, to resilience in Turkish dialysis populations, and to better adherence to dietary regimens in Iran. A 2025 latent profile analysis published in Hemodialysis International similarly explored how spiritual well-being shapes hope in this population. What distinguishes the new study is its focus on hope itself — a psychological construct that researchers increasingly view as a protective factor against the hopelessness, suicidal ideation, and depression that have been documented at alarming rates among people with end-stage renal disease.

Why would spirituality matter so much for patients whose kidneys have failed? The mechanisms are likely multifaceted. Chronic illness researchers often describe spiritual well-being as a resource for meaning-making: the ability to reframe suffering within a larger narrative of purpose, faith, or connection to something transcendent. For a patient facing an indefinite future of machine-dependent survival, that reframing capacity may be what allows hope — the belief that goals remain worth pursuing and attainable — to survive the daily reality of fatigue, dietary restrictions, and physical decline. Hope, in turn, has been associated in prior research with better treatment adherence, improved quality of life, and greater psychological resilience.

The clinical implications are concrete. The study’s author argues that integrating spiritual assessment and support into routine nursing care could help strengthen patients’ psychological resilience and perceived hope. In practice, that could mean nurses and clinicians routinely screening for spiritual distress alongside physical symptoms, referring patients to chaplaincy or spiritual counseling services, and acknowledging faith and meaning as legitimate dimensions of care rather than private matters outside the clinical sphere. In Turkey, where the study took place, religious coping is a culturally salient resource, but the underlying principle — that meaning and transcendence are health-relevant — applies across cultural contexts.

The study’s limitations deserve honest framing. As a cross-sectional design, it captures a single moment in time and cannot establish causality: it is equally plausible that hopeful patients find it easier to cultivate spiritual well-being, or that unmeasured third factors — social support, disease duration, comorbidities — drive both. The sample, drawn entirely from two hospitals in one Turkish region, also limits generalizability, and the author notes that causal inferences cannot be established from these data. Data supporting the findings are available from the corresponding author upon request, and the research received no external funding.

Even with those caveats, the study adds weight to an increasingly persuasive argument in psychonephrology and holistic nursing: that the inner life of the dialysis patient is not a luxury but a clinical variable. As hemodialysis continues to sustain a growing global population of patients with kidney failure, interventions that target spiritual well-being — from meaning-centered counseling to simple, structured spiritual assessments at the bedside — may offer a low-cost, culturally adaptable way to protect the one psychological resource that keeps patients engaged with their treatment: hope. The full study is available in Current Psychology, volume 45, article 1630, published online on 19 October 2026.

Subject of Research: The relationship between spiritual well-being and hope in patients undergoing hemodialysis

Article Title: The effect of spiritual well-being on hope in hemodialysis patients: a cross-sectional study

Article References: OLTULUOĞLU, H. (2026). The effect of spiritual well-being on hope in hemodialysis patients: a cross-sectional study. Current Psychology, 45(20), Article 1630. https://doi.org/10.1007/s12144-026-10195-5

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10195-5

Keywords: hemodialysis, spiritual well-being, hope, chronic kidney disease, psychology, nursing, cross-sectional study, FACIT-Sp-12, Adult Hope Scale, psychosocial factors, resilience, Current Psychology