title: The relationship between religious coping, psychological distress and quality of life in hemodialysis patients.
abstract: OBJECTIVE
  No studies have evaluated the relationship among religious coping, psychological distress and health-related quality of life (HRQoL) in patients with End stage renal disease (ESRD). This study assessed whether positive religious coping or religious struggle was independently associated with psychological distress and health-related quality of life (HRQoL) in hemodialysis patients.
  
  
  METHODS
  This cross-sectional study recruited a random sample of 170 patients who had ESRD from three outpatient hemodialysis units. Socio-demographic and clinical data were collected. Patients completed the Brief RCOPE, the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref).
  
  
  RESULTS
  Positive or negative religious coping strategies were frequently adopted by hemodialysis patients to deal with ESRD. Religious struggle correlated with both depressive (r=0.43; P<.0001) and anxiety (r=0.32; P<.0001) symptoms. These associations remained significant following multivariate adjustment to clinical and socio-demographic data. Positive religious coping was associated with better overall, mental and social relations HRQoL and these associations were independent from psychological distress symptoms, socio-demographic and clinical variables. Religious struggle was an independent correlate of worse overall, physical, mental, social relations and environment HRQoL.
  
  
  CONCLUSIONS
  In ESRD, religious struggle was independently associated with greater psychological distress and impaired HRQoL, while positive religious coping was associated with improved HRQoL. These data provide a rationale for the design of prospective and/or intervention studies targeting religious coping in hemodialysis populations.
authors.affiliation: Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
authors.forename: Susana P
authors.initials: SP
authors.lastname: Ramirez
authors.forename: Danielle S
authors.initials: DS
authors.lastname: Macêdo
authors.forename: Paulo Marcelo G
authors.initials: PM
authors.lastname: Sales
authors.forename: Saharoff M
authors.initials: SM
authors.lastname: Figueiredo
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
authors.forename: Sônia M
authors.initials: SM
authors.lastname: Araújo
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Pargament
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Hyphantis
authors.forename: André F
authors.initials: AF
authors.lastname: Carvalho
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012067:Religion; D006435:Renal Dialysis / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*