title: Does spiritual care program affect levels of depression in patients with Leukemia? A randomized clinical trial.
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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Adult Health Nursing, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Musarezaie
authors.affiliation: Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mahin
authors.initials: M
authors.lastname: Moeini
authors.affiliation: Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Taleghani
authors.affiliation: Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Mehrabi
keywords: Depression; leukemia; nursing; spirituality