Effect of Perceived Social Support, Spiritual Well-being, Health Literacy, and Resilience on Quality of Life in Patients Undergoing Hemodialysis: A Structural Equation Model

Abstract

Background: Spiritual well-being, social support, health literacy, and resilience may affect the quality of life (QOL) in patients undergoing hemodialysis. Objectives: The purpose of this study was to investigate the effect of perceived social support, spiritual well-being, health literacy, and resilience on the QOL in patients under hemodialysis. Methods: This descriptive cross-sectioanl study randomly included 260 patients from three educational hospitals in Ahvaz, Iran. Data were collected using a 36-item QOL questionnaire, Spiritual Health Questionnaire (SHQ), Perceived Social Support (PSS) Questionnaire, Resilience Questionnaire, and Montazeri et al.’s Health Literacy for Iranian Adults (HELIA) Questionnaire. Stata software version 14 was used for data analysis. The results were evaluated using descriptive statistics and a structural equation model (SEM). Results: In this study, a total of 260 patients (male: 138 vs. female: 122; mean age: 51.73 ± 15.32 years) undergoing hemodialysis were included. Most of the patients were married (76.9%) and had at least one comorbid disease (59.2%). Findings showed that health literacy, spiritual well-being, and social support had a significant correlation with the QOL (P < 0.001). However, resilience was not significantly related to the patients’ QOL (P > 0.58). Conclusions: To improve the QOL of patients undergoing hemodialysis, health care providers need to improve patients’ health literacy, social relationships, and spiritual well-being.