Existential and supportive care needs among patients with chronic kidney disease

J Pain Symptom Manage. 2010 Dec;40(6):838-43. doi: 10.1016/j.jpainsymman.2010.03.015. Epub 2010 Aug 24.


Context: Living with chronic kidney disease (CKD) is associated with spiritual distress and frequently precipitates a search for meaning and hope; yet, very little is known about these patients' spiritual needs.

Objectives: To describe the nature, prevalence, and predictors of spiritual and supportive care needs in CKD.

Methods: Prospective cohort study of 253 CKD patients who completed a seven-item spiritual and seven-item supportive care needs assessment.

Results: Patients reported a mean (standard deviation [SD]) number of 2.9 (2.6) spiritual needs, with 69.1% of patients reporting at least one spiritual need. The mean (SD) number of supportive care needs was 3.5 (2.1), with 91.4% of patients reporting at least one of these needs. Thirty-two percent of the patients had high spiritual needs (defined as reporting ≥5 of the seven needs). Similarly, 37% of the patients reported high supportive care needs. Neither spiritual nor supportive care needs were associated with age, gender, race, marital status, dialysis modality, time on dialysis, or comorbidity.

Conclusion: These patients had substantial spiritual and supportive care needs. There were no clear predictors of high spiritual or supportive care needs, highlighting the importance of evaluating all CKD patients for unmet needs. Health professionals will need to better understand and attend to CKD patients' spiritual needs to optimize quality care.

MeSH terms

  • Health Services Needs and Demand*
  • Humans
  • Kidney Failure, Chronic / psychology*
  • Prospective Studies
  • Quality of Life
  • Religion and Medicine*
  • Social Support*
  • Spirituality*
  • Terminal Care