Impact of spiritual care programs on stroke patients' death anxiety: A randomized controlled trial

Abstract

Background: Post-stroke disabilities, particularly in the first days and weeks, may lead to death anxiety and increase spiritual needs, so receiving spiritual care is important. Therefore, this study investigated the impact of spiritual care programs on stroke patients' death anxiety. Methods: This randomized controlled trial study was conducted on 89 stroke patients at Besat Hospital, Hamadan, Iran, between November 2022 and May 2023. According to inclusion criteria and the Modified Rankin Scale through the random permutation block sampling, participants were allocated to the experimental (N = 45) and control (N = 44) groups. The spiritual care program was held in six consecutive daily sessions (45–60 min each), including identifying spiritual needs, religious care, spiritual care, psychological-spiritual care, and supportive-spiritual care and evaluating the program. At baseline, immediately, and one month after the intervention, participants completed the demographic characteristics form and the Templer Death Anxiety Questionnaire. Results: At baseline, the between-group difference in death anxiety mean scores of stroke patients was non-significant (P = 0.104), while immediately and one month after the intervention, the between-group difference was significant (P<0.001). Moreover, in the experimental group, stroke patients' average death anxiety decreased significantly from the baseline to one month after the intervention (P<0.001), while in the control group was not observed a significant difference (P = 0.073). Limitations: Early fatigue among patients, completing self-report questionnaires, and anxiety related to COVID-19. Conclusion: According to the results of this study, it is recommended that nurses provide spiritual care as part of stroke patients' holistic care plans to reduce their death anxiety.

Keywords

• Spirituality
• Stroke
• Death
• Anxiety
• Hospitalization
• Nursing care