Reducing Suicidal Ideation in Hemodialysis Patients Treated in Urmia, Iran

Chronic renal failure occurs imposes heavy
financial burden on health-care systems. It
requires treatment methods such as hemodia-
lysis (HD), kidney transplantation, or perito-
neal dialysis to have a good quality of life for
patients although with the risk of several pro-
blems such as anemia, infection, hypertension,
bleeding, side effects of drugs, and other com-
plications that result due to the disease itself
and treatment methods.1,2 Dietary restrictions,
the likelihood of being labeled as a handi-
capped person, financial problems, tensions,
and many other factors cause psychiatric com-
plications such as depression and anxiety
which disrupt patients’ quality of life that may
lead to suicidal tendencies.3,4 Therefore, all
health-care providers should be aware of the
importance of this situation to protect the
patient offering the best care possible.5
In a quasi-experimental study, we tried to
reduce suicide tendencies of HD patients
treated in Urmia, Iran in 2014. One hundred
dialysis patients were studied by a demo-
graphic questionnaire and Euthanasia Attitude
Scale. The last scale has 30 questions about
ethical and legal issues of euthanasia with
Likert scale answer ranging from strongly
disagree to strongly agree. The minimum and
maximum extremes were 30 and 120, respec-
tively. A score of between 75 and 120 reveals
a high tendency and <75 indicates a low
tendency to suicide.6 Our training intervention
was a face-to-face method in three sessions of
the patient’s needs, about disease occurrence,
recommendations about appropriate diet, need
to exercise and importance of medication
adherence according to physician’s orders, and
their drug side effects. Data of the pretest were
gathered, and after the intervention, was
recorded again in a posttest and analyzed using
IBM SPSS Statistics software version 20.0
(IBM Corp., Armonk, NY, USA) by using
descriptive statistics.
The mean age of the patients was 37.4 ± 6.8
years, and (50%) of the patients were females.
The mean duration of the disease was 31.7 ±
15.9 months, and all the patients were on three
dialysis sessions/week. After training, mean
the attitude toward euthanasia among patients
was lower than the patients before intervention
(82.43 ± 14.37 vs. 52.88 ± 18.64) which was
statistically significant (P = 0.043). It was
revealed that patients with low quality of life
or family support, low education level, or
financial problems had a more positive attitude
toward euthanasia. However, positive