The Effect of Dhamma Practice on Depression Outcomes in Hemodialysis Patients

Background: Depression impairs the quality of life (QOL), increases risk of hospitalization and death in hemodialysis patients. Antidepressant medications can lead to more severe side effects. Dhamma practice by Chanting and Anapanasati meditation may relieve depressive symptoms in hemodialysis patients. Objective: To evaluate the effect of Dhamma practice on depression outcome and QOL in hemodialysis patients. Materials and Methods: The authors conducted a quasi-experimental research, a time series design. Patients who were hemodialyzed three times a week at Bhumirajanagarindra Kidney Institute Hospital were enrolled. Participants were trained to practice the Chanting with Anapanasati meditation for 35 minutes every hemodialysis session for six months. Comparison of depression scores, severity of depression, QOL, vital signs, laboratory data, and biomarkers (F2-isoprostanes) was made between the beginning and the end of the study. Results: Forty patients were eligible for participation in the present study. The average age was 63.7±13.1 years. Median dialysis vintage was 29.5 months. After Dhamma practice for six months, diastolic blood pressure was decreased significantly (p=0.015). Median depression score decreased from 9.5 to 4 (p<0.001). The proportion of depressive patients were decreased from 17.5% to 2.5%. The severity of depression trended to decrease, but without statistical significance. F2-isoprostanes was decreased significantly (p<0.001). Both physical aspects (role physical, bodily pain, and physical component scale) and mental aspects (vitality, role emotional, mental health, and mental component scale) of QOL were significantly improved. Conclusion: Dhamma practice by Chanting and Anapanassati meditation significantly decreased blood pressure, and depression, and improved QOL both physically and mentally, in hemodialysis patients. Keywords: Depression, Quality of life, Hemodialysis, Meditation, Buddhist chanting, Dhamma.