Effects of Spiritual/Religious Music on Anxiety and Spiritual Well-Being Among Adults Undergoing Hemodialysis: A Systematic Review
Keywords:
hemodialysis; dialysis patients; spiritual music; religious music; anxiety; spiritual well-being; music therapy; spirituality; systematic reviewAbstract
Background: Hemodialysis is a life-sustaining treatment for patients with end-stage kidney disease; however, long-term dependence on dialysis is associated with psychological and spiritual challenges, including anxiety, depression, stress, loss of independence, and disruption of daily life. Spiritual well-being is an important component of holistic care and has been associated with better psychological outcomes among patients receiving hemodialysis. Spiritual or religious music may provide a culturally meaningful, non-pharmacological approach to addressing these concerns.
Objective: This systematic review aimed to examine the effects of spiritual or religious music on anxiety and spiritual well-being among adults undergoing maintenance hemodialysis.
Methods: A systematic review was conducted using the Population, Intervention, and Outcome (PIO) framework and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. PubMed, CINAHL, and ProQuest were searched in August 2026. Eligible studies included quantitative comparative studies involving adults undergoing maintenance hemodialysis, spiritual or religious music interventions, and anxiety and/or spiritual well-being outcomes. Retrieved records were organized using Zotero, duplicates were removed, and records were screened according to predetermined inclusion and exclusion criteria. Data were extracted using a standardized extraction form, and methodological quality and risk of bias were assessed according to study design.
Results: The database searches identified 110 records: 46 from PubMed, 29 from CINAHL, and 35 from ProQuest. After removal of 33 duplicates, 77 records remained for title and abstract screening. Two candidate studies were identified for further assessment. One study evaluated spiritual chanting and listening and reported improvement in spiritual well-being, while another examined Holy Qur'an recitation combined with physical training and reported reduced anxiety. However, the latter study involved a multi-component intervention, making it difficult to determine the independent effect of spiritual/religious music. Final inclusion was therefore dependent on full-text eligibility assessment.
Conclusion: The available evidence suggests that spiritually meaningful auditory interventions may have potential benefits for anxiety and spiritual well-being among adults undergoing hemodialysis. However, the evidence specifically addressing spiritual or religious music is limited. Differences in intervention content, cultural context, study design, outcome measures, and the use of multi-component interventions limit the strength and comparability of the evidence. Further rigorous randomized controlled trials are needed to determine the independent effects of spiritual/religious music during hemodialysis.
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