Journal of Holistic Nursing American Holistic Nurses Association Volume XX Number X XXXX 201X 1–9 © The Author(s) 2017 10.1177/0898010117725429 journals.sagepub.com/home/jhn jhn 1 The 2010 “Global Burden of Disease” reported that, in the past decades, chronic kidney disease (CKD) has risen from the 27th to the 18th position in the list of causes of death worldwide, making it a significant public health problem (Jha et al., 2013). 725429JHN XX X 10.1177/0898010117725429SRC, QoL, and Depression in Dialysis Patients Vitorino et al. research-article 2017 Authors’ Note: Please address correspondence to Luciano Magalhães Vitorino, PhD, RN, Federal University of Juiz de Fora, Olegário Maciel Av., 255, Itajubá 37.550-030, Brazil; e-mail: lucianoenf@yahoo.com.br. Two Sides of the Same Coin The Positive and Negative Impact of Spiritual Religious Coping on Quality of Life and Depression in Dialysis Patients Luciano Magalhães Vitorino, PhD, RN Federal University of Juiz de Fora Renata de Castro e Santos Soares, RN Hospital School of Itajubá Ana Eliza Oliveira Santos, RN Federal University of São Paulo Alessandra Lamas Granero Lucchetti, MD, PhD Federal University of Juiz de Fora Jonas Preposi Cruz, PhD, RN Shaqra University Paulo José Oliveira Cortez, PhD Faculty of Medicine of Itajubá Giancarlo Lucchetti, MD, PhD Federal University of Juiz de Fora Background: Studies have shown that spiritual/religious beliefs are associated with mental health and health-related quality of life (HRQoL). However, few studies evaluated how spiritual/religious coping (SRC) could affect hemodialysis patients. Objectives: The present study investigated the role of SRC behaviors on HRQoL and depressive symptoms in hemodialysis patients. Design and Participants: This was cross-sectional study with 184 patients. Patients completed the Beck Depression Inventory, Brief SRC Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a Sociodemographic and Health Characterization Questionnaire. Results: From 218 patients, 184 (84.4%) were included (53.8% male with a median age of 55.9 years). Negative SRC, but not positive SRC, was associated with depressive symptoms. Positive SRC presented significant effects in SF-36 pain and physical and social functioning. On the other hand, negative SRC exhibited significant effects in SF-36 role emotional, energy/fatigue, pain, and physical functioning. Conclusion: SRC influences the mental health and HRQoL in Brazilian hemodialysis patients in two distinct ways. If used positively, it may have positive outcomes. However, if used negatively, it may lead to dysfunctional consequences such as greater depressive symptomatology and affect HRQoL. Health professionals must be aware of these “two sides of the same coin.” Keywords: depression; hemodialysis; health-related quality of life; religion; spirituality Quantitative Research