Background of the Study The researchers wish to conduct the study with the nurses and patients of National

Kidney Transplant Institution that is the researchers find accessible. Being in the nursing course, the researchers had the chances to visit different hospitals or institutions. National Kidney Transplant Institution was chosen to be the setting of the study because of its dedication to provide the best care possible of those individual afflicted with kidney and allied diseases. Spiritual care is important in todays changing health care climate. Nurse affects staff satisfaction, patient outcomes, and the fiscal status of the most health care organizations. This research delineates why spiritual care is important to nursing, how to strengthen nursing care for the long term dialysis patients, how to design methodology for building an internal nursing care development program based on the cooperation of patients and how the institution can help to improve the situation. And how it may affect on their conditions and how the other members of the health care team facilitate and motivate this kind of patient to continue life. People who have a failing kidney have to undergo kidney dialysis. Dialysis is used to clean the blood and remove excess chemicals. But it cannot help to regulate blood pressure or produce red blood cells. Patients have to take special care to ease long-term effects of dialysis. There is a chance of infection in both types of dialysis, but in peritoneal dialysis the changes are higher. Other side effects include low blood pressure, hernias, dry skin and weight gain. The long-term effects of liver dialysis include nerve damage, iron deficiency, heart disease and dementia. During dialysis, there can be problems including low blood pressure as well as dry or itchy skin. Low blood pressure is common during dialysis and can cause dizziness and nausea. A side effect of peritoneal dialysis is hernias. Inserting a catheter for dialysis can weaken abdominal muscles, pushing against the muscle and causing a tear in the muscle wall. During dialysis treatment, when fluid goes out of the body quickly or a large amount of fluid is removed, muscles may cramp, particularly leg muscles. The access area carries a high risk for infection and may become infected, inflamed or clotted with blood. Bleeding may occur due to blood thinning medications. The only alternative to dialysis is a kidney transplant.

There is a long waiting list for kidney transplant candidates. Most adults have to wait more than two years before they find the right kidney. Dialysis can also have psychological effects such as anxiety and depression, which can lead to a diminished sex drive. Alternatively, depression may be an independent factor in influencing survival. It's a very scary time when you or someone you care about faces the final stage of kidney disease. The question "how long do people live on kidney dialysis?" can bring about a very sobering reality. But the answer depends upon a wide range of variables. The incidence and prevalence of end-stage renal failure is increasing, with an approximate doubling of patients requiring renal replacement therapy per decade. Patients who require chronic renal dialysis carry a high burden of ill health and have an increased risk of death. Morbidity is particularly associated with cardiovascular disease, with an increased incidence of myocardial infarction, cardiac failure and stroke due to the prevalence of hypertension, cardiac hypertrophy and ventricular dysfunction in this population. Other health problems include sepsis, anaemia, bone disease, abnormalities of endocrine function (including diabetes mellitus), gastrointestinal complications, coagulopathies and disorders of the autonomic and peripheral nervous systems. There have been few data published describing the effect of an episode of multiple-organ failure on the long-term survival of patients with dialysis-dependent chronic renal disease. Thus our primary objective was to determine the impact of guided meditation and prayers to long-term survival of chronic dialysis patients who had survived an episode of multiple-organ failure, and to compare this with the survival of a group of chronic dialysis patients drawn from the background population who don not develop such. The unique features of this study are that the patients studied were included using a vigorous definition of critical illness, and that the duration of follow up was longer than any previously reported. In our study it is impossible to determine which patients would have developed acute renal failure (ARF) had they not already had end-stage renal failure (ESRF), but the high mortality demonstrated implies that our definition of critical illness

is in the order of this severity. Dialysis may be used for those with an acute disturbance in kidney function (acute kidney injury, previously acute renal failure) or for those with progressive but chronically worsening kidney functiona state known as chronic kidney disease stage 5 (previously chronic renal failure or end-stage kidney disease). Being a long-term dialysis patient brings many challenges to the affected individual that it can transform a very dynamic and goal-oriented individual to a lifeless, dull, and depressive state. Likewise, when one members of the family has this kind of situation, it can bring members to the panic state. Someone who is experiencing the emotion of depression may feel physically sluggish and be searching for answers to relieve spiritual doubts or spiritual questions. Someone who has become disturbed by an uncomfortable sense of an inner void or ecstatic about a religious or spiritual experience will be affected across all dimensions. In this research we want nurses to consider the spiritual aspect of an individual especially on this kind of patient because by this we can explore and determine the main burden or suffering of the patient. In providing spiritual nursing care we can appreciate and understand more their personality by first understanding their own beliefs and values. The researchers do believe that in order to provide quality nursing care to the individuals with kidney problem it is important to know the disease itself, the word dialysis, is a term that frightens most people not only for the pains but also for the wholeness of the person affecting not only physical but also psychological, emotional and spiritual aspects. Nurses inspire others to act by setting good examples. Their drive and perseverance spur others on. They motivate others through mutual trust. Nurses strive to be the best they can be not to impress but to do their duty. In fact, a nurses job is to help others make their best contribution toward a shared goal. With these, the researchers would like to examine the lived experiences of patients undergoing long-term dialysis (previously chronic renal failure or end-stage kidney disease) that are provided with spiritual care through this research entitled The

impact of guided meditation and prayers among long term dialysis patient on selected institutions since they believe that kidney disease is not just a illness with physical impact but a complex phenomenon that can affect the wholeness of an individual. Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. It is important to remember that you may need long-term care at any age. Learning to listen to God and to respond to him in loving obedience. A key means by which they can do this is through a regular encounter with God and guided meditation and prayer are central components of this encounter. Such relationship-building is as essential for spiritual growth as corporate worship and study groups. Every person has the will and power to make their own decisions. Yet every man has weakness too but can still stand up after the fall. There are people who can, there are those who cannot. However, we also need to find the balance that comes when the subjects of the study consciously develop their weaker areas. The quest for these things is what spirituality is about, and people seek to develop their spirituality in diverse ways. Humans seem to have basic built-in aspirations such as to understand what is really real beyond physical and material experiences; to have a sense of significance and; to be accepted as part of a community. This research outlines practical ways for Christians on developing their skills in this area, the impact of it to them, and how it may help them become stronger. But, with so many pressures facing them today, they will need an active support to persevere.