An Intervention Program Using the Health Belief Model to Modify Lifestyle in Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: Most effective interventions to control coronary heart disease (CHD) and prevent negative outcomes involve behavioral modification. This study examined how such modification based on the Health Belief Model (HBM) might improve lifestyle and clinical outcomes. METHODS: A total of 120 people with CHD seeking help at a general hospital in Iran were randomly assigned to either the intervention or control group. Information was collected using an HBM-specific questionnaire and the Health Promoting Lifestyle II (HPLP-II) scale. Clinical outcomes (blood pressure, body mass index, and fasting blood sugar) were also measured. The intervention group received a tailored education based on HBM principles plus routine care, while those in the control group received only routine care. Three months after the intervention, both groups were reassessed using Student's t test and analysis of covariance. RESULTS: All HBM subscale scores indicated significant improvements in the intervention group, in contrast to the control group, where scores worsened or stayed the same. Perceived severity and susceptibility were the dimensions that changed most. Total score on the HPLP-II improved significantly in the intervention group (p < 0.001, F = 747.5); however, subscale scores on spiritual growth and interpersonal relationships did not demonstrate significant between-group differences at follow-up. After adjustment for baseline scores, significant improvements in lifestyle subscales were also accompanied by significant improvements in clinical measures. CONCLUSIONS: This HBM-based behavior modification program improved both lifestyle and clinical measures in patients with CHD. Utilizing this program in patients with other cardiovascular diseases may in the future demonstrate similar results.

Health education using the theory of planned behavior to modify ergonomic posture in hospital computer users: a randomized controlled trial.

OBJECTIVE: Work-related musculoskeletal disorders are prevalent in those who use computers, and education using ergonomic principles may be helpful to prevent such conditions. The present study sought to identify how an educational intervention based on the theory of planned behavior (TPB) may be effective for adopting healthy ergonomic postures. METHODS: A convenience sample of 162 computer users working in a hospital setting in Iran were randomly assigned to intervention or control groups. The intervention group (n = 81) received six weekly educational sessions based on TPB principles, whereas the control group received no intervention during the study period. Both groups were assessed at baseline and 3 months after the intervention using a TPB questionnaire, rapid office strain assessment (ROSA), and Nordic musculoskeletal questionnaire. Data were analyzed using the independent/paired Student's t test, chi-square, and analysis of covariance. RESULTS: All TPB constructs in the intervention group improved from baseline to follow-up, indicating considerable progress compared to the control group (p < 0.001). More than 60% of intervention and control groups were categorized as high risk at baseline in terms of ergonomic posture measured by ROSA. This percentage was reduced to 21% for intervention group and increased to 65% in the control group at follow-up. Symptom relief was obtained for wrist/hands, lower back, neck, shoulders and upper back in the intervention group (all p < 0.05). The number of affected areas also significantly decreased in the intervention group compared to the control group three months after the intervention. CONCLUSION: Educational programs based on TPB principles may be helpful in correcting ergonomic postures among computer users. Such interventions are recommended for worksite health promotion in that they may prevent the development of musculoskeletal disorders in staff.

Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study.

Introduction: Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah. Methods: This descriptive cross-sectional study was conducted in the city of Jeddah. The Skin Picking Scale-Revised (SPS-R) scale was administered to a convenience sample of 520 respondents. A partial least squares path model (PLS-PM) for "impairment" and "symptoms severity" subscales was assessed by evaluating the validity of measurement and structural models. Results: Skin picking behavior was reported by 28.8% (n=150). A significant level of skin picking disorder symptoms was present in 1.2% (n=6). Skin picking visual effect, depressive symptoms, and being unmarried were the only positive independent predictors of the total SPS-R score. Conclusion: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.

Trichotillomania Prevalence in an Arab Middle Eastern Population.

Aim: Trichotillomania (TTM) (hair-pulling disorder) is a relatively rare psychiatric condition. We are aware of no studies of this disorder in Arab Middle Eastern populations. We examine the prevalence and correlates of TTM in a community sample of individuals living in a large port city in western Saudi Arabia. Methods: An observational cross-sectional study of 511 adults aged 18 years or over living in Jeddah, Saudi Arabia, was conducted. After inquiring about demographic information and self-reported psychiatric disorders, the Massachusetts General Hospital Hair-Pulling Scale (MGH-HPS) was administered to assess symptoms of TMM. Results: A total of 9 of 511 participants (1.8%) scored above the cutoff for suspected TTM on the MGH-HPS, whereas 203 (39.7%) had a history of hair-pulling. Those with suspected TTM were more likely to be female (2.8% vs 0.4% in males, P = 0.047) and somewhat more likely to have a history of obsessive-compulsive disorder (OCD) (6.7% vs 1.5%, P = 0.093). Hair pulling was also more common in unmarried, not living with family, and unemployed. Among those with a history of hair-pulling, the most frequent locations were from the face (62.7%), head (55.7%), and legs (15.3%). Conclusions: While a history of hair-pulling is common in this community sample (40%), suspected TTM is much less prevalent (<2%), although not rare by any means. When present, the condition is more common in women and possibly in those with OCD.

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial.

BACKGROUND: Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children. METHODS: A total of 112 children ages 6-12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student's t-test and analysis of covariance. RESULTS: All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = - 0.9 to - 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups. CONCLUSION: An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Body Dysmorphic Disorder Symptoms: Prevalence and Risk Factors in an Arab Middle Eastern Population.

Background: The present study examined the prevalence of and risk factors for symptoms of body dysmorphic disorder (BDD) in the general population of Jeddah, a large port city in Saudi Arabia. Methods: This cross-sectional study surveyed a convenience sample of 520 adults. We used a validated self-screening measure to assess BDD, the body dysmorphic disorder questionnaire (BDDQ). Results: The prevalence of significant BDD symptoms among the general Saudi population was 8.8% (ie, those scoring above the cut off for BDD on the BDDQ). Over half (52%) of all respondents reported concerns about the attractiveness of their body parts, and of those expressing such concerns, 66% were preoccupied with these thoughts. Only 3% of all respondents opted for cosmetic surgery because of these concerns, and most of those individuals (69%) had only one surgery. Nearly 9% of all respondents reported that these concerns affected their relationships with family and friends. Almost 15% of all participants spent an hour or more each day thinking about these concerns. Patients who reported a history of depression were 3.8 times more likely to have BDD. Other variables included in the model predicting high BDD scores (eg, age, job status, and marital status) did not achieve statistical significance. Conclusion: Significant symptoms of BDD (based on the BDDQ) are not uncommon among the general population of Jeddah, Saudi Arabia. Risk factors for this condition were female gender, younger age, being unmarried, and in bivariate and multivariate analyses, history of depression and female gender. These findings underscore the need for increased awareness by clinicians of this disorder, particularly when treating patients with depressive disorder, particularly among women.

How Relevant is Obstetrician and Gynecologist Gender to Women in Saudi Arabia?

BACKGROUND: The patient-doctor relationship is one of the most important factors in determining the outcome of healthcare. The first step in establishing this relationship is choosing a physician. This study sought to identify patient preferences concerning the gender of their obstetrics and gynecology (OB-GYN) physician and the effect of religion and society on these choices. METHODS: A cross-sectional study was conducted at the OB-GYN outpatient clinics at King Abdulaziz University Hospital in Jeddah between February 2017 and June 2017. A total of 227 female patients were recruited. Eligible were women ages 18 years or older who had attended the clinic at least three times. A 30-item questionnaire was administered. RESULTS: Significantly, more female doctors were preferred for pelvic examination in lower income group (p=0.003), while male doctors were preferred for surgery (p=0.010) in higher income group. Significantly more male doctors were preferred for pelvic examination and gynecological surgery in >35-year age group (p=0.015 and p=0.017, respectively). With regard to predictors, embarrassment was the most significant factor reported for not choosing a male obstetrician/gynecologist (OB-GYN) in the younger age group. Nearly three-quarters (71.2%) of respondents with age ≤35 reported embarrassment as a factor for not choosing a male OB-GYN; 79.7% of this subgroup indicated that female doctors were more knowledgeable about women's health issues. CONCLUSION: Participants expressed a strong preference for female providers overall, although some women preferred male providers during certain circumstances (gynecologic surgery). Despite these gender preferences, more important to women in their choice of OB-GYN provider was the doctor's experience, qualifications, and reputation. Such trends are consistent with those culturally similar countries and in line with trends worldwide. These findings have the potential to significantly impact the personal health for women in Saudi Arabia and elsewhere in the Middle East where religious and cultural traditions are so important in decision-making.

Psychometric Validation and Translation of Religious and Spiritual Measures.

Scale development, validation, and translation are complicated and often arduous procedures that involve considerable cost, time, personnel, and skills necessary to perform the complex statistical analyses required. The need to follow a standard procedure when developing new scales and translating old scales into new languages is essential in order to ensure that researchers accurately measure what they are claiming to measure. Well-designed scales form the foundation for much of the quantitative research conducted today in the psychological, social, behavioral and physical health sciences. This is also true for studies that examine the relationship between religiosity and/or spirituality (R/S) and health. The relationship between R/S and health is a complex one, requiring the development of measures that comprehensively, sensitively, reliably, and accurately measure R/S. As with many other emerging areas in the health sciences, quantitative measurement using psychometrically sound scales and the translation of existing scales into other languages is essential for advancement of the field of religion and health. In this article, a standard procedure for developing, validating, and translating multi-item scales is described.

Moral Injury: An Increasingly Recognized and Widespread Syndrome.

Moral injury (MI), originally discussed in relationship to transgressing moral beliefs and values during wartime among military personnel, has expanded beyond this context to include similar emotions experienced by healthcare professionals, first responders, and others experiencing moral emotions resulting from actions taken or observations made during traumatic events or circumstances. In this article, we review the history, definition, measurement, prevalence, distinctiveness, psychological consequences, manifestations (in and outside of military settings), and correlates of MI in different settings. We also review secular psychological treatments, spiritually integrated therapies, and pastoral care approaches (specific for clergy and chaplains) used to treat MI and the evidence documenting their efficacy. Finally, we examine directions for future research needed to fill the many gaps in our knowledge about MI, how it develops, and how to help those suffering from it.

Factors associated with mental health and quality of life during the COVID-19 pandemic in Brazil.

BACKGROUND: Although mental distress and quality of life (QoL) impairments because of the pandemic have increased worldwide, the way that each community has been affected has varied. AIMS: This study evaluated the impact of social distancing imposed by coronavirus disease-2019 (COVID-19) on Brazilians' mental health and QoL. METHOD: In this cross-sectional community-based online survey, data from 1156 community-dwelling adults were gathered between 11 May and 3 June 2020. We examined independent correlates of depression, anxiety and QoL, including sociodemographic and clinical characteristics, optimism/pessimism and spiritual/religious coping. Dependent variables were assessed using the 9-item Patient Health Questionnaire for depressive symptoms, the 7-item Generalized Anxiety Disorder Scale for anxiety symptoms, and the World Health Organization Quality of Life-BREF for QoL. Correlates of depressive and anxiety disorder were estimated using logistic regression. RESULTS: There were high levels of depressive symptoms (41.9%) and anxiety symptoms (29.0%) in participants. Negative spiritual/religious coping was positively correlated with depressive disorder (odds ratio (OR) = 2.14 95% CI 1.63-2.80; P < 0.001) and with anxiety disorder (OR = 2.46 95% CI 1.90-3.18; P < 0.001), and associated with worse social and environmental QoL (P < 0.001). Healthcare professionals were less likely to have depressive symptoms (OR = 0.71, 95% CI 0.55-0.93; P < 0.001). Participants with friend/family with COVID-19 scored lower on psychological and environmental QoL (P < 0.05). Participants with a longer duration of social isolation were less likely to experience anxiety disorder (OR = 0.99, 95% CI 0.98-0.99; P = 0.004). CONCLUSIONS: We found high levels of depressive and anxiety symptoms and low levels of QoL in Brazil, which has become a pandemic epicentre. Several characteristics were associated with negative mental health symptoms in this study. This information may contribute to local health policies in dealing with the mental health consequences of COVID-19.

Spirituality, moral injury and mental health among Chinese health professionals.

BACKGROUND: Moral injury has been found to be prevalent among healthcare professionals during the COVID-19 public health crisis. AIMS: The present study examines the relationship between spirituality, moral injury, and mental health among physicians and nurses in mainland China during the COVID-19 pandemic. METHOD: An online cross-sectional study was conducted involving 3006 physicians and nurses in mainland China, where the COVID-19 pandemic has caused high rates of hospital admission and death. The Moral Injury Symptoms Scale-Health Professional was administered, along with measures of mental health and spirituality. Hierarchical linear regression modelling was used to examine the mediating and moderating role of moral injury in the relationship between spirituality and mental health. RESULTS: Spirituality was positively correlated with moral injury (ß = 2.41, P < 0.01), depressive symptoms (ß = 0.74, P < 0.01) and anxiety symptoms (ß = 0.65, P < 0.01) after controlling sociodemographic variables. Moral injury significantly mediated the relationship between spirituality and both depression and anxiety, explaining 60% (0.46/0.76) of the total association between spirituality and depression and 58% (0.38/0.65) of the association with anxiety. No moderating effect of moral injury was found on the spirituality-mental health relationship. CONCLUSIONS: Although they were the findings of a cross-sectional study, these results suggest that concern over transgressing moral values during the pandemic may have been a driving factor for negative mental health symptoms among Chinese health professionals for whom spirituality was somewhat important. Future longitudinal studies are needed to determine the causal nature of these relationships.

Effects of a health education program to promote healthy lifestyle and glycemic control in patients with type 2 diabetes: A randomized controlled trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a common chronic disease with an increase in prevalence within developing countries. The aim of this study was to determine the efficacy of a structured educational program for improving lifestyle and health-related measures in Iranians with T2DM. METHODS: A randomized controlled trial was conducted in 80 participants with T2DM who were randomly assigned to either the intervention or a control group. A demographic questionnaire along with the Health Promoting Lifestyle Profile-II and related laboratory tests were used to assess the efficacy of the program. The intervention consisted of six educational sessions held over 45 days. The control group received routine diabetic care at the clinic. Three months after the intervention, participants completed the measures again. Within-group and between-group comparisons were then made. RESULTS: All subscales of lifestyle measure improved in the intervention group, whereas only the nutrition domain improved in the control group. After adjusting for baseline differences, physical activity and nutrition domains showed the greatest improvement in the intervention group compared to controls. All clinical measures were also significantly improved within intervention group from baseline to follow-up (p < 0.001), whereas HbA1c, fasting blood glucose, HDL, triglyceride, cholesterol, and weight also changed significantly in the control group. The frequency of HbA1c < 7% was increased from 27.5% at baseline to 37.5% at follow-up (10%) in the intervention group compared to only a 5% increase in the control group. CONCLUSION: This educational health program significantly improved lifestyle changes and health-related clinical characteristics in persons with T2DM, compared to routine diabetic care in Iran. Further research is needed to better understand the usefulness of such programs in diabetics and other medical conditions among those in different cultural settings.

A spiritual intervention to reduce stress, anxiety and depression in pregnant women: Randomized controlled trial.

We assessed the efficacy of a spiritually-integrated cognitive-behavioral educational group intervention for reducing stress, anxiety, depression, and blood pressure during pregnancy and improving delivery outcomes. A randomized controlled trial was conducted in 84 pregnant women randomly assigned to either the intervention or a control group. Demographic information was collected at baseline, along with measures of religiosity, stress, anxiety, depression, and blood pressure. Our intervention consisted of four 90-minute group sessions over 8 weeks that utilized a spiritually-integrated cognitive-behavioral approach to help participants cope with the stress of pregnancy. Stress, anxiety and depression scores in the intervention group decreased significantly by 41%, 28%, and 41%, respectively, from baseline to 3-month follow-up. There were also significant differences in systolic and diastolic blood pressure between groups at the 3-month follow-up, favoring the intervention group. Between-group differences were also significant for these outcomes. Applying such spiritually-integrated intervention may help to improve the mental and physical health of young, healthy nulliparous pregnant women.

Moral injury from war and other severe trauma.

Moral injury (MI) is a relatively new syndrome among military personnel with symptoms of post-traumatic stress disorder (PTSD). While MI has received considerable attention in the psychological sciences, the syndrome has received relatively little notice within psychiatry. MI has been defined as the negative emotions that emerge from transgressing moral boundaries by military personnel during combat such as killing enemy combatants or innocent civilians, failing to protect innocents or fellow combatants, or observing others transgress moral boundaries. MI may also be frequent among civilians and health professionals, although, as in military personnel, is often unrecognized.

Beliefs of cancer patients in Saudi Arabia.

Objectives: To examine oncology patients' beliefs about the transmissible nature of cancer or its treatments and to determine the correlates thereof.Design: Cross-sectional.Participants: Sixty-nine hospital outpatients completed the questionnaire.Methods: Beliefs about the spread of cancer, chemotherapy, and radiation therapy with physical contact, along with demographic, social, psychological, health-related characteristics were assessed by questionnaire. Bivariate and multivariate analyses identified correlations between these beliefs and patient characteristics.Findings: A percentage (5.8%) believed their cancer could spread like an infection or be transmitted through sexual or nonsexual contact and 15.9% were unsure. Even more (13.0%) believed that chemotherapy could spread through sexual or nonsexual contact and 18.8% were unsure. Likewise, many believed (10.1%) that radiation therapy could spread through sexual or nonsexual contact and 21.7% were unsure. Obsessions with contamination were most strongly associated with such beliefs (B = 0.73, SE = 0.09, p < .0001).Conclusions: Beliefs about the spread of cancer or its treatments are not uncommon in Saudi Arabia, where cultural beliefs and tradition strongly influence healthcare decisions.

Effects of a structured heart failure program on quality of life and frequency of hospital admission in Saudi Arabia.

OBJECTIVE:  To compare the quality of life (QOL) and frequency of hospital admission (FHA) in the past 4 months between congestive heart failure (CHF) patients involved in a structured heart failure program (HFP) compared with waitlisted controls. METHODS:   This study, employing an ex-post-facto comparative cross-sectional design, involved 80 patients with CHF (40 in the HFP and 40 controls). Those in the HFP had been enrolled for at least 4 months. Controls were waiting to be enrolled in the program. Participants completed a questionnaire assessing demographic, social/cultural, psychological, and CHF-related physical health characteristics, along with the primary dependent variables, QOL and FHA. Bivariate and multivariate analyses assessed differences between those in the HFP and controls. RESULTS:    Congestive heart failure patients in the HFP were significantly less likely than the control group to score below the median on heart failure-specific QOL, controlling for other variables (OR=0.83, 95% CI: 0.82-0.95, p=0.007). Those in the HFP were also significantly less likely than controls to be hospitalized within the past 4 months (OR=0.78, 95% CI: 0.69-0.88, p less than 0.001). Multivariate analyses indicated that CHF patients in the HFP were 95% less likely than controls to be admitted to the hospital during that period, independent of other risk factors for hospital admission. CONCLUSIONS:  Involvement by patients with CHF in a structured HFP at King Abdulaziz University in Jeddah, Kingdom of Saudi Arabia, is associated with significantly higher quality of life and lower likelihood of being hospitalized compared to CHF patients not involved.

Religiosity and Beliefs About the Transmission of Cancer, Chemotherapy, and Radiation Through Physical Contact in Saudi Arabia.

We examined relationships between religiosity and Saudi cancer patients' beliefs about the spread of cancer, chemotherapy, and radiation therapy through close physical contact. Surveyed were 64 patients seen in university oncology clinics. Assessed were beliefs about the spread of cancer and its treatments, along with religious, demographic, social, psychological, and cancer-related characteristics. Greater religiosity was related to older age, non-Saudi nationality, less anxiety, earlier cancer stage, and greater time since initial diagnosis. Non-significant trends suggested that religious practices were associated with less, but intrinsic religious beliefs with more concern about contagiousness, although the findings were limited by low statistical power.

The effectiveness of a model-based health education intervention to improve ergonomic posture in office computer workers: a randomized controlled trial.

PURPOSE: Lack of knowledge about computer ergonomics predisposes users to musculoskeletal and visual disorders. The present study examined the effect of a trans-theoretical model (TTM)-based educational program on work-related posture in office computer users. METHODS: This experimental study examined 102 hospital personnel whose primary job involved working at a computer. Participants were randomized to intervention and control groups. An educational intervention based on TTM was conducted over five sessions. A self-report questionnaire was used to collect data including stages of change, processes of change, pros and cons of change, and self-efficacy. A pen-paper-based observational method (i.e., Rapid Office Strain Assessment or ROSA) was used for assessing work posture. A visual analogue scale assessed pain intensity. Data were collected at baseline and 3-month follow-up. RESULTS: Significant differences were found on TTM's constructs and ROSA score between intervention and control groups at follow-up (p < 0.05). The mean ROSA score decreased from 5.65 (SD 1.03) to 3.95 (SD 0.83) in the intervention group, while no significant change was found in the control group. Pain intensity also decreased significantly among those in the intervention vs. control group (p < 0.001). CONCLUSION: An educational intervention based on TTM was effective in improving ergonomic posture in computer workers. Further research is needed to determine if these results can be generalized to computer workers in other settings.

Religiosity and Telomere Length in Colorectal Cancer Patients in Saudi Arabia.

Numerous studies have reported a significant relationship between psychological stress, depression, and telomere length (TL), an indicator of cellular lifespan. Religious involvement, which is associated with lower levels of stress and depression, has also recently been related to TL. To our knowledge, this relationship has not yet been examined in Muslims, colorectal cancer patients, cancer patients more generally, or any population outside the USA. A convenience sample of 50 colorectal patients was recruited from hospital-based oncology clinics in Jeddah, Saudi Arabia. Religious involvement was assessed with the 13-item Muslim Religiosity Scale. Social and psychological mediators were measured using established scales. TL was determined from whole-blood leukocytes using quantitative PCR technology. Bivariate analyses indicated a positive but nonsignificant relationship between religiosity and TL (r = 0.13, p = 0.35). Controlling for age, did not affect the relationship (B = 15.6, SE = 17.3, p = 0.37), nor did controlling for other demographic, social or psychological factors. Religious involvement was unrelated to TL in this small sample of colorectal patients. Future cross-sectional and prospective studies in different populations with larger samples are needed.

The Effect of Holy Qur'an Recitation on Depressive Symptoms in Hemodialysis Patients: A Randomized Clinical Trial.

Patients with advanced renal failure often face considerable sociopsychological stress as a result of lifestyle changes due to the disease and its treatment. The aim of the present study is to examine the effect of the Holy Qur'an recitation on depressive symptoms in hemodialysis patients. In this clinical trial, 54 hemodialysis patients were randomized to either an experimental (n = 27) or a control (n = 27) group. Patients completed the Beck Depression Inventory-II (BDI-II) at baseline and at 1 month after the intervention. Participants in the experimental group listened to recitation of the Holy Qur'an, while those in the control group received no intervention. The mean BDI-II score at baseline was 33.6 (±6.7) for the experimental group and 29.3 (±9.0) for the control group; at the end of treatment, BDI-II scores in the experimental and control groups were 14.5 (±4.8) and 31.6 (±9.2), respectively. Results from the repeated-measures general linear model controlling for baseline differences indicated a significant treatment effect (F = 9.30, p = 0.004, Cohen's d = 0.85). Holy Qur'an recitation has a significant effect on lowering depressive symptoms in hemodialysis patients. Holy Qur'an recitation is an easy-to-implement and cost-effective strategy that may be used to supplement the treatment of depression in this setting in Iran.