The Mediating Role of Religious Coping in the Link Between Religious Orientation and Life Satisfaction Among Hemodialysis Patients: A Cross-Sectional Path Analysis

Background: Hemodialysis patients experience substantial psychological, physical, and social stress, often leading to decreased life satisfaction. Religious orientation and coping are known to influence well-being, but their interrelations are not fully understood. Objective: To investigate the mediating role of religious coping in the relationship between religious orientation and life satisfaction among hemodialysis patients, accounting for sociodemographic and clinical factors. Methods: In 2024, 241 adult hemodialysis patients from Zanjan, Iran, were surveyed in a cross-sectional design. Participants completed the Religious Orientation Scale (ROS), Religious Coping Scale (RCS), and Satisfaction with Life Scale (SWLS). Path analysis was used to test the hypothesized mediation model. Model fit was assessed using RMSEA, SRMR, CFI, and TLI. Multivariable regression was conducted to evaluate the influence of demographic and clinical variables. Results: Religious orientation was significantly associated with religious coping (β = 0.56, p < 0.001), which was also positively linked to life satisfaction (β = 0.20, p = 0.007). The direct effect of religious orientation on life satisfaction was insignificant (p = 0.108). The model demonstrated excellent fit (RMSEA = 0.00, CFI = 1.00). However, after adjusting for sociodemographic and clinical variables, the mediating effect of religious coping was no longer significant (p = 0.592). Marital status, economic condition, and treatment access emerged as significant predictors. Conclusion: Religious coping partially mediates the association between religious orientation and life satisfaction, but external factors moderate its impact. Spiritual and social support should be considered in interventions to enhance life satisfaction among hemodialysis patients.