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The participants reported mild levels of depression and stress and moderate levels of anxiety. The mean score on the Templer Death Anxiety Scale indicated a high level of death anxiety (M\u2009=\u20098.80, SD\u2009=\u20091.88). Spiritual needs, assessed via a contamination-adjusted measure, were positively associated with death anxiety but were not significantly related to depression, anxiety, or stress. Hierarchical regression analysis revealed that spiritual needs significantly predict death anxiety even after controlling for psychological distress. These findings suggest that spiritual needs represent a distinct existential dimension in hemodialysis patients and play a unique role in shaping fear of death. Integrating spiritually sensitive and existentially informed care into hemodialysis services may help reduce death-related distress and support psychological well-being in this population.<\/jats:p>","DOI":"10.1007\/s10943-026-02716-0","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T05:32:29Z","timestamp":1782711149000},"page":"5049-5064","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Facing Mortality: Spiritual Needs, Psychological Distress, and Death Anxiety in Hemodialysis Patients in Eastern Turkey"],"prefix":"10.1007","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6577-6094","authenticated-orcid":false,"given":"Ebubekir","family":"Kaplan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-2177","authenticated-orcid":false,"given":"Cemile Hurrem","family":"Ayhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6529-9766","authenticated-orcid":false,"given":"Mehmet Cihad","family":"Aktas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4996-6459","authenticated-orcid":false,"given":"Huseyin","family":"Ata\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1990-4988","authenticated-orcid":false,"given":"Fuat","family":"Tanhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"issue":"1","key":"2716_CR1","first-page":"7","volume":"11","author":"F Ak\u00e7a","year":"2008","unstructured":"Ak\u00e7a, F., & K\u00f6se, A. 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