Introduction:
Patients with end-stage renal disease (ESRD) are at an elevated risk of developing psychiatric disorders including anxiety and depression due to the complex interplay of physical and psychosocial factors that significantly impact their quality of life. Patients undergoing hemodialysis, a critical life-sustaining treatment, often face physical and psychological symptoms related to membrane bioincompatibility. Additionally, dialysis patients navigate many substantial lifestyle changes, including adhering to strict treatment regimens, enduring frequent dialysis sessions, and coping with a loss of independence and autonomy.
Methods:
To better understand the psychological symptoms experienced by patients during dialysis and their impact on quality of life, our research group conducted a study involving 19 ESRD patients (11 male, 8 female) undergoing dialysis at St. Paul’s Hospital. Participants completed a psychological questionnaire consisting of 20 questions designed to capture their struggles, worries, and emotional challenges related to their health condition. Responses were rated on a 6-point Likert scale ranging from “strongly disagree” to “strongly agree” with higher scores reflecting greater psychological distress, and a maximum possible score of 120. The questions were categorized into three main themes—stress, anxiety, and depression—to provide a detailed exploration of specific psychological symptoms related to dialysis.
Results:
Overall, more than 58% of participants scored over 60 on the psychological questionnaire, with scores ranging from 29 to 102. This suggests that many participants experienced high amounts of psychological distress related to their health and treatment. Major sources of stress included the time-consuming and rigid schedule of treatment, which 73.7% of participants identified as a significant stressor. Furthermore, 63.1% of participants reported difficulty adapting to lifestyle changes, such as job loss and dietary restrictions. With regards to signs of anxiety and depression, many participants experienced significant symptoms: 63.2% reported difficulty sleeping, 46.8% worried about worsening health, and 47.4% felt a loss of independence and control over their lives. Despite these challenges, the majority of participants (68.4%) strongly disagreed with having thoughts of self-harm or ending their life.
Conclusions:
The survey reveals that many ESRD patients face significant challenges in adapting their lifestyle after starting dialysis treatment. Despite the presence of protective factors—such as hopefulness about dialysis, engagement in hobbies, and strong social support—many participants still experienced notable symptoms of stress, anxiety, and depression. The relatively low prevalence of suicidal thoughts among participants may be attributed to these protective factors. However, symptoms of stress, anxiety, and depression still affected a large percentage of the participants and may be exacerbated for patients who do not have the same social supports or protective factors. These findings highlight the importance of providing mental health support for all dialysis patients to help reduce psychological symptoms and improve quality of life.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.