Loneliness in Older Adults Receiving Hemodialysis and Associated Factors: A Cross-Sectional Study

BACKGROUND: The number of patients with end-stage renal disease (ESRD) in Taiwan continues to rise steadily, and hemodialysis is the primary treatment for these patients. More than 50% of patients on hemodialysis are over 65 years of age, indicative of an aging patient population. Changes in lifestyle, dietary habits, and social roles after commencing hemodialysis easily cause patients to feel uncertain, depressed, and/or lonely. However, a limited number of studies have examined the issue of loneliness among older adults on hemodialysis. PURPOSE: This study was designed to better understand loneliness and its associated factors among older patients receiving hemodialysis. METHODS: A cross-sectional research design with convenience sampling was employed with a total of 146 patients. Eligible participants aged 65 years or older and receiving hemodialysis for more than 3 months were recruited from two hospitals in northern Taiwan. Structured questionnaires, including a demographic characteristics questionnaire, the Hemodialysis Patient Fatigue Scale, Social Support Scale, and UCLA Loneliness Scale version 3, were used to collect data. RESULTS: The mean loneliness score was 41.5 out of a maximum of 80. A significant positive relationship was found between fatigue and loneliness, and a significant negative relationship was found between social support and loneliness. Gender, fatigue, and social support were identified as predictors of loneliness. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results indicate that older patients receiving hemodialysis have a moderate level of loneliness. Based on the identified predictors, nurses should pay particular attention to patients who are female, are experiencing a higher fatigue level, and/or have lower social support. Future studies may use these results to develop strategies for preventing and improving loneliness among older adults receiving hemodialysis.