“This Is Fate! Nothing We Can Do to Change It”: Triggers of Learned Helplessness Among Patients in Maintenance Hemodialysis – A Qualitative Study

As the global population of patients undergoing maintenance hemodialysis continues to grow, more than half are experiencing the psychological distress associated with learned helplessness, a condition potentially linked to adverse outcomes such as depression and suicidal ideation. However, the triggers contributing to learned helplessness in these patients remain poorly understood. This study employs an interpretative phenomenological approach to explore the experiences and triggers of learned helplessness among 26 maintenance hemodialysis patients across five hospitals in China. The analysis of participants' narratives reveals that learned helplessness in these patients is influenced by a combination of physiological, psychological, and social factors. Physical discomfort and psychological changes contribute to their sense of helplessness. Despite seeking support from family and healthcare providers, their distress often goes unnoticed. Additionally, the social stigma of being perceived as a "special group" further exacerbates their learned helplessness. Based on the findings, the following recommendations are provided to effectively mitigate learned helplessness: Healthcare professionals must reduce symptom burden, provide psychological assessment and support, and assist in rebuilding positive patient cognition. It is also crucial to enhance connections between patients, their families, and social support groups, reduce misunderstandings and stigmatization, and strengthen community support systems.