Predictors of psychosocial adaptation in haemodialysis patients according to haemodialysis vintage: a quantitative study

Haemodialysis (HD) patients face difficulties adapting to the drastic life changes associated with their treatment, emphasising the crucial role of psychosocial adaptation in improving long-term health outcomes. The level of psychosocial adaptation and its predictors are different according to the duration of HD therapy. The objective was to compare the predictors of psychosocial adaptation in HD patients based on the duration of haemodialysis, with a reference point of one year since initiating HD. A comparative cross-sectional survey design was used. Patients from one outpatient and four community-based haemodialysis centres in South Korea completed a paper-based survey during their dialysis admission. The survey included self-report questionnaires on psychosocial adaptation, depression, perceived social support, dialysis-related symptoms, and self-management. The adaptation score of short-term patients was below the average and lower than that of long-term patients. The predictors of adaptation were dialysis symptoms, social support, depression, and self-management for short-term patients, and depression and self-management for long-term patients. The findings highlight the need for interventions that address depression and promote self-management in HD patients, regardless of the duration of HD. Strategies aimed at increasing social support and effectively managing dialysis-related symptoms should also be considered, particularly for short-term patients within one year of initiating HD. Based on the identified predictors of adaptation in this study, tailored nursing interventions that effectively promote adaptation, consideringthe duration of the patient's HD, should be developed, and implemented in clinical practice.