Association rules of social alienation in maintenance hemodialysis patients: an Apriori algorithm analysis and intervention strategies.

INTRODUCTION

Social alienation significantly impacts maintenance hemodialysis (MHD) patients. This study aimed to identify key factors associated with social alienation in MHD patients using association rule mining to inform interventions.

METHODS

A cross-sectional study enrolled 250 MHD patients from 11 centers (March-April 2025). Social alienation was assessed using the General Alienation Scale (GAS). Sociodemographic, clinical, and treatment variables were analyzed using the Apriori algorithm with thresholds: support ≥ 30%, confidence ≥ 50%, lift > 1.

RESULTS

Among participants, 49.2% (n = 123) reported social alienation. Seven strong association rules were identified. Key combinations included: Urban employee insurance + thrice-weekly dialysis (support 58.8%, confidence 54.4%); Male + urban employee insurance + thrice-weekly dialysis (support 36.8%, confidence 54.4%); Age 36-50 + Han ethnicity (support 31.2%, confidence 56.4%). A dialysis treatment plan of 4-5 h per week for three times, middle-aged working patients, and limited support were prominent risk factors.

CONCLUSION

Social alienation in MHD patients is multifactorial. Interventions should include flexible dialysis scheduling, multidisciplinary psychosocial support, and community networks. Policy reforms addressing insurance-related employment stress are needed. Data-driven strategies enhance chronic disease management.