Self-Management of Chronic Illness in Patients Undergoing Hemodialysis: The Role of Individual Factors and Adaptation to Illness.

BACKGROUND

Chronic kidney disease adversely affects quality of life and requires continuous self-management.

OBJECTIVE

This study examined the effects of adaptation to chronic illness and individual characteristics on self-management in patients undergoing hemodialysis.

METHODS

This descriptive, cross-sectional study was conducted between June and August 2024 with 348 patients undergoing hemodialysis at a university hospital in the Mediterranean region of Turkey. Data collected included demographics, the Adaptation to Chronic Illness Scale, and the Chronic Disease Self-Management Scale. Relationships between dimensions of illness adaptation (physical, social, and psychological) and self-management components (self-stigma, coping with stigma, healthcare effectiveness, and treatment adherence) were examined using correlation and regression analyses.

RESULTS

Significant associations were identified between dimensions of illness adaptation (physical, social, and psychological) and self-management components among patients undergoing hemodialysis. Self-stigma was negatively associated with all adaptation dimensions (r = -0.181 to -0.338; P < .001). In contrast, healthcare effectiveness showed moderate positive associations, particularly with physical and psychological adaptation (r = 0.355-0.429; P < .001). Coping with stigma and treatment adherence were positively associated with adaptation, although these relationships were weaker and varied across dimensions (r = 0.153-0.260; P < 01). Robust regression analyses showed all models were significant (F = 6.121-24.187; P < .001; R2 = 0.158-0.182), and education level, illness-related education, having children, and engagement in non-work activities predicted self-management (β = -0.50 to 0.44; P < 0.05).

CONCLUSIONS

Physical, psychological, and social adaptation to chronic illness is significantly associated with self-management among patients undergoing hemodialysis, suggesting that holistic nursing approaches that emphasize patient education and engagement in daily activities may enhance self-management behaviors.