Factors Associated With Self-Care Among Patients Receiving Hemodialysis: A Cross-Sectional Observational Study

The global increase in prevalence of individuals with end-stage renal disease is a rising concern. Self-care is an essential and important component of chronic disease management. Poor self-care in patients receiving hemodialysis is associated with an increased risk of mortality and hospitalization. This study aimed to identify predictive factors for self-care in patients receiving hemodialysis based on a middle-range theory of self-care for chronic illness.

Adult patients with end-stage renal disease receiving hemodialysis were recruited at an artificial kidney unit in a general hospital. Data from 131 patients were analyzed. Self-report questionnaires assessed hemodialysis-related knowledge, health motivation, self-efficacy, social support, access to care, and self-care.

Participants who had a family caregiver showed significantly higher selfcare scores than those who did not, and self-care scores were higher in patients who reported hypertension as a causal disease of end-stage renal disease than in those who did not. Self-care was significantly correlated with knowledge, health motivation, self-efficacy, social support, and access to care. The study's regression model showed that self-efficacy, health motivation, and knowledge were predictive variables influencing self-care, and the explanatory power of this model was 55.9%.

The results support the middle-range theory of self-care for chronic illness. Strategies and education to improve self-efficacy, health motivation, and knowledge must be incorporated when designing self-care programs. Nursing interventions that patients can participate in with their family members might facilitate improving self-care.