Current Status and Determinants of Fatigue in Chinese Older Adults Receiving Maintenance Hemodialysis: A Multicentre...

Fatigue is highly prevalent in older adults receiving maintenance hemodialysis and seriously affects quality of life. However, evidence on the current status of fatigue and its determinants in this population remains scarce, especially in the unique socio-cultural context of China.

A multicenter cross-sectional study to investigate the current status of fatigue and analyze associated factors in Chinese older adults receiving maintenance hemodialysis to provide information for targeted interventions.

This multicenter cross-sectional study was conducted between July 2024 and February 2025. A convenience sampling method was used to recruit 279 older adults receiving maintenance hemodialysis from two tertiary hospitals in Wuxi City. The Revised Piper Fatigue Scale, the Self-Efficacy in Chronic Disease Scale, the Index of Family Caring Scale, the Medical Coping Scale, the Anxiety Self-Rating Scale, and the Depression Self-Rating Scale were used to assess fatigue and related factors. Influential factors were analyzed by t-test, Pearson correlation, and multiple linear regression.

The prevalence of fatigue was 80.3%, and multiple linear regression showed: dialysis vintage ≥5 years (β=0.092, P<0.05), self-efficacy (β=-0.309, P<0.001), family care (β=-0.212, P<0.001), confrontation coping style (β=-0.194, P<0.001), avoidance coping style (β= 0.090, P<0.01), depression (β=0.104, P<0.05), hemoglobin (β=-0.083, P<0.05), and serum albumin (β=-0.075, P<0.05) were independent determinants on fatigue.

Fatigue is a prominent and serious problem in Chinese older adults receiving maintenance hemodialysis, which is influenced by a combination of physical, psychological, and social factors. Based on the determinants identified, targeted interventions should prioritize enhancing self-efficacy through structured education and skill-building programs, strengthening family support systems via family empowerment models, and promoting adaptive coping strategies through cognitive-behavioral techniques. There is an urgent need to incorporate fatigue into routine clinical monitoring and implement such individualized management to improve quality of life and prognosis.