THE IMPACT OF SYMPTOMS EXPERIENCED BY PATIENTS UNDERGOING HEMODIALYSIS TREATMENT ON THEIR QUALITY OF LIFE: A CROSS-SECTIONAL STUDY FROM PALESTINE
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Date
2025-08-18
Authors
Attoun, Alaa
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Publisher
An-Najah National University
Abstract
Background: The present study aimed to evaluate the extent to which physical and psychological symptoms associated with hemodialysis treatment influence patients’ self-efficacy in managing their chronic illness, as well as the overall impact of these symptoms on their quality of life.
Methods: A cross-sectional study design was performed to investigate the research objectives. Data were collected from hemodialysis patients at selected centers in the West Bank, Palestine, including An-Najah National University Hospital in Nablus and Al-Hussein Government Hospital in Beit Jala. The physical and psychological symptoms experienced by patients were measured using the Dialysis Symptom Index (DSI). Self-efficacy in managing chronic illness was evaluated using the Self-Efficacy for Managing Chronic Disease 6-Item Scale, while health-related quality of life was assessed through the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument and the EQ Visual Analog Scale (EQ-VAS).
Results: In this study, a total of 306 hemodialysis patients were included. The mean age of the patients was 58.1 ± 13.3 years. In multivariable models, higher self-efficacy was predicted by lower BMI, urban residence, living with family, and higher education (p < 0.001 for BMI, place of residence and education; living conditions p = 0.001). Lower self-efficacy was predicted by diabetes (p < 0.001), constipation (p < 0.001), chest pain (p < 0.001), depression (p < 0.001), difficulty with sexual arousal (p < 0.001), more hemodialysis sessions per week (p < 0.001) and longer session length (p = 0.001); marital status also showed an association (p = 0.006). Mobility, self-care problems, anxiety/depression and low health ratings were additional significant negative predictors of self-efficacy (all p < 0.001). Similarly, the mean health rating of the patients was 60.3 ± 18.3. Higher self-efficacy can be significantly predicted by having a healthy weight, living in urban areas, living with family, and having higher education (p value < 0.05).
Conclusions: The results highlight the importance of addressing both the clinical and psychosocial components of patient treatment to improve both patients’ sense of self-efficacy and their physical and mental health.