Lived Experiences of Hemodialysis Patients in Sustaining Quality of Life: A Phenomenological Study
DOI:
https://doi.org/10.70716/mohr.v4i3.664Keywords:
hemodialysis, quality of life, chronic kidney disease, lived experience, coping strategiesAbstract
The increasing prevalence of chronic kidney disease requiring hemodialysis highlights the importance of understanding patients’ experiences in maintaining quality of life during long-term treatment. Hemodialysis imposes substantial physical, psychological, social, and spiritual challenges that require continuous adaptation. This study aimed to explore the lived experiences of hemodialysis patients in maintaining quality of life. A qualitative study with a phenomenological approach was conducted involving 13 hemodialysis patients selected through purposive sampling. Data were collected through in-depth interviews and analyzed using Interpretative Phenomenological Analysis (IPA). Trustworthiness was ensured through member checking and systematic thematic interpretation. Three major themes emerged: (i) lived experiences and changes in the meaning of life, including initial reactions of shock, fear, denial, and eventual acceptance of hemodialysis; (ii) coping strategies and social support during treatment, encompassing personal coping mechanisms, family and social support, and spirituality as a source of resilience; and (iii) perceptions of quality of life and future expectations, highlighting subjective interpretations of well-being and aspirations to remain healthy, independent, and meaningful in daily life. The findings revealed that hemodialysis patients sustained their quality of life through a dynamic process of adaptation. This process involved managing physical challenges, developing psychological resilience, maintaining supportive social relationships, and strengthening spiritual beliefs, all of which contributed to their overall well-being.
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Agarwal, P., Garg, V., Karagaiah, P., Szepietowski, J. C., Grabbe, S., & Goldust, M. (2021). Chronic kidney disease-associated pruritus. Toxins, 13(8), 527. https://doi.org/10.3390/toxins13080527
Antari, G. A. A., & Widyanthari, D. M. (2020). Symptom burden and health-related quality of life in hemodialysis patients. Enfermería Clínica, 30(Suppl. 2), 117–120. https://doi.org/10.1016/j.enfcli.2020.07.024
Asih, E. Y., & Aji, Y. G. T. (2022). Gambaran Kualitas Hidup Pasien Dengan Penyakit Ginjal Kronik Yang Menjalani Hemodialisis Di RSAU dr. Esnawan Antariksa. Jurnal Kesehatan Mahardika, 9(2), 29-36. https://doi.org/10.54867/jkm.v9i2.123
Atta, M. H. R., Hammad, H. A.-H., & Elzohairy, N. W. (2024). The role of empathy in the relationship between emotional support and caring behavior toward patients among intern nursing students. BMC Nursing, 23(1), 443. https://doi.org/10.1186/s12912-024-02074-w
Attoun, A. S., Abuhalima, D., Al-Jabi, S. W., & Zyoud, S. H. (2025). Impact of symptom burden clusters on self-efficacy and quality of life in hemodialysis patients: A multicenter cross-sectional study. Scientific Reports, 15(1), 37424. https://doi.org/10.1038/s41598-025-21174-4
Bonilla Sierra, P., Pérez-Jiménez, J. M., Espinoza Quezada, D. P., Lucchetti, G., & De-Diego-Cordero, R. (2025). Association between religious/spiritual coping and quality of life among hemodialysis patients in Ecuador. Frontiers in Public Health, 13, Article 1510329. https://doi.org/10.3389/fpubh.2025.1510329
Bosi, A., Xu, Y., Gasparini, A., Wettermark, B., Barany, P., Bellocco, R., Inker, L. A., Chang, A. R., McAdams-DeMarco, M., Grams, M. E., Shin, J.-I., & Carrero, J. J. (2022). Use of nephrotoxic medications in adults with chronic kidney disease in Swedish and US routine care. Clinical Kidney Journal, 15(3), 442–451. https://doi.org/10.1093/ckj/sfab210
Chen, C., Zhu, Y., Sun, Y., & Que, M. (2025). The relationship between social support and interpersonal self-efficacy among higher vocational college students: Parallel mediation effects of anxiety and loneliness. BMC Psychology, 13(1), 102. https://doi.org/10.1186/s40359-025-02418-4
Davison, S., Wearne, N., Bagasha, P., & Krause, R. (2023). Conservative kidney management and kidney supportive care: Essential treatments for kidney failure. Medical Research Archives, 11(8). https://doi.org/10.18103/mra.v11i8.4222
Erpiyana, R., Djamaludin, D., & Andoko, A. (2024). Perbandingan kualitas tidur pasien gagal ginjal kronik dengan komorbid hipertensi dan diabetes mellitus yang menjalani hemodialisa di Rumah Sakit Pertamina Bintang Amin Bandar Lampung. Malahayati Nursing Journal, 6(5), 2024–2035. https://doi.org/10.33024/mnj.v6i5.11070
Fadlalmola, H. A., & Elkareem, E. M. A. (2020). Impact of an educational program on knowledge and quality of life among hemodialysis patients in Khartoum State. International Journal of Africa Nursing Sciences, 12, 100205. https://doi.org/10.1016/j.ijans.2020.100205
Farooq, F. N., Nayak, A., Kumar, K, V., Natarajan, S., Pai, S., & Mascarenhas, R. (2025). Bridging the gap: Essential factors for poststroke community reintegration in low- and middle-income countries. PLOS ONE, 20(12), e0336517. https://doi.org/10.1371/journal.pone.0336517
Fletcher, B. R., Damery, S., Aiyegbusi, O. L., Anderson, N., Calvert, M., Cockwell, P., Ferguson, J., Horton, M., Paap, M. C. S., Sidey-Gibbons, C., Slade, A., Turner, N., & Kyte, D. (2022). Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLOS Medicine, 19(4), e1003954. https://doi.org/10.1371/journal.pmed.1003954
Foreman, K. J., Marquez, N., Dolgert, A., Fukutaki, K., Fullman, N., McGaughey, M., Pletcher, M. A., Smith, A. E., Tang, K.-W., Yuan, C.-W., Brown, J. C., Friedman, J., He, J., Heuton, K. R., Holmberg, M., Patel, D. J., Reidy, P., Carter, A., Cercy, K., ... Murray, C. J. L. (2018). Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: Reference and alternative scenarios for 2016–2040 for 195 countries and territories. The Lancet, 392(10159), 2052–2090. https://doi.org/10.1016/S0140-6736(18)31694-5
GBD 2021 Chronic Kidney Disease Collaborators. (2024). Global, regional, and national burden of chronic kidney disease, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 404(10454), 847–866. https://doi.org/10.1016/S0140-6736(24)01272-1
Gebrie, M. H., Asfaw, H. M., Bilchut, W. H., Lindgren, H., & Wettergren, L. (2023). Health-related quality of life among patients with end-stage renal disease undergoing hemodialysis in Ethiopia: A cross-sectional survey. Health and Quality of Life Outcomes, 21(1). https://doi.org/10.1186/s12955-023-02117-x
Hajdarevic, S., Norberg, A., Lundman, B., & Hörnsten, Å. (2025). Becoming whole again: Caring for the self in chronic illness: A narrative review of qualitative empirical studies. Journal of Clinical Nursing, 34(3), 754–771. https://doi.org/10.1111/jocn.17332
Hu, H., Liu, X., Chau, P. H., & Choi, E. P. H. (2022). Effects of intradialytic exercise on health-related quality of life in patients undergoing maintenance haemodialysis: A systematic review and meta-analysis. Quality of Life Research, 31(7), 1915–1932. https://doi.org/10.1007/s11136-021-03025-7
Jager, K. J., Kovesdy, C., Langham, R., Rosenberg, M., Jha, V., & Zoccali, C. (2019). A single number for advocacy and communication: Worldwide more than 850 million individuals have kidney diseases. Kidney International, 96(5), 1048–1050. https://doi.org/10.1016/j.kint.2019.07.012
Kementerian Kesehatan Republik Indonesia. (2021). Profil kesehatan Indonesia tahun 2021. Kementerian Kesehatan Republik Indonesia.
Kidney Disease: Improving Global Outcomes. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4 Suppl.), S117–S314. https://doi.org/10.1016/j.kint.2023.10.018
Kim, S., & Jeong, H. (2021). Effects of patient-selected music listening on the pain and anxiety of patients undergoing hemodialysis: A randomized controlled trial. Healthcare, 9(11), 1437. https://doi.org/10.3390/healthcare9111437
Li, C., Hsieh, C., Shih, Y., & Lin, Y. (2021). Spiritual well-being of patients with chronic renal failure: A cross-sectional study. Nursing Open, 8(5), 2461–2469. https://doi.org/10.1002/nop2.1004
Li, X., Gao, W., Yu, J., Mao, Y., Gu, H., Li, F., & Ren, D. (2024). Mental health and quality of life in chronic kidney disease patients with mild-to-moderate depression: A retrospective cohort study of mindfulness-based stress reduction therapy. Actas Españolas de Psiquiatría, 52(2), 138–148. https://doi.org/10.62641/aep.v52i2.1600
Liu, H.-H., Wu, C.-L., Chiang, Y.-C., Tsai, K.-H., Chu, T.-L., & Hsiao, Y.-C. (2024). Religion and spiritual health in patients with and without depression receiving hemodialysis: A cross-sectional correlational study. Journal of Nursing Research, 32(1), e309. https://doi.org/10.1097/JNR.0000000000000592
Machin, L. (2026). The range of response to loss: An innovative theory of grief and a framework for use in practice and research. Frontiers in Psychology, 17, Article 1656741. https://doi.org/10.3389/fpsyg.2026.1656741
Michaelsen, M. M., & Esch, T. (2023). Understanding health behavior change by motivation and reward mechanisms: A review of the literature. Frontiers in Behavioral Neuroscience, 17, Article 1151918. https://doi.org/10.3389/fnbeh.2023.1151918
Miller, M., Meyers, M., Krainak, K., & Lewis, S. P. (2025). Interventions to support spirituality among adults with cancer: A scoping review. Supportive Care in Cancer, 33(8), 742. https://doi.org/10.1007/s00520-025-09787-x
Pawar, Y. S., Gattani, V. S., Chaudhari, K. S., Chheda, B., & Vankudre, A. J. (2023). Impact of hemodialysis on sleep disorders in patients with end-stage renal disease in a tertiary care academic hospital. Cureus, 15, e44416. https://doi.org/10.7759/cureus.44416
Perhimpunan Nefrologi Indonesia. (2022). 13th report of Indonesian renal registry (IRR) 2020/2021. PERNEFRI.
Phyo, A. Z. Z., Freak-Poli, R., Craig, H., Gasevic, D., Stocks, N. P., Gonzalez-Chica, D. A., & Ryan, J. (2020). Quality of life and mortality in the general population: A systematic review and meta-analysis. BMC Public Health, 20, 1596. https://doi.org/10.1186/s12889-020-09639-9
Priatna, H., Danismaya, I., Safariyah, E., & Hamzah, A. (2025). Hubungan dukungan keluarga dengan kepatuhan pasien yang menjalani program perawatan hemodialisis di RSUD Jampangkulon. Malahayati Nursing Journal, 7(10), 4531–4541. https://doi.org/10.33024/mnj.v7i10.20656
Rambod, M., Pasyar, N., & Parviniannasab, A. M. (2023). A qualitative study on hope in Iranian end-stage renal disease patients undergoing hemodialysis. BMC Nephrology, 24(1), 281. https://doi.org/10.1186/s12882-023-03336-6
Religioni, U., Barrios-Rodríguez, R., Requena, P., Borowska, M., & Ostrowski, J. (2025). Enhancing therapy adherence: Impact on clinical outcomes, healthcare costs, and patient quality of life. Medicina, 61(1), 153. https://doi.org/10.3390/medicina61010153
Rhee, C. M., Edwards, D., Ahdoot, R. S., Burton, J. O., Conway, P. T., Fishbane, S., Gallego, D., Gallieni, M., Gedney, N., Hayashida, G., Ingelfinger, J., Kataoka-Yahiro, M., Knight, R., Kopple, J. D., Kumarsawami, L., Lockwood, M. B., Murea, M., Page, V., Sanchez, J. E., ... Kalantar-Zadeh, K. (2022). Living well with kidney disease and effective symptom management: Consensus conference proceedings. Kidney International Reports, 7(9), 1951–1963. https://doi.org/10.1016/j.ekir.2022.06.015
Romagnani, P., Agarwal, R., Chan, J. C. N., Levin, A., Kalyesubula, R., Karam, S., Nangaku, M., Rodríguez-Iturbe, B., & Anders, H.-J. (2025). Chronic kidney disease. Nature Reviews Disease Primers, 11(1), 8. https://doi.org/10.1038/s41572-024-00589-9
Sandy, G., Hanif, M. F., Bur, A. N. I., Maulidianti, A. N., Adizah, A., & Mananna, N. (2022). Pengaruh hope terhadap illness behavior pada pasien penyakit kronis. Syntax Literate: Jurnal Ilmiah Indonesia, 7(2), 2469–2478. https://doi.org/10.36418/syntax-literate.v7i2.6296
Simorangkir, R., Andayani, T. M., & Wiedyaningsih, C. (2021). Faktor-faktor yang berhubungan dengan kualitas hidup pasien penyakit ginjal kronis yang menjalani hemodialisis. Jurnal Farmasi dan Ilmu Kefarmasian Indonesia, 8(1), 83–90. https://doi.org/10.20473/jfiki.v8i12021.83-90
Sofyan, H., Ardesfira, G., Kesuma, Z. M., Marzuki, M., Andala, S., Wahyuni, L., & Marthoenis, M. (2025). A cross-sectional study of the impact of knowledge, medication adherence, and illness acceptance on the quality of life in hypertensive patients. The Open Public Health Journal, 18(1). https://doi.org/10.2174/0118749445383991250411050811
Stanisławski, K. (2019). The coping circumplex model: An integrative model of the structure of coping with stress. Frontiers in Psychology, 10, 694. https://doi.org/10.3389/fpsyg.2019.00694
Sulistyaningsih, D. R., Nurachmah, E., Yetti, K., & Hastono, S. P. (2021). Nurses' experience in improving adherence to fluid intake and diet in hemodialysis patients. Enfermería Clínica, 31(Suppl. 1), S20–S23. https://doi.org/10.1016/j.enfcli.2020.10.008
Tuot, D. S., Zhu, Y., Velasquez, A., Espinoza, J., Mendez, C. D., Banerjee, T., ... Powe, N. R. (2016). Variation in patients' awareness of chronic kidney disease according to how they are asked. Clinical Journal of the American Society of Nephrology, 11(9), 1566–1573. https://doi.org/10.2215/CJN.00490116
Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coates, M. M., Dandona, L., Dicker, D. J., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Foreman, K., Forouzanfar, M. H., Fraser, M. S., ... Murray, C. J. L. (2016). Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1459–1544. https://doi.org/10.1016/S0140-6736(16)31012-1
Warner, L. M., Ziegelmann, J. P., Schüz, B., Wurm, S., Tesch-Römer, C., & Schwarzer, R. (2011). Maintaining autonomy despite multimorbidity: Self-efficacy and the two faces of social support. European Journal of Ageing, 8(1), 3–12. https://doi.org/10.1007/s10433-011-0176-6
World Health Organization. (2022). Kidney health and kidney disease. World Health Organization.
Zhang, J., Zou, J., Wang, X., Luo, Y., Zhang, J., Xiong, Z., & Zhang, J. (2023). Clinical nurses' compassion fatigue psychological experience process: A constructivist grounded theory study. BMC Nursing, 22(1), 487. https://doi.org/10.1186/s12912-023-01665-3
Zhu, Y., Cai, N., Wang, Z., Li, J., Guo, T., He, J., Wang, H., Chen, J., Zhang, F., Huang, S., & Ren, Y. (2026). Perceived social support and psychosocial adaptation in patients with chronic skin diseases: The mediating role of self-disclosure. Frontiers in Psychiatry, 16, Article 1731560. https://doi.org/10.3389/fpsyt.2025.1731560
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