Exploring the Lived Experiences of Patients Undergoing Hemodialysis: A Qualitative Study

Abstract

Background: End-stage kidney disease (ESKD) requires hemodialysis or transplantation, both of which substantially limit patients’ physical, mental, and social functioning, thereby reducing their quality of life. Although previous studies have extensively documented the physical burden and clinical outcomes of hemodialysis, patients’ subjective lived experiences and daily challenges remain underexplored. Objectives: This study aimed to explore the lived experiences of patients with kidney failure undergoing hemodialysis and to understand the psychological, social, and existential challenges associated with long-term treatment. Methods: This qualitative study, using a conventional qualitative content analysis approach, was conducted between 2023 and 2024 at the Dialysis Center of Imam Reza Educational and Medical Hospital in Kermanshah, Iran. Eighteen patients with end-stage renal disease undergoing hemodialysis were recruited through purposive sampling. Data were collected through semi-structured, face-to-face interviews and analyzed according to the approach of Graneheim and Lundman (1). Results: A total of 18 participants (mean age, 57.33 years; mean duration of dialysis, 46 ± 11 months) participated in the study. Qualitative content analysis identified four main themes and nine subthemes: Living Under the Shadow of Lifelong Treatment (Subthemes: Physical and Functional Impairment, Psychological Distress, Mobility and Travel Restriction); Navigating Illness Through Family Bonds (Subthemes: Patient Care and Support, Family Attitudes Toward the Disease); Struggling Within an Unsupportive Healthcare System (Subthemes: Quality of Hospital Services, Financial Burden and Insurance Limitations); and The Burdensome Duty of Self-Management (Subthemes: Nutritional Adherence, Medication Adherence Challenges). These findings illustrate the multifaceted difficulties patients encounter during the treatment process. Conclusions: Our findings indicate that patients undergoing hemodialysis experience substantial challenges, including physical limitations, psychological distress, and systemic barriers within healthcare systems. To improve patient outcomes, comprehensive care models should extend beyond clinical management to incorporate psychosocial support, family-centered interventions, and improved access to healthcare services. Addressing these multidimensional challenges is essential for promoting better adaptation and quality of life among patients receiving hemodialysis.