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. 2025 Mar;34(3):978-989.
doi: 10.1111/jocn.17316. Epub 2024 Jun 9.

Influence of self-management, self-efficacy, depression and social support on quality of life in patients undergoing haemodialysis by disease stage in South Korea

Aekyung Chang  1 , Jisoo Kim  1
Affiliations

Influence of self-management, self-efficacy, depression and social support on quality of life in patients undergoing haemodialysis by disease stage in South Korea

Aekyung Chang et al. J Clin Nurs. 2025 Mar.

Abstract

Aim: To investigate the influence of self-management, self-efficacy, depression and social support by disease stage on quality of life in patients undergoing haemodialysis in South Korea.

Design: A cross-sectional survey design was used. Participants completed self-report questionnaires.

Methods: A convenience sample of 409 patients undergoing haemodialysis were recruited to complete self-report questionnaires. T-tests, ANOVA, multiple comparisons with Dunnett's T3 post hoc test, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 25.0.

Results: The crisis stage group had the highest mean quality of life score (M = 83.92). Factors influencing quality of life were social support and depression in the crisis stage and depression, self-efficacy and self-management in the stable stage, explaining 38.5% and 51.5% of the total variation each. In the downward stage, only depression was a significant predictor of quality of life, explaining 55.9% of it.

Conclusion: Long-term intervention to decrease depression regardless of disease stage to improve quality of life in haemodialysis patients is required. Nursing interventions should include increasing social support to promote patients' quality of life in the crisis stage and improving self-efficacy and self-management in the stable stage.

Implications for the profession and/or patient care: Based on quality of life predictors, the development and implementation of patient-centered nursing interventions considering the patient's disease stage can improve haemodialysis patients' quality of life.

Impact: There is minimal research on patients' quality of life considering disease stage. Depression was a significant factor of haemodialysis patients' quality of life in all stages, while social support was significant in the crisis stage and self-efficacy and self-management was significant in the stable stage.

Reporting method: This study was reported according to the STROBE checklist.

Patient or public contribution: Validated interviewer-administered questionnaires were completed by patients undergoing haemodialysis in this study.

Keywords: Haemodialysis; depression; disease progression; quality of life; self‐efficacy; self‐management; social support.

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