The Relationship between Fatigue, and Pruritus with the Quality of Life of HemodialysisPatients: A Model with a Concept of Treatment Adherence

Introduction: Hemodialysis often leads to various complications and symptoms that can significantly impactthe patient's quality of life. The purpose of this study was to examine the relationship between fatigue, andPruritus with the quality of life (QOL) of hemodialysis patients, while also considering the influence oftreatment adherence.Methods: This study employed a predictive correlational, and cross-sectional design on ۴۱۱ patients in ۲۰۲۳.Participants were selected from multiple dialysis centers in Iran (Amol and Sari) by convenience samplingmethod to respond to questions on demographic characteristics and items to measure the variables in the researchmodel by using FAS, PSS-۱۲, GR-SMAQ-HD, and SF-۱۲ tools. AMOS (v۲۷), RStudio (۲۰۲۳), and SPSS (v۲۶)software were utilized for all study analyses. Covariance-based structural equation modeling (SEM) was usedto assess the measurement and mediation models.Results: The structural model and hypothesis testing results showed that all hypotheses were supported in thisstudy. The study found that fatigue (r = -۰.۷۹۸, p-value < ۰.۰۰۱), and Pruritus (r = -۰.۵۶۳, p-value < ۰.۰۰۱) werethe significant negatively correlated with the QOL of hemodialysis patients and the significant Positiverelationship between Treatment Adherence and QOL (r = ۰.۵۶۸, p-value < ۰.۰۰۱). Patients experiencing higherlevels of fatigue, Pruritus, and thirst distress reported lower scores on various domains of the SF-۱۲questionnaire, including physical functioning, mental health, and overall QOL. Furthermore, treatmentadherence partially mediated the relationship between these symptoms and QOL. This means that treatmentadherence helped to buffer the negative effects of these symptoms on QOL. The mediation model explained۶۸.۵% of the total variance of QOL.Conclusion: This study highlights the significant impact of fatigue, and Pruritus on the quality of life ofhemodialysis patients. Importantly, treatment adherence was found to attenuate the negative effects of thesesymptoms on quality of life, emphasizing the importance of adherence in managing the impact of symptomsand optimizing patient outcomes. Healthcare providers should prioritize interventions aimed at improvingtreatment adherence, as it can significantly alleviate fatigue and Pruritus leading to enhanced quality of life inthis population. Further research is warranted to explore effective strategies to enhance treatment adherence andmitigate symptom burden in this population

کلیدواژه ها:

Fatigue ، Pruritus ، Quality of life ، Hemodialysis patients ، Treatment Adherence