Self-Management of Chronic Illness in Patients Undergoing Hemodialysis: The Role of Individual Factors and Adaptation to Illness.

BACKGROUND: Chronic kidney disease adversely affects quality of life and requires continuous self-management. OBJECTIVE: This study examined the effects of adaptation to chronic illness and individual characteristics on self-management in patients undergoing hemodialysis. METHODS: This descriptive, cross-sectional study was conducted between June and August 2024 with 348 patients undergoing hemodialysis at a university hospital in the Mediterranean region of Turkey. Data collected included demographics, the Adaptation to Chronic Illness Scale, and the Chronic Disease Self-Management Scale. Relationships between dimensions of illness adaptation (physical, social, and psychological) and self-management components (self-stigma, coping with stigma, healthcare effectiveness, and treatment adherence) were examined using correlation and regression analyses. RESULTS: Significant associations were identified between dimensions of illness adaptation (physical, social, and psychological) and self-management components among patients undergoing hemodialysis. Self-stigma was negatively associated with all adaptation dimensions (r = -0.181 to -0.338; P < .001). In contrast, healthcare effectiveness showed moderate positive associations, particularly with physical and psychological adaptation (r = 0.355-0.429; P < .001). Coping with stigma and treatment adherence were positively associated with adaptation, although these relationships were weaker and varied across dimensions (r = 0.153-0.260; P < 01). Robust regression analyses showed all models were significant (F = 6.121-24.187; P < .001; R2 = 0.158-0.182), and education level, illness-related education, having children, and engagement in non-work activities predicted self-management (β = -0.50 to 0.44; P < 0.05). CONCLUSIONS: Physical, psychological, and social adaptation to chronic illness is significantly associated with self-management among patients undergoing hemodialysis, suggesting that holistic nursing approaches that emphasize patient education and engagement in daily activities may enhance self-management behaviors.