Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 51 min ago
Peer-reviewedCC BYFrontiers in psychology

Experiences of moderate-to-severe demoralization syndrome among patients receiving maintenance hemodialysis: a qualitative study

  • Jianfang Bao1
  • Yijia Yin1
  • Xuan Cheng1
  • Xiaoxue Jiang1
  • Binhong Luo1
  • Suping Guo2
  • Jun Xu2
  • Min Qian1
  1. 1School of Nursing, Medical Department, Yangzhou University , , ,
  2. 2Northern Jiangsu People's Hospital , , ,
Read full textPDFDOICite

Abstract

Background

Patients receiving maintenance hemodialysis (MHD) are at high risk of demoralization syndrome (DS), which may adversely affect psychological wellbeing, quality of life, and treatment-related self-management. However, limited qualitative evidence exists regarding their experiences.Aim

To explore the experiences of moderate-to-severe DS among patients receiving MHD, focusing on stressors, psychological and behavioral experiences, coping strategies, and stress-buffering resources.Methods

A descriptive qualitative design guided by the Stress Process Model (SPM) was adopted. Purposive maximum-variation sampling was used to recruit 15 patients receiving MHD with moderate-to-severe DS (DS-II score >9) from a tertiary hospital in China between January and March 2026. Data were collected through semistructured, face-to-face, in-depth interviews. All interviews were audio-recorded and transcribed verbatim, and the transcripts were verified by participants. Data were analyzed using thematic analysis following Braun and Clarke's six-phase framework.Results

Four framework-informed themes and 14 subthemes were identified, corresponding to the major SPM domains of sources of DS, impacts of DS, coping strategies, and stress-buffering resources. Two important distinctions were identified: reduced social participation primarily reflected illness- and treatment-related restrictions, whereas social withdrawal represented a more intentional behavioral response associated with greater demoralization; and apparent acceptance of dialysis sometimes reflected helpless resignation and passive compromise rather than adaptive acceptance.Conclusion

DS among patients receiving MHD reflects a complex process shaped by interacting treatment-related stressors, coping responses, and social support resources. Interventions should aim to reduce modifiable stressors, strengthen adaptive coping and perceived control, and support psychological adaptation, functioning, and meaningful engagement during long-term dialysis.

Related

  1. Nurse-led education for adults receiving maintenance hemodialysis: A scoping review
    Fermata Sari, Elsa Sylvia, Neny Nursahaza +3
    Lentera PerawatPeer-reviewedCC BY-NCFull textGeneral medicineDOAJ
  2. Association of hemodialysis vascular access type with dialysis adequacy and access-related outcomes in patients receiving maintenance hemodialysis.
    Ying Zhu, Jie Zhao, Bing Liu
    Frontiers in medicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Systemic inflammatory response index as an independent predictor of all-cause mortality in patients receiving maintenance hemodialysis: a retrospective cohort study
    Emel Tatlı, Betül Çavuşoğlu Türker, Süleyman Tuna Yolcu +5
    Frontiers in MedicinePeer-reviewedCC BY 4.0Full textGeneral medicinePMC
  4. Predictors of physical performance decline in patients receiving maintenance hemodialysis: a prospective observational study
    Elisângela Andrade Assis Madeira, Joyce Noelly Vitor Santos, Vitória Emanuelli Rodrigues Silva +16
    BMC NephrologyPeer-reviewedCC BYFull textGeneral medicineDOAJ
  5. Mental health literacy in maintenance hemodialysis: a qualitative study on recognition, knowledge fragmentation, and stigma-related help-seeking barriers
    Wenyi Xiao, Chendong Xue, Yingying Che +3
    Frontiers in public healthPeer-reviewedCC BYFull textEpidemiology & public healthEurope PMCCrossref

Cite

BibTeXRIS
BibTeX
@article{bao2026experiences,
  title = {{Experiences of moderate-to-severe demoralization syndrome among patients receiving maintenance hemodialysis: a qualitative study}},
  author = {Jianfang Bao and Yijia Yin and Xuan Cheng and Xiaoxue Jiang and Binhong Luo and Suping Guo and Jun Xu and Min Qian},
  journal = {Frontiers in psychology},
  year = {2026},
  month = oct,
  doi = {10.3389/fpsyg.2026.1931026},
  url = {https://europepmc.org/article/PMC/PMC13716865},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Experiences of moderate-to-severe demoralization syndrome among patients receiving maintenance hemodialysis: a qualitative study
AU  - Jianfang Bao
AU  - Yijia Yin
AU  - Xuan Cheng
AU  - Xiaoxue Jiang
AU  - Binhong Luo
AU  - Suping Guo
AU  - Jun Xu
AU  - Min Qian
PY  - 2026
DA  - 2026/10/15
JO  - Frontiers in psychology
DO  - 10.3389/fpsyg.2026.1931026
UR  - https://europepmc.org/article/PMC/PMC13716865
AB  - Background  Patients receiving maintenance hemodialysis (MHD) are at high risk of demoralization syndrome (DS), which may adversely affect psychological wellbeing, quality of life, and treatment-related self-management. However, limited qualitative evidence exists regarding their experiences.Aim  To explore the experiences of moderate-to-severe DS among patients receiving MHD, focusing on stressors, psychological and behavioral experiences, coping strategies, and stress-buffering resources.Methods  A descriptive qualitative design guided by the Stress Process Model (SPM) was adopted. Purposive maximum-variation sampling was used to recruit 15 patients receiving MHD with moderate-to-severe DS (DS-II score >9) from a tertiary hospital in China between January and March 2026. Data were collected through semistructured, face-to-face, in-depth interviews. All interviews were audio-recorded and transcribed verbatim, and the transcripts were verified by participants. Data were analyzed using thematic analysis following Braun and Clarke's six-phase framework.Results  Four framework-informed themes and 14 subthemes were identified, corresponding to the major SPM domains of sources of DS, impacts of DS, coping strategies, and stress-buffering resources. Two important distinctions were identified: reduced social participation primarily reflected illness- and treatment-related restrictions, whereas social withdrawal represented a more intentional behavioral response associated with greater demoralization; and apparent acceptance of dialysis sometimes reflected helpless resignation and passive compromise rather than adaptive acceptance.Conclusion  DS among patients receiving MHD reflects a complex process shaped by interacting treatment-related stressors, coping responses, and social support resources. Interventions should aim to reduce modifiable stressors, strengthen adaptive coping and perceived control, and support psychological adaptation, functioning, and meaningful engagement during long-term dialysis.
SN  - 1664-1078
ER  -