Fatigue, Loneliness, and Self-Care under Hemodialysis

Table of Contents

Research Proposal

Title of the study: Relationship between levels of fatigue, loneliness, and self-care among patients Undergoing Hemodialysis


Hemodialysis plays a significant role in improving the quality of life in patients with end-stage renal disease. In most cases, patients encounter challenges during the procedure. These challenges include bodily changes, reliance on the HD machine as well as emotive problems such as apprehension and nervousness. The procedure also interferes with their societal roles and duties (Kauric-Klein, 2012). Recent times have seen a tremendous increase in the number of “practitioners encountering increasing numbers of older patients with end-stage renal disease (ESRD) who require renal replacement therapy” (Kara, 2009, p. 19). It is necessary to find out whether the use of nurse-guided procedures in hemodialysis settings yields similar have outcomes with physician-driven tactics in the management of anemia. Understanding this relationship provides useful information on improving the value of the life of patients in the final stages of kidney disease. It emphasizes the need for nurse practitioners to provide patients undergoing hemodialysis with physical, social, and emotive assistance (Akin, Mendi, Ozturk, Cinper, & Durna, 2012).

Understanding the challenges involved in hemodialysis provides insight into the influence of external factors on blood pressure outcomes in patients. Therefore, it is useful when assessing factors that affect the efficacy of blood pressure regimens. This highlights the role of patient support from health care providers and families in improving the adherence to hypertension medication (Kara, 2009). This is necessary for establishing the relevance in guiding the provision of hypertensive care by nurse practitioners to patients. The findings will provide a solution to the current challenge of inadequate personnel in the management of the increased incidence of chronic kidney disease. It will also indicate how nurses can facilitate the provision of dependable and efficient anemia care to patients on hemodialysis.


The study will seek to establish the degree of exhaustion in patients undergoing hemodialysis when the capacity to provide self-care is diminished in terms of the extent of loneliness. The association evaluation will reveal the capacity to provide self-care in terms of its ability to reduce the degree of exhaustion and increase solitude. In addition, the study will establish if an increase in the age of the patients translates to an increase in the extent of loneliness and a diminished ability to provide self-care or not. The study will use 25 patients above 18 years who are undergoing hemodialysis and are willing to participate. The researchers will obtain the required information from the patients using previously developed tools for assessing fatigue, loneliness, and self-care. The interview sessions will last between 45 minutes and one hour and will be recorded on audiotapes. The participants will be required to provide simple yes and no responses to the questions. Thereafter, the interview outcomes will be transcribed word for word and evaluated by content analysis. A self-created form will be used to obtain information regarding hemodialysis during interviews. The findings of the forms will then be analyzed statistically (Saunders, MacLeod, Salyers, MacMillan, & Ogborn, 2013).

The quantitative study will employ a nurse-directed strategy in the control of renal anemia while the control group uses the conventional physician-guided approach in the management of anemia. The patient outcomes that are observed during the study will include the level of fatigue and loneliness of the respondents (Lewis, 2011). The study concludes whether or not nurse-directed approaches to managing anemia in hemodialysis patients are as effective as physician-directed approaches.


Akin, S., Mendi, B., Ozturk, B., Cinper, C., & Durna, Z. (2012). Assessment of relationship between self-care and fatigue and loneliness in haemodialysis patients. Journal of Clinical Nursing, 23(5-6), 856–864.

Kara, B. (2009). Herbal product use in a sample of Turkish patients undergoing haemodialysis. Journal of Clinical Nursing, 18(15), 2197–2205.

Kauric-Klein, Z. (2012). Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention. Nephrology Nursing Journal, 39(3), 217-228.

Lewis L. M. (2011). Medication adherence and spiritual perspectives among African American older women with hypertension. Journal of Gerontological Nursing, 37(6), 34-41.

Saunders, S., MacLeod, M. L. P., Salyers, V., MacMillan, P. D., & Ogborn, M. R. (2013). Anaemia management protocols in the care of haemodialysis patients: Examining patient outcomes. Journal of Clinical Nursing, 22(15-16), 2206–2215.

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