Photo Credit: VSanandhakrishna

Perceived social support predicts resilience in patients on hemodialysis, with factors like education, income, and marital status also influencing outcomes.

“Long-term hemodialysis significantly impacts the lives of patients and their families, creating a range of psychosocial and economic challenges,” researchers wrote in BMC Nephrology. “Social support and resilience are critical in enabling patients to navigate these difficulties and restore balance.”

Investigators conducted a cross-sectional study to assess the relationship between perceived social support and resilience among patients undergoing hemodialysis. The study excluded patients with confirmed cognitive conditions or mental health disorders such as Alzheimer’s disease or depression.

Patient Characteristics

The analysis included 300 participants, with a notable gender distribution that favored men (60.0%) over women (40.0%). The average age of patients was 57.1 years.

Investigators found that other health conditions were prevalent, with only 10.7% of participants having no underlying medical issues. Hypertension was the most common condition (31.7%), followed by comorbid hypertension and diabetes (23.7%).

Kidney disease duration varied considerably, with 30% of patients diagnosed for less than 24 months and 28.0% living with the condition for more than 120 months. Similarly, hemodialysis treatment duration varied, with 36.0% undergoing dialysis for less than 12 months and 21.3% receiving hemodialysis for more than 60 months.

Significant Predictors of Resiliency

The researchers observed a strong positive correlation between perceived social support and overall resilience (r, 0.391; P=0.001) that was consistently significant across family (P=0.001) and significant others (P=0.001), but weaker for friends (P=0.001). No significant association was reported for spirituality.

Among resilience subscales, positive acceptance of change showed the strongest correlations (r, 0.460), followed by personal competence (r, 0.331) and self-control (r, 0.360). Tolerance of negative effects had weaker but still significant associations, particularly within the family subscale (r, 0.175), according to the study results.

A multivariable linear regression analysis conducted after verifying the necessary assumptions identified several significant predictors of resilience.

• Perceived social support emerged as the strongest predictor (β, 0.384;P=0.001), with each unit increase in social support associated with a 0.40-unit increase in resilience.
• Education level also had a notable influence, according to the study team, as patients with a university degree showed higher resilience levels than those without formal education (P=0.018).
• Marital status and gender were additional significant factors. Divorced individuals demonstrated higher resilience levels than single individuals (P=0.036), while men had higher resilience levels than women (P=0.014).
• Income level further contributed to resilience.

Improving Resilience Through Social Support

Collectively, these variables—perceived social support, gender, marital status, education level, and income—accounted for 26.0% of the variance in resilience, according to the researchers.

“The results of this study highlight a significant relationship between perceived social support and resilience among patients undergoing hemodialysis,” they wrote. “Given the diverse physical, emotional, and social challenges these patients face, it is crucial to design and strengthen community support systems. Such systems can play an essential role in helping patients adapt to their condition and effectively manage its associated difficulties.”

Social support has a multifaceted impact, they continued, as a coping mechanism and as a tool to enable emotional expression, greater self-awareness, and a sense of belonging. It can also lessen anxiety and enhance self-esteem, contributing to improved psychological well-being and resilience.

The researchers advocated for improving resilience through psychosocial interventions, such as support groups and counseling, and family empowerment models.