A qualitative systematic review of mental health among haemodialysis patients

Abstract

Abstract Background A high proportion of HD patients suffer from mental health problems, which have been linked to reduced quality of life and treatment adherence, and increased morbidity and mortality. Aims To review the existing literature and synthesise the findings to better understand the adult patients’ perspective on how outpatient HD affects their mental health. Methods A qualitative systematic review. Databases searched: CINAHL, PsycINFO and MEDLINE. Thematic synthesis was used. Findings Fifteen studies were included. The following key themes were identified: changed identities (coming to terms with HD, physical changes, role dysfunction), dependency on HD (treatment regime, restrictions), unanticipated futures (uncertainty, hopelessness, hope) and coping strategies (professional help, self-help). Conclusion Accounts of patients on HD suggest a ‘biographical disruption’ of all aspects of their lives: physical, social and psychological, which impact their mental health. Mental health support for patients on HD is an unmet need.