Authors
Jian Zhao, Qian Zhao, Huize Xu, Minghua Han, Zhongwen Chang, Juzi Wang
Published in
Scientific reports. Jul 03, 2026. Epub Jul 03, 2026.
Abstract
The global prevalence of end-stage kidney disease (ESKD) is rising, with maintenance hemodialysis (MHD) being a primary treatment. Despite advancements in dialysis technology, MHD patients still face high mortality rates and significant challenges in treatment adherence and quality of life. This study was designed to delineate distinct attitudinal profiles related to illness perception, and investigate the sociodemographic and clinical predictors of subgroup membership. Additionally, the study explored the lived experiences and personal narratives of patients within each subgroup to provide a comprehensive understanding of the underlying meanings of these profiles. This research adopted an explanatory mixed-methods design. In the quantitative stage, which took place from May to July 2024, data were collected from 291 hemodialysis patients at the Hemodialysis Center of Shanxi Provincial People's Hospital in China. Latent Profile Analysis (LPA) was utilized, based on the Brief Illness Perceptions Questionnaire (BIPQ), to uncover unique patterns of disease cognition. The influence of sociodemographic and clinical variables on these classifications was assessed via both univariate and multivariate logistic regression analyses. The qualitative phase followed from August to September 2024, during which semi-structured interviews were conducted with 16 participants. These interviews were systematically organized and analyzed using the Colaizzi seven-step method. LPA identified three distinct illness perception profiles: the Low Perception-Optimistic profile (39.2%), the Moderate Perception-Peaceful profile (16.5%), and the High Perception-Pessimistic profile (44.3%). Significant differences across profiles were found in age, education, employment, income, dialysis duration, primary disease, comorbidity count, anxiety and depression, symptom severity, health literacy, self-efficacy, coping style, and perceived social support (P < 0.05). Multivariate logistic regression analysis showed that, relative to the Low Perception-Optimistic profile, individuals aged 45-65 years or ≥ 65 years, those with primary diabetes, and those with high family support and adaptive coping strategies were less likely to be classified as the Moderate Perception-Peaceful profile. In contrast, patients inclined toward avoidance or surrender coping strategies had a higher likelihood of being classified into this profile. Similarly, patients with primary hypertension, high self-efficacy, strong family support, and adaptive coping strategies were less likely to be categorized as the High Perception-Pessimistic profile. Conversely, those favoring avoidance or surrender coping strategies had a greater probability of this classification. For the qualitative component, four major themes with ten subthemes were identified: Illness Experience (Disease Cognition, Disease Prognosis), Emotional Experience (Emotional Adjustment, Emotional Disturbance), Illness Impact (Work Impact, Life Impact, Social Impact), and Illness Coping (Illness Management, Medical Support, Family Support). This study highlights the significant heterogeneity in illness perceptions among MHD patients, emphasizing the need for personalized interventions. The identified profiles and their associated factors provide valuable insights for developing targeted interventions to improve treatment adherence, self-management, and quality of life in MHD patients. Future research should explore effective intervention strategies for patients in different illness perception profiles and investigate the broader contextual factors influencing illness perception.
PMID:
42393188
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.
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