Factors Influencing Stress Perception among Hemodialysis Patients: a Systematic Review


Hemodialysis patients
Stress perception


How to Cite

Gunarathne , T. G. N. S., Yoong, T. L., Lim Abdullah, K., Nanayakkara, N. ., Kun, L. S., & Mohajer, S. (2022). Factors Influencing Stress Perception among Hemodialysis Patients: a Systematic Review. Iranian Red Crescent Medical Journal, 24(6). https://doi.org/10.32592/ircmj.2022.24.6.2074


Context: Stress is a common comorbid disorder among hemodialysis patients, and diverse factors contribute to stress perception in such individuals. Although numerous findings have been consistent across the literature, there has been a lack of consensus on which factor is the most influential on stress perception. This systematic review aimed to provide an executive review on factors contributing to stress perception among hemodialysis patients.

Evidence Acquisition: A detailed search was carried out on Cumulative Index to Nursing and Allied Health Literature, PubMed, EBESCOhost, Google Scholar, Medline, and Web of Science databases. Rigorous search narrowed to 16 observational studies (n=3,567 participants) on factors determining stress perception among hemodialysis patients. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was incorporated. The selected 16 articles were used in the qualitative synthesis.

Results: Stressors were grouped as biological, psychological/behavioral, or social/environmental factors. It was revealed that the effects of socio-demographic factors on stress perception were scarce and inconsistent, while fatigue and itching were distressing biological factors. Limitations on time and place on vacation, limitation of food and fluid are psychological stressors and decrease in social life with substantial economic burden were enlightened as social stressors.

Conclusion: Multidisciplinary factors were found for stress perception among hemodialysis patients. Nursing care plans should address the holistic nature of stress with appropriate nursing interventions. Although this review adopted the strict selection criteria, it remains difficult to conclude determinants due to methodological drawbacks. Therefore, future research in this scope is highly appreciated with prospective longitudinal nature to produce solid clinical conclusions.



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