Health-Related Quality of Life and Comfort in Hemodialysis Patients: Explanatory Sequential Mixed-Methods Study

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Objective: Chronic kidney disease is a global health problem with growing prevalence today. One of the most common treatments for this disease is hemodialysis. The assessment of health-related quality of life and comfort levels of patients receiving hemodialysis treatment is crucial for managing the treatment process effectively. This study specifically aimed to evaluate these dimensions of health status and to explain the relationships between clinical indicators, quality of life, and comfort through an explanatory sequential mixed-methods design, where quantitative results guided the qualitative phase for in-depth exploration. Material and Methods: This study employed an explanatory sequential mixed-methods design. The sample consisted of 64 patients receiving hemodialysis treatment at a hospital in Türkiye, who met the study criteria. In the study, data were collected over a 3-month period using the personal information form, the Kidney Disease Quality of Life 36-Item Short Form, the Hemodialysis Comfort Scale Version II, and a semi-structured interview form. Quantitative analyses identified key relationships between quality of life, comfort, and clinical indicators, and qualitative interviews were then conducted to provide contextual understanding of these findings. Results: The study found significant positive correlations between quality of life, comfort, and dialysis adequacy levels. Regression analysis identified dialysis adequacy levels, hemoglobin, and hematocrit as important predictors of patient well-being. Thematic analysis revealed four main themes: psychological changes, social changes, physical changes, and coping strategies. Conclusion: Both clinical and psychosocial factors significantly influence the quality of life and comfort of hemodialysis patients. A holistic and multidisciplinary approach is required to improve patient outcomes.