Incidence and Influencing Factors of Demoralization Syndrome in Elderly Maintenance Hemodialysis Patients: A Multi-Center Cross-Sectional Study

Objective: This observational study aimed to investigate the prevalence and influencing factors of demoralization syndrome (DS) in elderly maintenance hemodialysis (MHD) patients, with a focus on improving their psychological distress levels. Methods: Convenient sampling was used to select 350 MHD patients aged 60 or older from three tertiary hospitals in China. Data was collected using questionnaires, including the Chinese version of the DS Scale. Statistical analysis was conducted using SPSS 26.0 software. Results: Single factor analysis revealed that sex, average monthly household income, living alone, dialysis duration, complications, and self-care abilities were significant influencers of DS levels. The average DS score was moderately high, with 59.4% of patients scoring in the high range. Multivariable linear regression identified average monthly household income, dialysis duration, complications, and self-management abilities as independent factors impacting DS. Conclusion: The study highlighted the importance of addressing complications, enhancing social support, improving self- management skills, and tailoring individualized hemodialysis plans to reduce DS levels and alleviate psychological distress in elderly MHD patients. These findings provide valuable insights for healthcare providers aiming to enhance patient well-being in this population.