대한신장학회

논문분류	춘계학술대회 초록집
제목	Fatigue, Pruritus, and Comfort Among Patients Undergoing Hemodialysis: A Structural Equation Modeling Analysis
저자	Nga Thi Thuy Nguyen
출판정보	2026; 2026(1):
키워드	hemodialysis, fatigue, comfort, pruritus, SEM
초록	Objectives: Hemodialysis is the most common kidney replacement therapy for patients with end-stage renal disease. These patients must regularly receive hemodialysis and often experience distressing symptoms that influence their health outcomes and quality of life. Fatigue and pruritus have been identified as factors negatively associated with comfort levels among hemodialysis patients. However, few studies have investigated the complex relationships among these symptoms. Therefore, this study aimed to develop and test a structural equation model to examine the relationships among pruritus, fatigue, and comfort in hemodialysis patients. Methods: A cross-sectional study was conducted with 328 hemodialysis patients. Instruments included the Post-Dialysis Fatigue, the 5-D Itch Scale, and the Hemodialysis Comfort Scale version II. Data was analyzed using structural equation modeling and bootstrapping with 500 resamples. Results: The average scores of comfort level, fatigue, and pruritus were 97.14±13.32, 38.85±8.97, and 10.15±4.47, respectively. The hypothesized model exhibited a good fit: χ2/df = 2.898 (p < .001), RMSEA=0.076 (p<0.001), GFI=0.92, CFI = 0.90, NFI = 0.86, TLI=0.88, SRMR=0.066. Pathway analysis indicated that pruritus was significantly associated with fatigue (r = 0.184, p = 0.005), and fatigue was significantly associated with comfort (r = -0.775, p < 0.001). Regarding the mediating effect of fatigue, the results confirmed that fatigue fully mediated the relationship between pruritus and comfort after controlling for the self-rated health covariate. Conclusion: The results indicate that greater fatigue and pruritus are associated with lower comfort levels in hemodialysis patients, with fatigue serving as a key mediating factor. These findings emphasize that fatigue and pruritus are significant predictors of comfort, highlighting the importance of addressing these symptoms in nursing care. A deeper understanding of the interrelationships among these symptoms can inform the development of holistic, patient-centered interventions aimed at improving the comfort and overall well-being of hemodialysis patients.
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