Loneliness and depression among older adults with cancer: an exploratory analysis of psychosocial constructs.

Hemodialysis is a procedure performed to prevent and treat uremia in patients whose renal function has been temporarily or permanently impaired []. As of 2023, the total number of patients receiving renal replacement therapy in South Korea is 137,705, with 110,443 undergoing hemodialysis, 5,253 receiving peritoneal dialysis, and 22,009 having undergone kidney transplants. Notably, hemodialysis accounts for 83.7% of the total, representing the highest proportion of renal replacement therapy []. The number of hemodialysis patients, which was approximately 20,000 in 2002, has increased nearly sevenfold, with 18,052 new cases reported in 2023 alone []. In hemodialysis, patients undergo three sessions per week, each lasting 4 hours []. For patients, dialysis represents the only viable option for survival, as the underlying disease is incurable. The long-term dependence on dialysis and the fear of death often lead to profound emotional distress, resulting in depression and despair []. Stressors such as illness can disrupt the sense of life’s meaning, leading to emotional turmoil, helplessness, internal emptiness, and feelings of worthlessness []. These negative emotional states, including depression, anxiety, and stress, adversely impact the treatment outcomes and overall quality of life of hemodialysis patients []. Chronic kidney disease, categorized as a non-cancerous terminal illness, has been included in the "Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at The End of Life" since April 2018 []. Life-long dependence on dialysis machines, coupled with the fear of complications, significantly influences the treatment outcomes and quality of life of dialysis patients []. Given the rapid increase in the number of hemodialysis patients in South Korea [], there is an urgent need to explore effective nursing interventions to address the growing demands and needs for stress management in this patient population.