Factors Influencing Stress Perception among Hemodialysis Patients: A Systematic Review

Background: Stress is a common comorbid disorders among hemodialysis patients and diverse factors contributed for stress perception among hemodialysis patients. Although, many findings have been consistent across the literature, there has been a surprising lack of consensus in which factor is most influence the stress perception. Objectives: This systematic review aimed to provide executive review on factors contribute for stress perception among hemodialysis patients Methods: Systematic review was conducted in Cumulative Index to Nursing and Allied Health Literature (CINHAL), PubMed, EBESCOhost, Google scholar, Medline and Web of Science (WOS) databases. Rigorous search narrowed to 16 observational studies (Total N=3567) on factors determine for stress perception among hemodialysis patients. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline were inco-operated. Selected 16 articles were used in the qualitative synthesis. Results: Stressors were clustered as Biological, Psychological/Behavioral, or Social/Environmental factors. Effect of socio-demographic factors on stress perception was scarce and inconsistent; whilst fatigue and itching were distressing biological factors. Limitations on time and place on vacation, limitation of food and fluid, decrease in social life with substantial economic burden were enlightened as psychological and social stressors respectively. Conclusion: Multidisciplinary factors were inspired for stress perception among hemodialysis patients. Nursing care plans should addressed 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. Thus, future research in this scope is highly appreciated with prospective longitudinal nature to produce solid clinical conclusions.