Exploring Health-Related Quality of Life and Psychosocial Predictors Among Family Caregivers of Patients Undergoing Hemodialysis in Pakistan

Abstract Background: Caregivers of individuals undergoing dialysis for end-stage renal disease (ESRD) face a gradual decline in their physical and emotional well-being, derived from the implications of treatment and the sustained responsibility of providing long-term care. Aims and Objectives: This study aims to evaluate the quality of life of caregivers of patients undergoing hemodialysis in Pakistan. It will also explore the determinants of quality of life and its association with clinical-sociodemographic factors to ensure the development of informed healthcare policies and interventions to enhance caregivers' quality of life and support systems. Methodology: A cross-sectional study was conducted among caregivers of patients undergoing hemodialysis in Pakistan. Participants were recruited from dialysis centres using convenience sampling. Data on caregivers' quality of life were collected using the validated EuroQol (EQ-5D-5L) questionnaire. Additional information on clinical-sociodemographic factors was obtained through a structured proforma. Data were analyzed using descriptive statistics, non-parametric tests, and a general linear model to assess associations and predictors of quality of life. Results: The study analyzed 362 caregivers of hemodialysis patients, primarily young adults aged 21–40 (59.9%), with a female majority (52.8%). Sociodemographic data revealed a cohort with limited education (42.8%), high unemployment (51.7%), and low household income (40.3%). Despite economic strain, familial support was evident, with 81.8% being married and 92.3% living with family. HRQoL (EQ-5D) revealed minimal self-care issues (82.0% unaffected) but challenges in daily activities (39.5% mild impairment) and mental health (anxiety/depression). Regression identified depression severity (PHQ) as a key negative predictor and self-rated health (VAS) as a positive contributor. Widowed marital status, younger age, and spousal/extended-family caregiving roles further impacted outcomes, with no collinearity issues (VIFs <2.0). Socioeconomic hardships, psychosocial stress, and caregiving burdens drove HRQoL disparities. Conclusions: Demographic features such as age, education, employment status, and income are pivotal in determining health-related quality-of-life outcomes among hemodialysis patients. Socioeconomic factors like unemployment, limited education, and psychosocial stressors such as prolonged caregiving are strongly associated with reduced quality of life. In contrast, higher education and self-rated health predict improved quality of life.