Investigation of work stress, symptoms, and self-care agency in employed and unemployed chronic hemodialysis patients

The study was conducted as a descriptive and cross-sectional research aiming to examine job stress, symptoms, and self-care agency among employed and unemployed individuals undergoing hemodialysis treatment. The study population comprised patients treated in six dialysis centres, with a sample of 500 haemodialysis patients aged 18-65 years who had been on treatment for at least six months and were cognitively intact. Data were collected using the "Patient Information Form"," the "General Work Stress Scale"," the "Self-Care Scale" and the "Dialysis Symptom Index Scale"." Statistical analyses included t-tests, ANOVA, Kruskal-Wallis, Mann-Whitney U-tests and Spearman correlation analyses. Of the participants, 14% were employed, with a mean age of 47.61±10.57 years. Of the working patients, 47.1% were blue-collar workers, 47.1% had been working for 11 years or more, 32.9% went to work after their morning dialysis session, and 64.3% reported working intensively. The mean Work Stress Score Scale for working haemodialysis patients was 11.28±2.88. Conversely, 86% of participants were unemployed, with a mean age of 53.81±9.59 years; 34.2% reported being unable to work due to their hemodialysis treatment. The mean scores for the Self-Care Agency Scale and the Dialysis Symptom Index Scale were 38.60±3.06 and 10.21±7.09, respectively, for the employed patients and 37.39±3.71 and 13.21±8.16, respectively, for the unemployed patients. Statistically significant differences were found between employed and unemployed patients in terms of Self-Care Agency Scale and Dialysis Symptom Index Scale (p<0.05). In addition, a weak but statistically significant negative correlation between the Psychological sub-dimension of Self-Care Agency Scale and the Dialysis Symptom Index Scale was found (p<0.05). In summary, the level of work stress in employed haemodialysis patients was low. Both employed and unemployed patients had adequate self-care agency and low symptom severity, with employed patients having significantly higher self-care agency and lower symptom severity. In addition, improvements in psychological well-being were associated with a reduction in dialysis-related symptoms.