Exploring Chronic Pain Management Experiences and the Use of Complementary Therapies Among Hemodialysis Patients: A Qualitative Study
DOI:
https://doi.org/10.69606/jps.v3i04.321Keywords:
chronic pain, hemodialysis, End-stage renal disease (ESRD), lived experiences, pain management, complementary therapyAbstract
Background: Chronic pain is a common and distressing experience for patients with end-stage renal disease (ESRD) undergoing hemodialysis, yet its complexity and management remain insufficiently explored. Understanding how patients perceive and manage this pain is crucial for developing holistic nursing interventions. Aim: To explore the lived experiences of chronic pain management among patients receiving long-term hemodialysis. Method: A qualitative descriptive approach was employed, using in-depth semi-structured interviews with a purposive sample of hemodialysis patients. Data were analyzed thematically to identify core patterns and meanings. Results: Three themes emerged: (1) perceived meaning and impact of pain during hemodialysis, reflecting patients’ physical discomfort, emotional distress, and disruption of daily life; (2) patterns and characteristics of pain, described as fluctuating in intensity, duration, and location throughout the hemodialysis process; and (3) complementary and supportive strategies for pain management, including spiritual practices, relaxation, distraction techniques, and reliance on family support. The findings underscore that pain during hemodialysis is not only a physical phenomenon but also a psychosocial and spiritual challenge. Nurses play a pivotal role in recognizing patients’ multidimensional pain experiences and in integrating complementary approaches alongside conventional care. Conclusion: This study highlights the importance of patient-centered, culturally sensitive strategies to enhance pain management and quality of life in ESRD care. It is recommended that future nursing practice and policies incorporate complementary therapies and patient education programs to strengthen pain management strategies in hemodialysis units.
References
Afifah, F. H., Nurjannah, I., & Sunaryo, E. Y. A. B. (2018). Pain characteristics on patient undertaking hemodialysis. Belitung Nursing Journal, 4(2). https://doi.org/10.33546/BNJ.337
Al Nazly, E. K., & Al Khatib, H. (2021). The Knowledge and Educational Needs of Nurses Regarding Pain Management of Patients on Maintenance Hemodialysis: A Qualitative Study. The Open Nursing Journal, 15(1), 93–102. https://doi.org/10.2174/1874434602115010093
Almutary, H., Bonner, A., & Douglas, C. (2016). Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced ckd stage and dialysis modality. Journal of Renal Care, 42(2). https://doi.org/10.1111/jorc.12152
Ariyanti, S. (2022). Nurse ’ s Therapeutic Communication Affects Patient Satisfaction and Motivation Level. Journal Of Complementary Nursing, 1(3), 91–98. https://doi.org/10.53801/jcn.v1i3.52
Atik, D., Karatepe, H., Karatepe, C., Demir, S., Cinar, S., & Sokmen, S. (2016). The effect of gender on the complications, pain intensity and pain management in hemodialysis patients. International Journal of Research in Medical Sciences, 1490–1495. https://doi.org/10.18203/2320-6012.ijrms20161216
Bouchachi, F. Z., AL Wachami, N., Iderdar, Y., Arraji, M., Elgot, A., & Chahboune, M. (2025). Bio-sociological and clinical factors of chronic pain and pain interference in patients undergoing hemodialysis: a cross-sectional study. BMC Nephrology, 26(1), 83. https://doi.org/10.1186/s12882-025-03987-7
Cox, K. J., Parshall, M. B., Hernandez, S. H. A., Parvez, S. Z., & Unruh, M. L. (2017). Symptoms among patients receiving in-center hemodialysis: A qualitative study. Hemodialysis International, 21(4). https://doi.org/10.1111/hdi.12521
Creswell, J. W., & Cresswell, D. (2018). Research design : Qualitative, quantitative, and mixed methods approaches. In Research design.
Davison, S. N., Koncicki, H., & Brennan, F. (2014). Pain in chronic kidney disease: A scoping review. Seminars in Dialysis, 27(2). https://doi.org/10.1111/sdi.12196
dos Santos, P. R., Mendonça, C. R., Hernandes, J. C., Borges, C. C., Barbosa, M. A., Romeiro, A. M. de S., Alves, P. M., Dias, N. T., & Porto, C. C. (2021). Pain in Patients With Chronic Kidney Disease Undergoing Hemodialysis: A Systematic Review. Pain Management Nursing, 22(5), 605–615. https://doi.org/10.1016/j.pmn.2021.05.009
Gómez-Batiste, X., Martínez-Muñoz, M., Blay, C., Espinosa, J., Contel, J. C., & Ledesma, A. (2012). Identifying needs and improving palliative care of chronically ill patients: A community-oriented, population-based, public-health approach. In Current Opinion in Supportive and Palliative Care (Vol. 6, Issue 3). https://doi.org/10.1097/SPC.0b013e328356aaed
Hustrini, N. M. (2023). Chronic Kidney Disease Care in Indonesia: Challenges and Opportunities. In Acta Medica Indonesiana (Vol. 55, Issue 1).
Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., Saran, R., Wang, A. Y. M., & Yang, C. W. (2013). Chronic kidney disease: Global dimension and perspectives. In The Lancet (Vol. 382, Issue 9888). https://doi.org/10.1016/S0140-6736(13)60687-X
Kalantar-Zadeh, K., & Li, P. K. T. (2020). Strategies to prevent kidney disease and its progression. In Nature Reviews Nephrology (Vol. 16, Issue 3). https://doi.org/10.1038/s41581-020-0253-1
Kartika, I. R. (2014). Nursing Care Quality Indicators and Patient Satisfaction in the Hospital: a systematic review. The 1st International Conference on Education and Nursing Research, 1(1), 73–79.
Kartika, I. R., Hariyati, T. S., & Nelwati. (2018). Nurses–patients interaction model and outpatients’ satisfaction on nursing care. Nursing & Care Open Access Journal, 5(2). https://doi.org/10.15406/ncoaj.2018.05.00123
Lestari, F. V. A., Rachmawaty, R., & Hariati, S. (2023). Komunikasi Terapeutik Perawat Melalui Pendekatan Budaya. Journal of Telenursing (JOTING), 5(2), 2843–2854. https://doi.org/10.31539/joting.v5i2.6834
Lufiyani, I., Zahra, A. N., & Yona, S. (2019). Factors related to insomnia among end-stage renal disease patients on hemodialysis in Jakarta, Indonesia. Enfermeria Clinica, 29. https://doi.org/10.1016/j.enfcli.2019.04.141
Mancin, S., Palomares, S. M., Sguanci, M., Palmisano, A., Gazineo, D., Parozzi, M., Ricco, M., Savini, S., Ferrara, G., Anastasi, G., Cangelosi, G., Godino, L., & Andreoli, D. (2025). Relational skills of nephrology and dialysis nurses in clinical care settings: A scoping review and stakeholder consultation. Nurse Education in Practice, 82, 104229. https://doi.org/10.1016/j.nepr.2024.104229
Marzouq, M. K., Samoudi, A. F., Samara, A., Zyoud, S. H., & Al-Jabi, S. W. (2021). Exploring factors associated with pain in hemodialysis patients: a multicenter cross‐sectional study from Palestine. BMC Nephrology, 22(1). https://doi.org/10.1186/s12882-021-02305-1
Mateus, A., & Silva, F. F. da. (2025). The Spiritual Dimension of Comprehensive Kidney Care. Portuguese Idney Ournal, 39(2), 94–102. https://doi.org/10.71749/pkj.95
Mizher, A., Hammoudi, H., Hamed, F., Sholi, A., AbuTaha, A., Abdalla, M. A., Jaber, M. M., Hassan, M., Koni, A. A., & Zyoud, S. H. (2023). Prevalence of chronic pain in hemodialysis patients and its correlation with C-reactive protein: a cross-sectional study. Scientific Reports, 13(1), 5293. https://doi.org/10.1038/s41598-023-32648-8
Rambod, M., & Rafii, F. (2010). Perceived social support and quality of life in Iranian hemodialysis patients. Journal of Nursing Scholarship, 42(3). https://doi.org/10.1111/j.1547-5069.2010.01353.x
Rasmiati, R., Herawati, T., & Sukmarini, L. (2023). Terapi Komplementer dalam Mengatasi Gangguan Tidur Pasien yang Menjalani Hemodialisis. Journal of Telenursing (JOTING), 5(1). https://doi.org/10.31539/joting.v5i1.6261
Razeen Davids, M., & Benghanem Gharbi, M. (2019). Global Considerations in Kidney Disease : Africa. In Brenner & Rector’s The Kidney.
Roy, P. J., Weltman, M., Dember, L. M., Liebschutz, J., & Jhamb, M. (2020). Pain management in patients with chronic kidney disease and end-stage kidney disease. In Current Opinion in Nephrology and Hypertension (Vol. 29, Issue 6). https://doi.org/10.1097/MNH.0000000000000646
Schweiger, V., Cacciapuoti, M., Nizzero, M., Simari, S., Lombardi, G., Gottin, L., Stefani, L., Martini, A., Varrassi, G., Finco, G., Polati, E., & Gambaro, G. (2025). Exploring Chronic Pain in Hemodialysis Patients: An Observational Study Based on the New IASP Classification for ICD-11. Pain and Therapy, 14(1), 375–385. https://doi.org/10.1007/s40122-024-00698-z
Szigeti, N., Csiky, B., Csikós, Á., & Sági, B. (2025). The Significance of Palliative Care in Managing Pain for Patients Undergoing Hemodialysis. Journal of Clinical Medicine, 14(20), 7129. https://doi.org/10.3390/jcm14207129
Yun, J., Seong, M., Cho, Y., & Sok, S. (2024). Influences of Nursing Professionalism, Empathy, and Clinical Decision-Making Ability on Shared Decision-Making Awareness among Hemodialysis Nurses. Journal of Nursing Management, 2024, 1–9. https://doi.org/10.1155/2024/2518065
Zeleke, S., Kassaw, A., & Eshetie, Y. (2021). Non-pharmacological pain management practice and barriers among nurses working in Debre Tabor Comprehensive Specialized Hospital, Ethiopia. PLoS ONE, 16(6 June). https://doi.org/10.1371/journal.pone.0253086
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