Palliative Care for Patients With End-Stage Renal Disease: An Examination of Unmet Needs and Experiencing Problems.

Abstract

Patients with end-stage renal disease face numerous physical, emotional, and financial burdens, necessitating palliative care (PC) interventions. This cross-sectional study assessed the problems and unmet needs of 129 patients under renal dialysis from 6 hospitals. Findings revealed that 64.7% of participants experienced significant challenges, primarily financial difficulties (78.5%), autonomy concerns (68.8%), and a need for information (68.0%). More than half (51.9%) reported needing PC, particularly for managing fatigue (78.3%), pain (79.8%), and depression (72.9%). Unmet needs were common (47.6%), with the most notable gaps in financial support (52.5%) and information provision (50%). Correlation analysis demonstrated strong positive associations between reported problems, care needs, and unmet needs ( r > 0.90, P < .001). Significant differences were observed by dialysis access type ( F = 5.71, P = .001), with arteriovenous fistula patients reporting higher problems and unmet needs. Increased dialysis frequency was linked to more problems and unmet needs ( F = 7.24, P < .001). In addition, patients with comorbidities experienced significantly higher problems, care needs, and unmet needs (all P s < .001). These findings underscored the urgent need for tailored PC interventions for end-stage renal disease patients, particularly in addressing symptom management, psychosocial and spiritual support, financial support, and information deficits, to enhance their quality of life.