Mitigating Social Isolation Among Peritoneal Dialysis Patients: The Impact of Educational Level, Physical Activity, and Familial Support

Objective: This study investigates the prevalence and determinants of social isolation in peritoneal dialysis (PD) patients, focusing on the influence of environmental systems and individual behaviors on their social well-being.
Methods: We conducted a cross-sectional study from December 2023 to February 2024 at Shenzhen Traditional Chinese Medicine Hospital. A total of 259 PD patients were enrolled using a consecutive sampling method. Data were collected via validated tools including the Pittsburgh Sleep Quality Index (PSQI), Lubben Social Network Scale-6 (LSNS-6), Family APGAR Questionnaire, and Social Anxiety Subscale of Self-Consciousness Scale (SASS-CS). Statistical analyses utilized Spearman correlation and multiple linear regression to identify factors associated with social isolation.
Results: The average score for social isolation was 11 (range 7– 15). Significant predictors of social isolation included education level, physical inactivity, and normal hemoglobin concentrations. Social isolation was negatively correlated with family functionality and positively correlated with social anxiety. Regression analysis confirmed education, family functionality, and social anxiety as significant independent predictors of social isolation.
Conclusion: Social isolation is common among PD patients, driven by factors such as education level, physical inactivity, and unexpectedly, normal hemoglobin levels linked to greater family isolation. Targeted interventions like education, physical activity promotion, and innovative therapies such as animal-assisted activities and social gardening can help reduce isolation and improve patient well-being.

Plain Language Summary: 1. Why is this study needed? Peritoneal dialysis is a common treatment for severe kidney disease. This study is crucial because it examines how being isolated affects patients undergoing this treatment, as social isolation can worsen their health outcomes.
2. What is the key problem/issue/question this manuscript addresses? The main issue addressed is understanding the factors that contribute to social isolation in peritoneal dialysis patients and how this isolation impacts their health and quality of life.
3. What is the main point of your study? The study explores how various factors such as education levels, physical activity, and family support influence social isolation among these patients. It also looks at the broader environmental and social settings that affect their interactions and mental health.
4. What are your main results and what do they mean? Our findings show that patients with higher education, better family support, and more physical activity are less socially isolated. Addressing these factors can greatly enhance the well-being and social interactions of peritoneal dialysis patients, suggesting the need for targeted support and community integration initiatives.

Keywords: peritoneal dialysis, social isolation, social support systems, physical inactivity, educational disparities, mental health