Comfort-oriented nursing interventions to improve quality of life in hemodialysis patients: A systematic review

https://doi.org/10.52235/lp.v7i3.802

Authors

  • Abiyyu Faqih Dhiyaus Suud Ahmad Universitas Islam Sultan Agung, Semarang, Indonesia
  • Enny Mulyatsih Universitas Islam Sultan Agung, Semarang, Indonesia
  • Dwi Retno Sulistyaningsih Universitas Islam Sultan Agung, Semarang, Indonesia

Keywords:

comfort-oriented care, hemodialysis, non-pharmacological interventions, nursing interventions, quality of life

Abstract

Background: Patients undergoing hemodialysis frequently experience fatigue, pain, muscle cramps, and reduced functional capacity, which adversely affect their quality of life. Non-pharmacological nursing interventions using a comfort-oriented approach are believed to improve patients’ physical comfort and functional status. However, the available recent evidence remains heterogeneous and has not been systematically synthesized.

Objective: This study aimed to review and synthesize recent evidence regarding the effectiveness of comfort-oriented nursing interventions in improving physical comfort, functional capacity, and quality of life among patients undergoing hemodialysis.

Methods: A systematic review was conducted by searching Scopus, PubMed, ScienceDirect, Google Scholar, and relevant research registries for studies published between 2020 and April 2026. Eligible studies included randomized controlled trials, quasi-experimental studies, observational studies, and qualitative studies reporting outcomes related to comfort, functional capacity, and quality of life among adult patients undergoing hemodialysis. Methodological quality was assessed using the Cochrane Risk of Bias Tool, Newcastle–Ottawa Scale, and Critical Appraisal Skills Programme checklists. Data were extracted and narratively synthesized to describe intervention effects, underlying mechanisms, and heterogeneity across the findings.

Results: Of the 801 records identified, 10 studies met the inclusion criteria. The interventions demonstrated improvements in physical comfort, muscle strength, mobility, and quality of life. Multicomponent and technology-based interventions also improved patient engagement, treatment adherence, and nutritional markers. Heterogeneity in study populations, intervention duration, and study designs affected the strength of the evidence. Nevertheless, consistent patterns indicated that nurse-delivered interventions provided beneficial outcomes within dialysis care settings.

Conclusion: Comfort-oriented nursing interventions appear to be safe, feasible, and effective in improving physical comfort, functional capacity, and quality of life among patients undergoing hemodialysis. The findings support the integration of physical exercise, relaxation techniques, and multicomponent strategies into routine dialysis nursing care.

Downloads

Download data is not yet available.

References

Aboumatar, H., Pitts, S., Sharma, R., Das, A., Smith, B. M., Day, J., Holzhauer, K., Yang, S., Bass, E. B., & Bennett, W. L. (2022). Patient engagement strategies for adults with chronic conditions: an evidence map. Systematic Reviews, 11(1). https://doi.org/10.1186/s13643-021-01873-5

Giri, P. C., Stevens, G. J., Merrill-Henry, J., Oyoyo, U., & Balasubramanian, V. P. (2021). Participation in pulmonary hypertension support group improves patient-reported health quality outcomes: a patient and caregiver survey. Pulmonary Circulation, 11(2). https://doi.org/10.1177/20458940211013258

Global Kidney Health Atlas. (2023). Prevalence of chronic kidney disease (CKD). Https://Gkha.Theisn.Org/.

Indonesia Renal Registry. (2023). ANNUAL REPORT OF INDONESIAN RENAL REGISTRY. Https://Www.Indonesianrenalregistry.Org/Media/2023%2016th%20Annual%20Report%20of%20Indonesian%20Renal%20Registry%20English.Pdf

Kasar, K. S., Erzincanli, S., & Akbas, N. T. (2020). The effect of a stress ball on stress, vital signs and patient comfort in hemodialysis patients: A randomized controlled trial. Complementary Therapies in Clinical Practice, 41, 101243. https://doi.org/10.1016/j.ctcp.2020.101243

Keivan, S., Shariati, A., Miladinia, M., & Haghighizadeh, M. H. (2023). Role of self-management program based on 5A nursing model in quality of life among patients undergoing hemodialysis: a Randomized Clinical Trial. BMC Nephrology, 24(1). https://doi.org/10.1186/s12882-023-03108-2

Li, J., Lin, Y., Wang, L., Wang, Q., & Wu, Q. (2024). Analysis of the application effect of the Clark comfortable nursing approach in hemodialysis patients with end stage renal failure. Renal Failure, 46(2). https://doi.org/10.1080/0886022X.2024.2423011

Meyer, B., Riepenhausen, A., Betz, L. T., Jauch-Chara, K., & Reshetnik, A. (2025). Internet-based digital intervention to support the self-management of hypertension compared to usual care: results of the HALCYON randomized controlled trial. BMC Cardiovascular Disorders, 25(1). https://doi.org/10.1186/s12872-025-04698-5

Pooresmaeil, M., Iranpour, S., & Aghamohammadi, M. (2023). Effects of a nurse-led structured home visiting program on quality of life and adherence to treatment in hemodialysis patients. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1013019

Shehata, A. M., Zaki, W. E., Ali, H. A., & Weheida, S. M. (2026). Effect of nurse-led intradialytic stretching exercises on muscle cramp burden among patients undergoing maintenance hemodialysis: a randomized controlled trial. BMC Nursing, 25(1). https://doi.org/10.1186/s12912-026-04430-4

Shu, P., Wang, X., Wen, Z., Wang, S., Wei, X., & Xu, F. (2025). Impact of nursing interventions based on the health ecology model on quality of life in maintenance hemodialysis patients. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03429-7

Sriprachot, N., Seangpraw, K., & Ong-Artborirak, P. (2024). Health Literacy, Self-Care Behaviors, and Biochemical Parameters Among Hypertensive Patients with Renal Complications in the Tai Lue Ethnic Community of Thailand. Vascular Health and Risk Management, 20, 97–107. https://doi.org/10.2147/VHRM.S450775

Still, C. H., Margevicius, S., Harwell, C., Huang, M. C., Martin, L., Dang, P. B., & Wright, J. T. (2020). A community and technology-based approach for hypertension self-management (Coachman) to improve blood pressure control in african americans: Results from a pilot study. Patient Preference and Adherence, 14, 2301–2313. https://doi.org/10.2147/PPA.S283086

Tao, L.-L., Zeng, C.-H., Mei, W.-J., & Zou, Y.-L. (2024). Sleep quality in middle-aged and elderly hemodialysis patients: Impact of a structured nursing intervention program. World Journal of Clinical Cases, 12(25), 5713–5719. https://doi.org/10.12998/wjcc.v12.i25.5713

Wang, Y., Sun, J., Guo, F., & Wan, D. (2024). Effect of periodic nursing interventions on improving compliance behavior and health status in long-term Hemodialysis patients. Pakistan Journal of Medical Sciences, 40(9). https://doi.org/10.12669/pjms.40.9.9076

Wong, S. P. Y., Prince, D. K., Kurella Tamura, M., Hall, Y. N., Butler, C. R., Engelberg, R. A., Vig, E. K., Curtis, J. R., & O’hare, A. M. (2023). Value Placed on Comfort vs Life Prolongation Among Patients Treated With Maintenance Dialysis. JAMA Internal Medicine, 183(5), 462–469. https://doi.org/10.1001/jamainternmed.2023.0265

Zhang, Q. L., Wang, S., Zhang, Y., & Meng, F. (2021). The effect of refined nursing intervention on patients undergoing maintenance hemodialysis in the hemodialysis center during the COVID-19 epidemic. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00584-5

Downloads

Published

2026-07-17

How to Cite

Ahmad, A. F. D. S., Mulyatsih, E., & Sulistyaningsih, D. R. (2026). Comfort-oriented nursing interventions to improve quality of life in hemodialysis patients: A systematic review. Lentera Perawat, 7(3), 670–680. https://doi.org/10.52235/lp.v7i3.802

Similar Articles

<< < 3 4 5 6 7 8 9 10 11 12 > >> 

You may also start an advanced similarity search for this article.