Self-Management in Hemodialysis Patients: A Concept Analysis

Context: Self-management (SM) in hemodialysis (HD) is a critical concept that empowers patients to actively participate in their health care. Despite its significance, the concept remains unclear, hindering its effective application in clinical settings. Clarifying SM can enhance nursing knowledge and contribute to improved care for HD patients. This study aimed to analyze the concept of SM in HD patients. Evidence Acquisition: The concept analysis was conducted according to Walker & Avant's eight-stage approach. To identify relevant literature, the keywords "self-management", "hemodialysis", and "End-Stage Renal Diseases" were searched in ProQuest, PubMed, Scopus, Embase, and MEDLINE databases, as well as Google Scholar and library resources until November 2024. Results: In hemodialysis patients, SM is characterized by real-time health adjustment, self-monitoring, lifestyle integration, adaptive problem-solving, therapeutic engagement, self-regulation, and emotional resilience and coping. The antecedents of SM in patients with HD are related to the patient and the health care system. Improved quality of life is the most important consequence of SM in HD patients. Furthermore, SM has positive effects on the health care system for HD patients. Conclusions: The SM in HD patients is shaped by motivation, social support, and healthcare accessibility. Effective SM enhances quality of life and optimizes healthcare efficiency by reducing hospitalizations. Integrating structured education, psychological support, and digital health tools can strengthen self-efficacy, therapeutic engagement, and real-time monitoring. Interdisciplinary collaboration is essential for implementation. Future research should examine long-term SM outcomes and address barriers to effective integration in diverse HD populations.