A Case Study on Risks to the Chronic Disease Management for Hemodialysis Patients Using Systems Thinking: Focusing on Pandemic Situations

The purpose of this study is to analyze the causal loop diagram of the risks of disruption in continuous chronic disease management among hemodialysis patients during the pandemic and, based on these findings, to derive effective systemic response strategies to ensure the continuity of chronic disease care in public health crises. The key determinant of self-care among hemodialysis patients is an appropriate perception of health risks. During a pandemic, reduced healthcare accessibility and the reallocation of resources for infection control impose significant restrictions on hemodialysis services. Additionally, nursing education, remote monitoring, and the establishment of a therapeutic trust relationship between nurses and patients are essential for enhancing self-management capacity. Lastly, telemedicine is considered a viable strategy for ensuring both the continuity of self-management among hemodialysis patients and the stability of healthcare systems.