A latent profile analysis of hierarchical management of supportive care needs in patients undergoing maintenance hemodialysis

Previous studies have shown that the maintenance hemodialysis (MHD) severity is pyramidal, with variations in self-management capabilities and supportive care needs generated by different patients during daily care procedures. This study aimed to explore the potential categories of self-management abilities and supportive care needs of patients undergoing MHD to inform the development of personalized intervention programs. We conducted a cross-sectional study using a self-made general data questionnaire, a hemodialysis self-management instrument, and an assessment of the supportive care needs of 302 outpatients undergoing MHD at two medical institutions (a tertiary hospital and a tertiary specialized hospital). Latent profile analysis was employed to classify self-management ability and supportive care needs. According to the latent profile analysis, the self-management and supportive care needs of MHD patients can be divided into three categories: the Self-Determination Model (72.7%), the Collaborative Support Model (20.0%), and the Comprehensive Care Model (7.3%). Statistically significant differences were observed in payment methods and caregiver health (P < 0.05). Among the 11 dimensions, nine showed statistically significant differences across the three profiles (Kruskal–Wallis H test, all P < 0.001), including all seven supportive care needs dimensions and two self-management dimensions (problem-solving and emotional processing). No significant differences were observed in self-care execution (P = 0.421) or partnership (P = 0.808). Medical staff can combine the self-management ability and supportive care needs of patients undergoing MHD to formulate personalized and targeted nursing intervention programs for different patients, which may help to improve patients’ self-management ability, respond to their care needs, and thus potentially contribute to the improvement of their quality of life.