Associations among pruritus, fatigue, and comfort in patients undergoing haemodialysis: a cross-sectional study

Patients undergoing haemodialysis require lifelong treatment and often suffer from symptoms such as fatigue and pruritus, which negatively affect their comfort, health outcomes, and quality of life. However, few studies have investigated the complex relationships among these symptoms. Therefore, in this study, we investigated relationships among pruritus, fatigue, and comfort in patients undergoing haemodialysis, and examined whether fatigue mediates the relationship between pruritus and comfort. This study used a cross-sectional design and convenience sampling. In total, 328 patients receiving haemodialysis were recruited from two hospitals. Instruments included participant background information, and the Vietnamese versions of the Post-Dialysis Fatigue Scale, the 5-D Itch Scale, and the Hemodialysis Comfort Scale version II. Data were analysed using independent t -tests, one-way ANOVAs, Pearson’s correlations, hierarchical multiple regressions, and bootstrapping for mediation analyses. Average scores of comfort, fatigue, and pruritus were 97.14 ± 13.32, 38.85 ± 8.97, and 10.15 ± 4.47, respectively. Both fatigue and pruritus were significantly and negatively associated with comfort levels. Fatigue explained 13.4% of the variance in comfort levels (change in R ² = 0.134, β = -0.66, p < 0.001), while pruritus accounted for an additional 3.3% of the variance (change in R ² = 0.033, β = -0.48, p < 0.001) after controlling for self-rated general health. Furthermore, the relationship between pruritus and comfort was partially explained by an indirect pathway through fatigue. Fatigue and pruritus were significantly associated with comfort among patients undergoing haemodialysis. The findings were consistent with an indirect effect model in which fatigue may partially explain the association between pruritus and comfort. These findings highlight the importance of addressing fatigue and pruritus to enhance overall comfort in this population.