“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Abstract

Background Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH. Methods We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi’s phenomenological approach. Results Twenty-two respondents completed the interviews (aged 29–75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends’ helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison). Conclusion The study reveals that multiple stressors drive MHD patients’ LH. These salient phenomena demonstrate the importance of recognizing MHD patients’ LH. We suggest that support services should be developed alongside a framework that addresses MHD patients’ LH from the beginning of treatment.

Mediating role of learned helplessness’ components in the association between health literacy/social support and self-management among maintenance haemodialysis patients in Changsha, China: a cross-sectional study

“…Those patients who were chronically helpless lacked the motivation to consistently learn self-care knowledge and skills. This point echoes the findings of our previous qualitative study 49. Therefore, successful renal disease education should provide knowledge and increase motivation.…”

Perceived Determinants of Health-Related Behaviors Among Patients with Coronary Heart Disease After Percutaneous Coronary Intervention: A Longitudinal Qualitative Study

“…Influenced by Buddhism and Taoism, some Chinese patients attribute their life events, including health and disease, to Ming (also known as fate), which is in consistent with our results. 68 In China, Buddhism emphasizes the cycle of life, and the occurrence, nature, duration, and content of a relationship are considered destined or inevitable. 64 Taoism advocates “let it be”, it portrays a belief in a natural lifecycle, according to which followers perceive death to be a natural and undisturbed form.…”

“…This attitude alleviates patients’ sense of helplessness to some extent, but this fatalism may also hinder patients’ health behaviors and compliance. 68 Therefore, when planning intervention measures for patients, it is important to understand their cognition about disease situations to promote their positive coping behaviors. Fatalism was generated in the first two interviews and disappeared in the last interview.…”

Complications and psychological impact of pressure ulcers on patients and caregivers

“…The persistence of pressure ulcers, in conjunction with their conspicuous appearance and accompanying physical discomfort and pain, can lead to considerable psychological anguish 14,15 . Because of the loss of autonomy and constant requirement for care, patients may develop melancholy, anxiety and feeling of helplessness 16 . The patient's mental well‐being may be negatively affected and persistent discomfort linked to advanced ulcers may intensify, thereby impeding the healing process.…”

“… 14 , 15 Because of the loss of autonomy and constant requirement for care, patients may develop melancholy, anxiety and feeling of helplessness. 16 The patient's mental well‐being may be negatively affected and persistent discomfort linked to advanced ulcers may intensify, thereby impeding the healing process. Additionally, social withdrawal can result from the stigma associated with wounds, exacerbating the patient's sense of isolation and compounding emotions of loneliness and desolation.…”