抄録
Adult patients undergoing hemodialysis must manage treatment-related tasks, including fluid and dietary restrictions and complication prevention, while balancing daily responsibilities such as employment and childcare, creating a need for supportive measures. This study focused on resilience, a component of self-management, to clarify the factors that influence resilience among adult hemodialysis patients. A self-administered questionnaire survey was administered to 1,645 patients across 329 dialysis facilities in Tokyo. Responses were obtained from 258 patients (response rate: 15.7%), of which 225 were valid (valid response rate: 87.2%) and were analyzed. Survey items included basic attributes, the Bidimensional Resilience Scale (BRS), the Self-Care Agency Questionnaire (SCAQ), and the 8-item Short-Form Health Survey (SF-8). The results showed that employed patients had significantly higher intrinsic resilience than unemployed patients, suggesting that employment contributes to economic independence, social roles, and self-realization. Conversely, patients experiencing difficulties at work or in daily life tended to show lower resilience. Logistic regression analysis identified “continuation of health management” and the “mental health summary (MCS) score” as predictors of intrinsic resilience, while “obtaining effective support” and the “MCS” were related factors for acquired resilience. These results indicate that it is important to support the fulfillment of social roles through employment and provide ongoing support for environmental adjustments and health management. Furthermore, it has been demonstrated that factors influencing acquired resilience include the importance of establishing an environment that facilitates access to support, based on long-term medical care experience and trust-based relationships with healthcare professionals.
https://ror.org/03zgadm16 
