Dynamics of Psychosocial Adaptation and Life Meaning among Stage 5 Chronic Kidney Disease Patients Undergoing Haemodialysis: A Scoping Review Based on the Roy Adaptation Model and Self-Transcendence Theory
DOI:
https://doi.org/10.37287/ijghr.v8i5.2290Keywords:
chronic kidney disease, haemodialysis, meaning of life, psychosocial adaptation, roy adaptation modelAbstract
Stage 5 chronic kidney disease (CKD) is a progressive condition requiring long-term renal replacement therapy; haemodialysis imposes a complex physical, psychological, social, and existential burden on patients. Although the impact of haemodialysis on patients’ lives has been extensively studied, the integration of psychosocial adaptation and self-transformation toward finding meaning in life within a comprehensive theoretical framework remains largely unexplored. To map and synthesize scientific evidence regarding the dynamics of psychosocial adaptation and life meaning among stage 5 chronic kidney disease (CKD) patients undergoing haemodialysis, and to develop an integrative conceptual framework based on the Roy Adaptation Model (RAM) and Self-Transcendence Theory (STT). This study employed a scoping review design in accordance with the Joanna Briggs Institute (JBI) guidelines and was reported in accordance with PRISMA-ScR. A literature search was conducted via Scopus, PubMed, and Google Scholar using the keywords “chronic kidney disease”, “end-stage renal disease”, “haemodialysis”, “adaptation”, “coping”, “psychosocial”, “spirituality”, “self-transcendence”, and “qualitative” for the period January 2022–May 2026, which initially identified 330 articles, of which nine qualitative articles ultimately met the inclusion criteria for analysis using thematic synthesis. The results of the thematic synthesis identified four main themes, namely: (1) psychosocial burden as a stimulus for adaptation, (2) the dynamics of psychosocial adaptation and the reconstruction of life meaning, (3) spirituality, hope, and coping strategies in the search for life meaning, and (4) social support as a factor that strengthens adaptation and the search for life meaning. Haemodialysis patients exhibit complex and multidimensional psychosocial adaptation dynamics, with the RAM explaining adaptive response processes, while the STT describes self-transformation toward life meaning and resilience. These findings underscore the importance of a holistic nursing approach and support a paradigm shift from disease-centered care toward meaning-centered care.
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