Cultivating A Positive Mindset In Hemodialysis Patients: A Phenomenological Study And Its Implications For Health

Hemodialysis is an important therapy for patients with end-stage chronic kidney disease (CKD), yet it often poses significant psychological and social burdens, including stress, depression, and a reduced sense of autonomy. While previous research has highlighted the benefits of cultivating a positive mindset in chronic care, little is known about the internal processes by which patients foster such resilience. This study aims to explore hemodialysis patients' lived experiences of developing a positive mindset and analyze its role in improving their quality of life. Using a qualitative research design with a descriptive phenomenological approach, data were collected through in-depth and semi-structured interviews with purposively drawn patients in a hospital, Indonesia. Data were analyzed using the Colaizzi method, ensuring rigorous and participant-centered thematic extraction. The findings revealed four interrelated themes: (1) self-awareness and acceptance, reflecting an emotional transition from denial to constructive adaptation; (2) family support, both emotional and practical, which enhances motivation and treatment adherence; (3) trust in medicine and spiritual engagement, which helps patients find inner peace and existential meaning; and (4) focus on controllable aspects of daily life, enabling self-regulated health behaviors and increasing agency. These themes coalesce into a holistic framework in which psychological, social and spiritual domains interact synergistically to build resilience and foster emotional well-being. This study underscores the importance of integrating cognitive-behavioral interventions, family engagement, and spiritual support in hemodialysis care. It also offers insights for educational institutions to reform health curricula and for healthcare systems to adopt a patient-centered interdisciplinary approach. Future research should explore comparative and longitudinal studies to assess the effectiveness of psychological and spiritual interventions across cultural and religious contexts in chronic care populations.

Keywords: cognitive behavioral therapy, hemodialysis, positive mindset, psychological resilience, phenomenology