Self-care and Quality of Life in Patients with Chronic Renal Failure Undergoing Hemodialysis at Sulaimaniyah Province, Kurdistan Region of Iraq


  • Khalil Hamad Ibrahim Department of Adult Nursing, College of Nursing, University of Sulaimani, Kurdistan Region, Iraq. & Ranya General Hospital, Directorate of Health, Ministry of Health, Sulaimani, Kurdistan Region, Iraq. Author
  • Niyan Hakim Ismael Department of Adult Nursing, College of Nursing, University of Sulaimani, Kurdistan Region, Iraq. Author



Chronic renal failure, hemodialysis, self-care, quality of life, descriptive-analytical study


Background: Chronic renal failure (CRF) is a significant and growing public health issue globally with a negative impact on self-care and quality of life (QoL). Self-care and QoL are essential aspects of controlling the adverse effects of the illness.


Objectives: To assess self-care and QoL of patients with CRF who undergo hemodialysis (HD).


Patients and Methods: A descriptive-analytical design was carried out in Sulaimani Province Hemodialysis Centers/Unit from March to September 2022. About 150 patients with CRF undergoing hemodialysis consented to participate in the study. Non-probability convince sample technique was used to select the participants. The data were collected through a questionnaire by direct interview.


Results: Most patients were ≥60 years, males, married, illiterate, lived in an urban area and had barely sufficient economic status with 4-6 family members. The study's findings revealed inadequate self-care in >50% of patients. A significant correlation between self-care and QoL in limitation of activities was found for CRF patients who underwent Hemodialysis with no correlation for general health, physical and emotional, and energy and emotion. Also, there was a significant difference between QoL and age (for the general health domain), gender, and level of education (for the limitations of the activities domain). Mean self-care measurement was significantly associated between previous occupation and duration of Hemodialysis.


Conclusions: Most patients had inadequate self-care and poor QoL, which means that higher self-care performance was associated with better QoL in the limitation of activities only and no other QoL domains.


Ho Y-W, Chau K-F, Choy B-Y, Fung K-S, Cheng Y-L, Kwan T-H, et al. Hong Kong renal registry report 2012. Hong Kong Journal of Nephrology. 2013;15(1):28-43. DOI:

Ibrahim S. Quality of care assessment and adherence to the international guidelines considering dialysis, water treatment, and protection against transmission of infections in university hospital‐based dialysis units in Cairo, Egypt. Hemodialysis International. 2010;14(1):61-7. DOI:

Poveda V, Amado L, Filgueiras M, Teixeira L, Miranda V, Santos-Silva A, et al. End-stage renal disease adherence questionnaire: translation and validation to the Portuguese language. Renal failure. 2016;38(10):1633-8. DOI:

Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Oxford University Press; 2019. p. 1803-5. DOI:

Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic kidney disease. The Lancet. 2021;398(10302):786-802. DOI:

Rini IS, Rahmayani T, Sari EK, Lestari R. Differences in the quality of life of chronic kidney disease patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis. Journal of Public Health Research. 2021;10(2):jphr. 2021.209. DOI:

Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. The lancet. 2017;389(10075):1238-52. DOI:

Hamza OF, Kotb SA, Hassanen RH, Elmaghawry AM. Self-Care BehaviorFor Hemodialysis Patients At Beni-Suef University Hospital. Assiut Scientific Nursing Journal. 2021;9(25.0):180-90. DOI:

Mogharab M, Hedayati H, Najafi R, Safari M, Amiri S, Adhami S. Prevalence of depression and life events in hemodialysis patients in Vali-Asr hospital in Birjand (2010). Modern Care Journal. 2011;8(3).

Kim Y, Evangelista LS. Relationship between illness perceptions, treatment adherence, and clinical outcomes in patients on maintenance hemodialysis. Nephrology nursing journal: journal of the American Nephrology Nurses' Association. 2010;37(3):271.

Wang V, Vilme H, Maciejewski ML, Boulware LE, editors. The economic burden of chronic kidney disease and end-stage renal disease. Seminars in Nephrology; 2016: Elsevier. DOI:

Alligood MR, Tomey A. Nursing theorists and their work. St. Louis, MO. Mosby Inc; 2014.

Shintani K. Association between the components of self-care and health locus of control among hemodialysis patients. Niigata journal of health and welfare. 2007;7(1):28-30.

Ware JE. The MOS 36-item short-form health survey (SF-36), part I: conceptual framework and item selection. Medical Care. 1992;30:473-83. DOI:

McHorney CA, Ware Jr JE, Lu JR, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care. 1994:40-66. DOI:

Shah S, Pokharel N. Knowledge Regarding Self Care Measures and Quality of Life among Patients with Chronic Renal Failure undergoing Hemodialysis. Journal of Lumbini Medical College. 2013;1(1):39-42. DOI:

Arsa SA. The Correlation Of Personal Self-Care Ability And Quality Of Life In Patients Undergoing Chronic Kidney Disease In Hemodialysis Installations Of Rsud Mardi Waluyo Blitar. The Proceeding of International Joint Conference; 2015: STIKes Patria Husada Blitar.

Aydin E. Determination of self-care power of hemodialysis patients. New Trends and Issues Proceedings on Humanities and Social Sciences. 2017;4(2):292-300. DOI:

Atashpeikar S, Jalilazar T, Heidarzadeh M. Self-care ability in hemodialysis patients. Journal of caring sciences. 2012;1(1):31-5.

Rahimi F, Oskouie F, Naser O, Sanandji ME, Gharib A. The effect of self-care on patients undergoing Hemodialysis in the Sanandaj Hospitals affiliated to Kurdistan University of Medical Sciences in 2016. Bali Medical Journal. 2017;6(3):684-9. DOI:

Kim H, Cho M-K. Factors influencing self-care behavior and treatment adherence in hemodialysis patients. International Journal of Environmental Research and Public Health. 2021;18(24):12934. DOI:

Jeon HM, You HS. Factors influencing sick role behavior compliance in patients on hemodialysis. Journal of Korean Academy of Fundamentals of Nursing. 2019;26(1):23-31. DOI:

Zyoud SeH, Daraghmeh DN, Mezyed DO, Khdeir RL, Sawafta MN, Ayaseh NA, et al. Factors affecting quality of life in patients on haemodialysis: a cross-sectional study from Palestine. BMC nephrology. 2016;17(1):1-12. DOI:

Saad MM, El Douaihy Y, Boumitri C, Rondla C, Moussaly E, Daoud M, et al. Predictors of quality of life in patients with end-stage renal disease on hemodialysis. International journal of nephrology and renovascular disease. 2015;8:119. DOI:

Gemmell LA, Terhorst L, Jhamb M, Unruh M, Myaskovsky L, Kester L, et al. Gender and racial differences in stress, coping, and health-related quality of life in chronic kidney disease. Journal of pain and symptom management. 2016;52(6):806-12. DOI:

Garib A, Khosravi F, Eftekari R, Kavakeb J, Rahimi F. Quality of life of in patients undergoing hemodialysis in Sanandaj, Iran. Journal of Chemical and Pharmaceutical Sciences. 2016;9(2):693-5.

Alhajim SA. Assessment of the quality of life in patients on haemodialysis in Iraq. Eastern Mediterranean Health Journal. 2017;23(12):815-20. DOI:

Mandoorah QM, Shaheen FA, Mandoorah SM, Bawazir SA, Alshohaib SS. Impact of demographic and comorbid conditions on quality of life of hemodialysis patients: a cross-sectional study. Saudi Journal of Kidney Diseases and Transplantation. 2014;25(2):432. DOI:

Al Salmi I, Kamble P, Lazarus ER, D’Souza MS, Al Maimani Y, Hannawi S. Kidney disease-specific quality of life among patients on hemodialysis. International journal of nephrology. 2021;2021. DOI:

Msc R, Babatsikou FP. Social aspects of chronic renal failure in patients undergoing haemodialysis. International journal of caring sciences. 2014;7(3):740.



How to Cite

Self-care and Quality of Life in Patients with Chronic Renal Failure Undergoing Hemodialysis at Sulaimaniyah Province, Kurdistan Region of Iraq. (2023). Journal of Zankoy Sulaimani - Part A, 25(1), 12.