Family function assessment on stress, anxiety and depression levels among hemodialysis patients

Abstract

Background: The number of patients with chronic kidney disease requiring hemodialysis in Indonesia has increased substantially. Many patients experience psychological difficulties, including stress, anxiety, and depression. Family support may help mitigate these challenges.

Objective: This pilot study evaluated the association between family functioning and psychological outcomes among hemodialysis patients at Royal Prima Medan Hospital.

Methods: This cross-sectional pilot study used purposive sampling to assess family functioning, stress, anxiety, and depression using the Family APGAR, Perceived Stress Scale, and Hospital Anxiety and Depression Scale, respectively. Data were collected through interviews and questionnaires in March 2025. Because of the small sample size and highly imbalanced distribution of family functioning, Fisher’s exact test was used for bivariate analyses instead of the prespecified logistic regression. A post hoc power calculation was also performed.

Results: Thirty-five participants were enrolled; 62.9% were men, and the most common age group was 41–50 years. Good family functioning was reported by 97.1% of participants, whereas 2.9% reported family dysfunction. Moderate stress was present in 31.4% of participants, anxiety in 25.7%, and depression in 5.7%. Family functioning was not significantly associated with stress (p=0.343), anxiety (p=1.000), or depression (p=1.000).

Conclusion: No significant associations were observed between family functioning and psychological outcomes. However, the study was severely underpowered because of the small sample size and minimal variation in family functioning. The findings are hypothesis-generating rather than definitive. Larger multicenter studies with longitudinal designs are warranted.