Enduring Through Care: A Systematic Review of Resilience, Social Support, and Psychological Well-Being in Hemodialysis Patients

Background: Hemodialysis (HD) patients face profound physical and psychosocial burdens that impact treatment adherence, quality of life, and caregiver well-being. Resilience, social support, self-efficacy, and spiritual health are increasingly recognized as critical factors shaping patient outcomes. Objective: This systematic review synthesizes evidence from six observational studies on the associations between psychosocial factors resilience, social support, self-efficacy, and spirituality and health outcomes in HD patients, while identifying implications for nursing practice and future research. Methods: Following PRISMA 2020 guidelines, six core studies (provided by the researcher) were critically analyzed for methodology, outcomes, and findings. To enrich the synthesis, an additional 20 peer-reviewed articles (2020-2025) from Scopus were systematically reviewed. Thematic synthesis was employed to identify patterns across psychosocial domains and patient-centered outcomes. Results: All six studies (cross-sectional) reported consistent positive correlations: higher resilience, perceived social support, self-efficacy, and spiritual well-being were linked to improved treatment adherence, enhanced quality of life, reduced psychological distress, and lower caregiver burden. Family support emerged as a key enabler, while internal coping mechanisms and existential meaning contributed to emotional adaptation. A summary table outlines study characteristics and findings. Thematic analysis highlighted the interdependence of personal strength and relational care in sustaining well-being. Conclusion: Psychosocial factors are vital determinants of holistic outcomes in hemodialysis. Nurses play a pivotal role in recognizing and nurturing resilience, facilitating family involvement, and integrating spiritual care. Future efforts should prioritize prospective and interventional studies to develop evidence-based, person- centered nursing models.