Determinants of Quality of Life of End-Stage Renal Disease Patients Undergoing Hemodialysis in Gaborone, Botswana

Abstract

ESRD and reliance on dialysis profoundly impact physical, mental, and social health. However, few studies in Botswana have examined how psychosocial, clinical, and demographic traits together shape QoL. This research focused on identifying key factors influencing QoL among dialysis patients in Gaborone. A cross-sectional study design was employed, and 165 participants from primary dialysis centres in Gaborone were selected. Research data were collected using a structured questionnaire that comprised demographic information, the WHOQOL-BREF, the Patient Health Questionnaire (PHQ-9), and the Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive statistics and correlation analysis were used to analyze quantitative data. Findings showed that 64.9% of patients rated their QoL as poor, and 72.1% were dissatisfied with their health. Psychological distress (r = –0.583, p < 0.01). It was associated with lower QoL, whereas social support (r = 0.555, p < 0.01) was associated with higher QoL. The research indicates that ESRD patients in Botswana experience a significantly reduced QoL, which, in their view, is primarily attributable to the factors of emotional distress. The article proposes targeted policies to address QoL challenges and to incorporate routine screening by health workers to identify and refer vulnerable individuals early. Medical professionals in Botswana should integrate mental health support into hemodialysis programs as a standard component to improve mental health outcomes, treatment adherence, and overall quality of life.