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Self-management is essential for patients who require regular hemodialysis treatment. This study aimed to explore the relationships between social support, sense of coherence (SOC), and self-management in hemodialysis patients and to examine whether SOC plays a mediating role. In a cross-sectional study, 402 hemodialysis patients from four tertiary hospitals were recruited. Data were analyzed using structural equation modeling. Social support, SOC, and self-management were significantly correlated with each other. The proposed model provided a good fit to the data. Social support had a direct effect on self-management and SOC, partially mediated the effect of social support on self-management (β = 0.248, p = 0.001). Social support and SOC explained 69% of the variance in self-management. Our findings indicate that health care providers can enhance social support with an emphasis on strengthening SOC strategies to better improve self-management in hemodialysis patients.

This cross-sectional study assessed the overall symptom burden, including the prevalence, frequency, severity, and distress of symptoms among hemodialysis patients, and explored the relationship between demographic characteristics, clinical variables, self-management, sense of coherence, social support, and symptom burden in these patients. Herein, a regression analysis was performed to determine associations with symptom burden. The mean score of symptom burden among the participants (n = 382) was 74.12, with an average number of 12 symptoms. The analysis revealed that self-management, sense of coherence, and social support were negatively associated with the overall symptom burden. The multiple regression model showed that 48.6% of the variance in symptom burden was explained by meaningfulness, emotional management, daily urine output, subjective support, gender, and manageability. These findings contribute to the knowledge of symptom burden among hemodialysis patients and some new predictors (self-management, sense of coherence, and social support) of their symptom burden.