“Alive Day is the Day”: A Qualitative Study of Experiences of Learned Helplessness in Maintenance Haemodialysis Patients

Chunyan Xie,1,2,* Li Li,2,3,* Yamin Li1 1Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China; 2Xiangya Nursing School of Central South University, Changsha, Hunan Province, 410013, People’s Republic of China; 3The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yamin Li, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China, Email aminny@csu.edu.cnBackground: Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH.Methods: We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi’s phenomenological approach.Results: Twenty-two respondents completed the interviews (aged 29– 75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends’ helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison).Conclusion: The study reveals that multiple stressors drive MHD patients’ LH. These salient phenomena demonstrate the importance of recognizing MHD patients’ LH. We suggest that support services should be developed alongside a framework that addresses MHD patients’ LH from the beginning of treatment.Keywords: maintenance haemodialysis, learned helplessness, qualitative study, phenomenology, patient experiences