Xu WL, Wang Y, Zhu L, Zhang X, Tan YS, Peng PP, Yang XJ. Impact of narrative support on stigma, anxiety, and depression in young and middle-aged patients undergoing maintenance hemodialysis. World J Psychiatry 2026; 16(9): 119511 [DOI: 10.5498/wjp.119511]
Corresponding Author of This Article
Xing-Ju Yang, Chief Nurse, Department of Nursing, People’s Hospital Affiliated to Shandong First Medical University, No. 001 Xuehu Street, Laiwu District, Jinan 271100, Shandong Province, China. doc_yangxingjv@163.com
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Psychiatry
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Xu WL, Wang Y, Zhu L, Zhang X, Tan YS, Peng PP, Yang XJ. Impact of narrative support on stigma, anxiety, and depression in young and middle-aged patients undergoing maintenance hemodialysis. World J Psychiatry 2026; 16(9): 119511 [DOI: 10.5498/wjp.119511]
World J Psychiatry. Sep 19, 2026; 16(9): 119511 Published online Sep 19, 2026. doi: 10.5498/wjp.119511
Impact of narrative support on stigma, anxiety, and depression in young and middle-aged patients undergoing maintenance hemodialysis
Wen-Li Xu, Yue Wang, Lin Zhu, Xin Zhang, Yong-Shun Tan, Pei-Pei Peng, Xing-Ju Yang
Wen-Li Xu, Yue Wang, Xing-Ju Yang, Department of Nursing, People’s Hospital Affiliated to Shandong First Medical University, Jinan 271100, Shandong Province, China
Lin Zhu, Xin Zhang, Yong-Shun Tan, Hemodialysis Room, People’s Hospital Affiliated to Shandong First Medical University, Jinan 271100, Shandong Province, China
Pei-Pei Peng, Department of Psychiatry, Laiwu Central Hospital of Shandong Yiyang Health Group, Jinan 250013, Shandong Province, China
Author contributions: Xu WL was responsible for writing the paper; Wang Y was responsible for analyzing the statistical data; Zhu L and Zhang X collected materials; Tan YS and Peng PP were responsible for providing clinical advice; Yang XJ was responsible for researching, designing, and developing the intervention plans; and all the authors have approved the manuscript.
Supported by Jinan Municipal Health Commission’s 2024 Science and Technology Development Plan Development Project, No. 2024305010.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Jinan City People’s Hospital, approval No. 2024yxkt-6.
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Corresponding author: Xing-Ju Yang, Chief Nurse, Department of Nursing, People’s Hospital Affiliated to Shandong First Medical University, No. 001 Xuehu Street, Laiwu District, Jinan 271100, Shandong Province, China. doc_yangxingjv@163.com
Received: March 25, 2026 Revised: April 28, 2026 Accepted: June 3, 2026 Published online: September 19, 2026 Processing time: 151 Days and 20.4 Hours
Abstract
BACKGROUND
End-stage renal disease requires maintenance hemodialysis (MHD), which imposes a huge psychological and social burden on young and middle-aged patients. This group often needs to balance professional and social roles, and is therefore highly vulnerable to stigma, anxiety and depression. These conditions can severely undermine treatment adherence and the quality of life. Although narrative support has shown benefits in other chronic illnesses, its structured application in young and middle-aged MHD populations remains underexplored.
AIM
To assess the effects of narrative support on stigma, adherence, sleep, and quality of life in patients undergoing MHD.
METHODS
This retrospective study included 158 patients who received MHD treatment. The control group (n = 73) received standard treatment, while the observation group (n = 85) received additional narrative support. The Social Impact Scale (SIS), Self-rating Anxiety Scale, Pittsburgh Sleep Quality Index, Self-rating Depression Scale, short form-36 health survey health questionnaire and end-stage renal disease compliance questionnaire were used to evaluate before and after intervention.
RESULTS
Compared to the control group, patients receiving narrative support showed a significantly greater reduction in perceived stigma, anxiety, and depression. In addition, the intervention group performed better in treatment compliance and sleep quality, and scored significantly higher in all eight dimensions of the short form-36 health survey scale, indicating that their physical and mental health had improved. After applying Bonferroni correction, all significant differences remained robust.
CONCLUSION
Narrative support can help to reduce the psychological burden of young and middle-aged patients undergoing hemodialysis, improve treatment compliance, and improve their quality of life.
Core Tip: Structured narrative support significantly reduces stigma, anxiety, and depression in young and middle-aged hemodialysis patients. It also improves treatment adherence, sleep quality, and health-related quality of life. This patient-centered approach helps patients reframe their illness experiences through guided storytelling, offering an effective strategy to address the psychosocial challenges of long-term dialysis. Narrative support is a valuable complement to the standard clinical care.
