Loneliness in Older Adults Receiving Hemodialysis and Associated Factors: A Cross-Sectional Study.

Participants were a convenience sample from two hospitals in northern Taiwan, so the findings may not apply to other dialysis populations. Most participants lived with family, had fair economic status, and had good self-care ability, so the study says little about patients who are isolated, financially strained, or unable to care for themselves. The study was cross-sectional, so it cannot show whether fatigue or low social support causes loneliness, or whether loneliness causes fatigue or withdrawal. People with diagnosed depression or another mental disease, cancer treatment, or hospice care were excluded, so very distressed patients may be underrepresented. The regression model accounted for only a small share of differences in loneliness scores (adjusted R2 = .153), so other unmeasured factors likely matter. Data were collected in 2019, although the authors state dialysis protocols in Taiwan have not changed much.

Do not read these associations as proof that reducing fatigue or increasing social support will lower loneliness. This was a cross-sectional survey, so it cannot show cause.