title: Physiological and psychosocial stressors among hemodialysis patients in educational hospitals of northern iran.
abstract: OBJECTIVE
  The hemodialysis (HD) patients are experiencing high biopsychosocial stress on all levels. Therefore, this study was designed to survey on physiologic and psychosocial stressors among HD patients in two educational hospitals of Northern Iran.
  
  
  METHODS
  This cross-sectional study included 80 HD patients who were referred to Khomeini and Fatemeh Zahra hospitals in Mazandaran (Northern Iran) during the year 2011. Data were collected using a demographic information record sheet and Baldree Hemodialysis Stress Scale.
  
  
  RESULTS
  THE FOLLOWING PHYSIOLOGIC STRESSORS WERE NOTED: Fatigue (51.25%), limited time and places for enjoyment (46.25%), and physical activation limitation (32.5%). Similarly the following psychosocial stressors were observed: Fistula (58.75%), limitation of drinking water (47.5%), low quality of life (47.5%), travelling difficulties to the dialysis center (45%), treatment cost (41.5%), and low life expectancy. The stress level was high in women who were married, younger, less dialysis vintage, and belonged to a low education level.
  
  
  CONCLUSIONS
  This study reports that HD patients have with significant physical and psychosocial problems and they need education, family, and social supports.
authors.affiliation: Department of Nursing, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Mohammad Ali Heidari
authors.initials: MA
authors.lastname: Gorji
authors.affiliation: Department of Nursing, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mahdavi
authors.affiliation: Department of Nursing, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Janati
authors.affiliation: Department of Nursing, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Ehteramossadat
authors.initials: E
authors.lastname: Illayi
authors.affiliation: Department of Bio Statistic, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Yazdani
authors.affiliation: Department of Neurologists, Member of Psychiatry and Behavioural Science Centre, Sari, Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Setareh
authors.affiliation: Department of Employment, Ministery of Health and Medical Education, Tehran, Iran.
authors.forename: Seyed Azam Hoseiny
authors.initials: SA
authors.lastname: Panjaki
authors.affiliation: Department of Education Development Centre, Medical Science University of Mazandaran, Iran.
authors.forename: Ali Morad Heidari
authors.initials: AM
authors.lastname: Gorji
keywords: Chronic renal failure; Hemodialysis patients; Psychosocial stress