Living Physical Environment

Environmental Domain

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ENVIRONMENTAL

In the Environmental Domain, the sociodemographics that were moderately correlated were marital status (V = .362) and occupational status (rpb = .321). These two factors had a stronger relationship to environmental quality of life (QoL) compared to the other variables, which showed only weak correlations.

Marital status affected the Environmental Domain because having a spouse often provided emotional, financial, and practical support—such as assistance with transportation to dialysis, navigating the healthcare system, and maintaining a safe, stable home environment. Married patients tended to have better access to resources that improve environmental QoL, while single, divorced, or widowed individuals sometimes struggled with these supports, impacting their living conditions and access to care. Occupational status also influenced the Environmental Domain significantly. Employed patients benefited from better financial stability, allowing them to afford safer housing, better transportation, and necessary healthcare services. On the other hand, unemployed patients often faced financial hardships, limiting their environmental supports and worsening their ability to maintain a healthy and stable living situation.

Thus, marital and employment statuses moderately affected how CKD patients experienced their environment, while other factors like age, sex, education, income, and comorbidities had only weak effects.

Living Physical Environment

Covers both natural and built environments that affect people’s health, such as air, water, housing, and community design (WHO, 2022). Furthermore, this relates to the patient’s condition and comfort of their home and surroundings .

General Interventions

(For age, sex, marital status, household income, comorbidities)

1. Maintain a clean and clutter-free living space, especially around your dialysis supplies.

A clean environment reduces infection risk (World Health Organization, 2022).

2. Ensure proper ventilation in your home to avoid respiratory issues that may worsen CKD conditions.

Good air circulation prevents respiratory complications (World Health Organization, 2022).

3. Set up a dedicated “safe zone” at home for recovery post-dialysis (quiet, sanitized, comfortable).

A calm, hygienic recovery area improves healing and comfort (World Health Organization, 2022).

Marital Status-Based: Married

1. Work with your spouse to regularly inspect your home for safety hazards (e.g., loose wires, wet floors).

Teamwork in home maintenance prevents accidents (DaVita Kidney Care, 2024).

2. Plan and budget together for home improvements that promote dialysis safety (e.g., installing railings, buying an air purifier).

Joint decisions ensure consistent health-focused environment upgrades (DaVita Kidney Care, 2024).

3. Divide household chores with your spouse to avoid overexertion after dialysis.

Energy conservation prevents fatigue and promotes faster recovery (DaVita Kidney Care, 2024).

Marital Status-Based: Widowed

1. Apply for senior citizen home modification programs that subsidize safety upgrades.

Senior programs prioritize safer homes for widowed elderly (National Kidney Foundation, 2025).

2. Join senior or dialysis peer groups that can offer practical tips on safer living arrangements.

Peer advice encourages practical, effective changes (National Kidney Foundation, 2025).

3. Install simple monitoring systems like door alarms to feel safer at home.

Added security increases peace of mind for widowed patients (National Kidney Foundation, 2025).

Marital Status-Based: Separated

1. Redesign your living space for independence — minimize stairs, use mobility aids if needed.

Environment adaptation boosts independence and reduces injury risk (DaVita Kidney Care, 2024).

2. Request home visits from barangay health workers to assess and advise on safety improvements.

Expert evaluation ensures safer living conditions (DaVita Kidney Care, 2024).

3. Use local handyman services or government programs that help separated individuals with home adjustments.

External help improves safety for separated individuals without home support (DaVita Kidney Care, 2024).

Marital Status-Based: Single

1. Create a simple checklist for home maintenance tasks to ensure a safer environment.

Regular self-assessments maintain a dialysis-friendly home (DaVita Kidney Care, 2024).

2. Reach out to community services that help with home repairs and cleaning

Community help lightens the burden of living alone with chronic illness (DaVita Kidney Care, 2024).

3. Consider living in low-maintenance accommodations if maintaining a large home becomes challenging.

Downsizing improves safety and ease of care (DaVita Kidney Care, 2024).

Occupational Status-Based: Unemployed

1. Join government-sponsored housing programs to secure safer living conditions.

Good housing improves health and ensures security. (Paterson et al., 2024).

2. Enroll in community “Healthy Homes” projects offering free home safety evaluations and upgrades.

Free assessments and modifications reduce environmental risks (Paterson et al., 2024).

3. Engage in low-cost DIY home projects to improve your living space’s safety and cleanliness.

Simple home improvements increase safety without financial strain (Paterson et al., 2024).

Occupational Status-Based: Employed

1. Adapt your home workspace for ergonomic safety (e.g., adjustable chairs, proper lighting).

Home ergonomics reduce injury risks, especially post-dialysis (Paterson et al., 2024).

2. Schedule professional house-cleaning services if work limits your time to maintain cleanliness.

Cleanliness is critical to prevent infections and complications (Paterson et al., 2024).

3. Create a flexible home schedule that balances work responsibilities and time for dialysis care.

Balanced routines prevent burnout and health deterioration (Paterson et al., 2024).

References

NANDA International. (2021). NANDA Nursing Diagnoses: Definitions and Classification, 16th Edition.
World Health Organization. (2022, April 4). Health and the environment – Our planet, our health. https://www.who.int/news/item/04-04-2022-health-and-the-environment
National Kidney Foundation. (2025, March 7). Preparing for home dialysis. https://www.kidney.org/kidney-topics/preparing-home-dialysis
DaVita Kidney Care. (2024). Safety and training for home dialysis. https://www.davita.com/treatment-services/home-dialysis/home-benefits/safety-and-training-for-home-dialysis
Paterson, B., Fox, D. E., Lee, C. H., & Smith, J. (2024). Integrated home dialysis model: Facilitating home-to-home transition. Hemodialysis International. Advance online publication. https://www.ncbi.nlm.nih.gov/articles/PMC11151120/