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.
Recreation
Covers recreational pursuits chosen for personal enjoyment and pleasure (WHO, 2022). Refers to the ability of the patients to enjoy leisure and relaxing activities.
1. Engage in light recreational activities such as walking, crafting, or listening to music to boost mood and energy.
Recreation improves mental well-being and reduces dialysis-related stress.
(Halle et al., 2024).
2. Schedule regular social recreation (including virtual activities) like game nights or group chats with friends.
Social activities enhance emotional support and reduce feelings of isolation.
(NANDA International, 2021).
3. Participate in meditation-based hobbies such as gardening, painting, or journaling to promote relaxation.
Mindful recreation helps manage anxiety and physical symptoms
(Halle et al., 2024).
Marital Status-Based: Married
1. Plan leisure activities with your spouse that are safe post-dialysis, like attending a park or cooking together.
Shared recreation strengthens bonds and reduces stress.
(8 Activities to Try During Dialysis, 2023).
2. Explore couple-friendly online fitness classes to stay active and healthy together.
Physical activity as a couple promotes adherence to exercise.
(8 Activities to Try During Dialysis, 2023).
3. Create a “wellness weekend” routine with your spouse involving light sports, movies, or creative projects.
Structured recreation maintains a healthy, happy relationship.
(8 Activities to Try During Dialysis, 2023).
Marital Status-Based: Widowed
1. Engage in memory preservation activities like scrapbooking or storytelling.
Reminiscence activities provide emotional healing and purpose
(NANDA International, 2021).
2. Join senior-friendly recreational classes like tai chi or painting classes.
Gentle recreation enhances physical and emotional health.
(Lambert et al., 2022).
3. Plan nature visits with senior groups, like park strolls or botanical garden tours.
Nature-based recreation improves mental clarity and emotional well-being.
(Halle et al., 2024).
Marital Status-Based: Separated
1. Attend art therapy or music therapy groups designed for emotional healing.
Therapeutic recreation assists emotional adjustment after separation.
(Lambert et al., 2022).
2. Develop a new recreational skill like learning a musical instrument or digital art.
New skills boost self-confidence and emotional recovery .
(Lambert et al., 2022).
3. Participate in peer-led recreation groups for people recovering from life transitions.
Peer groups promote social support and resilience.
(Lambert et al., 2022).
Marital Status-Based: Single
1. Join hobby clubs online or in your community (like book clubs or art classes).
Club membership fosters belonging and reduces loneliness
(Lambert et al., 2022).
2. Try independent hobbies like photography, solo travel blogs, or creative writing.
Solo hobbies encourage self-expression and emotional resilience.
(Lambert et al., 2022).
3. Volunteer for community recreational events suited for dialysis patients.
Volunteering combines recreation and social purpose
(8 Activities to Try During Dialysis, 2023).
Occupational Status-Based: Unemployed
1. Create a structured daily recreational schedule to maintain a sense of purpose (e.g., morning walks, afternoon crafts).
Structure enhances emotional stability and coping.
(Lambert et al., 2022).
2. Explore free or low-cost recreational activities offered by local community centers.
Accessible recreation maintains engagement without financial strain.
(Lambert et al., 2022).
3. Start a personal project like a blog, craft business, or community art initiative.
Personal projects provide joy, purpose, and possible future income.
(Lambert et al., 2022).
Occupational Status-Based: Employed
1. Integrate mini-recreation breaks during your workday, such as stretching, short walks, or music listening.
Micro-breaks help manage work-related stress
(NANDA International, 2021).
2. Plan a flexible recreational schedule that fits around dialysis and work demands.
Balanced recreation prevents burnout and supports quality of life.
(Halle et al., 2024).
3. Participate in employee wellness programs that include recreational activities.
Wellness programs improve overall physical and mental health
(Halle et al., 2024).
References
NANDA International. (2021). NANDA Nursing Diagnoses: Definitions and Classification, 16th Edition. 8 activities to try during dialysis. (2023). National Kidney Foundation. https://www.kidney.org/news-stories/8-activities-to-try-during-dialysis Halle, M., Manfredini, F., Floege, J., & Zoccali, C. (2024). Physical exercise in haemodialysis patients: which type of exercise is more convenient? Clinical Kidney Journal, 17(7). https://doi.org/10.1093/ckj/sfae165 Lambert, K., Lightfoot, C. J., Jegatheesan, D. K., Gabrys, I., & Bennett, P. N. (2022). Physical activity and exercise recommendations for people receiving dialysis: A scoping review. PLoS ONE, 17(4), e0267290. https://doi.org/10.1371/journal.pone.0267290
