Abstract
To compare the physical activity, sleep quality and depressive symptoms between patients with diabetes and non-diabetes undergoing maintenance hemodialysis, and identify associated influencing factors. A descriptive cross-sectional design was adopted. Maintenance hemodialysis patients were enrolled from two hemodialysis centers in Xi'an, China between April and May 2022. Sociodemographic and clinical data were collected, with physical activity assessed via Human Activity Profile, sleep quality via Pittsburgh Sleep Quality Index, and depressive symptoms via Beck Depression Inventory-II. Of 286 participants, 113 had diabetes and 173 did not. Diabetic patients had lower adjusted activity scores (40.07 ± 22.94 vs. 55.94 ± 21.35, P < 0.01), higher PSQI global scores (9.04 ± 4.48 vs. 7.15 ± 4.47, P < 0.01), and higher BDI-II scores (17.32 ± 10.75 vs. 12.95 ± 9.26, P < 0.01) than non-diabetic patients. Multivariate logistic regression showed that age (OR = 1.02, 95% CI: 1.01, 1.04) and BDI-II score (OR = 1.04, 95% CI: 1.01, 1.07) were positively associated with diabetes, whereas AAS (OR = 0.98, 95% CI: 0.97, 0.99) and MHD duration (OR = 0.99, 95% CI: 0.98, 1.00) were negatively associated. Diabetic patients receiving maintenance hemodialysis exhibit poorer physical activity levels, sleep quality, and depressive symptoms compared with non-diabetic counterparts. Accordingly, routine combined screening of physical activity, sleep disturbance and depressive symptoms should be embedded into daily dialysis nursing.