Resilience and Gender Differences in Patients with End-Stage Renal Disease Receiving Hemodialysis: A Cross-Sectional Study

Introduction: End-stage renal disease and hemodialysis impose substantial physical and emotional demands that compromise patients’ psychological well-being. Psychological resilience—the capacity to adapt positively to chronic adversity—plays a protective role, yet its sociodemographic and gender-related determinants remain poorly characterized in hemodialysis populations. Objective: To evaluate psychological resilience in adults receiving maintenance hemodialysis and to examine its association with gender, educational level, and clinical variables. Methods: A cross-sectional study was conducted in 55 hemodialysis patients at the Central Defense Hospital “Gómez Ulla” (Madrid, Spain). Sociodemographic and clinical data were collected, and resilience was assessed using the 14-item Resilience Scale (RS-14). Statistical analyses included independent-samples t-tests, Spearman’s correlations, and multiple linear regression. Results: Patients reported moderate resilience levels (mean = 74.02, SD = 13.99). Men showed significantly higher resilience than women (77.74 vs. 67.50; p = 0.008). Educational attainment correlated positively with resilience (ρ = 0.307; p = 0.023). In the multivariate model, gender and education together explained 22% of the variance in resilience scores (R² = 0.22), while clinical variables showed no significant associations. Conclusions: This preliminary study suggests that gender and educational level may influence psychological resilience in patients undergoing hemodialysis. These associations should be interpreted with caution due to the small, single-center sample and the absence of key psychosocial and contextual variables. Larger, adequately powered multicenter studies incorporating multidimensional gender measures and broader sociodemographic indicators are needed to clarify the mechanisms shaping resilience in ESRD. Tailored psychosocial interventions may help strengthen emotional adaptation in vulnerable groups.