BIOPSYCHOSOCIAL ADAPTATION AND QUALITY OF LIFE IN PATIENTS WITH END-STAGE RENAL DISEASE UNDERGOING DIALYSIS: A MULTIDIMENSIONAL ASSESSMENT

In contemporary clinical medicine, the evaluation of treatment outcomes has undergone a profound conceptual transformation. Historically, the dominant biomedical paradigm concentrated almost exclusively on hard endpoints—mortality rates, biochemical indices, complication profiles, and organ-specific functional parameters. Within this framework, therapeutic success was defined by survival extension and laboratory normalization. However, the progressive burden of chronic non-communicable diseases has exposed the limitations of such a reductionist approach. Longevity without functional autonomy, survival without psychosocial integration, and biochemical control without subjective well-being are increasingly recognized as incomplete therapeutic achievements. Consequently, healthcare systems worldwide have embraced a biopsychosocial paradigm, which recognizes that disease affects not only organ systems but also identity, social roles, psychological resilience, and existential outlook.