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Yang J, Li YQ, Gong YL, Yan HL, Chen J, Liu LL, Wu J, Chu J. Benefit finding in individuals undergoing maintenance hemodialysis in Shanghai: a latent profile analysis. Front Psychol 2024; 15:1292175. [PMID: 38500646 PMCID: PMC10946449 DOI: 10.3389/fpsyg.2024.1292175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Objective This multi-center cross-sectional study aimed to delineate latent profiles of benefit finding (BF) in individuals undergoing maintenance hemodialysis (MHD) in Shanghai and examine associations between these BF profiles, social support, and coping style. Methods A total of 384 individuals undergoing MHD (mean age = 57.90, SD = 13.36) were assessed using the Benefit Finding Scale, Simplified Coping Style Questionnaire, and Perceived Social Support Scale. Latent profile analysis (LPA) identified distinct BF categories. Analysis of variance (ANOVA) evaluated the correlation between BF groups and demographic variables, while the relationship between BF, social support, and coping style was tested through correlation and multiple regression analyses. Results LPA identified three BF groups: rich BF (54.17%), moderate BF (41.14%), and poor BF (4.69%). Regression analyses indicated that positive coping and social support are protective factors for BF. Additionally, older age and heightened understanding of MHD correlated with higher BF levels. Conclusion The findings highlighted the importance of recognizing different BF profiles in individuals on MHD and working toward promoting BF levels in the rich BF and moderate BF groups, while helping the poor BF group to identify and address their challenges. Medical professionals should consider interventions tailored to individual psychological profiles to improve mental health and quality of life outcomes in this population.
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Affiliation(s)
- Jie Yang
- School of Nursing, Naval Medical University, Shanghai, China
| | - Yong-qi Li
- School of Nursing, Naval Medical University, Shanghai, China
| | - Yan-lin Gong
- School of Nursing, Naval Medical University, Shanghai, China
| | - Hong-li Yan
- School of Health Services Management, Southern Medical University, Guangzhou, China
| | - Jing Chen
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Ling-ling Liu
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jing Wu
- School of Nursing, Naval Medical University, Shanghai, China
| | - Jing Chu
- School of Nursing, Naval Medical University, Shanghai, China
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Valente Santos CA, Aguiar J, Gato J, Fontaine AMGV, de Freitas DF, Kusumota L. Happiness of Older Adults in Haemodialysis: Findings from a Comparative Study. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:710-723. [PMID: 36541857 DOI: 10.1080/01634372.2022.2155286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Happiness is related to longevity and better health; nevertheless, there is a lack of knowledge about the construct, understood as subjective well-being (SWB), of older adults undergoing hemodialysis. This cross-sectional study investigated the extent to which hemodialysis treatment affects the SWB of older adults, compared to non-dialysis older adults. Regarding this, a total of 126 participants have interviewed: all the older adults in the hemodialysis service, 42 patients, from a city in Brazil, and 84 older adults from the Community, age- and gender-matched, predominantly men (64.3%), aged between 60 and 81 years. Participants respond to pattern questionnaires about SWB (life satisfaction, positive affect, negative affect), depressive symptoms, sociodemographic characteristics, and physical health status. Analysis of variance presented in hemodialysis had no effect on SWB and depressive symptoms. Furthermore, participants in the hemodialysis had fewer years of schooling, and those in the community presented more diseases. The high number of illnesses and low educational level demonstrate effects on SWB, as well the length of hemodialysis is negatively associated with SWB. Therefore, hemodialysis by itself does not make older adults unhappier and depressive, but some variables depending on the socioeconomical status and length of treatment are associated with depression and worst SWB.
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Affiliation(s)
| | - Joyce Aguiar
- Centre for Research in Higher Education Policies, Center for Psychology at the University of Porto, Porto, Portugal
| | - Jorge Gato
- Centre for Research in Higher Education Policies, Center for Psychology at the University of Porto, Porto, Portugal
| | - Anne Marie G V Fontaine
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, London, UK
| | - Daniela F de Freitas
- Faculty of Psychology and Educational Sciences of University of Porto, Porto, Portugal
| | - Luciana Kusumota
- Nursing College of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
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3
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Murea M, Highland BR, Yang W, Dressler E, Russell GB. Patient-reported outcomes in a pilot clinical trial of twice-weekly hemodialysis start with adjuvant pharmacotherapy and transition to thrice-weekly hemodialysis vs conventional hemodialysis. BMC Nephrol 2022; 23:322. [PMID: 36167537 PMCID: PMC9513956 DOI: 10.1186/s12882-022-02946-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background Physical and emotional symptoms are prevalent in patients with kidney-dysfunction requiring dialysis (KDRD) and the rigors of thrice-weekly hemodialysis (HD) may contribute to deteriorated health-related quality of life. Less intensive HD schedules might be associated with lower symptom and/or emotional burden. Methods The TWOPLUS Pilot study was an individually-randomized trial conducted at 14 dialysis units, with the primary goal to assess feasibility and safety. Patients with incident KDRD and residual kidney function were assigned to incremental HD start (twice-weekly HD for 6 weeks followed by thrice-weekly HD) vs conventional HD (thrice-weekly HD). In exploratory analyses, we compared the two treatment groups with respect to three patient-reported outcomes measures. We analyzed the change from baseline in the score on Dialysis Symptom Index (DSI, range 0–150), Generalized Anxiety Disorder-7 (GAD-7, range 0–21), and Patient Health Questionnaire-9 (PHQ-9, range 0–27) at 6 (n = 20 in each treatment group) and 12 weeks (n = 21); with lower scores denoting lower symptom burden. Analyses were adjusted for age, race, gender, baseline urine volume, diabetes mellitus, and malignancy. Participants’ views on the intervention were sought using a Patient Feedback Questionnaire (n = 14 in incremental and n = 15 in conventional group). Results The change from baseline to week 6 in estimated mean score (standard error; P value) in the incremental and conventional group was − 9.7 (4.8; P = 0.05) and − 13.8 (5.0; P = 0.009) for DSI; − 1.9 (1.0; P = 0.07) and − 1.5 (1.4; P = 0.31) for GAD-7; and − 2.5 (1.1; P = 0.03) and − 3.5 (1.5; P = 0.02) for PHQ-9, respectively. Corresponding changes from week 6 to week 12 were − 3.1 (3.2; P = 0.34) and − 2.4 (5.5; P = 0.67) in DSI score; 0.5 (0.6; P = 0.46) and 0.1 (0.6; P = 0.87) in GAD-7 score; and − 0.3 (0.6; P = 0.70) and − 0.5 (0.6; P = 0.47) in PHQ-9 score, respectively. Majority of respondents felt their healthcare was not jeopardized and expressed their motivation for study participation was to help advance the care of patients with KDRD. Conclusions This study suggests a possible mitigating effect of twice-weekly HD start on symptoms of anxiety and depression at transition from pre-dialysis to KDRD. Larger clinical trials are required to rigorously test clinically-matched incrementally-prescribed HD across diverse organizations and patient populations. Trial registration Registered at ClinicalTrials.gov with study identifier NCT03740048, registration date 14/11/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02946-w.
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Affiliation(s)
- Mariana Murea
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1053, USA.
| | - Benjamin R Highland
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wesley Yang
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Emily Dressler
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gregory B Russell
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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4
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Era DP, Sitorus R, Afiyanti Y. Empowerment In The Treatment Of Fatigue In Breast Cancer Patients. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This review aimed at providing a summary of a collection of literature that covers breast cancer and related phenomena, namely fatigue and the disruption of self-esteem and body image that can occur when a cancer diagnosis is given. As the most common symptom reported by survivors, fatigue is a unique personal symptom that burdened survivors, a consequence as well as an antecedent. Fatigue in cancer is caused by disease processes as well as treatment side effects and becomes a serious problem compared to pain and nausea due to limited physical function, and psychological and social welfare. Facing the problem of fatigue, and poor self-esteem and body image in nursing science contributes to the empowerment of survivors; this is achieved through nursing processes and is a standard that can be used to solve fatigue problems.
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Chen J, Liu L, Chen J, Ng MSN, Lou VWQ, Wu B, Jiang W, Jie Y, Zhu J, He Y. The cross-lagged association between depressive symptoms and health-related quality of life in patients receiving maintenance hemodialysis: a three-wave longitudinal study. Qual Life Res 2021; 30:3463-3473. [PMID: 33977414 DOI: 10.1007/s11136-021-02866-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To examine the cross-lagged relationship between depressive symptoms and health-related quality of life (HRQoL) in patients receiving maintenance hemodialysis. METHODS A longitudinal, observational study was conducted in two public hospitals in Shanghai, China. The sample consisted of 204 patients at baseline (T1). Of these, 144 completed the 12-month follow-up survey (T2), and 135 completed the 24-month follow-up survey (T3). Depressive symptoms were assessed using the depression subscale of the Hospital Anxiety and Depression Scale, and HRQoL was assessed using the Kidney Disease Quality of Life 36 short form. Cross-lagged path analysis was used to examine the temporal relationship between depressive symptoms and domains of health-related quality of life. RESULTS Lower levels of three out of five domains of HRQoL (physical functioning, burden of kidney disease, and symptoms of kidney disease) at T1 were associated with increases in depressive symptoms at T2. Moreover, higher depressive symptoms at T2 were associated with decreases in four domains of HRQoL (mental functioning, burden of kidney disease, symptoms of kidney disease, and effects of kidney disease) at T3. CONCLUSIONS Patients who had poor HRQoL were more likely to report more subsequent depressive symptoms, which in turn predict lower HRQoL over time. It indicates a need to break this cycle in patients receiving maintenance hemodialysis.
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Affiliation(s)
- Jieling Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Liu
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Marques S N Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Bibo Wu
- Department of Nephrology, Zha Bei District Center Hospital of Shanghai, Shanghai, China
| | - Weijie Jiang
- Department of Nephrology, Shanghai Shi Bei Hospital, Shanghai, China
| | - Yanqing Jie
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China.
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6
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Moore C, Wearden A, Carter LA, Mitra S, Skevington SM. Development of a measure for patients preparing to start dialysis and their partners: The Starting Dialysis Questionnaire (SDQ). Health Qual Life Outcomes 2020; 18:358. [PMID: 33160381 PMCID: PMC7648298 DOI: 10.1186/s12955-020-01610-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/23/2020] [Indexed: 01/24/2023] Open
Abstract
Background The transition onto dialysis is a stressful time that affects both patients and their partners. Research suggests that psychological and interpersonal characteristics within the couple are related to how well they adapt to dialysis. The aim of this multi-phase, mixed methods study was to develop a measure, the Starting Dialysis Questionnaire (SDQ), that is applicable to both patients and their partners and assesses their own thoughts and feelings about these constructs. Methods Data from semi-structured interviews with patients and their partners (n = 22 couples) were analysed using theoretical thematic analysis to identify and define constructs related to quality of life (QOL). Next, items addressing these constructs were derived from the interviews. Then, cognitive interviews were conducted with patients with chronic kidney disease and their partners (n = 5 couples) to assess the face validity and comprehensibility of the items. Lastly, preliminary psychometric properties were evaluated in a sample of patients preparing to start dialysis and their partners (n = 83 couples). Results Three themes related to QOL were identified, namely dialysis expectations, accepting dialysis and dyadic relationship characteristics. The cognitive interviews refined the SDQ and established its face validity. Psychometric assessments indicated that overall the items performed well and did not show significant floor or ceiling effects. Good internal consistency was found within the three domains, and items correlated within the domains. Conclusions The SDQ is a measure (34 items) that assesses key psychological and interpersonal factors in patients and their partners as they start dialysis. It shows good preliminary psychometric properties; however, a large-scale field trial is needed to establish its validity. Once validated, it could offer a clinically useful tool to assist clinicians in preparing patients and partners for dialysis.
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Affiliation(s)
- Currie Moore
- School of Health Sciences, Division of Psychological Sciences and Mental Health, Manchester Centre for Health Psychology, Coupland Building I, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. .,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Alison Wearden
- School of Health Sciences, Division of Psychological Sciences and Mental Health, Manchester Centre for Health Psychology, Coupland Building I, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Lesley-Anne Carter
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Sandip Mitra
- Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,NIHR Devices for Dignity, MedTech Cooperative, Sheffield, UK
| | - Suzanne M Skevington
- School of Health Sciences, Division of Psychological Sciences and Mental Health, Manchester Centre for Health Psychology, Coupland Building I, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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7
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Alosaimi FD, Alshahrani SM, Aladhayani MH, Alwethenani ZK, Alsahil MJ, Fadhul HA. Psychosocial predictors of quality of life among chronic hemodialysis patients. Saudi Med J 2020; 41:990-998. [PMID: 32893282 PMCID: PMC7557555 DOI: 10.15537/smj.2020.9.25271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To examine the association of several psychosocial disorders with quality of life (QoL) among chronic hemodialysis patients. METHODS A cross-sectional observational study was conducted in 2018 and recruited chronic hemodialysis patients from 3 major hemodialysis centers in Riyadh, Kingdom of Saudi Arabia (KSA). Quality of life was assessed using a previously validated Arabic version of the dialysis version-III of the QoL index. RESULTS A total of 101 patients (56 males and 45 females) were included. The mean age was 54.0±12.3 years. The overall mean of QoL was 88.8/100 points (out of 100). The family (95.0%) and psychological/spiritual (94.7%) domains had the highest scores. The prevalence of psychosocial disorders was 24.8% for depressive symptoms, 15.8% for anxiety symptoms, 88.1% for cognitive impairment, 76.8% for insecure attachment style, and 38.6% for medium/high severity of somatic symptoms. All psychosocial disorders and higher cognition level were negatively correlated with QoL (Spearman correlation r ranged between -0.228- -0.468). After adjusting for sociodemographic and clinical characteristics, anxiety symptoms and higher cognition level were independent predictors of poor QoL, while marital status (married) was an independent predictor of good QoL. CONCLUSION We report higher QoL and relatively better psychosocial profiles among current chronic hemodialysis patients than reported before. Psychosocial disorders specially anxiety can negatively impact QoL. Patients who were not cognitively impaired were more negatively affected in QOL. The findings re-emphasize the importance of the early detection and management of psychosocial disorders to improve QoL in chronic hemodialysis patients.
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Affiliation(s)
- Fahad D Alosaimi
- Department of Psychiatry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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8
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Chen J, Liu L, Chen J, Jiang W, Wu B, Zhu J, Lou VW, He Y. Physical activity and posttraumatic growth in patients receiving maintenance hemodialysis: A prospective study. J Health Psychol 2020; 26:2896-2907. [PMID: 32605396 DOI: 10.1177/1359105320937056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study used a prospective design to examine the association between self-reported physical activity and posttraumatic growth (PTG) over a 1-year period among 150 patients receiving maintenance hemodialysis. Transport-related, household, and leisure-time physical activity were positively associated with PTG at baseline and follow-up. Total physical activity could predict higher levels of PTG at follow-up, after controlling for baseline PTG and other covariates. The findings indicate that daily physical activity could be a modifiable behavioral factor associated with PTG among patients receiving maintenance hemodialysis. Further study is needed using a randomized controlled design and objective measures of physical activity.
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Affiliation(s)
| | | | - Jing Chen
- Shanghai Chang Zheng Hospital, China
| | | | - Bibo Wu
- Zha Bei Dsitrict Center Hospital of Shanghai, China
| | - Jingfen Zhu
- Shanghai Jiao Tong University School of Medicine, China
| | - Vivian Wq Lou
- The University of Hong Kong, China.,The University of Hong Kong, China
| | - Yaping He
- Shanghai Jiao Tong University School of Medicine, China
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Seekles ML, Ormandy P, Coyne E. Mapping the UK renal psychosocial workforce: the first comprehensive workforce survey. BMC Nephrol 2019; 20:100. [PMID: 30898110 PMCID: PMC6427898 DOI: 10.1186/s12882-019-1287-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/10/2019] [Indexed: 01/08/2023] Open
Abstract
Background Emerging evidence of psychosocial problems in CKD patients has led to an acceptance that a focus on the emotional wellbeing of the patient should be included in the provision of comprehensive CKD care. It is unclear if an increased attention for psychosocial needs in guidelines and policy documents has led to a rise in psychosocial staffing levels or change in composition of staff since the last workforce mapping in 2002. This paper offers a critical analysis and in-depth discussion of findings and their implications, in addition to providing an international perspective and exposing gaps in current knowledge. Methods Data on psychosocial staffing levels was taken from a survey based on the Scottish Renal Association’s (SRA) staffing survey that was sent to all units in England, Wales and Northern-Ireland in 2016. In addition, data from a psychosocial staffing survey designed by and distributed via psychosocial professional groups was used. This data was then completed with Freedom of Information (FOI) requests and collated to describe the current renal psychosocial workforce in all 84 UK renal units. This was compared to results from the last renal workforce mapping in 2002. Results The results from this mapping show great variability in models of service provision, significant exceeding of benchmarks for staffing levels, and a change in staffing patterns over the past 15 years. Adult psychology services have increased in number, but provision remains low due to increased patient numbers, whereas adult social work and paediatric services have decreased. Conclusion A lack in the provision of renal psychosocial services has been identified, together with the absence of a general service provision model. These findings provide a valuable benchmark for units, a context from which to review and monitor provision alongside patient need. Along with recommendations, this paper forms a foundation for future research and workforce planning. Research into best practice models of service provision and the psychosocial needs of CKD patients lies at the heart of the answers to many identified questions. Electronic supplementary material The online version of this article (10.1186/s12882-019-1287-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maaike L Seekles
- School of Health and Society, University of Salford, Room L530, Allerton Building, Salford, M6 6PU, UK.
| | - Paula Ormandy
- School of Health and Society, University of Salford, Room 2.78, Mary Seacole Building, Salford, M6 6PU, UK
| | - Emma Coyne
- Renal Unit, City Hospital Campus, Nottingham University Hospitals NHS Trust Hucknall, Road Nottingham, Nottingham, NG5 1PB, UK
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Liu BCP, Leung DSY, Warrener J. The Interaction Effect of Gender and Residential Environment, Individual Resources, and Needs Satisfaction on Quality of Life Among Older Adults in the United Kingdom. Gerontol Geriatr Med 2019; 5:2333721419878579. [PMID: 31598541 PMCID: PMC6764038 DOI: 10.1177/2333721419878579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 11/27/2022] Open
Abstract
Objectives: To examine the difference in gender and its impact on selected quality-of-life (QoL) domains of Social Production Function theory among older adults in England. Method: Based on an annual national adult social care service user survey conducted in the United Kingdom in 2016. QoL was assessed by a single-item construct, and independent variables were home design, access to information and local area, self-rated health, perceived pain/discomfort, perceived anxiety/depression, activities of daily living, use and satisfaction of formal and informal care, and demographic variables. Results: A total of 28,955 respondents aged 65+ years were interviewed. Multinomial logistic regression analysis found four interaction effects for predicting a very good/good QoL: (a) Female receiving non-co-residing informal care (odds ratio [OR] = 1.501, p < .01), (b) female feeling safe (OR = 1.499, p < .01), (c) female feeling satisfied with social contact with people (OR = 1.465, p < .05), and (d) female being helped in the use of time (OR = 1.370, p < .05). Conclusion: Findings suggest gender differences in QoL as men and women are heterogeneous with different health and disease patterns, health-/help-seeking behaviors, roles and responsibilities, and levels of resilience, needs, risks, and access and control resources. Practitioners should adopt a gender-specific assessment and personalized interventions to promote gender equality, empowerment, and long-term sustainable development for an aging society.
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Jankowska-Polańska B, Chudiak A, Uchmanowicz I, Dudek K, Mazur G. Selected factors affecting adherence in the pharmacological treatment of arterial hypertension. Patient Prefer Adherence 2017; 11:363-371. [PMID: 28280309 PMCID: PMC5338974 DOI: 10.2147/ppa.s127407] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Low adherence to hypertension (HT) management is one of the major contributors to poor blood pressure (BP) control. Approximately 40%-60% of patients with HT do not follow the prescribed treatment. The aim of the study was to analyze the relationship between selected variables and adherence to hypotensive pharmacological treatment. Besides socioclinical variables, the study focused on the role of illness acceptance. PARTICIPANTS AND METHODS The study included 602 patients with HT. Adherence and acceptance of illness were assessed using the following validated instruments: the Acceptance of Illness Scale (AIS) and the Morisky Medication Adherence Scale (MMAS). RESULTS The high-adherence group comprised a significantly higher percentage of patients with high illness acceptance scale scores than that of patients with low-to-moderate scores (42.4 vs 31.8%; P=0.008<0.01). The odds ratio (OR) showed that high adherence to pharmacological treatment was >1.5 times as likely to occur in the high acceptance group as in the low-to-moderate acceptance group (OR =1.58, 95% CI 1.14-2.19). Spearman's rank correlation coefficients showed statistically significant correlations between adherence and sex (men ρ=-0.101; P=0.012), age >45-66 years (ρ=0.098; P=0.015), higher education level (ρ=0.132; P=0.001), grade ESC of HT (ρ=-0.037; P=0.057), receiving one-tablet polytherapy (ρ=0.131; P=0.015), and illness acceptance (ρ=0.090; P=0.024). CONCLUSION Acceptance of illness is correlated with adherence to pharmacological treatment, and consideration should be given to more widespread assessment of illness acceptance in daily practice. Male sex, age >45-66 years, duration of illness grade ESC of HT, and receiving one-tablet polytherapy are significant determinants of adherence to pharmacological treatment in HT.
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Affiliation(s)
- Beata Jankowska-Polańska
- Department of Clinical Nursing, Wroclaw Medical University
- Correspondence: Beata Jankowska-Polańska, Department of Clinical Nursing, Wroclaw Medical University, ul. Bartla 3, 81-618 Wrocław, Poland Email,
| | - Anna Chudiak
- Department of Clinical Nursing, Wroclaw Medical University
| | | | - Krzysztof Dudek
- Department of Logistics and Transport Systems, Faculty of Mechanical Engineering, Wrocław University of Technology
| | - Grzegorz Mazur
- Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland
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Psychosocial Factors in End-Stage Kidney Disease Patients at a Tertiary Hospital in Australia. Int J Nephrol 2016; 2016:2051586. [PMID: 27807482 PMCID: PMC5078664 DOI: 10.1155/2016/2051586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/02/2016] [Accepted: 09/14/2016] [Indexed: 11/17/2022] Open
Abstract
Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD) from a tertiary hospital in Australia. Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database. Results. Of the 244 patients referred, the majority were >60 years (58.6%), male (60.7%), born in Australia (62.3%), on haemodialysis (51.6%), and reliant on government financial assistance (88%). Adjustment issues (41%), financial concerns (38.5%), domestic assistance (35.2%), and treatment nonadherence (21.3%) were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p = 0.004, <0.001, and =0.018, resp.). Independent risk factors for treatment nonadherence included age and financial and employment status (p = 0.041, 0.052, and 0.008, resp.). Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.
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13
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Fujimaki K, Takemoto H, Morinobu S. Cortical activation changes and sub-threshold affective symptoms are associated with social functioning in a non-clinical population: A multi-channel near-infrared spectroscopy study. Psychiatry Res Neuroimaging 2016; 248:73-82. [PMID: 26774423 DOI: 10.1016/j.pscychresns.2016.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/07/2015] [Accepted: 01/03/2016] [Indexed: 11/19/2022]
Abstract
Few studies have examined the relationship between social function and brain activation in non-clinical populations. The aim of the present study was to assess this relationship and examine the underlying cortical mechanisms in a non-clinical population. Eighty healthy volunteers performed a serial arithmetic task according to the Uchida-Kraepelin performance test while hemoglobin concentration changes were assessed on the surface of the prefrontal cortex (PFC) using 32-channel near-infrared spectroscopy. Participants were also assessed for quality of life (QOL) using the Short-Form 36-item Questionnaire (SF-36), for affective symptoms using the Zung Self-rating Depression Scale (SDS), for apathy using the Apathy Scale, for feelings of stress using the Stress Arousal Checklist (SACL), and for task performance using the number of answers in a serial arithmetic task. Activity in the frontopolar PFC displayed a significant positive correlation with social functioning on the SF-36. SDS and SACL scores correlated negatively with social functioning. Furthermore, in multiple regression analysis, social functioning was predicted by activity of the frontopolar PFC and SDS scores. These results suggest that the association between changes in cortical activation and sub-threshold affective symptoms may objectively identify individuals with QOL on social functioning.
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Affiliation(s)
- Koichiro Fujimaki
- Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-Machi, Mihara, Hiroshima 723-0053, Japan.
| | - Hidenori Takemoto
- Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-Machi, Mihara, Hiroshima 723-0053, Japan
| | - Shigeru Morinobu
- Department of Psychiatry, Kochi University School of Medicine, Oko-cho Kohasu, Nankoku-shi, Kochi 783-8505, Japan
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14
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Dang TL, Lai FC, Lin YK, Chou KR, Miao NF, Liao YM. Psychometric Evaluation of the Vietnamese Hemodialysis Stressor Scale. Clin Nurs Res 2016; 27:364-385. [PMID: 26912709 DOI: 10.1177/1054773816631724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The lack of a suitable assessment tool may limit optimal stress management and impair the health-related quality of life of patients undergoing hemodialysis. The purpose of the study was to examine latent constructs and psychometric properties of the Vietnamese Hemodialysis Stressor Scale (HSS-V). In total, 180 patients receiving hemodialysis were recruited. Psychometric properties of the HSS-V, including the construct validity, internal consistency, and test-retest reliability, were tested after the instrument translation. The exploratory factor analysis resulted in a 24-item HSS-V with four extracted factors, which explained 58.32% of the total variance. The construct validity was confirmed by significant negative correlations between scores on the HSS-V and Vietnamese-version Short Form-36. The internal consistency (Cronbach's α = .82-.91) and test-retest reliability (intra-class correlations coefficient = .91-.94) of the 24-item HSS-V were satisfactory. A simple structure and preliminary acceptable psychometric properties of the HSS-V were established and can serve as a basis for further studies.
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Affiliation(s)
- Thi Loan Dang
- 1 Faculty of Nursing and Midwifery, Hanoi Medical University, Vietnam
| | - Fu-Chih Lai
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taiwan
| | - Yen-Kuang Lin
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,3 Biostatistics Center, Taipei Medical University, Taiwan
| | - Kuei-Ru Chou
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,4 Psychiatric Research Center, Taipei Medical University Hospital, Taiwan.,5 Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taiwan
| | - Nae-Fang Miao
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taiwan
| | - Yuan-Mei Liao
- 2 School of Nursing, College of Nursing, Taipei Medical University, Taiwan
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15
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Tsutsui H, Ohkubo T, Tsuruta Y, Kato S, Yasuda Y, Oshida Y. Development and validation of a short-version checklist for patients undergoing hemodialysis based on the International Classification of Functioning, Disability and Health. Clin Exp Nephrol 2014; 19:953-60. [PMID: 25543186 DOI: 10.1007/s10157-014-1075-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/14/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2009, we developed a "100-category checklist" for patients undergoing hemodialysis (HD) based on the International Classification of Functioning, Disability and Health, and we confirmed its validity. However, we found that for patients' daily assessment, 100 categories were too many. The purpose of the present study was to develop and validate a short version of the "100-category checklist." METHODS A total of 100 outpatients undergoing HD were recruited. They were interviewed using the "100-category checklist" and asked whether they had experienced problems after starting HD. From the "100-category checklist," we extracted categories that had greater than a 50 % rate of "yes" responses. Content validity was evaluated using the frequency of patients who had a problem in each category. Criterion validity was evaluated based on the correlation of the score from the "short-version checklist" categories with that from the Kidney Disease Quality of Life (KDQOL™) questionnaire. Construct validity was evaluated using Spearman correlation coefficients between the number of problem categories and the presence of HD-related complications. Cronbach's coefficient alpha was calculated to evaluate internal consistency. RESULTS Twenty-two categories were identified as problem categories. Criterion validity showed that 12 categories were significantly correlated with subscales of the KDQOL™. Construct validity showed that the presence of complications contributed to an increased number of problems associated with HD. Cronbach's coefficient alpha of this checklist was 0.79. CONCLUSION The "short-version checklist" had a certain degree of validity, suggesting its usefulness in a simplified assessment of patients undergoing HD.
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Affiliation(s)
- Hideyo Tsutsui
- Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | | | - Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-0064, Japan
| | - Yoshinari Yasuda
- Department of Chronic Kidney Disease Initiatives, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-0064, Japan
| | - Yoshiharu Oshida
- Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan
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16
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Khalil AA, Abed MA. Perceived social support is a partial mediator of the relationship between depressive symptoms and quality of life in patients receiving hemodialysis. Arch Psychiatr Nurs 2014; 28:114-8. [PMID: 24673785 DOI: 10.1016/j.apnu.2013.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/13/2013] [Accepted: 11/14/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The meaning of social support is well documented, but less is known about mediating characteristics that examine which patients with end stage renal disease (ESRD) and depressive symptoms are most likely to benefit. AIMS The aim of this study was to examine whether perceived social support mediated depressive symptoms on the outcome of quality of life (QoL). DESIGN A correlational, cross-sectional study was conducted with a convenience sampling of 190 patients with ESRD. RESULTS There was partial mediation effect of social support on depressive symptoms in the prediction of QoL. CONCLUSION Effective management of depressive symptoms will improve QoL mostly when social support is promoted in patients with ESRD receiving hemodialysis.
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Affiliation(s)
- Amani A Khalil
- Faculty of Nursing-The University of Jordan, Amman 11962, Jordan.
| | - Mona A Abed
- Faculty of Nursing-Hashemite University, Zarqa-Jordan.
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17
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Matsuda A, Yamaoka K, Tango T, Matsuda T, Nishimoto H. Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: a systematic review and meta-analysis of randomized controlled trials. Qual Life Res 2014; 23:21-30. [PMID: 23881515 PMCID: PMC3929036 DOI: 10.1007/s11136-013-0460-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE Most breast cancer patients receive psychosocial support interventions. However, the effectiveness of these interventions has not yet been clarified. Quality of life (QOL) was an important construct that should be considered when assessing these interventions. The purpose was to evaluate the effectiveness of psychosocial and especially psychoeducational support interventions for early-stage breast cancer patients since the follow-up was bound up to 6 months after finishing the intervention. METHODS We conducted a systematic review and meta-analysis to identify randomized controlled trials with early-stage breast cancer patients receiving psychosocial (psychoeducational and other) support in which QOL was measured as a treatment outcome. We compared mean differences at less than 6 months post-intervention with a control group. The primary outcome was Global Health Status/QOL scale (Global QOL), and secondary outcomes were the subscales of QOL. RESULTS No significant effect was observed for Global QOL; however, individuals receiving psychosocial support scored higher on the Breast Cancer Symptoms subscale. For psychoeducational support in the psychosocial support, significant effect was observed on the Emotional subscale. CONCLUSIONS Our analysis strengthens the evidence of the effectiveness of psychosocial support in improving breast cancer symptoms and psychoeducational support in improving emotional well-being within 6 months post-intervention.
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Affiliation(s)
- Ayako Matsuda
- Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan,
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18
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Chan R, Brooks R, Erlich J, Gallagher M, Snelling P, Chow J, Suranyi M. How do clinical and psychological variables relate to quality of life in end-stage renal disease? Validating a proximal–distal model. Qual Life Res 2013; 23:677-86. [DOI: 10.1007/s11136-013-0499-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
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19
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The psychological defensive profile of hemodialysis patients and its relationship to health-related quality of life. J Nerv Ment Dis 2013; 201:621-8. [PMID: 23787481 DOI: 10.1097/nmd.0b013e318298294d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Preliminary data suggest that defensive profile of hemodialysis (HD) patients might influence adaptation to the disease. However, the association of defense mechanisms with health-related quality of life (HRQoL) of HD patients remains unknown. In this cross-sectional investigation, 170 HD patients and 170 age- and sex-matched healthy participants had their psychological profile assessed with the Defense Style Questionnaire-40 and the Hospital Anxiety and Depression Scale. Furthermore, the HD patients had their HRQoL measured with the World Health Organization Quality of Life instrument-abbreviated version. The HD patients had a more neurotic and immature defensive profile. Splitting, projection, reaction formation, and denial were significantly associated with impaired HRQoL, independent of psychological distress. Somatization was an independent correlate of worse overall and physical HRQoL. These findings suggest that, apart from the treatment of psychological distress symptoms, clinicians should also consider the defensive profile of HD patients because it is independently associated with HRQoL and may be amenable to treatment.
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20
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Unruh ML, Larive B, Chertow GM, Eggers PW, Garg AX, Gassman J, Tarallo M, Finkelstein FO, Kimmel PL. Effects of 6-times-weekly versus 3-times-weekly hemodialysis on depressive symptoms and self-reported mental health: Frequent Hemodialysis Network (FHN) Trials. Am J Kidney Dis 2013; 61:748-58. [PMID: 23332990 DOI: 10.1053/j.ajkd.2012.11.047] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 11/14/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients undergoing maintenance hemodialysis frequently exhibit poor mental health. We studied the effects of frequent in-center and nocturnal hemodialysis on depressive symptoms and self-reported mental health. STUDY DESIGN 1-year randomized controlled clinical trials. SETTING & PARTICIPANTS Hemodialysis centers in the United States and Canada. 332 patients were randomly assigned to frequent (6-times-weekly) compared with conventional (3-times-weekly) hemodialysis in the Frequent Hemodialysis Network (FHN) Daily (n = 245) and Nocturnal (n = 87) Trials. INTERVENTION The Daily Trial was a trial of frequent (6-times-weekly) compared with conventional (3-times-weekly) in-center hemodialysis. The Nocturnal Trial assigned patients to either frequent nocturnal (6-times-weekly) hemodialysis or conventional (3-times-weekly) hemodialysis. OUTCOMES Self-reported depressive symptoms and mental health. MEASUREMENTS Beck Depression Inventory and the mental health composite score and emotional subscale of the RAND 36-Item Health Survey at baseline and 4 and 12 months. The mental health composite score is derived by summarizing these domains of the RAND 36-Item Health Survey: emotional, role emotional, energy/fatigue, and social functioning scales. RESULTS In the Daily Trial, participants randomly assigned to frequent compared with conventional in-center hemodialysis showed no significant change over 12 months in adjusted mean Beck Depression Inventory score (-1.9 ± 0.7 vs -0.6 ± 0.7; P = 0.2), but experienced clinically significant improvements in adjusted mean mental health composite (3.7 ± 0.9 vs 0.2 ± 1.0; P = 0.007) and emotional subscale (5.2 ± 1.6 vs -0.3 ± 1.7; P = 0.01) scores. In the Nocturnal Trial, there were no significant changes in the same metrics in participants randomly assigned to nocturnal compared with conventional hemodialysis. LIMITATIONS Trial interventions were not blinded. CONCLUSIONS Frequent in-center hemodialysis, as compared with conventional in-center hemodialysis, improved self-reported general mental health. Changes in self-reported depressive symptoms were not statistically significant. We were unable to conclude whether nocturnal hemodialysis yielded similar effects.
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Affiliation(s)
- Mark L Unruh
- Division of Nephrology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
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21
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Chan R. The effect of acceptance on health outcomes in patients with chronic kidney disease. Nephrol Dial Transplant 2012; 28:11-4. [DOI: 10.1093/ndt/gfs334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Kim JY, Kim B, Park KS, Choi JY, Seo JJ, Park SH, Kim CD, Kim YL. Health-related quality of life with KDQOL-36 and its association with self-efficacy and treatment satisfaction in Korean dialysis patients. Qual Life Res 2012; 22:753-8. [PMID: 22638994 PMCID: PMC3636437 DOI: 10.1007/s11136-012-0203-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 01/12/2023]
Abstract
Background and objectives This study was conducted to measure the level of health-related quality of life (HRQOL) and to reveal the association of self-efficacy and treatment satisfaction with it in Korean dialysis patients. Design, setting, participants, and measurements The study subjects were 237 patients receiving either hemodialysis (HD) or peritoneal dialysis (PD) from two university hospitals, from February to June in 2010. We investigated HRQOL using the Korean version of Kidney Disease Quality of Life Short Form 36 (KDQOL-36), and self-efficacy and treatment satisfaction by self-administrative questionnaire and their dialysis-related variables by reviewing clinical records. The associations of self-efficacy and treatment satisfaction with HRQOL were assessed using multiple linear regression analysis. Results The mean HRQOL results were as follows: Physical component score (PCS) was 39.1 ± 8.5, Mental component score (MCS) 44.6 ± 6.8, symptom/problem list was 67.6 ± 17.1, effects of disease score was 58.5 ± 19.6, and burden of disease score was 41.1 ± 28.4. Between PD and HD patients, we could find significant difference only in the symptom/problem list. After removing confounder’s effects by multivariate analysis, respectively, treatment goal self-efficacy and treatment management self-efficacy were significantly related with all 5 domains, except PCS. Treatment satisfaction was significantly related with PCS, MCS, and effects of kidney disease. Conclusions Patients’ self-efficacy and treatment satisfaction could influence their HRQOL. Regular and systematic monitoring using KDQOL-36 and interventions to increase self-efficacy and treatment satisfaction should be considered in dialysis care in Korea.
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Affiliation(s)
- Jong-Yeon Kim
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Bokyoung Kim
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, 816-15 Jinjudaero, Jinju city, Gyeongnam Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, 816-15 Jinjudaero, Jinju city, Gyeongnam Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Ji-Young Choi
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Jung-Ju Seo
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Sun-Hee Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
- Clinical Research Center for End Stage Renal Disease, Daegu, Korea
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