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Ceylan H, Yangöz ŞT, Özer Z. Coping strategies and its relationship with sexual dysfunction in adults receiving haemodialysis and peritoneal dialysis: A cross-sectional study. J Clin Nurs 2024; 33:1421-1431. [PMID: 38062567 DOI: 10.1111/jocn.16930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/30/2023] [Accepted: 11/01/2023] [Indexed: 03/08/2024]
Abstract
AIM To explore relationship coping strategies and sexual dysfunction, and the predictive factors of sexual dysfunction in adults receiving haemodialysis and peritoneal dialysis. BACKGROUND Sexual dysfunction is a common problem in adults receiving haemodialysis and peritoneal dialysis. This problem may be related to psychological and physiological conditions. However, the association between psychological conditions such as coping strategies and sexual dysfunction is not clearly understood. DESIGN This study is a cross-sectional study. METHODS The data were collected from November 2021 to July 2022 using the General Information Form, Arizona Sexual Experiences Scale: Female and Male Versions, and the Ways of Coping Inventory. Correlation and multiple regression analyses were conducted to investigate the relationship between coping strategies and sexual dysfunction. REPORTING METHOD STROBE checklist. RESULTS A total of 110 adults, 67 on haemodialysis and 43 on peritoneal dialysis, who met the eligibility criteria were included in this study. The optimistic, helpless and submissive approach sub-dimensions of coping strategies had positive correlation with sexual dysfunction in adults receiving haemodialysis. Among the sub-dimensions of the ways of coping inventory, helpless approach was positive predictor and seeking social support was negative predictor of sexual dysfunction in adults receiving haemodialysis. The coping strategies were not predictors of sexual dysfunction for adults receiving peritoneal dialysis. CONCLUSIONS This study showed that helpless coping strategy increases sexual dysfunction, and seeking social support decreases sexual dysfunction in haemodialysis. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE According to this study, social support is effective coping strategy for reducing sexual dysfunction. Education and support for effective coping strategies should be provided to dialysis patients by healthcare professionals at the start of dialysis treatment. Effective coping strategies should be integrated into routine care standards and nursing or hospital policies. PATIENT OR PUBLIC CONTRIBUTION Adults receiving haemodialysis and peritoneal dialysis were involved in this study.
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Affiliation(s)
- Hatice Ceylan
- Department of Nursing, Bucak School of Health, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Şefika Tuğba Yangöz
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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2
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Lightfoot CJ, Wilkinson TJ, Patel NA, Jones CR, Smith AC. Patient activation and psychological coping strategies to manage challenging circumstances during the COVID-19 pandemic in people with kidney disease. J Nephrol 2024; 37:353-364. [PMID: 38236468 PMCID: PMC11043035 DOI: 10.1007/s40620-023-01851-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Coping with health problems requires some degree of self-management; however, an individual's ability to self-manage can be threatened during challenging times, such as the COVID-19 pandemic. Exploring differences and changes in psychological well-being and coping strategies between those with low and high patient activation may inform appropriate interventions to support psychological coping. METHODS People with chronic kidney disease (CKD) (non-dialysis and transplant) were recruited from 11 hospital sites across England between August and December 2020. Participants responded to an online survey study, including the Brief Coping Orientation to Problem Experienced (COPE) Inventory, Depression, Anxiety and Stress Scale (DASS-21), Short Health Anxiety Index (SHAI), and Patient Activation Measure (PAM-13). A follow-up survey was conducted 6-9 months later. Paired t tests assessed within-group changes, and chi-squared tests compared coping strategies utilised by low- and high-activated participants. General linear modelling was performed to determine the relationship between patient activation and coping strategies, and covariates. RESULTS Two hundred and fourteen participants were recruited (mean age: 60.7, 51% male, mean eGFR: 38.9 ml/min/1.73 m2). Low-activated participants were significantly more anxious than high-activated participants (P = 0.045). Health anxiety significantly decreased (i.e., got better) for high-activated participants (P = 0.016). Higher patient activation scores were associated with greater use of problem-focused strategies (β = 0.288, P < 0.001). Age (β = - 0.174, P = 0.012), sex (β = 0.188, P = 0.004), and education level (β = 0.159, P = 0.019) significantly predicted use of problem-focused strategies. DISCUSSION Those with higher activation had lower levels of anxiety, and more frequently used adaptive coping strategies during the pandemic. Targeted support and interventions may be required for people with CKD to enhance patient activation, encourage more positive adaptive coping strategies, and mitigate maladaptive coping strategies.
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Affiliation(s)
- Courtney Jane Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.
- Leicester NIHR Biomedical Research Centre, Leicester, UK.
| | - Thomas James Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Naeema Aiyub Patel
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
| | - Ceri Rhiannon Jones
- Department of Neuroscience Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Alice Caroline Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
- Leicester NIHR Biomedical Research Centre, Leicester, UK
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3
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Knowles SR, Apputhurai P, Jenkins Z, O'flaherty E, Ierino F, Langham R, Ski CF, Thompson DR, Castle DJ. Impact of chronic kidney disease on illness perceptions, coping, self-efficacy, psychological distress and quality of life. PSYCHOL HEALTH MED 2023; 28:1963-1976. [PMID: 36794381 DOI: 10.1080/13548506.2023.2179644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Chronic kidney disease (CKD) negatively impacts psychological well-being and quality of life (QoL). Underpinned by the Common Sense Model (CSM), this study evaluated the potential mediating role of self-efficacy, coping styles and psychological distress on the relationship between illness perceptions and QoL in patients living with CKD. Participants were 147 people with stage 3-5 kidney disease. Measures included eGFR, illness perceptions, coping styles, psychological distress, self-efficacy and QoL. Correlational analyses were performed, followed by regression modelling. Poorer QoL was associated with greater distress, engagement in maladaptive coping, poorer illness perceptions and lower self-efficacy. Regression analysis revealed that illness perceptions predicted QoL, with psychological distress acting as a mediator. The proportion of variance explained was 63.8%. These findings suggest that psychological interventions are likely to enhance QoL in CKD, if they target the mediating psychological processes associated with illness perceptions and psychological distress.
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Affiliation(s)
- Simon R Knowles
- School of Health Sciences, Swinburne University, Melbourne, Australia
| | | | - Zoe Jenkins
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
| | - Emmet O'flaherty
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco Ierino
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Robyn Langham
- St. Vincent's Hospital, University of Melbourne Department of Medicine, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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4
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Missikpode C, Ricardo AC, Brown J, Durazo-Arvizi RA, Fischer MJ, Hernandez R, Porter AC, Cook JA, Anderson A, Dolata J, Feldman HI, Horwitz E, Lora C, Wright Nunes J, Rao PS, Lash JP. Association between Depressive Symptom Trajectory and Chronic Kidney Disease Progression: Findings from the Chronic Renal Insufficiency Cohort Study. KIDNEY360 2023; 4:606-614. [PMID: 36814088 PMCID: PMC10278792 DOI: 10.34067/kid.0000000000000087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/26/2023] [Indexed: 05/27/2023]
Abstract
Key Points Depressive symptoms are largely stable over time among individuals with mild-to-moderate CKD Low educational attainment, cigarette smoking, and poor quality of life are associated with persistent depressive symptoms Persistent depressive symptoms are associated with nonlinear and rapid decline in kidney function Background Although depression is highly prevalent among individuals with CKD, little is known about the course of depressive symptoms over time. We characterized trajectories of depressive symptoms and CKD progression and evaluated the association between depressive symptoms trajectory and CKD progression. Methods Two thousand three hundred sixty-one individuals with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort Study were analyzed. The Beck Depression Inventory (BDI) was used to assess depressive symptoms at baseline and biennially. Higher BDI scores indicate worse depressive symptoms. eGFR was calculated using the 2021 CKD-EPI equation. Group-based trajectory models were used to determine trajectories of BDI score and eGFR change over time. Multinomial logistic regression was used to examine factors associated with BDI trajectories and to evaluate the association of BDI trajectories with eGFR change. Results Over 8 years of follow-up, three patterns of depressive symptoms were identified: persistently low BDI score (57.7%), persistently moderate BDI score (33.1%), and persistently high BDI score (9.2%). Three eGFR trajectory groups were identified: nonlinear, rapid eGFR decline (21.5%); linear, expected eGFR decline (54.8%); and stable eGFR (23.7%). Predictors of persistently moderate and high BDI trajectories included low educational attainment, smoking, and poor quality of life. Compared with those with a persistently low BDI score, the odds for nonlinear, rapid eGFR decline were higher for those with persistently moderate BDI scores (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.04 to 2.03) and persistently high BDI scores (OR, 1.90; 95% CI, 1.02 to 3.56). No association between moderate BDI score and linear, expected eGFR decline was observed. Conclusions Depressive symptoms remained largely stable among individuals with mild-to-moderate CKD, and persistently moderate and high BDI scores were associated with nonlinear, rapid eGFR decline. Future work is needed to better understand the interplay between depression and CKD progression.
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Affiliation(s)
- Celestin Missikpode
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Ana C. Ricardo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Julia Brown
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | | - Michael J. Fischer
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
- Medical Service, Jesse Brown VA Medical Center, Chicago, Illinois
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Anna C. Porter
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Judith A. Cook
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Amanda Anderson
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Jacquie Dolata
- Division of Nephrology and Hypertension, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Harold I. Feldman
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Edward Horwitz
- Division of Nephrology and Hypertension, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Claudia Lora
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | | | | - James P Lash
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
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5
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Sheth MS, Castle DJ, Wang W, Lee A, Jenkins ZM, Hawke LD. Changes to coping and its relationship to improved wellbeing in the optimal health program for chronic disease. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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6
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Luo W, Gong L, Chen X, Gao R, Peng B, Wang Y, Luo T, Yang Y, Kang B, Peng C, Ma L, Mei M, Liu Z, Li Q, Yang S, Wang Z, Hu J. Lifestyle and chronic kidney disease: A machine learning modeling study. Front Nutr 2022; 9:918576. [PMID: 35938107 PMCID: PMC9355159 DOI: 10.3389/fnut.2022.918576] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/27/2022] [Indexed: 12/23/2022] Open
Abstract
Background Individual lifestyle varies in the real world, and the comparative efficacy of lifestyles to preserve renal function remains indeterminate. We aimed to systematically compare the effects of lifestyles on chronic kidney disease (CKD) incidence, and establish a lifestyle scoring system for CKD risk identification. Methods Using the data of the UK Biobank cohort, we included 470,778 participants who were free of CKD at the baseline. We harnessed the light gradient boosting machine algorithm to rank the importance of 37 lifestyle factors (such as dietary patterns, physical activity (PA), sleep, psychological health, smoking, and alcohol) on the risk of CKD. The lifestyle score was calculated by a combination of machine learning and the Cox proportional-hazards model. A CKD event was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2, mortality and hospitalization due to chronic renal failure, and self-reported chronic renal failure, initiated renal replacement therapy. Results During a median of the 11-year follow-up, 13,555 participants developed the CKD event. Bread, walking time, moderate activity, and vigorous activity ranked as the top four risk factors of CKD. A healthy lifestyle mainly consisted of whole grain bread, walking, moderate physical activity, oat cereal, and muesli, which have scored 12, 12, 10, 7, and 7, respectively. An unhealthy lifestyle mainly included white bread, tea >4 cups/day, biscuit cereal, low drink temperature, and processed meat, which have scored −12, −9, −7, −4, and −3, respectively. In restricted cubic spline regression analysis, a higher lifestyle score was associated with a lower risk of CKD event (p for linear relation < 0.001). Compared to participants with the lifestyle score < 0, participants scoring 0–20, 20–40, 40–60, and >60 exhibited 25, 42, 55, and 70% lower risk of CKD event, respectively. The C-statistic of the age-adjusted lifestyle score for predicting CKD events was 0.710 (0.703–0.718). Conclusion A lifestyle scoring system for CKD prevention was established. Based on the system, individuals could flexibly choose healthy lifestyles and avoid unhealthy lifestyles to prevent CKD.
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Affiliation(s)
- Wenjin Luo
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lilin Gong
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiangjun Chen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rufei Gao
- Laboratory of Reproductive Biology, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Bin Peng
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yue Wang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Luo
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Yang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bing Kang
- Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chuan Peng
- The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linqiang Ma
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Mei
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiping Liu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qifu Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shumin Yang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhihong Wang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Zhihong Wang
| | - Jinbo Hu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Jinbo Hu
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Ahmed A, Anand AN, Shah I, Yakah W, Freedman SD, Thomas R, Sheth SG. Prospective evaluation of sleep disturbances in chronic pancreatitis and its impact on quality of life: a pilot study. Sleep Breath 2022; 26:1683-1691. [PMID: 34981297 DOI: 10.1007/s11325-021-02541-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/13/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022]
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8
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Duan D, Yang L, Zhang M, Song X, Ren W. Depression and Associated Factors in Chinese Patients With Chronic Kidney Disease Without Dialysis: A Cross-Sectional Study. Front Public Health 2021; 9:605651. [PMID: 34123983 PMCID: PMC8192721 DOI: 10.3389/fpubh.2021.605651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has been a globally public health problem over the past decades. The maintenance of physical and mental health is of importance for patients nowadays. Notably, depression is prevalent and associated with various adverse events in CKD patients without dialysis. Prior studies have reported that pain, negative illness perception, pain, and low self-esteem are potential risk factors of depression, while few studies have comprehensively investigated the mechanisms among these factors and depression among this population. Purpose: This study aims to investigate the prevalence of depression and further explore the factors associated with depression among CKD patients without dialysis in China. Design and Methods: We conducted a cross-sectional study in patients with diagnosed CKD to investigate the prevalence of depression was by the Beck Depression Inventory-II (BDI-II). The data on pain interference, illness perception, and self-esteem were also collected via self-administered questionnaires. A structural equation model (SEM) was used to examine the factors associated with depression. Main Findings: From June to October 2019, we successfully interviewed 334 CKD patients at the outpatient clinics. Their mean age was 45.6 years (ranging from 19 to 74 years), and 48.5% were male. Most respondents were at early CKD stages (77.5% stage 1–3) and the prevalence of depression was 22.2%. We found a moderate association between illness perception and depression, which was modified by self-esteem. Similar but weaker association was found between pain interference and depression. Conclusion and Recommendations: Negative illness perception, low self-esteem and severe pain interference were associated with depression among Chinese CKD patients without dialysis. Future studies are warranted to investigate the underlying mechanism and formulate the intervention strategies for this high-risk population.
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Affiliation(s)
- Difei Duan
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.,West China School of Nursing, Sichuan University, Sichuan, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Min Zhang
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Xiaoli Song
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
| | - Wen Ren
- Department of Nephrology, West China Hospital, Sichuan University, Sichuan, China
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9
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Muscat P, Weinman J, Farrugia E, Callus R, Chilcot J. Illness perceptions predict distress in patients with chronic kidney disease. BMC Psychol 2021; 9:75. [PMID: 33962685 PMCID: PMC8105921 DOI: 10.1186/s40359-021-00572-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis. Distress in patients with predialysis CKD, has been linked to several adverse events; including increased risk of hospitalisation, early dialysis initiation and even death, suggesting that distress is a matter of great concern during routine care in predialysis CKD. AIMS The present study aimed to assess the nature of illness perceptions and the level of distress in a CKD cohort diagnosed with different stages of kidney disease. It also aimed to explore the correlates of distress and to create a model for distress and its associated predictors making use of hierarchical regression analysis. METHODS A sample of 200 patients diagnosed with Chronic Kidney Disease were recruited for this study from the nephrology outpatient clinics of Mater Dei Hospital, Malta. The participants were assessed for their; illness perceptions, treatment beliefs, level of depression and anxiety, coping style, as well as treatment adherence. Routine clinical information was also collected for participants, including a co-morbidity score. RESULTS A percentage of 33.5% of the participants reported moderate distress, whilst 9.5% reported severe distress. Stronger illness identity, a perception of timeline as being increasingly chronic or cyclical in nature, greater consequences and higher emotional representations were associated with more advanced stages of CKD. In contrast, lower personal and treatment control and poorer illness coherence were associated with more advanced stages of CKD. Results from the hierarchical regression analysis showed that illness perceptions contributed significantly to distress over and above the clinical kidney factors. Being female, having low haemoglobin and specific illness perceptions including; perceptions of greater symptomatology, longer timeline, low personal control and strong emotional representations, as well as resorting to maladaptive coping, were all significantly associated with distress symptoms. Nevertheless, illness perceptions accounted for the greatest variance in distress thus indicating that the contribution of illness perceptions is greater than that made by the other known covariates. CONCLUSION Illness perceptions hold a principal role in explaining distress in CKD, relative to other traditional covariates. For this reason, illness perceptions should be addressed as a primary modifiable component in the development of distress in CKD.
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Affiliation(s)
- Priscilla Muscat
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, SE1 9RT, UK.
| | - John Weinman
- Institute of Pharmaceutical Science, Pharmaceutical Sciences Clinical Academic Group, King's College London, 5th floor, Franklin -Wilkins Building, 150 Stamford Street, London, SE19NH, UK
| | | | | | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, SE1 9RT, UK
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10
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Ng JH, Vialet J, Diefenbach MA. Illness perception in patients with chronic kidney disease and kidney failure: a scoping review protocol. BMJ Open 2021; 11:e042298. [PMID: 33593776 PMCID: PMC7888318 DOI: 10.1136/bmjopen-2020-042298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Patient education is a crucial component in the management of chronic kidney disease (CKD); however, many education programmes do not tailor to patients' disease-related belief and emotional reactions. According to Leventhal's self-regulation model, such beliefs and reactions, known as illness perceptions, are a part of patients' understanding of their disease and treatment-related actions. The existing research of illness perception in the field of nephrology has been heterogenous in terms of study outcomes and in study population; and the evidence of how illness perceptions affect behavioural and decisional outcomes is limited. This scoping review aims to map and summarise the evidence of published literature on illness perception among patients with CKD not yet treated by dialysis and kidney failure. METHODS AND ANALYSIS This study bases its approach on Joanna Brigg's Institute Guidelines on scoping review methods. The search strategy was developed together with a medical information specialist. Searches will be performed on acceptance of publication in the following databases: PubMed, EMBASE, PsycINFO via Ovid, Scopus and the Cumulative Index to Nursing and Allied Health Literature. Searches will be run without incorporating a date restriction in order to capture content from the databases' inception to present day. Search terms including 'illness perception', 'kidney disease' and 'kidney failure' will be screened in titles and abstracts. Two independent researchers will screen the abstracts and full text for full eligibility. We will include studies focusing on illness perception of patients with CKD with estimated glomerular filtration rate <60 mL/min/1.73 m2, kidney failure or recipients of kidney transplant. We will exclude patients <18 years of age, patients with acute kidney injury and non-English articles. All demographic data, study design and study findings will be collected and analysed using a data abstraction tool. ETHICS AND DISSEMINATION This study does not require internal review board approval. We will present the findings of this scoping review in a peer-reviewed journal.
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Affiliation(s)
- Jia Hwei Ng
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Jaclyn Vialet
- Clinical Medical Library, North Shore University Hospital, Manhasset, New York, USA
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11
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Jenkins ZM, Tan EJ, O'Flaherty E, Knowles S, Thompson DR, Ski CF, Rossell SL, Coco C, Ierino FL, Gock H, Castle DJ. A psychosocial intervention for individuals with advanced chronic kidney disease: A feasibility randomized controlled trial. Nephrology (Carlton) 2021; 26:442-453. [PMID: 33484221 DOI: 10.1111/nep.13850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 12/17/2022]
Abstract
AIM The current study evaluated the feasibility and preliminary efficacy of a psychosocial intervention, the Kidney Optimal Health Program, in reducing symptoms of depression and anxiety in individuals with advanced chronic kidney disease. METHODS Patients with stage 4 or 5 chronic kidney disease were randomized to either a nine-session psychosocial intervention programme or usual care. Feasibility was assessed through recruitment and retention rates and programme acceptability. Participants completed assessments of depression, anxiety and psychosocial health at baseline and at 3-, 6- and 12-month follow-up. A repeated-measures analysis of variance was used to compare groups on outcomes over time. RESULTS One hundred and twenty-eight patients were screened for eligibility; 84 consented to participant and were randomized to receive the intervention (N = 42) or usual care (N = 42). 27 (32.1%) participants withdrew prior to baseline assessment. Of those who completed the baseline assessment (N = 57), trial retention was high (75.4% at 3-month, 80.7% at 6-month and 70.2% at 12-month follow-up). Participants reported high levels of programme acceptability. The patients who completed the intervention (N = 17) demonstrated significantly decreased depression at 12-month follow-up compared to the usual care group (N = 13). CONCLUSION The results support the feasibility of the Kidney Optimal Health Program intervention in recruitment, retention and programme acceptability with an improved screening protocol. Preliminary support is provided for improvement in depressive symptoms in patients with advanced chronic kidney disease. Further investigation through a fully powered randomized controlled trial is warranted.
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Affiliation(s)
- Zoe M Jenkins
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Eric J Tan
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Emmet O'Flaherty
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia
| | - Simon Knowles
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Department of Psychology, Swinburne University of Technology, Melbourne, Australia
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,University of Suffolk, Integrated Care Academy, Ipswich, UK
| | - Chantal F Ski
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,University of Suffolk, Integrated Care Academy, Ipswich, UK
| | - Susan L Rossell
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Carolee Coco
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco L Ierino
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia.,Department of Nephrology, University of Melbourne, Melbourne, Australia
| | - Hilton Gock
- Department of Nephrology, St. Vincent's Hospital, Melbourne, Australia
| | - David J Castle
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Canada
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12
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Mavali S, Mahmoodi H, Sarbakhsh P, Shaghaghi A. Psychometric Properties of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) in the Iranian Older Adults. Psychol Res Behav Manag 2020; 13:693-700. [PMID: 32884372 PMCID: PMC7443441 DOI: 10.2147/prbm.s256323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/25/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Mental wellbeing is considered as an important and effective factor in older adults' psychological health. Due to lack of a standard instrument for the assessment of mental wellbeing in Iranian older adults, the present study was performed to examine validity and reliability of the Persian version of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS-P) for use among Iranian older adults. PATIENTS AND METHODS The study sample included 304 older adults aged 60 and over, admitted to the Shohada Educational Hospital affiliated to the Tabriz University of Medical Sciences, North West of Iran. The participants were recruited through the convenience sampling method in May to September 2017. RESULTS The mean and standard deviation of the mental wellbeing score were 50.30 and 8.82, respectively. Exploratory factor analysis (EFA) results demonstrated a one-factor solution with 13 items which was verified by the confirmatory factor analysis (CFA). The estimated internal consistency measure of Cronbach's alpha (0.93) and two weeks' time test-retest reliability index (0.84) met the prerequisite criteria. CONCLUSION According to the results, the WEMWBS-P with 13 items has acceptable validity and reliability to assess the mental wellbeing of Iranian and other Persian-speaking older adults.
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Affiliation(s)
- Sonia Mavali
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Hassan Mahmoodi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Parvin Sarbakhsh
- Department of Biostatistics and Epidemiology, Faculty of Health, Tabriz University of Medial Sciences, Tabriz, Iran
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medial Sciences, Tabriz, Iran
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13
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Knowles SR, Apputhurai P, O’Brien CL, Ski CF, Thompson DR, Castle DJ. Exploring the relationships between illness perceptions, self-efficacy, coping strategies, psychological distress and quality of life in a cohort of adults with diabetes mellitus. PSYCHOL HEALTH MED 2019; 25:214-228. [DOI: 10.1080/13548506.2019.1695865] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Simon R Knowles
- Department of Psychology, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
| | - Pragalathan Apputhurai
- Department of Psychology, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
| | - Casey L O’Brien
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
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14
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Haines C, Loades M, Davis C. Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: Application of the common sense model. Clin Child Psychol Psychiatry 2019; 24:546-563. [PMID: 30770020 PMCID: PMC7100035 DOI: 10.1177/1359104519829796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The common sense model (CSM) proposes that illness perceptions guide coping and illness management, which subsequently affects outcomes. Chronic fatigue syndrome (CFS) is associated with severe functional impairment. CFS is distinct from other physical health conditions in that individuals can experience high levels of uncertainty, stigma and disbelief from others. This study aimed to compare illness perceptions in adolescents with CFS with other physical health conditions, using a cross-sectional, between-groups design. METHODS Adolescents (aged 11-18) with CFS (n = 49), type 1 diabetes (n = 52) and juvenile idiopathic arthritis (n = 42) were recruited through National Health Service (NHS) clinics and online, and completed a series of questionnaires. RESULTS Adolescents with CFS differed on the perceived consequences, timeline, personal control, treatment control, identity and understanding dimensions of illness perceptions. Except for identity, these dimensions were predicted by health condition even when accounting for age, gender, fatigue, physical functioning, anxiety and depression. CONCLUSIONS Results offer preliminary evidence for the applicability of the CSM in adolescents, with implications for supporting adolescents with physical health conditions. Results suggest that psychological interventions targeting perceived control, understanding and identity may have particular utility for adolescents with CFS.
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Affiliation(s)
- Cara Haines
- 1 Department of Psychology, University of Bath, UK
| | - Maria Loades
- 1 Department of Psychology, University of Bath, UK.,2 Bristol Medical School, University of Bristol, UK
| | - Cara Davis
- 1 Department of Psychology, University of Bath, UK
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15
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Balogun SA, May NB, Briley M, Bosch A, Duerr I, Owens JE, Rahman EA. A Qualitative Pilot Study of the Perceptions in Older Adults with End-Stage Kidney Disease on Hemodialysis. Can Geriatr J 2019; 22:55-63. [PMID: 31258828 PMCID: PMC6542579 DOI: 10.5770/cgj.22.342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Little is known about the perceptions of older adults with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) even though this could potentially influence how treatment is received. This study explores the perceptions of older adults with ESKD on HD, specifically their decision to initiate HD, preconceptions and expectations of HD, perceived difficulties with HD, and coping strategies. DESIGN Cross-sectional. SETTING Outpatient chronic dialysis units. PARTICIPANTS Older adults with ESKD on HD. INTERVENTION Open-ended interviews were conducted with 15 participants. Inclusion criteria were age 60 years and older, HD duration of at least three months, and ability to consent and participate in the interview process. RESULTS We report on four identified domains: decision to initiate HD; preconceptions and expectations of HD; drawback of HD; and coping strategies. All participants were reluctant to initiate HD, but made the decision on advice from their physicians for varying reasons. Trust in physicians' opinions also played a role for some. Some participants had positive preconceptions of HD, while a few had negative preconceptions or unrealistic expectations. Even though the majority of participants identified several difficulties with being on HD, they also had positive coping strategies, and the majority indicated that they would make the same decision to initiate HD. CONCLUSION As clinicians are turning more to patient-centered medicine, understanding patients' perceptions of HD is of crucial importance. Our study highlights the importance of improving pre-hemodialysis education to ensure that patients' expectations are realistic, as well as identifying individualized coping strategies by patients.
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Affiliation(s)
- Seki A. Balogun
- Division of General Medicine/Geriatrics, University of Virginia Health System, Charlottesville, VA, USA
| | - Natalie B. May
- Division of General Medicine/Geriatrics, University of Virginia Health System, Charlottesville, VA, USA
| | - Meagan Briley
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Allison Bosch
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Isabelle Duerr
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Justine E. Owens
- Department of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Emaad Abdel Rahman
- Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA
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16
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Jankowska‐Polańska B, Duczak A, Świątoniowska N, Karniej P, Seń M, Rosińczuk J. The influence of selected psychological variables on quality of life of chronically dialysed patients. Scand J Caring Sci 2019; 33:840-847. [DOI: 10.1111/scs.12680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/21/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Beata Jankowska‐Polańska
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Agnieszka Duczak
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Natalia Świątoniowska
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Piotr Karniej
- Department of Health Promotion Public Health Department Wroclaw Medical University Wrocław Poland
| | - Mariola Seń
- Department of Health Promotion Public Health Department Wroclaw Medical University Wrocław Poland
| | - Joanna Rosińczuk
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
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17
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Self-awareness and the evaluation of hot flash severity: observations from the Seattle Midlife Women's Health Study. Menopause 2018; 26:476-484. [PMID: 30531442 DOI: 10.1097/gme.0000000000001272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to test the association of two dimensions of self-awareness with hot flash (HF) severity. METHODS A subset of women from the Seattle Midlife Women's Health Study (N = 232) provided data for these analyses. Structural equation modeling was used to evaluate two dimensions of self-awareness (Internal States Awareness [ISA] and Self-Reflectiveness [SR]), and secondary factors of perceived stress, anxiety, and attitudes toward menopause as continuous with earlier life, health perceptions, and menopausal stage with respect to HF severity. The measurement and structural models were tested with a maximum likelihood missing values estimator and displayed good model fit. RESULTS Women with greater ISA reported greater HF severity (β = 0.17, P < 0.05). In addition, women in later menopausal transition stages reported greater HF severity and those with attitudes of continuity toward menopause reported less severe HFs (β = 0.20, P < 0.01, β = -0.30, P < 0.001, respectively). SR was not related to HF severity. Women with higher levels of SR reported greater perceived stress levels (β = .51, P < 0.001), and those with greater perceived stress reported greater anxiety levels (β = 0.63, P < 0.001) and attitudes of continuity toward menopause as less continuous with earlier life (β = -0.30, P < 0.001). CONCLUSIONS ISA (balanced self-awareness) was associated with greater HF severity, suggesting that enhanced balanced self-awareness may promote women's ability to evaluate their symptom experience. A multidimensional construct of self-awareness, perceived stress, anxiety, and attitude toward menopause are all plausible targets for future intervention studies of symptom management.
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18
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Muscat P, Chilcot J, Weinman J, Hudson J. Exploring the relationship between illness perceptions and depression in patients with chronic kidney disease: A systematic literature review. J Ren Care 2018; 44:174-185. [PMID: 29806175 DOI: 10.1111/jorc.12243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prevalence of depression is found to increase from early stages to later stages of chronic kidney disease. Research on illness perceptions in patients undergoing dialysis has confirmed that patients' beliefs are associated with important outcomes; one of the most significant being depression. However, the association between illness perceptions and depression in patients in pre-dialysis care remains unclear. OBJECTIVE The main objective of this systematic review was to explore the associative relationship between illness perceptions and depression in patients with CKD prior to the commencement of dialysis. METHODS The inclusion criteria for papers in this review were studies investigating illness perceptions and depression in patients diagnosed with CKD. Eligible studies were identified by searching the following electronic databases; Medline, CENTRAL, Embase, Psych INFO, Web of Science and Scopus. Data on the participants and the severity of kidney disease, illness perceptions and depression were extracted. RESULTS Sixty-four studies met the criteria for full text review and of these, only four studies met the inclusion criteria following data extraction and quality assessment. Consistent with the common sense model, disease severity was found to be significantly associated with illness perceptions, and both were found to be associated with depression CONCLUSIONS: The results from this review provide further evidence that the illness perceptions and disease severity play a crucial role in the adaption to CKD. This review highlights the lack of research in this area and concludes that more studies are needed to determine the nature and impact of illness perceptions in relation to depression in pre-dialysis CKD.
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Affiliation(s)
- Priscilla Muscat
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, UK
| | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, UK
| | - John Weinman
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, UK
| | - Joanna Hudson
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 5th floor Bermondsey Wing, Guy's Campus, London, UK
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19
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Goh ZS, Griva K. Anxiety and depression in patients with end-stage renal disease: impact and management challenges - a narrative review. Int J Nephrol Renovasc Dis 2018; 11:93-102. [PMID: 29559806 PMCID: PMC5856029 DOI: 10.2147/ijnrd.s126615] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Psychiatric disorders commonly co-exist with the diagnosis of chronic kidney disease (CKD). Research on depression and CKD has increased to a great extent. Multiple studies have demonstrated that depression is more prevalent in CKD and that end-stage renal disease is a robust risk factor for adverse outcomes such as hospitalization and mortality, yet these are often underdiagnosed or untreated. This review provides a selective overview on the prevalence rates of depression and anxiety in patients with CKD and across renal replacement therapies, the factors most consistently associated with symptoms of distress and their clinical implications. Finally, treatment and management strategies from relevant literature are appraised and discussed.
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Affiliation(s)
- Zhong Sheng Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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20
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Järemo P, Arman M, Gerdle B, Larsson B, Gottberg K. Illness beliefs among patients with chronic widespread pain - associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychol 2017; 5:24. [PMID: 28679446 PMCID: PMC5499007 DOI: 10.1186/s40359-017-0192-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/20/2017] [Indexed: 12/31/2022] Open
Abstract
Background Chronic widespread pain (CWP) is a disabling condition associated with a decrease in health. Illness beliefs are individual and are acquired during life. Constraining beliefs may prevent patients from regaining health. Understanding these patients’ illness beliefs may be a way to improve the health care they are offered. The aim of this study was to describe illness beliefs among patients with CWP and associations with self-reported health, anxiety and depressive symptoms, and impact of pain. Method In this cross-sectional study, questionnaires were sent by mail to 330 patients including socio-demographic information, the Illness Perception Questionnaire (IPQ-R), the Short-Form General Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Data were analysed using descriptive statistics, non-parametric tests and linear regression analyses. Results Patients experienced and related a high number of symptoms to CWP (mean (SD) 9 (3)). The patients believed their illness to be long lasting, to affect their emotional well being, and to have negative consequences for their lives. Some 72% reported having severe or very severe pain, and impact of pain according to SF-36 was negatively correlated to several illness beliefs dimensions, anxiety- and depressive symptoms. In regression analyses, the Identity, Consequences and Personal control dimensions of IPQ-R and Anxiety- and Depressive symptoms explained 32.6–56.1% of the variance in the two component scores of SF-36. Conclusion Constraining illness beliefs in patients with CWP are related to worse health status, especially in cases of high number of physical or mental symptoms, beliefs of negative consequences or the illness affecting them emotionally. Identification and understanding of these beliefs may reduce patients’ suffering if they are taken into consideration in rehabilitation programs and in development of new evidence-based interventions aimed at increasing health in patients with CWP.
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Affiliation(s)
- P Järemo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden.
| | - M Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
| | - B Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - B Larsson
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - K Gottberg
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, S-141 83, Huddinge, Sweden
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21
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22
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Speyer E, Morgenstern H, Hayashino Y, Kerr PG, Rayner H, Robinson BM, Pisoni RL. Reliability and validity of the coping strategy inventory-short form applied to hemodialysis patients in 13 countries: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Psychosom Res 2016; 91:12-19. [PMID: 27894457 DOI: 10.1016/j.jpsychores.2016.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Coping Strategies Inventory-Short Form (CSI-SF) measures four coping strategies based on 16 items: 4 items each indicating problem- vs. emotion-focused engagement or disengagement. Here we provide the first assessment of reliability and construct validity of the CSI-SF among hemodialysis patients across 13 countries. METHODS The CSI-SF was completed by patients in 9 languages in phase 4 of the Dialysis Outcomes and Practice Patterns Study (2009-11). Cronbach's alpha was used to assess internal consistency. Exploratory and confirmatory factor analyses were applied to assess the factor structure of the CSI-SF by country and language. CSI-SF data were analyzed from 7201 patients (60% male; median age 62.5 [range 18-96] years). RESULTS Good internal consistency (α=0.56-0.80) was seen for three scales in English (US, UK, Canada, Australia, New Zealand), German, and Swedish versions. The fourth scale was internally consistent if two items were dropped. In these countries, both exploratory and confirmatory factor analyses indicated a factor structure consistent with the four CSI-SF scales. Other language versions showed a factor structure inconsistent with these four scales. CONCLUSION The slightly modified English, German, and Swedish versions of the CSI-SF are reliable and valid instruments for measuring coping strategies in hemodialysis patients.
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Affiliation(s)
- Elodie Speyer
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States.
| | - Hal Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Yasuaki Hayashino
- Department of Endocrinology, Admission Coordination Center Tenri Hospital, Japan
| | - Peter G Kerr
- Monash Health & Monash University, Clayton, Australia
| | - Hugh Rayner
- Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - Bruce M Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Ronald L Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
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23
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Knowles SR, Ski CF, Langham R, O'Flaherty E, Thompson DR, Rossell SL, Moore G, Hsueh YSA, Castle DJ. Design and protocol for the Dialysis Optimal Health Program (DOHP) randomised controlled trial. Trials 2016; 17:447. [PMID: 27612446 PMCID: PMC5018180 DOI: 10.1186/s13063-016-1558-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 08/13/2016] [Indexed: 11/23/2022] Open
Abstract
Background Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis. Methods The study design is a randomised controlled trial. Ninety-six adult patients initiating haemodialysis or peritoneal dialysis will be randomly allocated to either the intervention (DOHP) or usual care group. Participants receiving the intervention will receive nine (8 + 1 booster session) sequential sessions based on a structured information/workbook, psychosocial and educational supports and skills building. The primary outcome measures are depression and anxiety (assessed by the Hospital Anxiety and Depression Scale; HADS). Secondary outcomes include health-related quality of life (assessed by the Kidney Disease Quality of Life instrument; KDQOL), self-efficacy (assessed by General Self-Efficacy Scale) and clinical indices (e.g. albumin and haemoglobin levels). Cost-effectiveness analysis and process evaluation will also be performed to assess the economic value and efficacy of the DOHP. Primary and secondary measures will be collected at baseline and at 3-, 6-, and 12-month follow-up time points. Discussion We believe that this innovative trial will enhance knowledge of interventions aimed at supporting patients in the process of starting dialysis, and will broaden the focus from physical symptoms to include psychosocial factors such as depression, anxiety, self-efficacy, wellbeing and community support. The outcomes associated with this study are significant in terms of enhancing an at-risk population’s psychosocial health and reducing treatment-related costs and associated pressures on the healthcare system. Trial registration ANZCTR no. 12615000810516. Registered on 5 August 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1558-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Simon R Knowles
- Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia. .,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia. .,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Robyn Langham
- Department of Neurology, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Emmet O'Flaherty
- Department of Neurology, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - Susan L Rossell
- Department of Psychology, Swinburne University, Melbourne, VIC, 3122, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Gaye Moore
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia
| | - Ya-Seng Arthur Hsueh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 3010, Australia.,Mental Health Service, St. Vincent's Hospital, Melbourne, VIC, 3065, Australia.,Centre for the Heart and Mind, Australian Catholic University, Melbourne, VIC, 3000, Australia
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24
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Clarke AL, Yates T, Smith AC, Chilcot J. Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review. Clin Kidney J 2016; 9:494-502. [PMID: 27274839 PMCID: PMC4886910 DOI: 10.1093/ckj/sfw014] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/17/2016] [Indexed: 12/13/2022] Open
Abstract
Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception–based interventions.
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Affiliation(s)
- Amy L Clarke
- Leicester Kidney Exercise Team, Department of Renal Medicine, University Hospitals of Leicester, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology , University of Leicester , Leicester , UK
| | - Alice C Smith
- Leicester Kidney Exercise Team, Department of Renal Medicine, University Hospitals of Leicester, Leicester, UK; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Joseph Chilcot
- Institute of Psychiatry, Psychology and Neuroscience , King's College London , London , UK
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