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Duan DF, Liu M, Ma DY, Yan LJ, Huang YY, Chen Y, Jiang W, Tang X, Xiong AQ, Shi YY. Exploring Symptom Clusters in Chinese Patients with Diabetic Kidney Disease: A Network Analysis. Int J Gen Med 2024; 17:871-884. [PMID: 38468820 PMCID: PMC10926920 DOI: 10.2147/ijgm.s447921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose The research on symptom management in patients with diabetic kidney disease (DKD) has shifted from separate symptoms to symptom clusters and networks recently. This study aimed to evaluate the unpleasant symptoms of DKD patients, and to investigate how these symptom clusters could affect patients. Methods 408 DKD patients were recruited in this cross-sectional study. The symptoms of DKD patients were measured using the modified Dialysis Symptom Index. Network analysis was employed to evaluate the symptom network and the characteristics of individual nodes, while factor analysis was utilized to identify symptom clusters. Results Blurred vision was the most prevalent symptom among DKD patients. The symptoms identified as the most distressing, severe, and frequent were light headache or dizziness, arteriovenous fistula/catheterization pain, and diarrhea, respectively. Five symptom clusters were obtained from factor analysis, and the most central symptom cluster in the entire symptom network was sexual dysfunction. Conclusion This study identified five symptom clusters in Chinese DKD patients, with sexual dysfunction emerging as the most central cluster. These findings carry significant clinical implications, underscoring the necessity of assessing symptom clusters and their associations to enhance symptom management in DKD patients. Further research is essential to elucidate the underlying mechanisms of symptoms and to clarify the associations among symptoms in DKD patients across different disease trajectories or treatment modalities.
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Affiliation(s)
- Di-Fei Duan
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Min Liu
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Deng-Yan Ma
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Lin-Jia Yan
- The Nethersole School of Nursing Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Yue-Yang Huang
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Yi Chen
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Wei Jiang
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xi Tang
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - An-Qi Xiong
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan Province, People’s Republic of China
| | - Yun-Ying Shi
- Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
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Kose S, Mohamed NA. The Interplay of Anxiety, Depression, Sleep Quality, and Socioeconomic Factors in Somali Hemodialysis Patients. Brain Sci 2024; 14:144. [PMID: 38391719 PMCID: PMC10887329 DOI: 10.3390/brainsci14020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study aimed to assess anxiety, depression, and sleep quality in kidney failure patients receiving hemodialysis (HD) in Somalia and examine the relationship between anxiety, depression, and sleep quality. METHODS We conducted a study with 200 kidney failure patients on HD treatment for over 3 months. Participants completed sociodemographic questionnaires, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS Among the 200 participants (mean age = 52.3; SD = 14.13), 58.5% were men, 64% had CKD for 1-5 years, and 52.6% received HD for 1-5 years. Depressive symptoms were found in 61.5% (PHQ-9) and 37.5% (HADS depression subscale) of HD patients. Poor sleep quality (PSQI) was observed in 31.5% and significantly correlated with PHQ-9 (rs = 0.633), HADS anxiety (rs = 0.491), and HADS depression (rs = 0.529). The ISI score correlated significantly with PHQ-9 (rs = 0.611), HADS anxiety (rs = 0.494), and HADS depression (rs = 0.586). All PSQI components correlated with depression and anxiety, except sleep medication use. Hierarchical regression analysis revealed that HADS anxiety (β = 0.342) and HADS depression (β = 0.372) predicted ISI scores. HADS anxiety (β = 0.307) and HADS depression (β = 0.419) predicted PSQI scores. CONCLUSIONS Higher anxiety and depression levels negatively correlated with various dimensions of sleep quality in kidney failure patients. Early identification and appropriate management of these psychological disturbances are crucial for enhancing patients' overall quality of life.
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Affiliation(s)
- Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
- Department of Psychiatry, Basaksehir Cam Sakura City Hospital, Health Sciences University, Istanbul 34480, Türkiye
| | - Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
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Chen C, Lee S, Tsay S, Tung H. Resilience, activities of daily living, and well-being in patients with chronic kidney disease. Nurs Open 2023; 10:7759-7766. [PMID: 37804104 PMCID: PMC10643819 DOI: 10.1002/nop2.2018] [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: 10/04/2022] [Revised: 08/24/2023] [Accepted: 09/17/2023] [Indexed: 10/08/2023] Open
Abstract
AIM The aim was to investigate the associations of activities of daily living, resilience and the well-being among patients with chronic kidney disease (CKD) and provide a long-term follow-up study. DESIGN A longitudinal design was used. METHODS The instruments included the Instrumental Activities of Daily Living (IADLs) Scale to assess the activities of daily living as well as the Resilience Scale and Well-Being Scale. A regression analysis was used to predict the factors related to well-being. A repeated-measures ANOVA was used for long-term follow-up with regard to IADLs, resilience and well-being. RESULTS A total of 105 eligible participants were enrolled, of whom 59% were men and 41% were women. Interactions at three time points among IADLs, resilience, and well-being were reported. IADLs were significantly and positively associated with resilience and well-being. Resilience was a significant predictor of well-being. The well-being score increased by 0.24 points for every 1-point increase in the resilience score. CONCLUSION IADLs, resilience, and well-being are correlated in patients with CKD, and resilience is a predictor of well-being. Higher resilience is associated with higher well-being. Therefore, clinical care providers need to access the resilience level of CKD patients as early as possible and design appropriate interventions to improve mental health and quality of life.
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Affiliation(s)
- Chia‐Pei Chen
- Department of NursingJenteh Junior College of Medicine, Nursing and ManagementHou‐Loung TownMiaoli CountyTaiwan
| | - Szu‐Ying Lee
- Department of NursingMackay Medical CollegeNew Taipei CityTaiwan, R.O.C.
| | - Shiow‐Luan Tsay
- College of Nursing & Health Sciences, DaYeh UniversityChanghuaTaiwan, R.O.C.
| | - Heng‐Hsin Tung
- College of Nursing, National Yang Ming Chiao Tung UniversityTaipeiTaiwan, R.O.C.
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Chan FHF, Newman S, Khan BA, Griva K. Prevalence and trajectories of subjective cognitive complaints and implications for patient outcomes: A prospective study of haemodialysis patients. Br J Health Psychol 2023; 28:651-671. [PMID: 36720474 DOI: 10.1111/bjhp.12645] [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: 10/20/2022] [Revised: 01/03/2023] [Accepted: 01/13/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Cognitive impairment is common in haemodialysis patients and is associated with increased hospitalization and mortality. However, subjective cognitive complaints (SCCs), the self-experienced difficulties in everyday cognitive activities, remain poorly understood. This study examined the prevalence and course of SCCs in haemodialysis patients and its longitudinal associations with sociodemographic, clinical and patient-reported variables. DESIGN Observational prospective study with baseline and 12-month follow-up assessment. METHODS Based on a validated cut-off point on the Kidney Disease Quality of Life Cognitive Function subscale, haemodialysis patients (N = 159; 40.3% female, mean age 53.62) were classified into cognitive complaint trajectories: (1) resilient (60.4%; no/low SCCs throughout); (2) persistent (8.8%; stable high SCCs); (3) deterioration (17.6%; from no/low to high SCCs); and (4) recovery (13.2%; from high to no/low SCCs). Sociodemographic/clinical characteristics, self-efficacy, self-management skills, adherence, mood and biochemical assays were measured at both assessments and compared among trajectories using mixed ANOVAs. RESULTS Interaction effects indicated significant improvements in the recovery group in clinical outcomes (i.e., decreased phosphorus and calcium-phosphorus product), self-efficacy and mood over time. Group effects indicated significantly poorer self-efficacy, self-management skills and adherence in the persistent group than other trajectories across both assessments. None of the sociodemographic/clinical characteristics was associated with SCC trajectories. CONCLUSIONS The extent of SCCs vary over time across haemodialysis patients. Routine screening of SCCs in dialysis settings may help identifying patients at risk of poor self-management and worse prognosis. Strategies that compensate for cognitive lapses may mitigate the perceived cognitive burden of this population.
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Affiliation(s)
- Frederick H F Chan
- Population/Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore
| | - Stanton Newman
- Division of Health Services Research and Management, School of Health Sciences, City University of London, London, UK
| | - Behram A Khan
- National Kidney Foundation, Singapore City, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Konstadina Griva
- Population/Global Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore
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Li Y, Zhu B, Shen J, Miao L. Depression in maintenance hemodialysis patients: What do we need to know? Heliyon 2023; 9:e19383. [PMID: 37662812 PMCID: PMC10472011 DOI: 10.1016/j.heliyon.2023.e19383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Chronic kidney disease (CKD) is now recognized as a major public health problem in the world. The global prevalence of CKD is estimated at 13.4% (11.7-15.1%), with an estimated 490.2 to 7.083 million patients with End stage renal disease requiring renal replacement therapy. Hemodialysis is the main treatment for End stage renal disease patients because of its high safety and efficiency. The survival time of these patients was significantly prolonged, but many psychological problems followed. Depression is a type of mood disorder caused by a variety of causes, often manifested as disproportionate depression and loss of interest, sometimes accompanied by anxiety, agitation, even hallucinations, delusions and other psychotic symptoms. Depression has become the most common mental disorder in maintenance hemodialysis (MHD) patients according to the meta-analysis. In recent years, depression has seriously affected the quality of life and prognosis of MHD patients from dietary, sleep, treatment adherence, energy and other dimensions. This article reviews the epidemiology, etiology, diagnosis and treatment of depression in MHD patients.
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Affiliation(s)
- Yulu Li
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bin Zhu
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jianqin Shen
- Blood Purification Centre, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Liying Miao
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Al-hakeim HK, Twaij BAA, Ahmed MH, Almulla AF, Moustafa SR, Maes M. In end-stage kidney disease, inflammation, erythron abnormalities and declined kidney function tests are accompanied by increased affective symptoms, chronic-fatigue, and fibromyalgia.. [DOI: 10.1101/2023.01.12.23284460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
AbstractBackgroundNumerous neuropsychiatric symptoms, including affective symptoms, chronic fatigue syndrome, and fibromyalgia symptoms, are present in patients with end-stage renal disease (ESRD). This study examines the relationship between neuropsychiatric symptoms and red blood cell (RBC) parameters, kidney function tests, zinc, C-reactive protein, and calcium levels in patients with ESRD.MethodsThe above biomarkers and the Beck-Depression Inventory, the Hamilton Anxiety Rating Scale, and the Fibro-Fatigue Rating Scale were measured in 70 patients with end-stage renal disease (ESRD) and 46 healthy controls.ResultsIncreased scores of depressive, anxious, cognitive, and physiosomatic symptoms (including chronic fatigue, fibromyalgia, and autonomous symptoms) characterise ESRD. One latent vector could be extracted from these diverse symptom domains, which are, therefore, manifestations of a common core referred to as the physio-affective phenome. The combined effects of aberrations in red blood cells (RBC) (number of RBC, hematocrit, and haemoglobin), kidney function tests (glomerular filtration rate, ureum, creatinine, albumin, and total serum protein), C-reactive protein, zinc, and copper explained 85.0% of the variance in the physio-affective phenome. In addition, the effects of kidney function decline on the phenome were partially mediated by RBC aberrations and elevated copper, whereas the effects of dialysis frequency were entirely mediated by decreased zinc and elevated CRP.ConclusionsAffective (depression and anxiety), cognitive, and physiosomatic symptoms due to ESRD are interrelated manifestations of the physio-affective phenome, which is driven by (in descending order of importance) kidney dysfunctions, erythron deficits, inflammation, elevated copper, and decreased zinc.
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Alshelleh S, Alhawari H, Alhouri A, Abu-Hussein B, Oweis A. Level of Depression and Anxiety on Quality of Life Among Patients Undergoing Hemodialysis. Int J Gen Med 2023; 16:1783-1795. [PMID: 37193250 PMCID: PMC10183175 DOI: 10.2147/ijgm.s406535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Background Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. Methods This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. Results In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). Conclusion The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.
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Affiliation(s)
- Sameeha Alshelleh
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Hussein Alhawari
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Abdullah Alhouri
- Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, Reading, UK
- Correspondence: Abdullah Alhouri, Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK, Email
| | | | - Ashraf Oweis
- Division of Nephrology, Department of Medicine, Jordan University of Science and Technology, Amman, Jordan
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Kalini S, Zartaloudi A, Kavga A, Stamou A, Alikari V, Fradelos EC, Gerogianni G. Investigation of Anxiety and Health Locus of Control in Patients Undergoing Hemodialysis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:47-57. [PMID: 37581780 DOI: 10.1007/978-3-031-31986-0_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
INTRODUCTION Hemodialysis is the most frequent treatment modality for End-Stage Renal Disease (ESRD). However, a number of limitations and modifications accompany this treatment, affecting people's physical and psychological well-being and increasing anxiety symptoms. The aim of this study was to investigate the level of anxiety and health locus of control among dialysis patients. METHODOLOGY One hundred and five patients on hemodialysis treatment completed a questionnaire with demographic characteristics, the State-Trait Anxiety Inventory and the Multidisciplinary Health Locus of Control Scale. RESULTS Women had significantly higher levels of state anxiety than men (p = 0.019). Similarly, patients with primary school education had significantly higher trait and total anxiety levels than those with technological education (p = 0.002 and p = 0.033, respectively). Widowed patients exhibited significantly higher state, trait, and total anxiety levels than married (p = 0.032, p = 0.012, and p = 0.012, respectively). Participants who did not do any kind of exercise had significantly higher level of state, trait, and total anxiety than those who did (p = 0.011, p = 0.015, and p = 0.006, respectively). Respondents who did not have any self-care skills had significantly higher level of state, trait, and total anxiety than those who had (p = 0.011, p = 0.015, and p = 0.006, respectively). State, trait, and total anxiety levels were significantly (p ≤ 0.05) correlated negatively with internal locus of control and positively with "chance" locus of control scale. CONCLUSIONS Hemodialysis patients had increased anxiety symptoms and believed that others had control over their health to a greater extent. Renal professionals need to apply effective interventions to dialysis patients in order to help them gain a better sense of control over their health and reduce anxiety symptoms.
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Affiliation(s)
- Sofia Kalini
- Department of Nursing, University of West Attica, Athens, Greece
| | | | - Anna Kavga
- Department of Nursing, University of West Attica, Athens, Greece
| | - Angeliki Stamou
- Department of Nursing, University of West Attica, Athens, Greece
| | - Victoria Alikari
- Department of Nursing, University of West Attica, Athens, Greece
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Chan FHF, Newman S, Khan BA, Griva K. The role of subjective cognitive complaints in self-management among haemodialysis patients: a cross-sectional study. BMC Nephrol 2022; 23:363. [PMID: 36376848 PMCID: PMC9661809 DOI: 10.1186/s12882-022-02994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Subjective cognitive complaints refer to self-experienced difficulties with everyday cognitive tasks. Although there has been a fair amount of research on cognitive impairments and cognitive complaints in end-stage renal disease, the practical implications of these complaints remain unclear. The current study aims to examine the associations of cognitive complaints with sociodemographic and clinical variables, mood, as well as key patient-reported outcomes, i.e., self-efficacy, self-management skills, and treatment adherence. Methods A total of 305 haemodialysis patients (mean age = 53.97 years, 42.6% female) completed the Kidney Disease Quality of Life Cognitive Function subscale, a brief measure of cognitive complaints. The recommended cut-off point of 60 was used to identify probable cognitive impairment. Measures of self-efficacy, self-management skills (i.e., symptom coping, health monitoring, health service navigation), treatment adherence, and mood symptoms were also administered. Between-group comparisons and correlational analyses were performed to examine associations of cognitive complaints with sociodemographic, clinical, and health behaviour variables. Mediation analyses were also conducted to investigate the mediating role of self-efficacy on the relationship between cognitive complaints and treatment adherence. Results Nearly a quarter (23.0%) of haemodialysis patients reported cognitive complaints indicative of clinical impairments. Risk of probable impairments was higher for patients with hypertension, diabetes, those diagnosed with end-stage renal disease at an older age, and those with shorter time on dialysis. Subjective cognitive complaints (both rates of probable impairments as per cut-off and continuous scores) were significantly associated with lower disease and treatment self-efficacy, poorer self-management skills, lower treatment adherence, as well as higher symptoms of distress. Mediation analysis indicated that treatment self-efficacy mediated the relationship between cognitive complaints and treatment adherence. Conclusions The current study demonstrated the clinical characteristics of haemodialysis patients who report cognitive complaints indicative of probable cognitive impairments and showed the associations of these complaints with self-management outcomes. Future studies should adopt more comprehensive measures of cognitive complaints and longitudinal designs to confirm the current findings.
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Jang H, Lee K, Kim S, Kim S. Unmet needs in palliative care for patients with common non-cancer diseases: a cross-sectional study. Palliat Care 2022; 21:151. [PMID: 36038840 PMCID: PMC9426270 DOI: 10.1186/s12904-022-01040-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background Non-cancer patients experience the chronic process of disease that increases the patients’ suffering as well as families’ care burden. Although two-thirds of deaths are caused by non-cancer diseases, there is a lack of studies on palliative care for non-cancer patients. This study identified the palliative care needs and satisfaction, anxiety and depression, and health-related quality of life (HRQOL) of non-cancer patients and identified the factors influencing their HRQOL. Methods A cross-sectional survey design was employed. Participants were 114 non-cancer patients with chronic heart failure, stroke, end-stage renal disease, or end-stage liver disease who were admitted to the general ward of a tertiary hospital in South Korea. Measures included the Palliative Care Needs and Satisfaction Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcome Study 36-items Short Form Health Survey version 2. Data were analysed with descriptive statistics, independent t-tests, analyses of variance, Pearson’s correlations, and multiple linear regression analyses. Results The average score of palliative care needs was 3.66 ± 0.62, which falls between ‘moderate’ and ‘necessary’. Among the four domains, the average score of palliative care needs in the psychosocial domain was the highest: 3.83 ± 0.67. Anxiety was nearly in the normal range (7.48 ± 3.60; normal range = 0–7) but depression was higher than normal (9.17 ± 3.71; normal range = 0–7). Similar to patients with cancer, physical HRQOL (38.89 ± 8.69) and mental HRQOL (40.43 ± 11.19) were about 80% of the general population’s score (50 points). Duration of disease and physical performance were significant factors associated with physical HRQOL, whereas physical performance, anxiety, and depression were significant factors associated with mental HRQOL. Conclusion It is necessary to maintain non-cancer patients’ physical performance and assess and manage their mental health in advance for effective palliative care. This study provides relevant information that can be used to develop a tailored palliative care model for non-cancer patients.
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Affiliation(s)
- Hyoeun Jang
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Kyunghwa Lee
- College of Nursing, Konyang University, 158, Gwanjeodong-ro, Seo-gu, 35365, Daejeon, Republic of Korea
| | - Sookyung Kim
- School of Nursing, Soonchunhyang University, 50, Suncheonhyang 4-gil, Dongnam-gu, Chungcheongnam-do, 31151, Cheonan-si, Republic of Korea
| | - Sanghee Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
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Dang LT, Luong TC, Nguyen DH, Hoang TA, Nguyen HT, Nguyen HC, Duong TH, Tran TT, Pham LV, Ngo TV, Nguyen HT, Trieu NT, Do TV, Trinh MV, Ha TH, Phan DT, Do BN, Yang SH, Wang TJ, Duong TV. The Associations of Suspected COVID-19 Symptoms with Anxiety and Depression as Modified by Hemodialysis Dietary Knowledge: A Multi-Dialysis Center Study. Nutrients 2022; 14:nu14122364. [PMID: 35745093 PMCID: PMC9230868 DOI: 10.3390/nu14122364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/22/2022] [Accepted: 06/02/2022] [Indexed: 02/06/2023] Open
Abstract
During the COVID-19 pandemic, it is essential to evaluate hemodialysis patients’ dietary knowledge, especially among those with COVID-19 related symptoms, in order to identify appropriate strategies in managing their mental health. The study’s purposes were to test the psychometric properties of the hemodialysis dietary knowledge (HDK) scale, and to investigate the modifying impact of HDK on the associations of suspected COVID-19 symptoms (S-COVID-19-S) with anxiety and depression among hemodialysis patients. A cross-sectional study was conducted from July 2020 to March 2021 at eight hospitals across Vietnam. Data of 875 hemodialysis patients were analyzed, including socio-demographic, anxiety (the generalized anxiety disorder scale, GAD-7), depression (the patient health questionnaire, PHQ-9), S-COVID-19-S, HDK, health literacy, and digital healthy diet literacy. Confirmatory factor analysis (CFA) and logistic regression models were used to analyze the data. The HDK scale demonstrates the satisfactory construct validity with good model fit (Goodness of Fit Index, GFI = 0.96; Adjusted Goodness of Fit Index, AGFI = 0.90; Standardized Root Mean Square Residual, SRMR = 0.05; Root Mean Square Error of Approximation, RMSEA = 0.09; Normed Fit Index, NFI = 0.96; Comparative Fit Index, CFI = 0.96, and Parsimony goodness of Fit Index, PGFI = 0.43), criterion validity (as correlated with HL (r = 0.22, p < 0.01) and DDL (r = 0.19, p < 0.01), and reliability (Cronbach alpha = 0.70)). In the multivariate analysis, S-COVID-19-S was associated with a higher likelihood of anxiety (odds ratio, OR, 20.76; 95% confidence interval, 95%CI, 8.85, 48.70; p < 0.001) and depression (OR, 12.95; 95%CI, 6.67, 25.14, p < 0.001). A higher HDK score was associated with a lower likelihood of anxiety (OR, 0.70; 95%CI, 0.64, 0.77; p < 0.001) and depression (OR, 0.72; 95%CI, 0.66, 0.79; p < 0.001). In the interaction analysis, the negative impacts of S-COVID-19-S on anxiety and depression were mitigated by higher HDK scores (p < 0.001). In conclusion, HDK is a valid and reliable tool to measure dietary knowledge in hemodialysis patients. Higher HDK scores potentially protect patients with S-COVID-19-S from anxiety and depression during the pandemic.
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Affiliation(s)
- Loan T. Dang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112-19, Taiwan;
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi 115-20, Vietnam
| | - Thuc C. Luong
- Director Office, Military Hospital 103, Hanoi 121-08, Vietnam;
- Department of Cardiology, Cardiovascular Center, Military Hospital 103, Hanoi 121-08, Vietnam
| | - Dung H. Nguyen
- Hemodialysis Department, Nephro-Urology-Dialysis Center, Bach Mai Hospital, Hanoi 115-19, Vietnam; (D.H.N.); (T.A.H.)
| | - Trung A. Hoang
- Hemodialysis Department, Nephro-Urology-Dialysis Center, Bach Mai Hospital, Hanoi 115-19, Vietnam; (D.H.N.); (T.A.H.)
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan;
| | - Hoai T. Nguyen
- Division of Military Scientific Information, Vietnam Military Medical University, Hanoi 121-08, Vietnam;
| | - Hoang C. Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen 241-24, Vietnam; (H.C.N.); (T.H.D.)
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 241-17, Vietnam
| | - Thai H. Duong
- Director Office, Thai Nguyen National Hospital, Thai Nguyen 241-24, Vietnam; (H.C.N.); (T.H.D.)
- Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 241-17, Vietnam
| | - Tu T. Tran
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan;
- Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 241-17, Vietnam
| | - Linh V. Pham
- Department of Pulmonary & Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong 042-12, Vietnam;
| | - Tuan V. Ngo
- Department of Hemodialysis, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong 042-12, Vietnam;
| | - Hoi T. Nguyen
- Director Office, Hai Phong International Hospital, Hai Phong 047-08, Vietnam;
| | - Nga T. Trieu
- Hemodialysis Division, Hai Phong International Hospital, Hai Phong 047-08, Vietnam;
| | - Thinh V. Do
- Director Office, Bai Chay Hospital, Ha Long 011-21, Vietnam;
| | - Manh V. Trinh
- Director Office, Quang Ninh General Hospital, Ha Long 011-08, Vietnam;
| | - Tung H. Ha
- Director Office, General Hospital of Agricultural, Hanoi 125-16, Vietnam;
| | - Dung T. Phan
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi 116-22, Vietnam;
- Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi 112-06, Vietnam
| | - Binh N. Do
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi 121-08, Vietnam;
- Division of Military Science, Military Hospital 103, Hanoi 121-08, Vietnam
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan;
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Research Center of Geriatric Nutrition, Taipei Medical University, Taipei 110-31, Taiwan
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112-19, Taiwan;
- Correspondence: (T.-J.W.); (T.V.D.); Tel.: +886-2-2822-7101 (ext. 3118) (T.-J.W.); +886-2-2736-1661 (ext. 6545) (T.V.D.)
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan;
- Correspondence: (T.-J.W.); (T.V.D.); Tel.: +886-2-2822-7101 (ext. 3118) (T.-J.W.); +886-2-2736-1661 (ext. 6545) (T.V.D.)
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12
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Kim DS, Kim SW, Gil HW. Emotional and cognitive changes in chronic kidney disease. Korean J Intern Med 2022; 37:489-501. [PMID: 35249316 PMCID: PMC9082446 DOI: 10.3904/kjim.2021.492] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/02/2022] [Indexed: 11/30/2022] Open
Abstract
Chronic kidney disease (CKD) leads to cognitive impairment and emotional changes. However, the precise mechanism underlying the crosstalk between the kidneys and the nervous system is not fully understood. Inflammation and cerebrovascular disease can influence the development of depression in CKD. CKD is one of the strongest risk factors for cognitive impairment. Moreover, cognitive impairment occurs in CKD as patients experience the dysregulation of several brain functional domains due to damage caused to multiple cortical regions and to subcortical modulatory neurons. The differences in structural brain changes between CKD and non-CKD dementia may be attributable to the different mechanisms that occur in CKD. The kidney and brain have similar anatomical vascular systems, which may be susceptible to traditional risk factors. Vascular factors are assumed to be involved in the development of cognitive impairment in patients with CKD. Vascular injury induces white matter lesions, silent infarction, and microbleeds. Uremic toxins may also be directly related to cognitive impairment in CKD. Many uremic toxins, such as indoxyl sulfate, are likely to have an impact on the central nervous system. Further studies are required to identify therapeutic targets to prevent changes in the brain in patients with CKD.
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Affiliation(s)
- Duk-Soo Kim
- Department of Anatomy, Soonchunhyang University College of Medicine, Cheonan,
Korea
| | - Seong-Wook Kim
- Graduate School of New Drug Discovery & Development, Chungnam National University, Daejeon,
Korea
| | - Hyo-Wook Gil
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan,
Korea
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13
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Nowicka M, Górska M, Edyko K, Szklarek-Kubicka M, Kazanek A, Prylińska M, Niewodniczy M, Kostka T, Kurnatowska I. Association of Physical Performance, Muscle Strength and Body Composition with Self-Assessed Quality of Life in Hemodialyzed Patients: A Cross-Sectional Study. J Clin Med 2022; 11:jcm11092283. [PMID: 35566409 PMCID: PMC9103996 DOI: 10.3390/jcm11092283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 12/03/2022] Open
Abstract
(1) Patients on chronic hemodialysis (HD) experience impaired quality of life (QoL). We analyzed HD’s relationship with physical performance, body composition, and muscle strength; (2) QoL was assessed with the Short Form-36, composed of physical (PCS) and mental (MCS) health dimensions. Physical performance was assessed with the Short Physical Performance Battery (SPPB), body composition (lean tissue mass% (LTM%), fat tissue mass% (FTM%), and skeletal muscle mass% (SMM%)) was assessed with bioelectrical impedance, and lower extremity strength was assessed with a handheld dynamometer; and (3) we enrolled 76 patients (27 F, 49 M), age 62.26 ± 12.81 years, HD vintage 28.45 (8.65−77.49) months. Their QoL score was 53.57 (41.07−70.64); their PCS and MCS scores were 52.14 (38.69−65.95) and 63.39 (44.64−76.79) and strongly correlated (p < 0.0001, R = 0.738). QoL correlated positively with SPPB (R = 0.35, p ≤ 0.001), muscle strength (R from 0.21 to 0.41, p < 0.05), and LTM% (R = 0.38, p < 0.001) and negatively with FTM% (R = −0.32, p = 0.006). PCS correlated positively with SPPB (R = 0.42 p < 0.001), muscle strength (R 0.25−0.44, p < 0.05), and LTM% (R = 0.32, p = 0.006) and negatively with FTM% (R = −0.25, p = 0.031). MCS correlated positively with SPPB (R = 0.23, p = 0.047), SMM% (R = 0.25; p = 0.003), and LTM% (R = 0.39, p < 0.001) and negatively with FTM% (R = −0.34; p = 0.003). QoL was unrelated to sex (p = 0.213), age (p = 0.157), HD vintage (p = 0.156), and BMI (p = 0.202); (4) Better physical performance, leaner body composition, and higher muscle strength are associated with better mental and physical QoL in HD.
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Affiliation(s)
- Maja Nowicka
- Department of Internal Medicine and Transplant Nephrology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Monika Górska
- Department of Internal Medicine and Transplant Nephrology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Krzysztof Edyko
- Department of Internal Medicine and Transplant Nephrology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | - Adam Kazanek
- Therapeutic Rehabilitation Outpatient Clinic, Medical Center Lodz Baluty, 91-745 Lodz, Poland
| | - Malwina Prylińska
- Therapeutic Rehabilitation Outpatient Clinic, Medical Center Lodz Baluty, 91-745 Lodz, Poland
| | - Maciej Niewodniczy
- Rehabilitation Department, Norbert Barlicki Memorial Teaching Hospital No. 1, 90-153 Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Center, Medical University of Lodz, 90-647 Lodz, Poland
| | - Ilona Kurnatowska
- Department of Internal Medicine and Transplant Nephrology, Medical University of Lodz, 90-153 Lodz, Poland
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Shouket H, Gringart E, Drake D, Steinwandel U. “Machine-Dependent”: The Lived Experiences of Patients Receiving Hemodialysis in Pakistan. Glob Qual Nurs Res 2022; 9:23333936221128240. [PMID: 36405243 PMCID: PMC9669685 DOI: 10.1177/23333936221128240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the lived experiences of patients receiving
maintenance hemodialysis in Pakistan. Purposive sampling was used to recruit 24
patients and six healthcare professionals, each participated in a
semi-structured interview. Interpretive Phenomenological Analysis was used to
analyze interviews’ data. Two superordinate themes, “The experience of
hemodialysis” and “The conceptualizations of hemodialysis” as well as six
sub-themes were identified. The experience of hemodialysis was related to, the
implications of HD procedure on everyday life, social, cognitive, emotional,
financial, and occupational influences. While all participants recognized the
importance of hemodialysis for their survival, their conceptualizations of the
treatment varied. Despite facing multiple challenges, optimism and independence
were observed among participants. Stigma related to hemodialysis, and role
adaptation, which appear unique to the Pakistani context, highlight a need for
tailored interventions designed to enhance and maintain the mental health of
patients receiving hemodialysis in Pakistan.
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Affiliation(s)
- Haseeba Shouket
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Eyal Gringart
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Dierdre Drake
- Edith Cowan University, Joondalup, Western Australia, Australia
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15
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Hsieh CH, Li D. Understanding how virtual reality forest experience promote physiological and psychological health for patients undergoing hemodialysis. Front Psychiatry 2022; 13:1007396. [PMID: 36590601 PMCID: PMC9794622 DOI: 10.3389/fpsyt.2022.1007396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Growing research has found that exposing patients to forest landscapes through technology improves their health. However, studies on the effects of nature therapy sessions on particularly vulnerable groups that require frequent regular treatment such as patients of chronic kidney disease (CKD) is lacking. This study aims to understand the effects of watching panoramic videos of forest walks through virtual reality (VR) headsets on patients. We also examine the effects of the frequency of virtual exposure to forests on the physiological and psychological parameters of patients undergoing dialysis. Twenty-four dialysis patients with a mean age of 65.11 year underwent a virtual nature intervention over the course of 3 weeks. The intervention consists of 3 numbers of 6-min 360-degree nature videos delivered using VR headsets. We measured heart rate variability (HRV) and heart rate (HR) using continuous electrocardiographic (ECG) monitoring and assessed their emotional states using a questionnaire survey and in-depth interviews. The results showed that the initial 6 min of watching of the panoramic videos through VR headsets resulted in significantly reduced HR and sympathetic nerve activity and increased positive emotional responses. However, repeated VR exposure did not further improve the physiological health of the respondents. Considering these results, the use of VR headsets to watch 6-min nature videos indoors can be used to enhance the positive psychological responses among dialysis and bed-ridden patients. As this study is preliminary, future random controlled trials are needed to compare and determine the best dose, content, and delivery methods of such an intervention.
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Affiliation(s)
- Chung-Heng Hsieh
- Department of Landscape Architecture, College of Art, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Dongying Li
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, United States
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16
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Zhang H, Gan L, Li X, Shao X, Zuo L, Gao J, Huang X, Jia X, Liang J, Hou Z, Wang Y, Wang L, Gao Z, Wang J, Chen H. The Implementation of Patient-Centered Humanistic Care for COVID-19 Closely Contacted Hemodialysis Patients Under the Hospital-Based Group Medical Quarantine: A Brief Research Report. Front Psychol 2021; 12:553234. [PMID: 34690846 PMCID: PMC8531721 DOI: 10.3389/fpsyg.2021.553234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
In February 2020, an inpatient in Peking University People's Hospital (PKUPH), China, was confirmed positive for the novel coronavirus. In this case, 143 hemodialysis patients were labeled as close contacts and required to be placed under the hospital-based group medical quarantine (HB-GMQ) for 2 weeks by the authorities. After the case was reported, false or misleading information about the case flourished on social media platforms, which led to infodemic. Under this context, PKUPH adopted patient-centered humanistic care to implement the HB-GMQ, through the synergy of administrative, healthcare, logistical, and other measures under the model of patient-centered care of the Massachusetts Medical Society (MMS). As a result, all the patients tided over the HB-GMQ with no COVID-19 infection and no unanticipated adverse events, and all met the criteria for lifting the HB-GMQ. According to the questionnaires taken during the HB-GMQ, a high level of satisfaction was found among the quarantined and no symptomatic increase of anxiety and depression in the patients before and during the HB-GMQ, by comparing the Zung self-rating anxiety scale (SAS) and self-rating depression scale (SDS) conducted in December 2019 and on the 12th day of the HB-GMQ. This article is to brief on PKUPH's experience in implementing patient-centered humanistic care tailored to hemodialysis patients under the HB-GMQ, and to validate the hypothesis that patient-centered humanistic care is effective and helpful to help them tide over the HB-GMQ, so as to shed light on how to implement the HB-GMQ and cope with the HB-GMQ-induced problems in other hospitals.
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Affiliation(s)
- He Zhang
- Administration Office, Peking University People's Hospital, Beijing, China.,School of International Studies, Renmin University of China, Beijing, China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Xiaodan Li
- Department of Nursing, Peking University People's Hospital, Beijing, China
| | - Xiaofeng Shao
- Department of Publicity, Peking University People's Hospital, Beijing, China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Jie Gao
- Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing, China
| | - Xiaobo Huang
- Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China
| | - Xiaojun Jia
- Urology and Lithotripsy Center, Peking University People's Hospital, Beijing, China
| | - Junqing Liang
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Zhihua Hou
- Department of General Affairs, Peking University People's Hospital, Beijing, China
| | - Yanhua Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, Beijing, China
| | - Lei Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Zhancheng Gao
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China
| | - Hongsong Chen
- Peking University People's Hospital, Beijing, China.,Peking University Hepatology Institute, Beijing, China
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17
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Griva K, Chia JMX, Goh ZZS, Wong YP, Loei J, Thach TQ, Chua WB, Khan BA. Effectiveness of a brief positive skills intervention to improve psychological adjustment in patients with end-stage kidney disease newly initiated on haemodialysis: protocol for a randomised controlled trial (HED-Start). BMJ Open 2021; 11:e053588. [PMID: 34548369 PMCID: PMC8458344 DOI: 10.1136/bmjopen-2021-053588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Initiation onto haemodialysis is a critical transition that entails multiple psychosocial and behavioural demands that can compound mental health burden. Interventions guided by self-management and cognitive-behavioural therapy to improve distress have been variably effective yet are resource-intensive or delivered reactively. Interventions with a focus on positive affect for patients with end-stage kidney disease are lacking. This study will seek (1) to develop a positive life skills intervention (HED-Start) combining evidence and stakeholder/user involvement and (2) evaluate the effectiveness of HED-Start to facilitate positive life skills acquisition and improve symptoms of distress and adjustment in incident haemodialysis patients. METHODS AND ANALYSIS This is a single/assessor-blinded randomised controlled trial (RCT) to compare HED-Start to usual care. In designing HED-Start, semistructured interviews, a codesign workshop and an internal pilot will be undertaken, followed by a two-arm parallel RCT to evaluate the effectiveness of HED-Start. A total of 148 incident HD patients will be randomised using a 1:2 ratio into usual care versus HED-Start to be delivered in groups by trained facilitators between January 2021 and September 2022. Anxiety and depression will be the primary outcomes; secondary outcomes will be positive and negative affect, quality of life, illness perceptions, self-efficacy, self-management skills, benefit finding and resilience. Assessments will be taken at 2 weeks prerandomisation (baseline) and 3 months postrandomisation (2 weeks post-HED-Start completion). Primary analyses will use an intention-to-treat approach and compare changes in outcomes from baseline to follow-up relative to the control group using mixed-effect models. ETHICS AND DISSEMINATION Ethics approval was obtained from Nanyang Technological University Institutional Review Board (IRB-2019-01-010). Written informed consent will be obtained before any research activities. Trial results will be disseminated via publications in peer-reviewed journals and conference presentations and will inform revision(s) in renal health services to support the transition of new patients to haemodialysis. TRIAL REGISTRATION NUMBER NCT04774770.
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Affiliation(s)
- Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Jace Ming Xuan Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | | | - Job Loei
- National Kidney Foundation Singapore, Singapore
| | - Thuan Quoc Thach
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
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18
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Ng MSN, Chan DNS, Cheng Q, Miaskowski C, So WKW. Association between Financial Hardship and Symptom Burden in Patients Receiving Maintenance Dialysis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189541. [PMID: 34574463 PMCID: PMC8464840 DOI: 10.3390/ijerph18189541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients on maintenance dialysis experience financial hardship. Existing studies are mainly cost analyses that quantify financial hardship in monetary terms, but an evaluation of its impact is also warranted. This review aims to explore the definition of financial hardship and its relationship with symptom burden among patients on dialysis. METHODS A literature search was conducted in November 2020, using six electronic databases. Studies published in English that examined the associations between financial hardship and symptom burden were selected. Two reviewers independently extracted data and appraised the studies by using the JBI Critical Appraisal Checklists. RESULTS Fifty cross-sectional and seven longitudinal studies were identified. Studies used income level, employment status, healthcare funding, and financial status to evaluate financial hardship. While relationships between decreased income, unemployment, and overall symptom burden were identified, evidence suggested that several symptoms, including depression, fatigue, pain, and sexual dysfunction, were more likely to be associated with changes in financial status. CONCLUSION Our findings suggest that poor financial status may have a negative effect on physical and psychological well-being. However, a clear definition of financial hardship is warranted. Improving this assessment among patients on dialysis may prompt early interventions and minimize the negative impact of financial hardship.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
- Correspondence: ; Tel.: +852-3943-8165
| | - Qinqin Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
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19
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Meissner VH, Olze L, Schiele S, Ankerst DP, Jahnen M, Gschwend JE, Herkommer K, Dinkel A. Fear of cancer recurrence and disease progression in long-term prostate cancer survivors after radical prostatectomy: A longitudinal study. Cancer 2021; 127:4287-4295. [PMID: 34358337 DOI: 10.1002/cncr.33836] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/08/2021] [Accepted: 05/03/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although fear of cancer recurrence (FCR) or disease progression is among the most endorsed unmet needs and concerns of cancer survivors, research on the course of FCR in long-term survivors is scarce. The objective of this study was to assess longitudinally the prevalence and predictors of FCR in long-term prostate cancer (PCa) survivors. METHODS In all, 2417 survivors from the multicenter German Familial Prostate Cancer Database completed the Fear of Progression Questionnaire-Short Form on average 7 years (T1 in 2010) after radical prostatectomy and at follow-up 9 years later (T2 in 2019). Hierarchical multivariable logistic regression was used to assess predictors of FCR at follow-up. RESULTS The mean age at the initial assessment was 69.5 years (standard deviation, 5.9 years); 6.5% and 8.4% of patients reported clinical FCR at the initial assessment (T1) and at the follow-up (T2), respectively. In a multivariable analysis controlling for concurrent associations, longitudinal predictors of FCR 9 years later included a lower level of education (odds ratio [OR], 4.35; 95% confidence interval [CI], 2.33-8.33), years since radical prostatectomy (OR, 1.10; 95% CI, 1.03-1.18), biochemical recurrence (OR, 1.67; 95% CI, 1.02-2.72), no current adjuvant therapy (OR, 2.38; 95% CI, 1.19-4.76), FCR (OR, 10.75; 95% CI, 6.18-18.72), and anxiety (OR, 1.35; 95% CI, 1.06-1.72). CONCLUSIONS FCR remains a burden to certain PCa survivors even many years after their diagnosis and treatment. Health care professionals should monitor for FCR and identify patients at risk to provide appropriate psychosocial care because FCR is leading to limitations in quality of life and psychological well-being.
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Affiliation(s)
- Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa Olze
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Technical University of Munich, Garching, Germany
| | - Matthias Jahnen
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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20
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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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21
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Huang CW, Wee PH, Low LL, Koong YLA, Htay H, Fan Q, Foo WYM, Seng JJB. Prevalence and risk factors for elevated anxiety symptoms and anxiety disorders in chronic kidney disease: A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 69:27-40. [PMID: 33516963 DOI: 10.1016/j.genhosppsych.2020.12.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anxiety is associated with poor health outcomes among chronic kidney disease (CKD) patients. This review summarizes the prevalence and risk factors associated with elevated anxiety symptoms and disorders among CKD patients. METHODS Articles evaluating the prevalence and risk factors associated with elevated anxiety symptoms and disorders among CKD patients, as diagnosed via DSM 4th or 5th edition criteria, clinical interviews or validated questionnaires, were searched in Medline®, Embase®, PsychINFO® and CINAHL®. Using random-effects meta-analyses, the prevalence of elevated anxiety symptoms and disorders were estimated. A narrative review on the risk factors associated with elevated anxiety symptoms and disorders was presented. RESULTS From 4941 articles, 61 studies were included. The pooled prevalence of anxiety disorders (9 studies, n = 1071) among CKD patients across studies was 19% while that of elevated anxiety symptoms (52 studies, n = 10,739) was 43%. Across continents, prevalence of elevated anxiety symptoms was highest in Europe and Asia. Between pre-dialysis and dialysis patients, the prevalence of elevated anxiety symptoms was not statistically different at 31% and 42% respectively. Common risk factors associated with elevated anxiety symptoms included concomitant depression, lower parathyroid hormone levels, increased comorbidities, increased duration of hospitalization, reduced perceived quality of life, and decreased vitality levels. CONCLUSION Given the high prevalence of anxiety disorders and elevated anxiety symptoms, more studies are required to assess the role and outcomes of anxiety screening among CKD patients. This could facilitate early identification of at-risk patients and potentially improve their clinical outcomes.
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Affiliation(s)
| | - Poh Hui Wee
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore.
| | - Lian Leng Low
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Outram Rd, 169608, Singapore; SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, 169608, Singapore; Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, 168582, Singapore; SingHealth Regional Health System PULSES Centre, Singapore Health Services, Singapore, Outram Rd, 169608, Singapore.
| | - Ying Leng Agnes Koong
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore; SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, 169608, Singapore; Marine Parade Polyclinics, SingHealth Polyclinics, 80 Marine Parade Central, 440080, Singapore.
| | - Htay Htay
- Department of Renal Medicine, Singapore General Hospital, Outram Rd, 169608, Singapore.
| | - Qiao Fan
- Center for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Wai Yin Marjorie Foo
- Department of Renal Medicine, Singapore General Hospital, Outram Rd, 169608, Singapore.
| | - Jun Jie Benjamin Seng
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore; SingHealth Regional Health System PULSES Centre, Singapore Health Services, Singapore, Outram Rd, 169608, Singapore.
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22
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Fradelos EC, Alikari V, Tsaras K, Papathanasiou IV, Tzavella F, Papagiannis D, Zyga S. Assessment of psychological distress in end stage renal disease: is it spirituality related? Med Pharm Rep 2021; 94:79-87. [PMID: 33629053 PMCID: PMC7880071 DOI: 10.15386/mpr-1623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/27/2020] [Accepted: 05/23/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Patients undergoing hemodialysis (HD) are faced with bearing this burden and report poor mental health. Spirituality can be a key factor in managing these problems among HD patients. Aim This cross-sectional study aimed at exploring possible factors that are associated with psychological distress among HD patients and testing its relation to spirituality. Methods HD patients were recruited from six dialysis units in Greece. Psychological distress was assessed using the scale Symptom Check List 90-R and spirituality using the Facit Sp-12 questionnaire. In addition, a special design questionnaire regarding demographic, social, and clinical characteristic was administrated. Results According to the results, factors such age, gender, marital status and area of residence are associated with psychological distress, while dimensions of spirituality such Meaning in Life and Peace can have a positive influence on psychological distress. Conclusion This study highlights the vital role of spirituality, which can act as a mechanism for managing stressful situations. In particular, this study highlights the positive effect of the meaning and purpose of life, as well as the role of peace and harmony.
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Affiliation(s)
- Evangelos C Fradelos
- Community Nursing Lab, Nursing department, University of Thessaly, Larissa, Greece.,Department of Nursing, University of Peloponnese, Sparta, Greece
| | - Victoria Alikari
- Department of Nursing, University of Peloponnese, Sparta, Greece
| | - Konstantinos Tsaras
- Community Nursing Lab, Nursing department, University of Thessaly, Larissa, Greece
| | | | - Foteini Tzavella
- Community Nursing Lab, Nursing department, University of Thessaly, Larissa, Greece
| | | | - Sofia Zyga
- Department of Nursing, University of Peloponnese, Sparta, Greece
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23
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Relationship between Ineffective Attitudes and General Health in Patients with Chronic Renal Disease Undergoing Hemodialysis in a Hospital in Gorgan, Iran. JOURNAL OF CLINICAL AND BASIC RESEARCH 2021. [DOI: 10.52547/jcbr.5.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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24
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Um-e-Kalsoom, Khan S, Ahmad I. Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD).
Result
A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS.
Conclusion
The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.
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Skoumalova I, Geckova AM, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7913. [PMID: 33126638 PMCID: PMC7663113 DOI: 10.3390/ijerph17217913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023]
Abstract
Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21-3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26-2.98) or anxiety (OR/95% CI: 1.81/1.22-2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients' psychological distress to ensure adequate adherence with recommended diet.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
- 2nd Department of Internal Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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Keskindag B, Farrington K, Oygar DD, Mertan B, Hucker A, Sharma S. Illness perceptions of Turkish Cypriot patients receiving haemodialysis: A qualitative study. J Ren Care 2020; 47:113-122. [PMID: 33040486 DOI: 10.1111/jorc.12351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Illness perceptions refer to cognitive appraisals that help patients understand and make sense of their condition. Although their importance in health behaviour and outcomes has been evidenced, less is known about cultural influences on mental representations of kidney failure amongst patients receiving haemodialysis in different settings. OBJECTIVE To explore the illness perceptions of Turkish patients receiving haemodialysis in North Cyprus (Turkish Cypriots). DESIGN A qualitative study involving individual semistructured interviews. PARTICIPANTS Fourteen patients receiving haemodialysis, recruited from three state hospitals in North Cyprus. APPROACH All interviews were conducted in Turkish, audio-recorded, and transcribed verbatim. They were analysed inductively in the original language using reflexive thematic analysis. Once the analysis was completed, it was translated into English. Quality assurance was integral to the research process to retain semantic equivalence. FINDINGS Three themes were developed. "Illness appraisal" highlighted a lack of factual knowledge about kidney failure and how this is related to attempts at sense-making, whilst retaining hope for the future. "Life-changing effects" centred around the negative consequences of haemodialysis across multiple domains (e.g., emotional and physical). "Active coping strategies" focused on mechanisms that patients adopt to manage the burden of haemodialysis, particularly approaches that are culturally rooted. CONCLUSION There is a need for better communication to address the lack of individual patient knowledge about kidney failure. Haemodialysis is described as a burdensome treatment though existing coping mechanisms suggest that psycho-spiritual interventions may be advantageous to aid adjustment for Turkish Cypriots receiving haemodialysis.
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Affiliation(s)
- Buse Keskindag
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Psychology, Bahçeşehir Cyprus University, Nicosia, North Cyprus
| | - Ken Farrington
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Duriye D Oygar
- Department of Nephrology, Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus
| | - Biran Mertan
- Department of Psychology, Bahçeşehir Cyprus University, Nicosia, North Cyprus
| | - Abigail Hucker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Shivani Sharma
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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27
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Wang Q, Liu H, Ren Z, Xiong W, He M, Fan X, Guo X, Li X, Shi H, Zha S, Qiao S, Zhao H, Li N, Zhang X. Gender difference in the association of coping styles and social support with psychological distress among patients with end-stage renal disease. PeerJ 2020; 8:e8713. [PMID: 32257634 PMCID: PMC7103200 DOI: 10.7717/peerj.8713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/10/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives The study aimed to explore the association of coping styles and social support with psychological distress among patients with end-stage renal disease (ESRD) as well as gender differences in these associations. Methods A cross-sectional study of 769 ESRD patients was conducted at 25 hospitals in Qiqihar City, China. All information was collected using structured questionnaires that were self-administered by the patients. Patients' psychological health status, coping styles and perceived social support were measured using the 12-item General Health Questionnaire, the Medical Coping Modes Questionnaire and the Multidimensional Scale of Perceived Social Support. Student's t test, analysis of variance (ANOVA) and binary logistic regression analysis were used for data analysis. Results A total of 72.3% of participants reported psychological distress, and the prevalence of distress was higher in females (77.0%) than in males (68.8%). The usage of the acceptance-resignation coping style was positively related to psychological distress (B = 0.459, P < 0.001). Social support level was negatively associated with psychological distress (B = -0.049, P < 0.001). The use of the confrontation style was negatively related to psychological distress in females (OR = 0.87, 95% CI [0.78-0.96]) but not in males (OR = 0.98, 95% CI [0.91-1.06]) (P for interaction term = 0.007). Conclusions Greater use of the acceptance-resignation style and lower social support are related to a higher risk of psychological distress. Greater use of the confrontation style is related to a lower risk of psychological distress in females but not in males.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.,The First Hospital of Qiqihar City, Qiqihar, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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Srettabunjong S. Fatal external bleeding from self-severed arterial dialysis tube: An unusual method of suicide. MEDICINE, SCIENCE, AND THE LAW 2019; 59:210-213. [PMID: 31480916 DOI: 10.1177/0025802419872670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A high risk of suicide has been observed in adults with end-stage renal disease who are undergoing haemodialysis. Since suicide is preventable, early screening, a prompt multidisciplinary approach and appropriate treatment of depression are critical and are recommended to treating physicians. Recently, the case of a woman with end-stage renal disease who had been undergoing haemodialysis was encountered. She died by suicide after self-severing the temporary haemodialysis catheter secured to the right side of her neck. This method of suicide is unusual and rare. This case not only underscores the association between haemodialysis and suicide in patients with end-stage renal disease but also raises awareness of the possibility of such deaths.
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Affiliation(s)
- Supawon Srettabunjong
- Department of Forensic Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
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29
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Schouten RW, Haverkamp GL, Loosman WL, Chandie Shaw PK, van Ittersum FJ, Smets YFC, Vleming LJ, Dekker FW, Honig A, Siegert CEH. Anxiety Symptoms, Mortality, and Hospitalization in Patients Receiving Maintenance Dialysis: A Cohort Study. Am J Kidney Dis 2019; 74:158-166. [PMID: 31027882 DOI: 10.1053/j.ajkd.2019.02.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 02/09/2019] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Anxiety symptoms are common in dialysis patients and have a large impact on quality of life. The association of anxiety symptoms with adverse clinical outcomes in dialysis patients is largely unknown. This study examined the association of anxiety symptoms with hospitalization and mortality in patients receiving maintenance dialysis. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS Maintenance dialysis patients treated at 10 dialysis centers in the Netherlands between 2012 and 2016. EXPOSURES Time-varying symptoms of anxiety and depression using the Beck Anxiety Inventory and Beck Depression Inventory. OUTCOMES All-cause mortality, 1-year hospitalization rate, and hospital length of stay. ANALYTICAL APPROACH Cox proportional hazards and Poisson regression models adjusted for sociodemographic and clinical variables. Sensitivity analyses included multiple imputation of missing data and restriction to incident patients only. RESULTS 687 patients were included, composed of 433 prevalent and 242 incident dialysis patients. Median follow-up time was 3.1 (IQR, 3.0-3.5) years, during which 172 deaths occurred. 22% of patients had anxiety symptoms and 42% had depressive symptoms. Anxiety symptoms were associated with all-cause mortality and 1-year hospitalization rate and length of stay in all multivariable models. Anxiety symptoms showed a clear dose-response relationship with mortality. LIMITATIONS Depression and anxiety often coexist and share symptoms. The observational design of this study limits inferences about causal mechanisms between anxiety and clinical outcomes. CONCLUSIONS Anxiety symptoms are independently associated with increased risk for mortality and 1-year hospitalization. Anxiety symptoms are a clinically relevant risk factor for morbidity and mortality in dialysis patients and warrant further research on effective treatment.
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Affiliation(s)
- Robbert W Schouten
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands.
| | - Gertrud L Haverkamp
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | - Wim L Loosman
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | | | | | - Yves F C Smets
- Department of Nephrology, OLVG, Amsterdam, the Netherlands
| | - Louis-Jean Vleming
- Department of Nephrology, Haga Teaching Hospital, The Hague, the Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Adriaan Honig
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
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30
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KauricKlein Z. Effect of yoga on physical and psychological outcomes in patients on chronic hemodialysis. Complement Ther Clin Pract 2019; 34:41-45. [DOI: 10.1016/j.ctcp.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
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31
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Bawazier LA, Stanley I, Sianipar W, Suhardjono S. Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital. MEDICAL JOURNAL OF INDONESIA 2018. [DOI: 10.13181/mji.v27i4.2999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: In Indonesia, chronic kidney disease (CKD) is primarily managed by hemodialysis (HD) because limited resources rule out the possibility of renal transplantation. HD patients are commonly accompanied by caregivers. However, most studies have neglected the health of caregivers, who play an important role in the survival of HD patients. This study aimed to determine the proportion of caregivers who suffer from anxiety and depression and the factors involved.Methods: This was a cross-sectional study involving 100 caregivers in the HD unit of Cipto Mangunkusumo Hospital, Jakarta. This study used the hospital anxiety depression scale (HADS) to determine the extent of anxiety and depression among caregivers. All caregivers were asked to fill out the questionnaire without assistance.Results: A total of 28% and 18% of caregivers were found to be anxious and depressed respectively. The caregiver’s relationship with the patient, whether the caregiver was being paid or unpaid, the total duration of care, and income were not associated with levels of anxiety and depression. However, the proportion of each 24-hour period spent on care was significantly associated with anxiety (p=0.037) and depression (p=0.015). The time spent on care every 24 hours was also a significant predictor of anxiety (p=<0.001) and depression (p=0.021).Conclusion: One-third of caregivers were found to be anxious and/or depressed. The time spent on care every 24 hours was a strong predictor of both anxiety and depression.
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Griva K, Lam KFY, Nandakumar M, Ng JAH, McBain H, Newman SP. The effect of brief self-management intervention for hemodialysis patients (HED-SMART) on trajectories of depressive and anxious symptoms. J Psychosom Res 2018; 113:37-44. [PMID: 30190046 DOI: 10.1016/j.jpsychores.2018.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Depression is often comorbid with End-Stage Renal Disease, and associated with poor adherence and clinical outcomes but course of symptoms is variable. This study sought to describe the long-term trajectories of anxiety and depression in hemodialysis patients, to identify predictors of these trajectories over 12 months and to evaluate the effectiveness of the HEmoDialysis Self-Management Randomized Trial (HED SMART) against usual care on symptoms of anxiety and depression. METHODS A secondary analysis of data from a randomized controlled trial that contrasted HED SMART (n = 101) against usual care (n = 134). Depressive and anxious symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline, 1 week and at 3 and 9 months post-intervention. Latent class growth analysis identified trajectories of depression and anxiety, and their sociodemographic and clinical predictors. RESULTS Symptoms of depression and anxiety over 12 months were characterized by two trajectories: low stable (depression: 55%; anxiety: 59%) with non-clinical levels of distress, and high stable (depression: 45%; anxiety: 41%) with clinical levels of distress. HED SMART predicted significant reductions in depression relative to usual care. A similar trend was noted for anxiety. Younger age, Chinese ethnicity, and more comorbidities were associated with persistent high depression. Younger age and shorter dialysis vintage was associated with persistent high anxiety. CONCLUSION A brief self-management intervention designed to support behavioral change can also lead to significant reductions in symptoms of depression and may be of great value for younger HD patients shown to be at greater risk for persistent distress. TRIAL REGISTRATION ISRTN31434033.
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Affiliation(s)
- Konstadina Griva
- Department of Psychology, National University of Singapore, 9Arts Link AS4 02/28, Singapore 117570, Singapore; School of Health Sciences, City, University of London, Northampton Square, London, UK.
| | - Kevin F Y Lam
- Department of Psychology, National University of Singapore, 9Arts Link AS4 02/28, Singapore 117570, Singapore
| | - Mooppil Nandakumar
- National Kidney Foundation, 81 Kim Keat Road, Singapore 328836, Singapore
| | - Jo-An H Ng
- Department of Psychology, National University of Singapore, 9Arts Link AS4 02/28, Singapore 117570, Singapore
| | - Hayley McBain
- School of Health Sciences, City, University of London, Northampton Square, London, UK; Community Health Newham, East London NHS Foundation Trust, 9 Alie Street, London, UK
| | - Stanton P Newman
- School of Health Sciences, City, University of London, Northampton Square, London, UK
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Bowman B, Zheng S, Yang A, Schiller B, Morfín JA, Seek M, Lockridge RS. Improving Incident ESRD Care Via a Transitional Care Unit. Am J Kidney Dis 2018; 72:278-283. [DOI: 10.1053/j.ajkd.2018.01.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/07/2018] [Indexed: 11/11/2022]
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Liu CH, Yeh MK, Weng SC, Bai MY, Chang JC. Suicide and chronic kidney disease: a case-control study. Nephrol Dial Transplant 2018; 32:1524-1529. [PMID: 27638910 DOI: 10.1093/ndt/gfw244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/05/2016] [Indexed: 01/22/2023] Open
Abstract
Background The association of chronic kidney disease (CKD) and dialysis with suicide is not well established. The objectives of this study were to assess the association of suicide with CKD and dialysis and investigate whether differences exist between dialysis modalities or the durations of dialysis. Methods Data were obtained from the Taiwan National Health Insurance Research Database. A total of 51 642 patients who died from suicide between 2000 and 2012 and 206 568 living control patients matched by age, gender and residency area were examined. Known risk factors included sociodemographic characteristics, physical comorbidities and psychiatric disorders, which were controlled for as covariates in the analysis. The crude odds ratios (ORs) and adjusted ORs (aORs) for various risk factors were obtained using conditional logistic regression. Results After potential confounders were controlled for, CKD was significantly associated with an increased risk of suicide [aOR = 1.25, 95% confidence interval (CI) = 1.17-1.34]. End-stage renal disease patients on haemodialysis (HD) had an increased risk of suicide compared with controls (aOR = 3.35, 95% CI = 3.02-3.72). Moreover, patients who initially underwent dialysis within 0-3 months had a significantly increased risk of suicide (aOR = 20.26, 95% CI = 15.99-25.67). Conclusions CKD and HD are positively associated with suicide. Suicide is preventable; therefore, assessing mental and physical disorders is essential and recommended to all physicians, particularly those treating patients in the early phase of HD.
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Affiliation(s)
- Chao-Han Liu
- Biomedical Engineering Program, Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Ming-Kung Yeh
- Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan.,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Chuan Weng
- Department of Business Administration, Taipei City University of Science and Technology, Taipei, Taiwan
| | - Meng-Yi Bai
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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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: 80] [Impact Index Per Article: 13.3] [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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Kazama S, Kazama JJ, Wakasugi M, Ito Y, Narita I, Tanaka M, Horiguchi F, Tanigawa K. Emotional disturbance assessed by the Self-Rating Depression Scale test is associated with mortality among Japanese Hemodialysis patients. Fukushima J Med Sci 2018; 64:23-29. [PMID: 29398691 DOI: 10.5387/fms.2016-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emotional disturbance including depression is associated with increased mortality among dialysis patients. The Self-Rating Depression Scale (SDS) is a simple tool for assessing emotional disturbance. This study investigated the relationship between emotional conditions as assessed with the SDS test and mortality among 491 hemodialysis patients. At baseline, 183 (37.3%), 180 (36.7%), 108 (22.0%), and 20 (4.1%) were classified as normal, borderline depression, depression, and severe depression, respectively. During the two years of observation period, 57 of 491 (11.6%) died. The SDS scores in the non-survivors were significantly higher than those in the survivors (p<0.0001). Logistic analyses showed that the diagnoses made by the SDS test were associated with significantly greater risks for all-cause mortality (99%CI: 1.905-3.698 for that without adjustment, 1.999-4.382 for that with full adjustment). When the SDS score = 50 was selected as the cut off value, the test screened two-year all cause death with sensitivity = 57.9% and the specificity = 78.1%. In conclusion, hemodialysis patients had high prevalence of emotional disturbance assessed by the SDS test, and high SDS score was significantly associated with all-cause mortality. These findings underscore the importance of screening for emotional conditions using the SDS test among hemodialysis patients.
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Affiliation(s)
- Sakumi Kazama
- Futaba Emergency and General Medical Support Center, Fukushima Medical University
| | | | - Minako Wakasugi
- Department of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
| | - Yumi Ito
- Department of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
| | - Ichiei Narita
- Department of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
| | | | - Fumi Horiguchi
- Department of Gynecology, Tokyo Dental College Ichikawa General Hospital
| | - Koichi Tanigawa
- Futaba Emergency and General Medical Support Center, Fukushima Medical University
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Cruz JP, Reyes RWP, Colet PC, Estacio JC, Caldeira S, Vitorino LM, Koenig HG. Psychometric Evaluation of the Filipino Versions of the Duke University Religion Index and the Spiritual Coping Strategies Scale in Filipino Hemodialysis Patients. JOURNAL OF RELIGION AND HEALTH 2017; 56:1381-1396. [PMID: 28054216 DOI: 10.1007/s10943-016-0355-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study evaluated the psychometric properties of the Filipino versions of the Duke University Religion Index (DUREL-F) and the Spiritual Coping Strategies scale (SCS-F) for hemodialysis (HD) patients in the Philippines. A convenient sample of 162 HD patients was included in this descriptive, cross-sectional study. The DUREL-F and SCS-F exhibited acceptable internal consistency and stability reliability, as well as excellent content and construct validity. The findings confirmed the soundness of the psychometric properties of the two scales. Thus, they can be used for timely and accurate assessment of religiosity and spiritual coping utilization among Filipino patients receiving HD.
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Affiliation(s)
- Jonas Preposi Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, PO Box 1678, Dawadmi, 11911, Saudi Arabia.
| | - Ralph Warren P Reyes
- Ilocos Training and Regional Medical Center, San Fernando, La Union, Philippines
| | - Paolo C Colet
- Nursing Department, College of Applied Medical Sciences, Shaqra University, PO Box 1678, Dawadmi, 11911, Saudi Arabia
| | - Joel C Estacio
- Midwifery Department, Institute of Community Health and Allied Medical Sciences, Don Mariano Marcos Memorial State University South La Union Campus, Agoo, La Union, Philippines
| | - Sílvia Caldeira
- Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
| | | | - Harold G Koenig
- Duke University Medical Center, Durham, NC, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
- Ningxia Medical University, Yinchuan, China
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Müller F, Tuinman MA, Janse M, Almansa J, Sprangers MAG, Smink A, Ranchor AV, Fleer J, Hagedoorn M. Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis. Br J Health Psychol 2017. [DOI: 10.1111/bjhp.12253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Fabiola Müller
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Marrit A. Tuinman
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Moniek Janse
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Josué Almansa
- Division of Community and Occupational Medicine; Department of Health Sciences; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology; Academic Medical Center; University of Amsterdam; The Netherlands
| | - Ans Smink
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Adelita V. Ranchor
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Joke Fleer
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
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Annema C, Roodbol PF, Van den Heuvel ER, Metselaar HJ, Van Hoek B, Porte RJ, Ranchor AV. Trajectories of anxiety and depression in liver transplant candidates during the waiting-list period. Br J Health Psychol 2017; 22:481-501. [PMID: 28474774 DOI: 10.1111/bjhp.12241] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 03/29/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To explore whether distinct trajectories of anxiety and depression exist among liver transplant candidates, and to gain insight into demographic, clinical, and individual characteristics related with these trajectories. DESIGN A multicentre, prospective cohort study among 216 liver transplant candidates. Respondents filled out a questionnaire at study entrance and subsequently every 6 months until transplantation or removal from the waiting list. METHODS Anxiety (STAI6), depression (CES-D), demographic, and individual variables were assessed by questionnaire. Clinical variables were retrieved by medical record review. The SAS PROC TRAJ procedure was used to identify distinct trajectories. Univariate and multiple ordinal logistic regression analyses were used to explore related variables. RESULTS Regarding anxiety, three stable trajectories were identified as follows: below clinical level (51%), slightly above clinical level (34%), and high above clinical level (15%). Regarding depression, four stable trajectories were identified as follows: below clinical level (23%), slightly below clinical level (34%), slightly above clinical level (28%), and high above clinical level (6%). For anxiety as well as for depression, experiencing more liver disease symptoms, a lower level of personal control, making more use of emotional coping, and making less use of task-oriented coping increased the likelihood of membership in those trajectories with higher symptom levels. CONCLUSION Distinct, but stable, trajectories of anxiety and depression were present in liver transplant candidates. The trajectories with symptom levels above clinical relevant levels for anxiety or depression comprised, respectively, 49% and 34% of the respondents. Therefore, psychological screening and subsequently providing appropriate interventions are warranted early in the transplant process. Statement of contribution What is already known on this subject For transplant candidates, the waiting-list period is a period of uncertainty and unpredictability. Psychological problems, such as anxiety and depression, are common among liver transplant candidates. Several demographic, clinical, and individual characteristics are associated with anxiety and depression, but these results remain inconclusive. What does this study add Distinct trajectories of symptoms of anxiety and depression are present among liver transplant candidates. Given the stability of the trajectories over time, the symptom level at baseline is indicative of the symptom level during the waiting-list period. Experiencing more liver disease symptoms, low mastery, more use of emotional coping, and less use of task-oriented coping are associated with trajectories of high symptom levels.
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Affiliation(s)
- Coby Annema
- Department of Nursing Research, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Petrie F Roodbol
- Department of Nursing Research, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Edwin R Van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, the Netherlands
| | - Herold J Metselaar
- Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bart Van Hoek
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, the Netherlands
| | - Robert J Porte
- Department of Surgery, Section of Hepato-Pancreatic-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, the Netherlands
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Gibson EL, Held I, Khawnekar D, Rutherford P. Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients. Front Psychol 2016; 7:1864. [PMID: 27965605 PMCID: PMC5126042 DOI: 10.3389/fpsyg.2016.01864] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/10/2016] [Indexed: 02/01/2023] Open
Abstract
Patients with chronic kidney disease (CKD) often require regular hemodialysis (HD) to prolong life. However, between HD sessions, patients have to restrict their diets carefully to avoid excess accumulation of potassium, phosphate, sodium, and fluid, which their diseased kidneys can no longer regulate. Failure to adhere to their renal dietary regimes can be fatal; nevertheless, non-adherence is common, and yet little is known about the psychological variables that might predict this dietary behavior. Thus, this study aimed to assess whether dietary adherence might be affected by a variety of psychological factors including stress, personality, and health locus of control, as well as dietary knowledge, in chronic HD patients. Fifty-one patients (30 men; age range 25-85) who had undergone HD for at least 3 months and had been asked to restrict at least one of potassium, phosphate or fluid, were recruited from a hospital renal unit. Measures of adherence to each of potassium, phosphate, and fluid were derived from standard criteria for these physiological indices in renal patients. Knowledge of food/drink sources of these dietary factors, and their medical implications in relation to HD and CKD were assessed by a bespoke questionnaire. Psychological factors including stress, personality and health locus of control beliefs were measured by standardized questionnaires. Having to restrict a particular nutrient was associated with better knowledge of both food sources and medical complications for that nutrient; however, greater dietary knowledge was not linked to adherence, and knowledge of medical complications tended to be associated with poorer adherence to potassium and phosphate levels. Adherence to these two nutrient requirements was also associated with lower reported stress in the past week. Adherence was associated with differences in locus of control: these differences varied across indices although there was a tendency to believe in external loci. For potassium, phosphate, and fluid restriction, adherers were less likely to be sensation seekers but did not differ from non-adherers on impulsivity, anxiety sensitivity, or hopelessness. In conclusion, the links between dietary adherence and stress, locus of control and personality suggests that screening for such psychological factors may assist in managing adherence in HD patients.
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Affiliation(s)
- E Leigh Gibson
- Department of Psychology, Whitelands College, University of Roehampton London, UK
| | - Ines Held
- Renal Unit, Wrexham Maelor Hospital Wrexham, UK
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Lilympaki I, Makri A, Vlantousi K, Koutelekos I, Babatsikou F, Polikandrioti M. EFFECT OF PERCEIVED SOCIAL SUPPORT ON THE LEVELS OF ANXIETY AND DEPRESSION OF HEMODIALYSIS PATIENTS. Mater Sociomed 2016; 28:361-365. [PMID: 27999485 PMCID: PMC5149439 DOI: 10.5455/msm.2016.28.361-365] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 10/10/2016] [Indexed: 11/06/2022] Open
Abstract
Purpose: of this study was to explore the effect of social support on the levels of anxiety and depression of hemodialysis patients. Material and Methods: 258 patients undergoing hemodialysis were enrolled. A questionnaire developed for the purpose of the study was used to collect data through the interview process. Apart from socio-demographic, clinical and other characteristics, the questionnaire also included the Multidimensional Scale of Perceived Social Support (MSPSS) to assess social support from significant others, family and friends, and the questionnaire Hospital Anxiety and Depression Scale (HADs) to assess the levels of anxiety and depression of patients. Results: 53,9% of the participants were male while 34,1% of the participants were >70 years old. 32,9% and 30,2% of the participants felt high levels of anxiety and depression, respectively. Analysis of data showed a statistically significant association between anxiety/depression and social support from significant others, family and friends (p=<0,001 for all associations). In particular, patients with high levels of anxiety and depression felt less support from their significant others, family and friends. The multinomial logistic regression, showed a statistically significant effect of social support from friends in anxiety levels (p=0,004). An one point increase of the support from friends seems to reduce by 57% the probability of having high levels of anxiety. In addition, statistically significant effect of social support from significant others, family and friends was observed on the levels of depression (p=<0,001, p=0,001 & p=0,003, respectively). Specifically, an one point increase of the support from significant others, family and friends it was found to reduce by 77%, 71% and 56% respectively the probability of experiencing high levels of depression. Conclusions: Phyco-social evaluation is essential when providing holistic care to hemodialysis patients.
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Affiliation(s)
- Ioanna Lilympaki
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
| | - Andriana Makri
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
| | - Kyriaki Vlantousi
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
| | - Ioannis Koutelekos
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
| | - Fotoula Babatsikou
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
| | - Maria Polikandrioti
- Department of Nursing, Technological Institute of Athens (TEI) of Athens, Athens, Greece
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Chan R, Dear BF, Titov N, Chow J, Suranyi M. Examining internet-delivered cognitive behaviour therapy for patients with chronic kidney disease on haemodialysis: A feasibility open trial. J Psychosom Res 2016; 89:78-84. [PMID: 27663114 DOI: 10.1016/j.jpsychores.2016.08.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Treating depression among patients with chronic kidney disease (CKD) is imperative because of its high prevalence and health-related costs. However, many patients with CKD experience significant barriers to effective face-to-face psychological treatments. Internet-delivered cognitive behaviour therapy (iCBT) may help overcome the treatment barriers. The aim of the present study was to explore the acceptability and preliminary efficacy of iCBT for depression and anxiety among patients with CKD on haemodialysis. METHODS A single-group open trial design involving 22 patients on dialysis and an established iCBT treatment for anxiety and depression was employed. The primary outcomes were symptoms of depression, anxiety and general psychological distress. The secondary and tertiary outcomes were disability, quality of life, kidney disease-related loss and kidney disease burden. A generalised estimation equation modelling technique was employed. RESULTS Clinically significant improvements (avg. % of improvement) were observed in the primary outcomes of depression (34%), anxiety (31%) and general distress (26%), which were maintained or further improved to 3-month follow-up. Improvements were also observed for quality of life (12%) and kidney disease-related loss (30%). However, no improvements in disability and kidney disease burden were found. High levels of acceptability were reported and relatively little clinician time (99.45min; SD=14.61) was needed to provide the treatment. CONCLUSION The present results provide encouraging support for the potential of iCBT as an innovative way of increasing access to effective psychological treatment for CKD patients. These results provide much needed support for further research in this area. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry: ACTRN12613000103763.
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Affiliation(s)
- Ramony Chan
- Renal Unit, Liverpool Hospital, Sydney, Australia; Consultation Liaison Psychiatry, Liverpool Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia.
| | - Blake F Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nick Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Josephine Chow
- Clinical Innovation & Business Unit, South Western Sydney Local Health District, Sydney, Australia; The University of Sydney, Sydney, Australia; The University of Tasmania, Hobart, Australia
| | - Michael Suranyi
- Renal Unit, Liverpool Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia; Western Sydney University, Sydney, Australia
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Barros A, Costa BED, Mottin CC, d'Avila DO. Depression, quality of life, and body composition in patients with end-stage renal disease: a cohort study. ACTA ACUST UNITED AC 2016; 38:301-306. [PMID: 26870913 PMCID: PMC7111352 DOI: 10.1590/1516-4446-2015-1681] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/28/2015] [Indexed: 01/09/2023]
Abstract
Objective: To prospectively evaluate depressive symptoms, nutritional status, and quality of life (QoL) and search for possible associations in patients with end-stage renal disease undergoing hemodialysis. Methods: A cohort study of 104 adult patients with end-stage renal disease undergoing hemodialysis was conducted. Anthropometric, clinical, and biochemical variables were evaluated after a midweek hemodialysis session. The participants’ body composition was assessed by direct segmental multi-frequency bioimpedance analysis. The WHOQOL-Bref questionnaire was used to evaluate QoL. Participants were separated into two groups - depressive symptoms and no depressive symptoms - at inclusion and evaluated annually for 2 years thereafter using the Beck Depression Inventory. Survival analysis used the Kaplan-Meier method and Cox regression analysis for the goodness of fit of associated factors. All-cause mortality was the outcome of interest. Results: Participants’ mean age was 55.3±15.6 years, 60% were male, and the median time on hemodialysis was 17.5 (8.0-36.8) months. Thirty-two patients had depressive symptoms and a significantly lower QoL compared with the 72 patients in the no depressive symptoms group. The fitted outcome model showed that lean body mass had a protective effect against all-cause mortality (hazard ratio [HR] = 0.89; 95%CI 0.80-0.99; p = 0.038). Conclusion: Depressive symptoms were highly prevalent in the cohort, and correlated with the physical and psychological components of the QoL life questionnaire, as well as with C-reactive protein and phosphorus levels. Lean body mass was protective for the assessed outcome.
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Affiliation(s)
- Annerose Barros
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Bartira E da Costa
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Claudio C Mottin
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Cirurgia), Faculdade de Medicina, PUCRS, Porto Alegre, RS, Brazil
| | - Domingos O d'Avila
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Abstract
End-stage renal disease (ESRD) is an irreversible and life-threatening condition. In Jordan, the number of ESRD patients treated with hemodialysis is on the rise. Identifying stressors and coping strategies used by patients with ESRD may help nurses and health care providers to gain a clearer understanding of the condition of these patients and thus institute effective care planning. The purpose of this study was to identify stressors perceived by Jordanian patients on hemodialysis, and the coping strategies used by them. A convenience sample of 131 Jordanian men and women was recruited from outpatients' dialysis units in four hospitals. Stressors perceived by participants on hemodialysis and the coping strategies were measured using Hemodialysis Stressor Scale, and Ways of Coping Scale-Revised. Findings showed that patients on hemodialysis psychosocial stressors scores mean was higher than the physiological stressors mean. Positive reappraisal coping strategy had the highest mean among the coping strategies and the lowest mean was accepting responsibility. Attention should be focused towards the psychosocial stressors of patients on hemodialysis and also helping patients utilize the coping strategies that help to alleviate the stressors. The most used coping strategy was positive reappraisal strategy which includes faith and prayer.
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Affiliation(s)
- Muayyad M Ahmad
- a Faculty of Nursing, Clinical Nursing Department , University of Jordan , Amman , Jordan
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