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Lan X, Yi B, Wang Z. Quality of Life Among Older Adults With Frailty: A Structural Equation Modeling. J Psychosoc Nurs Ment Health Serv 2024; 62:49-55. [PMID: 38285905 DOI: 10.3928/02793695-20240122-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
PURPOSE Frailty is a complex age-related clinical condition among older adults. Quality of life (QOL) among older adults with frailty is an important topic of interest. The current cross-sectional study aimed to develop a structural equation model to identify factors affecting QOL. METHOD A total of 180 older adults with frailty were recruited from general units in two hospitals in Fuzhou, China. Data were collected using the World Health Organization Quality of Life Brief Version, Pittsburgh Sleep Quality Index, Geriatric Depression Scale-15, and Simplified Coping Style Questionnaire. Structural equation modeling was used to analyze data. RESULTS The final model exhibited a good fit. Poor sleep quality was associated with depression, passive coping style, and poor QOL. Depression was also associated with poor QOL. Passive coping style was associated with better QOL. CONCLUSION This study demonstrated that sleep quality has direct and indirect effects on QOL of older adults with frailty through depression and passive coping style. Recommendations are that care providers pay attention to biological and physiological variables, symptom status, and functional status of older adults with frailty. This study also provides a theoretical basis for developing interventions that may lead to improvements in QOL among older adults with frailty. [Journal of Psychosocial Nursing and Mental Health Services, 62(5), 49-55.].
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Holas P, Figueira-Putresza E, Domagala-Kulawik J. Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis. Respir Med 2023; 211:107171. [PMID: 36906186 DOI: 10.1016/j.rmed.2023.107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Although stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis. METHODS In two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2). RESULTS Across two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level). CONCLUSION These findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.
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Affiliation(s)
- Pawel Holas
- University of Warsaw, Faculty of Psychology, Poland.
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Sheth MS, Castle DJ, Wang W, Lee A, Jenkins ZM, Hawke LD. Changes to coping and its relationship to improved wellbeing in the optimal health program for chronic disease. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2023.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Waterman AD, Nair D, Purnajo I, Cavanaugh KL, Mittman BS, Peipert JD. The Knowledge Assessment of Renal Transplantation (KART) 2.0: Development and Validation of CKD and Transplant Knowledge Scales. Clin J Am Soc Nephrol 2022; 17:555-564. [PMID: 35332061 PMCID: PMC8993477 DOI: 10.2215/cjn.11490821] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/18/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Many individuals with kidney disease, particularly those belonging to racial and ethnic minority groups and whose primary language is not English, lack knowledge related to kidney disease symptoms, physiologic functions of the kidney, and benefits and risks of kidney transplantation. Valid instruments to assess patients' knowledge of CKD and kidney transplantation are needed. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Using a sample of 977 patients with stages 3-5 CKD in the Kaiser Permanente health system, we developed the Knowledge Assessment of Renal Transplantation (KART) 2.0 instrument. We conducted cognitive interviews followed by item response theory (IRT) to reduce 48 candidate items. Construct validity was tested by examining differences in scores between patients who spent <1 and ≥1 hour receiving CKD and transplant education. RESULTS Cognitive interviews modified four items and omitted 11. IRT analyses resulted in two scales: the KART 2.0-Transplant Knowledge Scale (16 items; Cronbach's α=0.8) and the KART 2.0-CKD Knowledge Scale (nine items; Cronbach's α=0.79). Differential item functioning showed that the scales were unbiased to capture knowledge across self-identified race, primary language, CKD stage, and sex. Both scales distinguished patients who had spent <1 and ≥1 hour speaking with health professionals (effect size [ES]=0.33 [transplant], 0.54 [CKD]; P<0.001 for both), reading about kidney disease (ES=0.45 [transplant], 0.62 [CKD]; P<0.001), reading about kidney transplantation (ES=0.67 [transplant], 0.69 [CKD]; P<0.001), and reading about living donor kidney transplant (ES=0.76 [transplant], 0.62 [CKD]; P<0.001). CONCLUSIONS The KART 2.0 is a valid tool to assess patients' knowledge of CKD and kidney transplantation.
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Affiliation(s)
- Amy D Waterman
- Department of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Devika Nair
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee
| | | | - Kerri L Cavanaugh
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt O'Brien Center for Kidney Disease, Nashville, Tennessee
- Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brian S Mittman
- Health Services Research and Implementation Science, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - John Devin Peipert
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Feinberg School of Medicine, Chicago, Illinois
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health Literacy and Change in Health-Related Quality of Life in Dialysed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020620. [PMID: 35055440 PMCID: PMC8776225 DOI: 10.3390/ijerph19020620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 12/10/2022]
Abstract
Health-related quality of life (HRQoL) is likely to deteriorate with the progression of chronic kidney disease (CKD). This change may be worsened by low health literacy (HL). We performed a longitudinal study at over 20 dialysis clinics in Slovakia (n = 413; mean age = 64.8 years; males = 58.4%). We assessed the association of three HL groups with a change in HRQoL over two years using binary logistic regression adjusted for type of vascular access, dialysis effectiveness, comorbidity, age and gender. We found that patients with low HL had poorer HRQoL at baseline in comparison to high-HL patients. We did not find significant associations of lower HL with the deterioration of mental or physical HRQoL after two years. In the adjusted model, patients with lower HL were not more likely to have deteriorated physical (low-HL patients: odds ratio/95% confidence interval: 0.99/0.53–1.84; moderate-HL patients: 0.97/0.55–1.73) or mental HRQoL (low-HL patients: 1.00/0.53–1.87; moderate-HL patients: 0.95/0.53–1.70) in comparison to high-HL patients. The HRQoL of lower-HL patients is worse at baseline but develops similarly to that of high-HL patients during dialysis treatment. Their relative HRQoL, thus, does not worsen further, but it does not improve either. Tailoring care to their needs may help to decrease the burden of low HL in dialysed patients.
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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 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Correspondence: ; Tel.: +421-055-234-3390
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
- II. Internal Clinic, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 11 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenná 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia; (A.F.d.W.); (J.P.v.D.)
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands;
- Olomouc University Social Health Institute, Palacky University, Univerzitní 22, 771 47 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;
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Laksmita OD, Chung MH, Liao YM, Haase JE, Chang PC. Predictors of resilience among adolescent disaster survivors: A path analysis. J Adv Nurs 2020. [PMID: 32301129 DOI: 10.1111/jan.14396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/19/2020] [Accepted: 04/08/2020] [Indexed: 12/26/2022]
Abstract
AIMS To investigate a theoretical model of risk and protective factors to predict resilience among adolescent disaster survivors. DESIGN A cross-sectional study. METHODS Parent's consent and student's informed consent forms were distributed at seven schools in a postdisaster setting (Yogyakarta, Indonesia) between July-October 2017; those who agreed to participate had to complete the self-reported questionnaires. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined using a path analysis. RESULTS Results of the model test analysis indicated that six of the seven the hypothesized paths were supported by data from our samples and demonstrated significance on the path coefficients (p < .01). One path coefficient on the association between posttraumatic stress disorder (PTSD) symptoms and resilience was found to be insignificant (β = -0.002, p > .05). However, overall, our hypothesized model was retained, indicating empirical support and adequate model's fit indices for the theoretical model. CONCLUSIONS Overall, the findings demonstrated the predictive roles of risk and protective factors in adolescent disaster survivors' resilience. IMPACT Resilience is known to be an important concept in recovering from long-term impacts following a disaster in adolescent populations, but its risk and protective factors have not been adequately explored. We found that PTSD symptoms influenced how adolescent disaster survivors developed defensive coping, social support had an indirect effect on resilience through courageous coping and defensive coping acted as a mediator between PTSD symptoms and courageous coping. These findings can help mental health professionals (i.e., community mental health nurses) promote intervention strategies to enhance resilience through improving coping skills in adolescent populations exposed to a disaster.
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Affiliation(s)
- Okki D Laksmita
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Yuan-Mei Liao
- School of Nursing, College of Nursing, Yang-Ming University, Taipei, Taiwan
| | - Joan E Haase
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Han E, Shiraz F, Haldane V, Koh JJK, Quek RYC, Ozdemir S, Finkelstein EA, Jafar TH, Choong HL, Gan S, Lim LWW, Legido-Quigley H. Biopsychosocial experiences and coping strategies of elderly ESRD patients: a qualitative study to inform the development of more holistic and person-centred health services in Singapore. BMC Public Health 2019; 19:1107. [PMID: 31412824 PMCID: PMC6694659 DOI: 10.1186/s12889-019-7433-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/01/2019] [Indexed: 12/02/2022] Open
Abstract
Background As the incidence and prevalence rates of end stage renal disease (ESRD) rise globally, a disproportionate increase has been observed in the elderly population. Singapore has the fifth highest incidence of treated ESRD worldwide, with the upward trend of ESRD being most apparent among those aged 70 years and older. Although it is well-documented that ESRD patients suffer an impaired quality of life compared to the general population, there is limited research focusing on the unique experiences and needs of elderly ESRD patients in Asian populations. To address the knowledge gap, this study seeks to explore the impact of ESRD and dialysis on the quality of life of elderly (≥70 years old) ESRD patients in Singapore and examine the coping strategies utilised by these patients. Methods This qualitative study involved semi-structured, in-depth interviews with 7 peritoneal dialysis patients, 5 haemodialysis patients, 4 patients on non-dialysis supportive care and 7 caregivers in Singapore. Interviews were conducted in English, Chinese, and Malay and fully transcribed. QSR NVivo 11 software was used for analysis. Results Participants reported that ESRD and dialysis had an impact on three highly interconnected areas of their quality of life: (a) biological/physical (general symptoms, neuromuscular problems, skin problems and poor sleep quality); (b) psychological (depressive symptoms, anxiety and fears, stress and negative self-perceptions); and (c) social (increased dependence on family and loss of social life). There were four key strategies that participants used to cope with these biopsychosocial challenges: (a) family support (financial, practical and emotional support); (b) religious/spiritual support (experiencing gratitude/contentment, the power of prayer and belonging to a faith community); (c) avoidance (cognitive avoidance and distraction techniques); and (d) acceptance (positive thinking and problem solving). Conclusions This study has provided insights into the biopsychosocial impact of ESRD and dialysis, as well as cultural and religious factors that shape the experiences and coping mechanisms of elderly ESRD patients and caregivers in Singapore, which can be used to further the development and implementation of more holistic and person-centred services to help each patient achieve a better quality of life. Electronic supplementary material The online version of this article (10.1186/s12889-019-7433-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore.
| | - Victoria Haldane
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Joel Jun Kai Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Rina Yu Chin Quek
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Semra Ozdemir
- Duke NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | | | | | - Hui-Lin Choong
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Sheryl Gan
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Lydia W W Lim
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
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Sultanov M, İsmailova K. EEG rhythms in prefrontal cortex as predictors of anxiety among youth soccer players. TRANSLATIONAL SPORTS MEDICINE 2019. [DOI: 10.1002/tsm2.72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Murad Sultanov
- Laboratory of Ecological Toxicology A.I.Qaraev Institute of Physiology, Azerbaijan National Academy of Sciences Baku Azerbaijan
| | - Khadidja İsmailova
- Laboratory of Ecological Toxicology A.I.Qaraev Institute of Physiology, Azerbaijan National Academy of Sciences Baku Azerbaijan
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Garrido Blanco R, Arroyo Priego E, Arana Ruiz AI, López Zamorano MD, Tierno Tendero C, Crespo Montero R. Calidad de vida y enfermedad renal crónica avanzada. Influencia del aclaramiento renal. ENFERMERÍA NEFROLÓGICA 2018. [DOI: 10.4321/s2254-28842018000400005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivos: El objetivo del presente estudio fue analizar la Calidad de Vida Relacionada con la Salud en pacientes con Enfermedad Renal Crónica Avanzada en prediálisis y su relación con el aclaramiento renal. Métodos: Se estudiaron 124 pacientes en prediálisis y edad de 67,2±14,3 años (45% mujeres). Se realizó un estudio descriptivo y transversal, en el Servicio de Nefrología de Hospital Reina Sofía de Córdoba. Se utilizó el cuestionario KDQOL-SF, para el análisis de la Calidad de Vida Relacionada con la Salud. También se analizó el aclaramiento renal y la comorbilidad asociada. Resultados: En el KDQOL, las dimensiones más afectadas fueron: Situación Laboral, Carga de la Enfermedad Renal y Sueño. Las mujeres presentaron peor puntuación en Listado de Síntomas/problemas. En las dimensiones del SF-36, Salud General, Vitalidad, Función Física y Rol Físico, fueron las más afectadas. Las mujeres obtuvieron peor puntuación en Salud General, Vitalidad, Rol Físico, Dolor y Rol Emocional. Los pacientes con menor aclaramiento renal presentaron peores puntuaciones en Efectos de la Enfermedad Renal, Carga de la Enfermedad Renal y Función Sexual; y en Rol Físico y Salud General. Conclusiones: Los pacientes en prediálisis tienen disminuida su calidad de vida en las dimensiones Carga de la enfermedad renal, Sueño, Salud general, Vitalidad, Función física y Rol físico. El aclaramiento renal, aunque influye directamente en los síntomas derivados de la enfermedad renal, no parece ser tan influyente en la calidad de vida, siendo el sexo femenino, la edad y la comorbilidad asociada, las variables que más se asocian
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Kristofferzon ML, Engström M, Nilsson A. Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study. Qual Life Res 2018; 27:1855-1863. [PMID: 29623597 PMCID: PMC5997720 DOI: 10.1007/s11136-018-1845-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. METHODS The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. RESULTS The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. CONCLUSIONS Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.
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Affiliation(s)
- Marja-Leena Kristofferzon
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Maria Engström
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Nursing Department, Medicine and Health College, Lishui University, Lishui, China
| | - Annika Nilsson
- Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Ambivalence over emotional expression and physical functioning and limitations: mediating and moderating effects of PTSD symptoms and acculturation among Chinese breast cancer survivors. Support Care Cancer 2018; 27:311-319. [DOI: 10.1007/s00520-018-4329-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Relationship Between Defense Mechanisms and the Quality of Life in Women With Breast Cancer. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.11116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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The Relationship between Burden and Depression in Spouses of Chronic Kidney Disease Patients. DEPRESSION RESEARCH AND TREATMENT 2018; 2018:8694168. [PMID: 29862072 PMCID: PMC5971334 DOI: 10.1155/2018/8694168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/04/2018] [Accepted: 03/25/2018] [Indexed: 01/02/2023]
Abstract
The purpose of the present study was to investigate the burden and depression in spouses of patients with chronic kidney disease (CKD). The interrelation between burden and depression in family caregivers has been pointed out by previous researches in several chronic diseases and researchers agree that they clearly go together and one cannot talk about one without considering the other. More particularly, in the present study, the caregiver burden, the depression, anxiety, and also health-related quality of life and demographic factors of spouses of patients with CKD were examined, using self-report questionnaires. Participants were 50 spouses of patients with CKD, 29 of whom were dialysis dependent and 21 were not dialysis dependent. Group differences were examined for participants. Results confirm the interrelation between caregiver burden and depression in spouses. The increased perceived burden related to higher levels of depression. Low levels of caregiver burden, depression, anxiety, and satisfactory quality of life were found in spouses, with no differences between them relevant to whether the patients were dialysis dependent or not. All the above parameters interrelated. Implications for the findings and future research directions are discussed.
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de Brito DCS, de Paula AM, Grincenkov FRDS, Lucchetti G, Sanders-Pinheiro H. Analysis of the changes and difficulties arising from kidney transplantation: a qualitative study. Rev Lat Am Enfermagem 2017; 23:419-26. [PMID: 26312633 PMCID: PMC4547064 DOI: 10.1590/0104-1169.0106.2571] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 01/15/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: to identify the main gains and stressors perceived by the patient, one year
subsequent to kidney transplantation. METHOD: a qualitative study, in which the data were obtained and analyzed through the
Discourse of the Collective Subject and frequency counting, with the participation
of 50 patients who had received kidney transplantation. RESULTS: the sample presented a mean age of 44±12.8 years old, and a predominance of males
(62%). The principal positive changes provided by the transplant were: return to
activities; freedom/independence; well-being and health; strengthening of the I;
and closening of interpersonal relationships. The most-cited stressors were: fear;
medication; excess of care/control; specific characteristics of the treatment; and
failure to return to the social roles. CONCLUSION: kidney transplantation caused various positive changes in the patient's routine,
with the return to activities of daily living being the most important gain, in
the participants' opinion. In relation to the stressors, fear related to loss of
the graft, and questions relating to the immunosuppressive medication were the
main challenges to be faced following transplantation.
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Affiliation(s)
| | | | | | - Giancarlo Lucchetti
- Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR
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Gunning A, van Heijl M, van Wessem K, Leenen L. The association of patient and trauma characteristics with the health-related quality of life in a Dutch trauma population. Scand J Trauma Resusc Emerg Med 2017; 25:41. [PMID: 28410604 PMCID: PMC5391585 DOI: 10.1186/s13049-017-0375-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 03/20/2017] [Indexed: 02/03/2023] Open
Abstract
Background It is suggested in literature to use the Health Related Quality of Life (HRQoL) as an outcome indicator for evaluating trauma centre performances. In order to predict HRQoL, characteristics that could be of influence on a predictive model should be identified. This study identifies patient and injury characteristics associated with the HRQoL in a general trauma population. Methods Retrospective study of trauma patients admitted from 1st January 2007 through 31th December 2012. Patients were aged ≥18 years and discharged alive from the level I trauma centre. A combined health survey (SF-36 and EQ-5D) was sent to all traceable patients. The subdomain outcomes and EQ-5D index value (EQ-5Di) were compared with the reference population. A linear regression analysis was performed to identify parameters associated parameters with the HRQoL outcome. Results A total of 1870 patients were included for analyses. Compared to the eligible population, included patients were significantly older, more severely injured, more often admitted in the ICU and had a longer admission duration. The SF-36 and EQ-5Di were significantly lower compared to the Dutch reference population. The variables age, Injury Severity Score, hospital length of stay, ICU length of stay, Revised Trauma Score, probability of survival, and severe injury to the head and extremities were associated with the HRQoL in the majority of the subdomains. Discussion In order to use HRQoL as an indicator for trauma centre performances, there should be a consensus of the ideal timing for the measurement of HRQoL post-injury and the appropriate HRQoL instrument. Furthermore, standardised HRQoL outcomes must be developed. Conclusion This study revealed eight factors (described above) which could be used to predict the HRQoL in trauma patients.
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Affiliation(s)
- Amy Gunning
- Department of Trauma Surgery, University Medical Center Utrecht, Suite: G04.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Mark van Heijl
- Department of Trauma Surgery, University Medical Center Utrecht, Suite: G04.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Karlijn van Wessem
- Department of Trauma Surgery, University Medical Center Utrecht, Suite: G04.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Luke Leenen
- Department of Trauma Surgery, University Medical Center Utrecht, Suite: G04.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Gozdowska J, Zatorski M, Torchalla P, Białek Ł, Bojanowska A, Tomaszek A, Serwańska-Świętek M, Kieszek R, Kwiatkowski A, Chmura A, Durlik M. Living-Donor Versus Deceased-Donor Kidney Transplantation: Comparison of Psychosocial Consequences for Recipients. Transplant Proc 2017; 48:1498-505. [PMID: 27496435 DOI: 10.1016/j.transproceed.2016.01.075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients. MATERIALS AND METHODS The study involved 89 patients after renal transplantation: 48 from LDs and 41 from DDs. Interview data indirectly indicated the patients' health, whereas physiological parameters directly pinpointed the patients' health and the graft function. All study participants completed questionnaires to measure quality of life and the specificity of emotional and cognitive functioning. RESULTS LD kidney recipients were younger than DD recipients (40 years vs. 49 years). LD and DD transplantation patients were similar in health status assessed by indirect methods (data from an interview) and direct methods (laboratory tests results). They, however, differed in their psychosocial functioning. LD patients had a greater sense of happiness (P < .01) and of self-efficacy (P = .07). Moreover, these patients were more actively involved in their social lives (P < .02) and were more satisfied with their social relationships (P = .07). LD recipients also had a higher quality of life in terms of mental functioning (P < .01) and satisfaction with their environments (P < .01). Additionally, there were significant correlations between quality of life and the quality of cognitive and emotional functioning in the group of LD recipients. The perceived impact of health on physical and professional activity and daily routines was similar in LD and DD groups. CONCLUSIONS LD post-transplantation patients may derive greater psychosocial benefits from this form of treatment. This effect is not dependent on somatic parameters (comparable data from an interview and laboratory tests results). This study suggests that patients should be assisted by a multidisciplinary healthcare team, and receive continuous support from relatives during the post-transplantation adaptation process. This facilitates the patients' postoperative quality of life.
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Affiliation(s)
- J Gozdowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
| | - M Zatorski
- University of Social Sciences and Humanities, Poznań, Poland
| | - P Torchalla
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Ł Białek
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - A Bojanowska
- University of Social Sciences and Humanities, Poznań, Poland
| | - A Tomaszek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - M Serwańska-Świętek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - R Kieszek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - A Kwiatkowski
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - A Chmura
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - M Durlik
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
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17
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Speyer E, Morgenstern H, Hayashino Y, Kerr PG, Rayner H, Robinson BM, Pisoni RL. Reliability and validity of the coping strategy inventory-short form applied to hemodialysis patients in 13 countries: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Psychosom Res 2016; 91:12-19. [PMID: 27894457 DOI: 10.1016/j.jpsychores.2016.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Coping Strategies Inventory-Short Form (CSI-SF) measures four coping strategies based on 16 items: 4 items each indicating problem- vs. emotion-focused engagement or disengagement. Here we provide the first assessment of reliability and construct validity of the CSI-SF among hemodialysis patients across 13 countries. METHODS The CSI-SF was completed by patients in 9 languages in phase 4 of the Dialysis Outcomes and Practice Patterns Study (2009-11). Cronbach's alpha was used to assess internal consistency. Exploratory and confirmatory factor analyses were applied to assess the factor structure of the CSI-SF by country and language. CSI-SF data were analyzed from 7201 patients (60% male; median age 62.5 [range 18-96] years). RESULTS Good internal consistency (α=0.56-0.80) was seen for three scales in English (US, UK, Canada, Australia, New Zealand), German, and Swedish versions. The fourth scale was internally consistent if two items were dropped. In these countries, both exploratory and confirmatory factor analyses indicated a factor structure consistent with the four CSI-SF scales. Other language versions showed a factor structure inconsistent with these four scales. CONCLUSION The slightly modified English, German, and Swedish versions of the CSI-SF are reliable and valid instruments for measuring coping strategies in hemodialysis patients.
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Affiliation(s)
- Elodie Speyer
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States.
| | - Hal Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States; Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Yasuaki Hayashino
- Department of Endocrinology, Admission Coordination Center Tenri Hospital, Japan
| | - Peter G Kerr
- Monash Health & Monash University, Clayton, Australia
| | - Hugh Rayner
- Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - Bruce M Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Ronald L Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
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18
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Vitorino LM, Lucchetti G, Santos AEO, Lucchetti ALG, Ferreira EB, Adami NP, Vianna LAC. Spiritual Religious Coping is Associated with Quality of Life in Institutionalized Older Adults. JOURNAL OF RELIGION AND HEALTH 2016; 55:549-559. [PMID: 26649565 DOI: 10.1007/s10943-015-0148-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to investigate the relationship between spiritual/religious coping (SRCOPE) strategies and quality of life (QoL) in institutionalized older adults. This is a cross-sectional, correlational study, with a sample of 77 older adults in Brazil. The present study found long-term care patients use religious and spiritual coping strategies to deal with their chronic health conditions. Positive SRCOPE and Total SRCOPE have positive correlations with most QoL domains from the WHOQOL-OLD and WHOQOL-BREF. On the other hand, Negative SRCOPE strategies correlated negatively with the facets of "death and dying" from the WHOQOL-OLD. These results suggest the need for an integrative approach for long-term care patients, considering the positive and negative aspects of coping.
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Affiliation(s)
| | | | | | | | - Eric Batista Ferreira
- Institute of Exact Sciences, Federal University of Alfenas - UNIFAL, Alfenas, Brazil
| | - Nilce Piva Adami
- Paulista School of Nursing, Federal University of São Paulo - UNIFESP, São Paulo, Brazil
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19
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Brandão T, Tavares R, Schulz MS, Matos PM. Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clin Psychol Rev 2016; 43:114-27. [DOI: 10.1016/j.cpr.2015.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/25/2015] [Accepted: 10/16/2015] [Indexed: 01/17/2023]
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20
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Xu D, Liu N, Qu H, Chen L, Wang K. Relationships among symptom severity, coping styles, and quality of life in community-dwelling women with urinary incontinence: a multiple mediator model. Qual Life Res 2015. [PMID: 26198664 DOI: 10.1007/s11136-015-1070-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the relationships among symptom severity, coping styles, and quality of life (QOL) in community-dwelling women with urinary incontinence (UI). METHODS A total of 592 women with UI participated in this cross-sectional study. Bivariate Pearson's correlation was used to examine the correlations between symptom severity, coping styles, and QOL. Multivariate regression models and Sobel tests were used to test the mediating effect of coping styles. Additionally, a multiple mediator model was used to examine the mediating role of coping styles collectively. All regression models were adjusted for age, education, marital status, income, duration of UI, and type of UI. RESULTS Participants tended to use avoidant and palliative coping styles and not use instrumental coping style. Avoidant and palliative coping styles were associated with poor QOL, and partially mediated the association between symptom severity and QOL. Nearly 73% of the adverse effect of symptom severity on QOL was mediated by avoidant and palliative coping styles. CONCLUSIONS The use of avoidant and palliative coping styles was higher with more severe urine leakage, and QOL tended to be poorer. Coping styles should be addressed in UI management. It may be of particular value to look closely at negative coping styles and implement education and training of patients in improving their coping skills related to managing UI, which will in turn improve their QOL.
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Affiliation(s)
- Dongjuan Xu
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China.,School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nana Liu
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China
| | - Haili Qu
- Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Liqin Chen
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China.
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21
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Piccoli GB, Postorino V, Cabiddu G, Ghiotto S, Guzzo G, Roggero S, Manca E, Puddu R, Meloni F, Attini R, Moi P, Guida B, Maxia S, Piga A, Mazzone L, Pani A, Postorino M. Children of a lesser god or miracles? An emotional and behavioural profile of children born to mothers on dialysis in Italy: a multicentre nationwide study 2000–12. Nephrol Dial Transplant 2015; 30:1193-1202. [DOI: 10.1093/ndt/gfv127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Exploring the relationships between health status, illness perceptions, coping strategies and psychological morbidity in a chronic kidney disease cohort. Am J Med Sci 2015; 348:271-6. [PMID: 24751421 DOI: 10.1097/maj.0000000000000242] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Using the common sense model of illness adjustment, this study aimed to explore the impact of chronic kidney disease (CKD) on individual illness perceptions, coping styles and psychological well-being. METHODS Eighty individuals (50 men and 30 women) with an average age of 62.66 years (standard deviation, 11.98) were included in the study. All participants were under the care of the Renal Unit of a metropolitan tertiary referral hospital. Twenty-nine patients (36%) had CKD stage 3b-4, and 51 (64%) had CKD stage 5 (or end stage kidney disease [ESKD]). Disease severity was evaluated using the health perceptions questionnaire, coping styles assessed with the Carver brief COPE scale, illness perceptions explored with the brief illness perceptions questionnaire and anxiety and depression measured using the hospital anxiety and depression scale. RESULTS The hospital anxiety and depression scale assessment revealed 13 patients (16.3%) with moderate or severe anxiety and 6 (7.5%) with moderate depression. Consistent with the common sense model, disease activity had a significant direct influence on illness perceptions, while, in turn, illness perceptions had a significant direct influence on depression and anxiety. Adaptive and maladaptive coping were found to mediate the relationship between illness perceptions, and anxiety and depression. CONCLUSIONS The results provide evidence that it is the perception of an illness rather than the actual symptoms themselves that best account for adaption to CKD. These findings suggest that intervention strategies aimed at increasing psychological well-being need to focus on changing illness perceptions rather than improving symptoms of CKD or coping mechanisms.
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23
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Turkistani I, Nuqali A, Badawi M, Taibah O, Alserihy O, Morad M, Kalantan E. The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia. Ren Fail 2014; 36:1510-5. [DOI: 10.3109/0886022x.2014.949761] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Muhammad S, Allan M, Ali F, Bonacina M, Adams M. The renal patient support group: supporting patients with chronic kidney disease through social media. J Ren Care 2014; 40:216-8. [PMID: 25065504 DOI: 10.1111/jorc.12076] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Renal Patient Support Group (RPSG) is a voluntary Facebook group that was developed in 2009 in the UK. The RPSG now has in excess of 5000 members. OBJECTIVE To highlight the work of the RPSG and to describe how the use of social media has helped raise awareness of chronic kidney disease (CKD). The RPSG offers online peer support internationally, with members sharing their experiences. METHODS Since the RPSG is mainly a Facebook platform, this medium has lent itself to raising CKD awareness, also allowing group members to share real-life stories. CONCLUSION The RPSG continues to expand and invites health professionals to gain opportunities provided by social media networks to improve the health of their patients by facilitating and getting involved in 'real' discussions.
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25
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Hayes WN, Tennankore K, Battistella M, Chan CT. Vascular access-related infection in nocturnal home hemodialysis. Hemodial Int 2014; 18:481-7. [PMID: 24467296 DOI: 10.1111/hdi.12140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Frequent hemodialysis is associated with increased vascular access adverse events. We hypothesized that bacteremia would be more frequent in patients with central venous catheter (CVC) than arteriovenous fistula or arteriovenous graft (AVF/AVG) in nocturnal home hemodialysis (NHHD). We reviewed blood culture reports and concurrent clinical data for a cohort of one hundred eighty-seven NHHD patients between January 1, 2006 and June 30, 2012. The primary outcome was time to first bacteremia, technique failure, or death after commencing NHHD. Types of bacteremia and clinical consequences were analyzed. Analyses were adjusted for a priori defined confounders. One hundred eighty-seven patients were included with a total follow up of six hundred five patient years. Initial vascular access was AVF in seventy-eight (42%) patients, AVG in eleven (6%) patients, and CVC in ninety-eight (52%) patients. A total of 79.3% of patients with a CVC reached the composite endpoint of bacteremia, technique failure, or death in the study period; 44.5% of patients with an AVF or AVG reached this composite endpoint. Adjusted time to first bacteremia, technique failure, or death was significantly shorter in patients with initial CVC access (hazard ratio 2.42, 95% confidence interval 1.50-3.90, p < 0.001). Risk factors for bacteremia were comorbid status quantified by the Charlson Comorbidity Index (p < 0.001) and diabetes (p < 0.001). Coagulase negative staphylococcus was the commonest organism cultured accounting for 51.4% bacteremias. The second commonest organism was staphylococcus aureus (20.3% bacteremias). Patients undergoing NHHD with a CVC have a shorter duration to first infection, technique failure, or death than those with permanent vascular access.
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Affiliation(s)
- Wesley N Hayes
- Division of Nephrology, Hospital for Sick Children, Toronto, Canada
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26
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Relationship between psychiatric disorders and quality of life in nondialysis patients with chronic kidney disease. Am J Med Sci 2013; 345:218-21. [PMID: 22990044 DOI: 10.1097/maj.0b013e318255a561] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between psychiatric disorders (anxiety and depression) and quality of life (QOL) in nondialysis patients with chronic kidney disease (CKD). METHODS QOL was evaluated in a sample of 57 nondialysis patients with CKD using the 36-item Short Form Health Survey questionnaire comprising 8 scales, including the physical component summary and mental component summary measures. Depression and anxiety were estimated using the Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale, respectively. RESULTS Depression and anxiety scores were negatively correlated with 7 of the 8 scales of the Short Form 36 questionnaire, and with the physical component summary and mental component summary scores, despite 38.6% patients with depression and 54.4% with anxiety, whereas QOL in the depression group, the anxiety group, and the anxiety and depression comorbid group was lower than that for those without the corresponding psychiatric disorders (P < 0.05). CONCLUSIONS This study demonstrates that depression and anxiety, commonly encountered in patients with CKD, could be a risk factor for QOL in these patients.
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Feldman CH, Bermas BL, Zibit M, Fraser P, Todd DJ, Fortin PR, Massarotti E, Costenbader KH. Designing an intervention for women with systemic lupus erythematosus from medically underserved areas to improve care: a qualitative study. Lupus 2013; 22:52-62. [PMID: 23087258 PMCID: PMC3543784 DOI: 10.1177/0961203312463979] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (lupus) disproportionately affects women, racial/ethnic minorities and low-income populations. We held focus groups for women from medically underserved communities to discuss interventions to improve care. METHODS From our Lupus Registry, we invited 282 women, ≥18 years, residing in urban, medically underserved areas. Hospital-based clinics and support groups also recruited participants. Women were randomly assigned to three focus groups. Seventy-five-minute sessions were recorded, transcribed and coded thematically using interpretative phenomenologic analysis and single counting methods. We categorized interventions by benefits, limitations, target populations and implementation questions. RESULTS Twenty-nine women with lupus participated in three focus groups, (n = 9, 9, 11). 80% were African American and 83% were from medically underserved zip codes. Themes included the desire for lupus education, isolation at the time of diagnosis, emotional and physical barriers to care, and the need for assistance navigating the healthcare system. Twenty of 29 participants (69%) favored a peer support intervention; 17 (59%) also supported a lupus health passport. Newly diagnosed women were optimal intervention targets. Improvements in quality of life and mental health were proposed outcome measures. CONCLUSION Women with lupus from medically underserved areas have unique needs best addressed with an intervention designed through collaboration between community members and researchers.
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Affiliation(s)
- C H Feldman
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Chen JB, Lam KK, Su YJ, Lee WC, Cheng BC, Kuo CC, Wu CH, Lin E, Wang YC, Chen TC, Liao SC. Relationship between Kt/V urea-based dialysis adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients. BMC Nephrol 2012; 13:39. [PMID: 22697882 PMCID: PMC3423003 DOI: 10.1186/1471-2369-13-39] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 06/14/2012] [Indexed: 12/03/2022] Open
Abstract
Background It is well known that the quality of life of patients with chronic kidney disease can be improved by dialysis. While previous studies have used retrospective designs and adhered to a standard target prescribed by clinical guidelines, our study prospectively investigates the association between the adequacy of peritoneal dialysis (PD) and measures of nutritional status on quality-of-life domains in a cohort of incident PD patients. Methods It was a prospective 6-month observational study. Eighty incident PD participants who were treated in a hospital-based PD center were enrolled. The period of enrollment was January 2009–June 2010; follow-up continued until December 2010. PD adequacy indices, including Kt/V urea, weekly Ccr (WCcr), measures of nutritional status (albumin, BMI), and nPCR were measured at 1 month and 6 months after PD initiation. SF-36 health survey questionnaires were used to measure the quality of life. The outcomes were used to measure the changes in the domains of the SF-36 after 6 months of PD therapy. Results Seventy-seven incident patients who underwent PD for 6 months were included in the study. The mean age was 47.3 years, and the male-to-female ratio was 38:39. A peritoneal Kt/V urea value of 1.2, which was also the baseline cutoff value, was found to have the highest influence on SF-36 domains. Patients with baseline peritoneal Kt/V urea value of <1.2 showed improvement in the physical functioning and role limitation of physical functioning components after 6 months of PD. In contrast, patients with baseline peritoneal Kt/V urea values of ≥1.2 showed remarkable improvement in the general health, physical functioning, role limitation caused by physical problems, and bodily pain components. However, the trend of improvement decreased in patients with baseline nPCR of <1.2. Baseline renal WCcr did not influence the improvement in the SF-36 domains. Limitations A small cohort and a short observation period. Conclusions The baseline level of peritoneal Kt/V urea affected the components of the quality of life after PD initiation. In contrast, a lower baseline nPCR level was associated with deterioration in the quality of life after PD therapy.
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Affiliation(s)
- Jin-Bor Chen
- Division of Nephrology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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