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Al Sharji A, Alaloul F, Al Yazeedi B, Alharrasi M. Fatalistic and Optimistic Coping Strategies Predict Depression in Arab Muslim Patients With End-Stage Renal Disease. J Transcult Nurs 2024; 35:134-141. [PMID: 38140779 DOI: 10.1177/10436596231217696] [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] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Depression is one of the common psychological problems in patients on hemodialysis. We aimed to identify the predictors associated with depressive symptoms among patients on hemodialysis from a population under-represented in research and minoritized in countries like the United States. METHODS This cross-sectional study used a convenience sample of patients in Oman. Data were analyzed using linear multiple regression. RESULTS A total of 157 patients on hemodialysis participated in the study, with 40.5% reporting different levels of depressive symptoms. Higher stress levels (β = .643; p < .01) and higher perceived effectiveness of the fatalistic coping style (β = .144; p < .05) were significant predictors of depressive symptoms. Patients with a higher optimistic coping style (β = -.182; p < .01) had lower levels of depressive symptoms. CONCLUSION Arab Muslim hemodialysis patients have significant levels of depressive symptoms. Identifying predictors of depressive symptoms may help identify those at risk and provide culturally appropriate interventions.
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Affiliation(s)
- Amal Al Sharji
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Fawwaz Alaloul
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Basma Al Yazeedi
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Maryam Alharrasi
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
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Wang Y, Guo X, Chen B, Chen H, Chen Y, Ma L, Liu H. The Relationship Between Psychosocial Behavior and the Quality of Life of Male Gout Patients in Southwest China: A Cross-Sectional Study Based on an Information-Motivation-Behavioral Skills Model. Patient Prefer Adherence 2023; 17:3503-3514. [PMID: 38146501 PMCID: PMC10749546 DOI: 10.2147/ppa.s434875] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Gout is more severe in men, leading to a poor quality of life. Previous studies did not sufficiently pay attention to the quality of life and related factors in gout patients in Southwest China. This study aimed to investigate the quality of life of men with gout in Southwest China and explore the relationship between psychosocial factors and health-related quality of life from the perspective of an information-motivation-behavioral skill model. Patients and Methods This was a cross-sectional study conducted in the West China Hospital of Sichuan University located in Southwest China. In total, 230 male patients with gout were enrolled. The health-related quality of life of patients was assessed using the gout impact scale. The gout knowledge questionnaire was used to assess patients' information. The positive psycap questionnaire was used to assess motivation. The gout patients' self-management assessment scale was used to assess behavioral skills. Multiple linear regression was used to identify the factors associated with the health-related quality of life of patients. Results The overall mean gout impact scale score was 52.7±15.3 (maximum possible = 100). Factors associated with the total gout impact scale score were tophi (β=0.138, P=0.050), pain (β=0.255, P<0.001), and resiliency (β=-0.282, P<0.001). In addition, demographic characteristics (educational level, smoking and marital status), clinical characteristics (tophi, pain, number of attacks over half a year, and number of affected joints) and psychosocial behavior variables (resiliency, hope, disease treatment management, diet management) were associated with several dimensions of the gout impact scale. Conclusion The health-related quality of life of male patients with gout in Southwest China was at a medium level. We found that demographic characteristics, clinical characteristics, and psychosocial factors were associated with health-related quality of life of patients with gout. These findings can be used as a reference to improve health-related quality of life of patients with gout.
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Affiliation(s)
- Ying Wang
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xin Guo
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Bo Chen
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yanling Chen
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Ling Ma
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Huan Liu
- Department of Rheumatology and Immunology, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Moreira M, Cavalli N, Righi N, Schuch F, Signori L, da Silva A. Quality of life and functional capacity in depressive patients on hemodialysis: a systematic review and meta-analysis. Braz J Med Biol Res 2023; 56:e12850. [PMID: 38126536 PMCID: PMC10729646 DOI: 10.1590/1414-431x2023e12850] [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: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Depression is a common disorder in patients with chronic kidney disease (CKD), and some data support its relationship with functional capacity and quality of life. However, to date, this has not been evaluated systematically or through meta-analysis. We sought to investigate the relationship of quality of life and functional capacity with depressive disorder in patients with CKD on hemodialysis. This systematic review considered studies published up to 2021 and included cross-sectional and cohort studies. PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane (CENTRAL) databases were used to search for studies. The New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies. A total of 4,626 studies were found and, after applying the selection criteria, 16 studies (2,175 patients) remained for qualitative analysis and 10 for meta-analysis (1,484 patients). The physical component summary (MD=-6.563; 95%CI: -9.702 to -3.424) and mental component summary (MD=-18.760; 95%CI: -28.641 to -8.879) were lower in depressive patients, as in all Short Form Health Survey 36 (SF-36) domains. Only one study provided data regarding functional capacity, but it was not evaluated by the defined outcome measure. Twelve studies were classified as "moderate quality" (5 to 6 stars) and four were classified as "low-quality" (0 to 4 stars). This meta-analysis with CKD patients on hemodialysis showed a negative relationship between depression and quality of life, with worsening in all physical and mental domains of the SF-36 in depressed patients.
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Affiliation(s)
- M.B. Moreira
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - N.P. Cavalli
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - N.C. Righi
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - F.B. Schuch
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
- Departamento de Métodos e Técnicas Desportivas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - L.U. Signori
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - A.M.V. da Silva
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
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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: 2] [Impact Index Per Article: 2.0] [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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Li L, Xie C, Li Y. Factors Associated with Self-Management of Peritoneal Dialysis Patients in Urumqi of Xinjiang of China: A Cross-Sectional Survey. Patient Prefer Adherence 2023; 17:1573-1589. [PMID: 37431511 PMCID: PMC10329827 DOI: 10.2147/ppa.s415593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023] Open
Abstract
Purpose To explore the factors associated with self-management of Peritoneal Dialysis (PD) patients and methods of acquiring PD knowledge. Design Cross-sectional survey design. Setting Urumqi, Xinjiang, China. Patients 131 Chinese maintenance Peritoneal Dialysis (PD) patients. Methods This cross-sectional study was conducted from October 2019 to March 2020 in the First Affiliated Hospital of Xinjiang Medical University of China. 131 PD patients were recruited. Data were collected, including demographic characteristics, clinical dialysis data, self-management ability scale, and methods to obtain PD knowledge. A self-management questionnaire was used for the evaluation of self-management ability. Results The score of the self-management ability of PD patients in Xinjiang, China, was (57.6±13.7) points, which was at the middle level in China. There was no statistically significant difference in the self-management ability scores of patients with different ages, sex, ethnicity, marital status, pre-dialysis status, PD time, PD procedures, self-care ability, PD satisfaction, and 24-hour average urine output (P>0.05). There were significant differences in the self-management ability scores of patients with different education levels, occupations, and medical insurance forms (P<0.05). The self-management ability of PD patients was positively correlated with the disease course of uremia and attending lectures on PD knowledge (P<0.05). The main factor affecting self-management ability was education level. There 73.28% of patients considered that it was necessary to establish a WeChat group for PD patients, and 65.7% believed that establishing a WeChat group for PD patients could facilitate communication between patients and enhance treatment confidence. Conclusion The study surveyed PD patients who have certain self-management ability. For patients with different education levels, different health education methods should be adopted to promote the improvement of patients' self-management ability. Furthermore, WeChat is essential for Chinese PD patients to obtain disease-related information.
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Affiliation(s)
- Li Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Department of Urological Surgery and Nephrology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China
- XiangYa School of Nursing, Central South University, Changsha, People’s Republic of China
| | - Chunyan Xie
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- XiangYa School of Nursing, Central South University, Changsha, People’s Republic of China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China
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Liu Z, Zhao L, Wang S, Gao Y, Zhang L. The Association between Occupational Stress and Mental Health among Chinese Soccer Referees in the Early Stage of Reopening Soccer Matches during the COVID-19 Pandemic Outbreak: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16750. [PMID: 36554631 PMCID: PMC9778837 DOI: 10.3390/ijerph192416750] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The sudden and unpredictable changes caused by the COVID-19 pandemic are a serious threat to the occupational stress and mental health of referees worldwide, which has not attracted widespread attention. The mental health of football referees has a certain influence on their job satisfaction or the accuracy of judgments. METHODS This study constructed a moderated mediation model to explore the buffer factors between occupational stress and mental health in Chinese soccer referees in the early stage of reopening soccer matches during the COVID-19 pandemic outbreak. Data from 317 Chinese soccer referees (aged 19-45) were collected through an online questionnaire in September-October 2022. Occupational stress, mental health, job burnout and perceived social support were measured, and moderated mediation model was analyzed. RESULTS The results of this study showed that occupational stress was negatively correlated with mental health through the mediating effect of job burnout and the moderated effect of perceived social support after controlling for demographic variables. Specifically, the association between occupational stress and mental health was weaker when perceived social support was higher and stronger. CONCLUSIONS The results demonstrate that job burnout and perceived social support played important roles in buffering the negative effects of occupational stress on the mental health of Chinese soccer referees in the early stage of reopening soccer matches during the COVID-19 pandemic outbreak. The findings provide implications for mental health interventions in soccer referees during the public health crises.
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Aránega-Gavilán S, Guillén-Gómez I, Blanco-García M, Crespo-Montero R. Aspectos psicosociales del paciente en diálisis. Una revisión bibliográfica. ENFERMERÍA NEFROLÓGICA 2022. [DOI: 10.37551/52254-28842022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción: La enfermedad renal crónica es una patología progresiva e infradiagnosticada en sus primeros estadios y que va a necesitar un tratamiento renal sustitutivo en estadios avanzados, siendo el más utilizado la diálisis. Esto va a provocar un fuerte impacto en el bienestar psicosocial de los pacientes, con repercusión en su calidad de vida.Objetivo: Conocer la evidencia científica existente acerca de los factores psicosociales asociados a los pacientes sometidos a diálisis.Metodología: Se realizó una revisión bibliográfica sistematizada basada en la declaración PRISMA, en las bases de datos Pubmed, Proquest y Scielo. Para ello, se utilizaron una serie de estrategias de búsqueda en las que se utilizaron los siguientes términos Mesh: “Hemodyalisis”, “Peritoneal dyalisis”, “Factors psychosocial”, “Psychosocial cares”. La búsqueda se restringió a 5 años.Resultados: Se seleccionaron 28 artículos. Todos fueron de diseño observacional descriptivo, menos un ensayo controlado aleatorizado. De esta revisión emergieron como variables importantes: alteración del estado emocional, afrontamiento, situación laboral, depresión y ansiedad, apoyo social y calidad de vida relacionada con la salud.Conclusiones: Los principales aspectos psicosociales asociados a los pacientes en diálisis fueron la depresión y ansiedad, el apoyo social, la alteración del estado emocional, situación laboral y afrontamiento; siendo los más prevalentes la depresión y la ansiedad. La situación laboral y la depresión y ansiedad, se relacionan con una peor calidad de vida, mientras que la presencia de apoyo social y el estilo de afrontamiento de “evitación” mejoran la calidad de vida de estos pacientes.
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Ahmadi Halili S, Kharaj M, Sabetnia L, Hayati F, Pourshams M. Relationship Between Depression and Its Severity with Dialysis Adequacy in Hemodialysis Patients in Ahvaz Teaching Hospitals. JUNDISHAPUR JOURNAL OF CHRONIC DISEASE CARE 2021; 10. [DOI: 10.5812/jjcdc.117136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 10/16/2024]
Abstract
Background: Depression is a prevalent psychological disorder among hemodialysis patients and is associated with a variety of adverse outcomes. Dialysis adequacy also affects hemodialysis patients' survival rates. Objectives: This study aimed to investigate the prevalence of depression in hemodialysis patients and its association with dialysis adequacy. Methods: In this cross-sectional study, 205 individuals undergoing hemodialysis at Ahvaz teaching hospitals in 2019 were included. The depression level was determined using the Beck Depression Inventory (BDI-II) for the participants aged below 65 years and Geriatric Depression Scale (GDS) for the patients aged above 65 years. Dialysis adequacy measures, including the Kt/V and urea reduction rate (URR), were calculated using standard formulas. Results: In this study, 60.5% of the participants suffered from depression, and the overall prevalence of depression was 54.6% in individuals aged below 65 and 67% in those aged above 65 years. Among the patients with age below 65 years, 19 persons (17.6%) were suffering from mild depression, 22 individuals (20.4%) were suffering from moderate depression, and 18 individuals (16.7%) had severe depression. Among the patients aged above 65 years, moderate depression was found to affect 45 persons (46.4%), and 20 individuals (20.6%) had severe depression. The mean values of Kt/V and URR were not significantly correlated with depression scores (P > 0.05). Conclusions: Depression is a common disorder among hemodialysis patients in Iran; however, it is not significantly associated with dialysis adequacy. However, the results of studies on the relationship between depression and dialysis adequacy cannot be analyzed simply.
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Virani A, Shah RP, Haneef G, Khan AT, Dias CC, Pereira KN, Gupta S, Sharma P. Depression Impairs Level of Functioning in Chronic Kidney Disease Inpatients: A Case-Control Study. Cureus 2021; 13:e16017. [PMID: 34336507 PMCID: PMC8320405 DOI: 10.7759/cureus.16017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 01/23/2023] Open
Abstract
Objectives To evaluate the difference in demographics and clinical correlates during hospitalization for chronic kidney disease (CKD) between patients with depression and those without depression, and its impact on the severity of illness and in-hospital mortality. Methods We conducted a case-control study and included 2,296 adult inpatients (age ≥18 years) with a primary discharge diagnosis of CKD using the nationwide inpatient sample (NIS). We used propensity score matching to extract the cases i.e., CKD inpatients with depression (N = 1,264) and the controls i.e. CKD inpatients without depression (N = 1,032). The matching was done based on demographic characteristics of age at admission, sex, race, and median household income. Our outcomes of interest are the severity of illness and all-cause in-hospital mortality. All patient refined drg (APR-DRG) are allocated using health information systems software by the NIS and the severity of illness within each base APR-DRG was classified into minor, moderate, or major loss of body functions. Binomial logistic regression analysis was conducted to find the odds ratio (OR) of association for major loss of function in CKD inpatients with depression, and this model was adjusted for potential confounders of congestive heart failure (CHF), coronary artery disease (CAD), diabetes, hypertension, obesity, and tobacco abuse, and utilization of hemodialysis. Results A higher proportion of CKD inpatients with depression had a statistically significant higher prevalence of major loss of function (49.8% vs. 40.3% in non-depressed). There was a statistically significant difference with higher utilization of hemodialysis in CKD inpatients with depression (76.2% vs. 70.7% in non-depressed). The all-cause in-hospital mortality rate was lower in CKD inpatients with depression (2.1% vs. 3.5% in non-depressed). After controlling the logistic regression model for potential comorbidities and utilization of hemodialysis, depression was associated with increased odds (OR 1.46; 95% CI 1.227 - 1.734) for major loss of function versus in non-depressed CKD inpatients Conclusion Comorbid depression increases the likelihood of major loss of functioning in CKD inpatients by 46%. Treating depression can allow patients to better cope emotionally and physically with CKD and other comorbidities and significantly improve the patient's quality of life (QoL) and health outcome.
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Affiliation(s)
- Anuj Virani
- Family Medicine, Windsor University School of Medicine, Cayon, KNA
| | - Rushi P Shah
- Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, Rajkot, IND
| | - Goher Haneef
- Internal Medicine, University of Health Sciences, Lahore, PAK
- Emergency Medicine, University of Cincinnati Medical Center, Cincinnati, USA
| | - Asma T Khan
- Internal Medicine, Larkin Community Hospital, South Miami, USA
| | - Caroline C Dias
- Psychiatry, Yenepoya Medical College and Hospital, Toronto, CAN
| | | | - Siddharth Gupta
- Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, IND
| | - Prerna Sharma
- Psychiatry, Government Medical College, Amritsar, IND
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Hoang VL, Green T, Bonner A. Examining social support, psychological status and health-related quality of life in people receiving haemodialysis. J Ren Care 2021; 48:102-111. [PMID: 34041850 DOI: 10.1111/jorc.12380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Being on haemodialysis can lead to many burdens on patients' lives. Social support for patients is crucial; however, whether social support affects health outcomes including both depression, anxiety and health-related quality of life is not well understood. OBJECTIVES To explore the relationship between social support, psychological status and health-related quality of life of people undergoing haemodialysis. DESIGN A cross-sectional study. PARTICIPANTS Convenience sampling recruited 388 patients from one dialysis centre. MEASUREMENTS Survey data collected included demographic and clinical data, the Medical Outcomes Social Support Survey, Depression Anxiety Stress Scales and Short-Form Health Survey 36. Multiple linear regression was used to determine the direct and mediation effects of social support on health outcomes. RESULTS Participants' ages ranged from 19 to 84 years and most had undergone haemodialysis for more than 5 years (53.2%). Overall, there was a moderate level of social support, and although tangible support was high, emotional-oriented support functions were missing. Participants reported a high level of anxiety, moderate levels of depression, mild levels of stress and impaired physical and mental health. Greater social support independently and positively affected mental health, and also reduced the negative influences of depression on the mental health component but not the physical health component. Social support, depression, anxiety and participation in social groups explained 48% of the variance in mental health. CONCLUSIONS People undergoing haemodialysis require both tangible and emotional social support. When there is enough social support, there are positive effects on reducing depression and improving mental, but not physical health.
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Affiliation(s)
- Van Lan Hoang
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Theresa Green
- School of Nursing and Midwifery, University of Queensland, Brisbane, Australia.,Surgical Treatment and Rehabilitation Service, Metro North Hospital and Health Service, Brisbane, Australia
| | - Ann Bonner
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia
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Elkheir HK, Wagaella AS, Badi S, Khalil A, Elzubair TH, Khalil A, Ahmed MH. Prevalence and risk factors of depressive symptoms among dialysis patients with end-stage renal disease (ESRD) in Khartoum, Sudan: A cross-sectional study. J Family Med Prim Care 2020; 9:3639-3643. [PMID: 33102343 PMCID: PMC7567259 DOI: 10.4103/jfmpc.jfmpc_1229_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/26/2020] [Accepted: 03/30/2020] [Indexed: 01/08/2023] Open
Abstract
Background Depression is the most common prevalent psychiatric condition among patients with chronic kidney disease (CKD), and especially during dialysis. This study aimed to evaluate depression symptoms in Sudanese patients with end-stage renal diseases (ESRD) who undergo hemodialysis. Methods This is a case finding, hospital-based study recruited 75 patients on dialysis in Khartoum, Sudan. Data were analyzed by statistical package for social science (SPSS, version 23). Results The percentage of depression symptoms that satisfies the criteria for the diagnosis of major depression disorders in patients with ESRD undergoes dialysis was 68%. The new patients who undergo dialysis for less than 1 year had more depression symptoms (66.7%) than those on dialysis for 2-3 years (21.6%) or more than 3 years with a percentage of11.8%. Chi-square test showed significant associations between depression and age, the duration of dialysis, signs of significant weight loss when no dieting, and when the clinical symptoms related to distress or social or functional impairment (P = 0.016, 0.000, 0.004, and 0.000, respectively). Logistic regression test showed that age and duration of dialysis were significantly associated with depression with (odds ratios [OR]: 0.724, 0.211). Conclusion More than two-thirds of patients on dialysis have depressive symptoms. Risk factors associated with depression in Sudanese patients on dialysis were age, duration of dialysis, weight loss, and social and functional impairment. Future research is needed in order to assess the benefit of antidepressants in patients on dialysis. Family physicians should be aware of the association between depression and dialysis, in order to provide early treatment and prevent suicide.
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Affiliation(s)
- Habab Khalid Elkheir
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, and Faculty of Pharmacy University of Sciences and Technology (UST), Khartoum, Sudan
| | - Arwa Siddig Wagaella
- Clinical Pharmacy Program, Graduate College, Omdurman Islamic University, Khartoum, Sudan, Sudan
| | - Safaa Badi
- Clinical Pharmacy Department, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan, Sudan
| | - Abbas Khalil
- Department of Medicine, Arrowe Park Hopsital, Liverpool, UK
| | - Tarig Hassan Elzubair
- Department of Psychiatry, University of Sciences and Technology (UST), Khartoum, Sudan
| | - Atif Khalil
- Department of Nephrology, Noble Hospital, Isle of Man, UK
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes, Buckinghamshire, UK
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Sahathevan S, Khor BH, Ng HM, Abdul Gafor AH, Mat Daud ZA, Mafra D, Karupaiah T. Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review. Nutrients 2020; 12:E3147. [PMID: 33076282 PMCID: PMC7602515 DOI: 10.3390/nu12103147] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022] Open
Abstract
Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.
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Affiliation(s)
- Sharmela Sahathevan
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Ban-Hock Khor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (B.-H.K.); (A.H.A.G.)
| | - Hi-Ming Ng
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Lakeside Campus, No 1, Jalan Taylors, Subang Jaya 47500, Malaysia;
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (B.-H.K.); (A.H.A.G.)
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia;
| | - Denise Mafra
- Post Graduation Program in Medical Sciences and Post-Graduation Program in Cardiovascular Sciences, (UFF), Federal Fluminense University Niterói-Rio de Janeiro (RJ), Niterói-RJ 24033-900, Brazil;
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health & Medical Sciences, Taylor’s University Lakeside Campus, No 1, Jalan Taylors, Subang Jaya 47500, Malaysia
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Ling C, Evans D, Zhang Y, Luo J, Hu Y, Ouyang Y, Tang J, Kuang Z. The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review. BMC Psychiatry 2020; 20:369. [PMID: 32664880 PMCID: PMC7362428 DOI: 10.1186/s12888-020-02754-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms. METHODS All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools -this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies. RESULTS Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD = - 5.28, 95%CI - 7.9 to - 2.65, P = 0.37) and counselling (MD = - 2.39, 95%CI - 3.49 to - 1.29), while less effective than sertraline (MD = 2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline. CONCLUSIONS CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies.
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Affiliation(s)
- Chen Ling
- Department of Nephrology, Huadu Hospital, Southern Medical University (People's Hospital of Huadu District), 22 Baohua Road, Huadu District, Guangzhou, 510800, People's Republic of China. .,The Third School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.
| | - Debra Evans
- grid.19822.300000 0001 2180 2449Birmingham City University, City South Campus, Faculty of Health, Education and Life Sciences, 15 Bartholomew Row, Birmingham, B5 5JU UK
| | - Yunfang Zhang
- grid.284723.80000 0000 8877 7471Department of Nephrology, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 22 Baohua Road, Huadu District, Guangzhou, 510800 People’s Republic of China ,grid.284723.80000 0000 8877 7471The Third School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China
| | - Jianying Luo
- grid.284723.80000 0000 8877 7471Nursing Department, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 48 Xinhua Road, Huadu District, Guangzhou, 510800 People’s Republic of China
| | - Yanping Hu
- grid.284723.80000 0000 8877 7471Nursing Department, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 48 Xinhua Road, Huadu District, Guangzhou, 510800 People’s Republic of China
| | - Yuxia Ouyang
- grid.284723.80000 0000 8877 7471Nursing Department, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 48 Xinhua Road, Huadu District, Guangzhou, 510800 People’s Republic of China
| | - Jiamin Tang
- grid.284723.80000 0000 8877 7471Department of Nephrology, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 22 Baohua Road, Huadu District, Guangzhou, 510800 People’s Republic of China
| | - Ziqiao Kuang
- grid.284723.80000 0000 8877 7471Department of Breast Surgery, Huadu Hospital, Southern Medical University (People’s Hospital of Huadu District), 48 Xinhua Road, Huadu District, Guangzhou, 510800 People’s Republic of China
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Exploring demands of hemodialysis patients in Taiwan: A two-step cluster analysis. PLoS One 2020; 15:e0228259. [PMID: 32032397 PMCID: PMC7006915 DOI: 10.1371/journal.pone.0228259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 01/10/2020] [Indexed: 11/23/2022] Open
Abstract
Aims and objectives To classify hemodialysis patients into subgroups via cluster analysis according to the Somatic Symptoms Disturbance Index, Taiwanese Depression Scale, and Herth Hope Index scores. Patient demands in each cluster were also examined. Background Overall patient demands among hemodialysis patients have been demonstrated in numerous reports; however, variables among subgroups have not been explored. Methods Data were analyzed from a cross-sectional survey of 114 hemodialysis patients recruited from dialysis centers in Northern Taiwan. Hope, depression, and symptom disturbance were used as parameters for clustering because they have been shown to be important factors affecting patient demands. A two-step cluster analysis was performed to classify participants into clusters. Patient demands in each cluster were analyzed. Results Among the 114 participants, there was a negative correlation between hope and depression as well as between hope and symptom disturbance; there was a positive correlation between depression and symptom disturbance. Two clusters were identified: Cluster 1 (n = 49) included patients with moderate levels of hope and symptom disturbance, and high levels of depression; and Cluster 2 (n = 65) included patients with low levels of depression and symptom disturbance and high levels of hope. Demographic profiles differed between the two clusters. Regarding patient demands, medical demand showed the highest average score; whereas, occupational demand exhibited the lowest average score. Psychological and occupational demands differed significantly between the two clusters. The two clusters were defined as subgroups: Cluster 1 was labeled “resting”; Cluster 2 was labeled “active”. Conclusions Cluster analysis may further classify hemodialysis patients into distinct subgroups base on their specific patient demands. A better understanding of patient demands may help health professionals to provide a holistic individualized treatment to improve patients’ outcomes.
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Jeon HO, Kim J, Kim O. Factors affecting depressive symptoms in employed hemodialysis patients with chronic renal failure. PSYCHOL HEALTH MED 2019; 25:940-949. [PMID: 31829030 DOI: 10.1080/13548506.2019.1702218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Depressive symptoms are commonly experienced by hemodialysis patients, generally related to withdrawal from dialysis and compliance with dialysis prescription. This study aimed to identify the factors affecting depressive symptoms in employed hemodialysis patients with chronic renal failure. A cross-sectional, correlational study design was utilized, consisting of 71 patients with chronic renal failure receiving hemodialysis treatment, all employed. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) and fatigue by the Chalder Fatigue Scale. Psychosocial adaptation was measured by the Korean version of the Social Profile. In this study, 32.4% of the participants were depressed. Female patients had a higher score for depressive symptoms than males (25.78 ± 10.15 vs. 16.42 ± 10.25, p = .013). Mental fatigue (β = .425, p < .001), psychosocial adaptation (β = -.275, p < .001), and subjective health (β = -.199, p < .05) were predictive variables of depressive symptoms in hemodialysis patients, with mental fatigue being the most important factor. Depressive symptoms can affect the self-management of hemodialysis patients; therefore, it is important that healthcare providers identify factors that affect depressive symptoms, particularly those associated with mental fatigue.
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Affiliation(s)
- Hae Ok Jeon
- Department of Nursing, Cheongju University , Cheonju, South Korea
| | - Jiyoung Kim
- Department of Nursing, Dongeui University , Busan, South Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University , Seoul, South Korea
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Chironda G, Bhengu B. Barriers to management of Chronic Kidney Disease (CKD) CKD in a renal clinic in KwaZulu-Natal Province, South Africa – A qualitative study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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17
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Management of anxiety and depression in haemodialysis patients: the role of non-pharmacological methods. Int Urol Nephrol 2018; 51:113-118. [DOI: 10.1007/s11255-018-2022-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/29/2018] [Indexed: 01/13/2023]
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18
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Hao G, Lu W, Huang J, Ding W, Wang P, Wang L, Ding F, Hu M, Hou L. Predialysis fluid overload linked with quality of sleep in patients undergoing hemodialysis. Sleep Med 2018; 51:140-147. [PMID: 30165338 DOI: 10.1016/j.sleep.2018.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/04/2018] [Accepted: 07/23/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Hemodialysis (HD) patients are exposed to dysregulated fluid balance which can lead to overhydration. Poor sleep quality and excessive daytime sleepiness are particularly common in these patients, however the relationship between fluid status and sleep quality and daytime sleepiness has not yet been studied. Therefore, the aim of this study is to evaluate the correlations between fluid status and sleep quality and daytime sleepiness in HD patients. METHOD This cross-sectional study included 115 HD patients and 30 healthy control subjects from the HD center of Shanghai Ninth People's Hospital. Fluid compartments [total body water (TBW)], extracellular water (ECW)] and overhydration index (OH) were analyzed by multifrequency bio-impedance (BCM). Overhydration was defined as OH/ECW≥7%. HD patients were divided into an overhydration group and non overhydration group according to OH/ECW. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and excessive daytime sleepiness was evaluated by the Epworth Sleepiness Scale (ESS). RESULTS The prevalence rate of fluid overload in HD patients was 65.2%. Poor sleep quality (PSQI≥5) and excessive daytime sleepiness (ESS≥11) were significantly higher in HD patients compared with the healthy controls [6 (3, 10) vs.2.11 ± 1.59, p = 0.000; 3 (0, 6) vs.1.68 ± 1.07, p = 0.045]. Furthermore, the PSQI scores were higher in HD patients with overhydration (7.8 ± 4.5 vs. 4.8 ± 3.2, p = 0.000). The component scores 1, 2, 3 and 5 of the PSQI showed significant differences between the overhydration and non overhydration groups. The ESS scores did not show differences between the two groups (3.9 ± 4.1 vs. 3.3 ± 3.5, p = 0.508). OH was correlated with Systolic BP and Diastolic BP, and additionally was an independent predictor of poor sleep quality. CONCLUSION Fluid overload is significantly linked with poor quality of sleep in HD patients, however there is no association with excessive daytime sleepiness. Our study provides new insight into possible treatment strategies. Future studies should examine the effects of optimizing fluid status on quality of sleep.
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Affiliation(s)
- Guihua Hao
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Wei Lu
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Jie Huang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Wei Ding
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Pengfei Wang
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Lili Wang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Feng Ding
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Min Hu
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China.
| | - Lili Hou
- Department of Nursing, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, Shanghai 200011, China.
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He S, Zhu J, Jiang W, Ma J, Li G, He Y. Sleep disturbance, negative affect and health-related quality of life in patients with maintenance hemodialysis. PSYCHOL HEALTH MED 2018; 24:294-304. [PMID: 30160172 DOI: 10.1080/13548506.2018.1515493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The study was designed to examine the relationships between sleep disturbance, negative affect and quality of life among patients with maintenance hemodialysis. A total of 118 patients in Shanghai, China, with maintenance hemodialysis (>40 years old) participated in the study. They completed three questionnaires: the Positive and Negative Affect Scale (PANAS), the Pittsburgh Sleep Quality Index (PSQI) and the European Quality of 5-Dimensions (EQ-5D-5L). Results showed that male participants' negative affect scored significantly higher than female participants'.The mean global PSQI score was 8.64 (poor sleepers score 6 or more); sleep disturbance affected 63.6% of the patients, which indicated that in general the participants' sleep quality was relatively poor.The patients with worse sleep quality and negative affect were more likely to have a lower quality of life. In addition, the effect of the sleep disturbance on quality of life was mediated by negative affect (The Z value of Sobel test was -3.18, p< .01).These findings suggest sleep disturbance and negative affect were common among patients with maintenance hemodialysis and had a negative impact on their quality of life; negative affect may mediate the relationship between sleep disturbance and quality of life.
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Affiliation(s)
- Shanshan He
- a School of Social Development , East China Normal University , Shanghai , China
| | - Jingfen Zhu
- b School of Public Health , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Weijie Jiang
- c Department of Nephrology , Shanghai Shi Bei Hospital , Shanghai , China
| | - Jun Ma
- d Department of Nephrology , Jing An District Center Hospital of Shanghai , Shanghai , China
| | - Guohong Li
- b School of Public Health , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Yaping He
- b School of Public Health , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,e Center for HTA , China Hospital Development Institute, Shanghai Jiao Tong University , Shanghai , China
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Hassan K, Elimeleh Y, Shehadeh M, Fadi H, Rubinchik I. The relationship between hydration status, male sexual dysfunction and depression in hemodialysis patients. Ther Clin Risk Manag 2018; 14:523-529. [PMID: 29559788 PMCID: PMC5856048 DOI: 10.2147/tcrm.s147723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Disturbances in sexual function are common among dialysis patients. Normal erections require a complex balance of physiological, psychological, emotional, hormonal, neurological and vascular factors. This study examined a possible association of overhydration (OH) with male sexual dysfunction and depression in hemodialysis (HD) patients. Patients and methods This cross-sectional study assessed hydration status by whole-body bioimpedance spectroscopy in patients on maintenance HD for more than 12 months. Patients were categorized according to OH to extracellular water (ECW) ratio: OH/ECW ratio >0.15 and OH/ECW ratio ≤0.15. Sexual function was assessed using the International Index of Erectile Function (IIEF) score. Psychological status was evaluated using the Beck Depression Inventory (BDI) score. Serum sex hormones were determined. Results Of 39 stable participants on HD, 53.8% were overhydrated (OH/ECW ratio >0.15) and 46.2% not overhydrated (OH/ECW ratio ≤0.15). Of participants with OH/ECW ratio >0.15, 85.7% had mild to severe ED, and 71.4% had abnormal BDI scores, ranging from mild mood disturbance to severe depression. Compared to patients with OH/ECW ratio ≤0.15, BDI scores, serum estradiol and plasma hsCRP were higher (18.48±8.34 vs 10.61±5.46, p<0.001; 140.10±44.51 vs 126.10±32.26, p=0.034; and, 17.70±12.14 vs 9.76±8.79, p=0.013; respectively) in those with OH/ECW ratio >0.15, while their IIEF score, serum total testosterone and dehydroepiandrosterone (DHEA) were lower (12.81±7.31 vs 41.44±23.79, p<0.001; 8.97±5.43 vs 14.10±8.30, p=0.013; and 85.31±55.14 vs 133.3±95.48, p=0.029; respectively). The OH/ECW ratio correlated inversely with the IIEF score (r=−0.69, p<0.001) and positively with BDI scores (r=0.64, p<0.001). IIEF scores were inversely correlated with BDI scores (r=−0.54, p<0.001). Conclusion OH in HD patients was found to be associated with a higher prevalence of sexual dysfunction and depression, lower serum levels of total testosterone and DHEA, and higher levels of serum estradiol.
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Affiliation(s)
- Kamal Hassan
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.,Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel
| | - Yotam Elimeleh
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Mona Shehadeh
- Biochemistry Laboratory, Galilee Medical Center, Nahariya, Israel
| | - Hassan Fadi
- Internal Medicine Department E, Galilee Medical Center, Nahariya, Israel
| | - Irina Rubinchik
- Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel
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