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Nutritional status and anxiety-depression relationship in hemodialysis patients. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.802547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gebrie MH, Ford J. Depressive symptoms and dietary non-adherence among end stage renal disease patients undergoing hemodialysis therapy: systematic review. BMC Nephrol 2019; 20:429. [PMID: 31752741 PMCID: PMC6873524 DOI: 10.1186/s12882-019-1622-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/08/2019] [Indexed: 11/16/2022] Open
Abstract
Background Research suggests that patients with end stage renal disease undergoing hemodialysis have a higher rate of depression and dietary non adherence leading to hospitalization and mortality. The purpose of this review was to synthesize the quantitative evidence on the relationship between depressive symptoms and dietary non adherence among end stage renal disease (ESRD) patients receiving hemodialysis. Methods A systematic review was undertaken. Three electronic databases were searched including PubMed, CINHAL and Web of Science. Only quantitative studies published between 2001 and 2016 were included in the review. Result A total of 141 publications were reviewed during the search process and 28 articles that fulfilled the inclusion criteria were included in the review. Eleven studies (39.3%) reported on the prevalence of depressive symptoms or depression and its effect on patient outcomes. Ten studies (35.7%) focused on dietary adherence/non adherence in patients with ESRD and the remaining seven (25%) articles were descriptive studies on the relationship between depressive symptoms and dietary non adherence in patients with ESRD receiving hemodialysis. The prevalence of depressive symptoms and dietary non adherence ranged as 6–83.49% and from 41.1–98.3% respectively. Decreased quality of life & increased morbidity and mortality were positively associated with depressive symptoms. Other factors including urea, hemoglobin, creatinine and serum albumin had also association with depressive symptoms. Regarding dietary non adherence, age, social support, educational status, behavioral control and positive attitudes are important factors in ESRD patients receiving hemodialysis. Having depressive symptoms is more likely to increase dietary non adherence. Conclusion Depressive symptoms and dietary non adherence were highly prevalent in patients with end stage renal disease receiving hemodialysis therapy. Nearly all of the articles that examined the relationship between depressive symptoms and dietary non adherence found a significant association. Future research using experimental or longitudinal design and gold standard measures with established cut-points is needed to further explain the relationship.
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Affiliation(s)
- Mignote Hailu Gebrie
- University of Gondar, College of Medicine and Health Sciences, School of Nursing, Gondar, Ethiopia.
| | - Jodi Ford
- The Ohio State University, College of Nursing, Columbus, OH, USA
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A holistic approach to factors affecting depression in haemodialysis patients. Int Urol Nephrol 2018; 50:1467-1476. [PMID: 29779116 DOI: 10.1007/s11255-018-1891-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/10/2018] [Indexed: 12/26/2022]
Abstract
Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.
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The role of socio-demographic factors in depression and anxiety of patients on hemodialysis: an observational cross-sectional study. Int Urol Nephrol 2017; 50:143-154. [PMID: 29159509 DOI: 10.1007/s11255-017-1738-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/06/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Depression and anxiety have high prevalence in patients on hemodialysis and are strongly associated with socio-economic factors. The aim of this study was to evaluate the prevalence of depression and anxiety in hemodialyzed patients in Greece and its association with socio-demographic factors. METHODS Four hundred and fourteen (414) patients on hemodialysis (262 males and 152 females) from 24 dialysis centers in Greece participated in this observational cross-sectional study. Mean age was 63.54 (54.06-72.41), and mean time of dialysis treatment was 36 (16-72) months. Depression and anxiety were assessed by the state-trait anxiety inventory (STAI), the beck depression inventory (BDI) and the hospital anxiety and depression scale (HADS). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels (HADS scale). Multiple linear regression was performed to estimate the factors being independently associated with BDI and STAI. RESULTS From a total of 414 participants, (29.4%, n = 122) had depression and 35.9% (n = 149) had anxiety. Depression and anxiety were significantly associated with females, low level of education, increased patients' age, retirement, poor financial situation, marital status and co-morbidities. CONCLUSION The overall study findings indicated a significant correlation between the levels of anxiety and depression in patients on hemodialysis. Patients with high levels of anxiety had higher levels of depression and those with high depression scores had higher anxiety scores.
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Naderifar M, Zagheri Tafreshi M, Ilkhani M, Kavousi A. The outcomes of stress exposure in hemodialysis patients. J Renal Inj Prev 2017. [DOI: 10.15171/jrip.2017.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Farragher JF, Polatajko HJ, Jassal SV. The Relationship Between Fatigue and Depression in Adults With End-Stage Renal Disease on Chronic In-Hospital Hemodialysis: A Scoping Review. J Pain Symptom Manage 2017; 53:783-803.e1. [PMID: 28042060 DOI: 10.1016/j.jpainsymman.2016.10.365] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/11/2016] [Accepted: 10/24/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT Fatigue and depression are two prominent concerns in patients on in-hospital hemodialysis (IHHD) that have recently been identified as research priorities in the nephrology community. Although they are often reported to co-exist, no synthesis of the literature examining their relationship is available. OBJECTIVE The aim of this study was to characterize the literature on the relationship between fatigue and depression in IHHD patients. METHODS A scoping review as described by Arksey and O'Malley was conducted. Seven electronic databases were searched for relevant literature using search terms pertaining to fatigue, depression, and IHHD. Key journals and article reference lists were also hand searched to identify relevant literature. Articles were examined for relevance, and data were extracted to describe the nature and scope of the literature and to characterize the relationship between fatigue and depression. Findings were grouped thematically and summarized descriptively. RESULTS AND CONCLUSIONS Current literature on this topic is dominated by cross-sectional studies, which support the existence of an association between fatigue and depression in IHHD patients in various practice settings and subpopulations. Numerous multivariable analyses have been performed which suggest the association remains after adjustment for confounding factors. However, there is generally a dearth of longitudinal or interventional literature to clarify the nature of the relationship over time. Current literature is sufficient to justify routine screening for depression in IHHD patients who present with fatigue. Future research should aim to clarify the nature of the relationship over time in IHHD patients, explore mediators and modifiers of the relationship, and investigate the effects of interventions.
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Affiliation(s)
- Janine F Farragher
- Division of Nephrology, University Health Network, Toronto, Canada; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Helene J Polatajko
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarbjit V Jassal
- Division of Nephrology, University Health Network, Toronto, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada
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Picariello F, Moss-Morris R, Macdougall IC, Chilcot AJ. The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review. Clin Kidney J 2016. [PMID: 28638608 PMCID: PMC5469558 DOI: 10.1093/ckj/sfw113] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Fatigue is a common and debilitating symptom, affecting 42-89% of end-stage kidney disease patients, persisting even in pre-dialysis care and stable kidney transplantation, with huge repercussions on functioning, quality of life and patient outcomes. This paper presents a critical review of current evidence for the role of psychological factors in renal fatigue. To date, research has concentrated primarily on the contribution of depression, anxiety and subjective sleep quality to the experience of fatigue. These factors display consistent and strong associations with fatigue, above and beyond the role of demographic and clinical factors. Considerably less research is available on other psychological factors, such as social support, stress, self-efficacy, illness and fatigue-specific beliefs and behaviours, and among transplant recipients and patients in pre-dialysis care. Promising evidence is available on the contribution of illness beliefs and behaviours to the experience of fatigue and there is some indication that these factors may vary according to treatment modality, reflecting the differential burdens and coping necessities associated with each treatment modality. However, the use of generic fatigue scales casts doubt on what specifically is being measured among dialysis patients, illness-related fatigue or post-dialysis-specific fatigue. Therefore, it is important to corroborate the available evidence and further explore, qualitatively and quantitatively, the differences in fatigues and fatigue-specific beliefs and behaviours according to renal replacement therapy, to ensure that any model and subsequent intervention is relevant and grounded in the experiences of patients.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | | | - And Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
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Silva LD, Cunha CCD, Cunha LRD, Araújo RF, Barcelos VM, Menta PL, Neves FS, Teixeira R, Rocha GA, Gontijo ED. Depression rather than liver impairment reduces quality of life in patients with hepatitis C. BRAZILIAN JOURNAL OF PSYCHIATRY 2015; 37:21-30. [PMID: 25806552 DOI: 10.1590/1516-4446-2014-1446] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 06/15/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations. METHODS One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest. RESULTS Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis. CONCLUSIONS MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful.
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Affiliation(s)
- Luciana D Silva
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Cláudia C da Cunha
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciana R da Cunha
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Renato F Araújo
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vanessa M Barcelos
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Penélope L Menta
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Fernando S Neves
- Department of Mental Health, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Rosangela Teixeira
- Viral Hepatitis Outpatient Clinic, Instituto Alfa de Gastroenterologia, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Gifone A Rocha
- Laboratory of Research in Bacteriology, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Eliane D Gontijo
- Department of Preventive and Social Medicine, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
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Indicators and correlates of psychological disturbance in Chinese patients receiving maintenance hemodialysis: a cross-sectional study. Int Urol Nephrol 2015; 47:679-89. [PMID: 25627912 DOI: 10.1007/s11255-015-0910-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE Depression and anxiety have been considered as the most common comorbidities in maintenance hemodialysis (MHD) patients. This study aimed to assess mental disorder in hemodialysis patients and to study the indicators and correlates of psychological disturbance among patients receiving MHD in China. METHODS A cross-sectional study was conducted in 187 outpatients undergoing regular hemodialysis for at least 3 months. All the participants completed the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue, Chinese mainland version), Pittsburgh Sleep Quality Index (PSQI), Family APGAR Index (PAGAR), Family Adaptability and Cohesion Evaluation Scale (FACES II, Chinese version) and the Social Functioning Questionnaire (SFQ). RESULTS Based on the cutoff point of HADS-D/A ≥ 8, 51 (27.3%) and 29 (15.5%) patients reported depression and anxiety, respectively; 26 (13.9%) of all reported both depression and anxiety. Depressive patients had lower economic status, less subsidies, less than 3 years duration on hemodialysis and comorbidities when compared to patients without depression (all P < 0.05). HADS-D showed positive correlations with HADS-A, PSQI and SFQ and negative correlations with FACIT-Fatigue, PAGAR, family cohesion and adaptability (all P < 0.001). Patients with better family cohesion showed higher level of psychosocial well-being no matter their economic status. Binary logistic regression analysis demonstrated that anxiety (OR 1.80, P < 0.001) and bad social functioning (OR 1.31, P < 0.001) were independently associated with depression. CONCLUSION More attention should be paid on assessment and management psychological disturbance, and development family/social/medical supporting system for Chinese patients receiving MHD.
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Tomich GM, Bernardino LS, Ferreira FO. Impact of physical therapy on functional capacity and life quality of patients with chronic kidney disease. FISIOTERAPIA EM MOVIMENTO 2014. [DOI: 10.1590/0103-5150.027.004.ao16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Studies have demonstrated beneficial effects of exercise in patients with chronic kidney disease, however, based on current scientific literature, more research is needed to increase evidence level of potential effects of physical activity for this population. Objective To evaluate effects of physical therapy based on the supervised exercise practice on functional capacity and life quality of patients with chronic kidney disease. Material and methods This quasi-experimental study, with repeated measures design, was conducted in the ambulatory of physical therapy, in a public hospital, located in a city of the state of Pará (north region of Brazil). Functional capacity and life quality were assessed at baseline and after six weeks of aerobic and resistance training performed three times per week on alternate days with hemodialysis. Results Eight patients (3M / 5F) with a mean age of 60.38 years (SD = 14.75) were evaluated. There was significant increase of 24% in distance walked in six minute walk test (p = 0.007), and of 47% in number of repetitions during sit-to-stand test (p = 0.002); there was also significant improvement in emotional role (p = 0.043) of life quality assessed with SF36 questionnaire. Conclusion There was a positive impact of only six weeks of rehabilitation with physical exercise on functional capacity and emotional role of life quality of patients with chronic kidney disease.
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Khalil AA, Abed MA. Perceived social support is a partial mediator of the relationship between depressive symptoms and quality of life in patients receiving hemodialysis. Arch Psychiatr Nurs 2014; 28:114-8. [PMID: 24673785 DOI: 10.1016/j.apnu.2013.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/13/2013] [Accepted: 11/14/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND The meaning of social support is well documented, but less is known about mediating characteristics that examine which patients with end stage renal disease (ESRD) and depressive symptoms are most likely to benefit. AIMS The aim of this study was to examine whether perceived social support mediated depressive symptoms on the outcome of quality of life (QoL). DESIGN A correlational, cross-sectional study was conducted with a convenience sampling of 190 patients with ESRD. RESULTS There was partial mediation effect of social support on depressive symptoms in the prediction of QoL. CONCLUSION Effective management of depressive symptoms will improve QoL mostly when social support is promoted in patients with ESRD receiving hemodialysis.
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Affiliation(s)
- Amani A Khalil
- Faculty of Nursing-The University of Jordan, Amman 11962, Jordan.
| | - Mona A Abed
- Faculty of Nursing-Hashemite University, Zarqa-Jordan.
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Cavalcanti CTDA, Araújo Filho JCD, Marinho PÉDM. Physical activity level and depressive symptoms in patients undergoing hemodialysis: a cross-sectional study. FISIOTERAPIA E PESQUISA 2014. [DOI: 10.1590/1809-2950/49921022014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the association between the presence of depressive symptoms and physical activity level (PAL) in patients with chronic kidney disease undergoing hemodialysis (HD). Cross-sectional study comprising 101 patients on HD, mean age 47.4±12.5 years. Sociodemographic data, economic, clinical, assessment of depressive symptoms (Beck Depression Scale - BDI), PAL (International Physical Activity Questionnaire - IPAQ), guidance for performing physical activity (PA) and time of HD. The prevalence of sedentary and depressive symptoms was 79.2% and 39.6%, respectively. Depressive symptoms were observed in 47.5% of sedentary patients (χ2=10.029, p=0.002), the ratio of prevalence of these symptoms five times higher in this group. 68.3% of patients on HD received no guidance for PA. Under 49 months of hemodialysis treatment, 63.8% of sedentary (χ2=3.011, p=0.083) and 57.5% of patients with depressive symptoms (χ2=0.100, p=0.752) already had these features. Although little is known about the relationship between depression and PA among patients undergoing HD, this study found that depressive symptoms were more prevalent among inactive. The results of this study demonstrate that patients undergoing HD have low PAL, relative presence of depressive symptoms and high lack of guidance on PA.
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Nabolsi MM, Wardam L, Al-Halabi JO. Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis. Int J Nurs Pract 2013; 21:1-10. [DOI: 10.1111/ijn.12205] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Manar M Nabolsi
- Clinical Nursing Department-Faculty of Nursing; The University of Jordan; Amman Jordan
| | - Lina Wardam
- Community Nursing Department-Faculty of Nursing; The University of Jordan; Amman Jordan
| | - Jehad O Al-Halabi
- College of Nursing; Jeddah King Saud bin Abdulaziz University for Health Sciences-National Guard; Jeddah Saudi Arabia
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Santos PR, Capote JRFG, Cavalcanti JU, Vieira CB, Rocha ARM, Apolônio NAM, de Oliveira EB. Sexual dysfunction predicts depression among women on hemodialysis. Int Urol Nephrol 2013; 45:1741-6. [DOI: 10.1007/s11255-013-0470-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 05/08/2013] [Indexed: 11/28/2022]
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Psychological Characteristics of Patients Treated by Chronic Maintenance Hemodialysis. Int J Artif Organs 2013; 36:77-86. [DOI: 10.5301/ijao.5000188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2012] [Indexed: 11/20/2022]
Abstract
Studies related to psychological aspects of dialysis patients show that depression and anxiety are the most common characteristics. The aim of our study was to analyze the personality profile in patients on chronic maintenance dialysis and to evaluate more specifically the level of depression. The total number of patients was 68 (30 females and 38 males), with mean age 62.3 and 56.5 for females and males respectively. Mean duration of dialysis was 6.73 years for females and 6.68 years for men (the period varied from 0.5 to 18 years). For the evaluation of psychological characteristics, we used two psychometric instruments: Minnesota Multiphase Personality Inventory (MMPI- 201) and Beck Depression Inventory. The obtained results confirmed the presence of depression in patients treated with hemodialysis. The level of depression is variable (minimal is present in 21.43%; mild in 35.71%; moderate in 17.85% and severe in 14.28% of patients). The depression is significantly positively correlated with age (p<0.05) as well as with educational level, and negatively with the duration of dialysis. Specific characteristics of personality obtained with MMPI are hypersensitivity, depressive mood, and withdrawal from friends and relatives. More specific emotional traits are the accentuated anxiety, low level of hostility, but very high passive aggression which destroys their social communications. Some response measures for depression such as relaxation training, psychological support, music therapy, or peripheral biofeedback are recommended.
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Santos PR, Arcanjo FPN. Social adaptability and substance abuse: predictors of depression among hemodialysis patients? BMC Nephrol 2013; 14:12. [PMID: 23320829 PMCID: PMC3557216 DOI: 10.1186/1471-2369-14-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 01/11/2013] [Indexed: 12/03/2022] Open
Abstract
Background Several aspects linked to social are involved in the onset of depressive feelings. We aimed to find out if social adaptability and substance abuse predict depression among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Methods We included 145 ESRD patients undergoing HD. Social adaptability was estimated by the Social Adaptability Index (SAI). Substance abuse was defined according to SAI. We screened for depression by applying the 20-item version of the Center for Epidemiologic Studies Depression Scale. A score ≥ 24 classified the patients as depressed. Comparisons between depressed and non-depressed patients were carried out and logistic regression was performed to test gender, age, total SAI, SAI without the substance abuse item, only the substance abuse score and substance abuse as a categorical variable (yes/no) as predictors of depression. Results There were 36 (24.8%) depressed patients. There were no differences regarding demographic and laboratory data between the depressed and non-depressed patients. Mean SAI among depressed and non-depressed patients was, respectively, 6.1 ± 1.6 vs. 6.2 ± 1.9 (p=0.901). The percentage of patients with or without substance abuse among depressed patients was, respectively, 13.8% vs. 13.9% (p=1.000). Gender, age, total SAI, SAI without the substance abuse item, only the substance abuse score and substance abuse as a categorical variable did not predict depression. Conclusions Social adaptability and substance abuse did not predict depression in HD patients. We propose that aspects related to socioeconomic status not comprised in SAI items should be ruled out as predictors of depression.
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Affiliation(s)
- Paulo Roberto Santos
- Sobral School of Medicine, Federal University of Ceará, Avenida Comandante Maurocélio Rocha Ponte, 100 - CEP 62,042-280, Sobral, CE, Brazil.
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Santos PR, Arcanjo FPN. Distance between residence and the dialysis unit does not impact self-perceived outcomes in hemodialysis patients. BMC Res Notes 2012; 5:458. [PMID: 22925177 PMCID: PMC3477091 DOI: 10.1186/1756-0500-5-458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 08/13/2012] [Indexed: 11/30/2022] Open
Abstract
Background Patients have to travel long distances to undergo hemodialysis (HD) in some regions. We aimed to search for an association of the distance between patients’ residence and the dialysis unit with quality of life, depression and coping among end-stage renal disease (ESRD) patients undergoing maintenance HD. Methods We studied 161 ESRD patients undergoing HD during April 2009. Quality of life, depression and coping were assessed by the SF-36, the 10-item CES-D and the Jalowiec Coping Scale, respectively. The sample was stratified in three groups: I-patients residing in Sobral (where the dialysis unit is located); II-patients residing in towns up to 100 km from Sobral; and III-patients residing in towns distant greater than 100 km from Sobral. Analysis of variance was used to detect differences in quality of life and coping scores between the groups. Logistic regression was used to test distance as a predictor of depression. Results There were 47 (29.2%) patients residing in Sobral, 46 (28.6%) up to 100 km away and 68 (42.2%) greater than 100 km from Sobral. There were no differences related to quality of life and coping scores between the groups. Distance was not a predictor of depression. Conclusions Social and cultural factors may explain the lack of differences. Studies from other regions are needed to clarify the distance effects on self-perceived outcomes among HD patients.
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Affiliation(s)
- Paulo Roberto Santos
- Sobral School of Medicine, Federal University of Ceará, Avenida Comandante Maurcélio Rocha Ponte 100, Sobral, 62042-280, Brazil.
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