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Alkubati SA, Al-Sayaghi KM, Salameh B, Halboup AM, Ahmed WAM, J. Alkuwaisi M, Zoromba MA. Prevalence of Depression and Its Associated Factors Among Hemodialysis Patients in Hodeida City, Yemen. J Multidiscip Healthc 2024; 17:689-699. [PMID: 38370607 PMCID: PMC10874630 DOI: 10.2147/jmdh.s452935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
Background Depression has a negative impact on the health outcomes of hemodialysis (HD) patients, including decreased quality of life and increased morbidity and mortality rates. Therefore, this study aimed to determine the prevalence of depression and its associated factors among HD patients in Hodeida city, Yemen. Methods A cross-sectional study involving 200 HD patients at the Dialysis Center in Hodeida was conducted from February to May 2022. Data on depression were collected using the 9-item Patient Health Questionnaire (PHQ-9). Association of sociodemographic characteristics of patients with depression were assessed using chi-square, subsequently by multivariable logistic regression. Statistical significance was set at P-values <0.05. Results The response rate was 98% (200/204). Depression was prevalent among 63% of HD patients at the Dialysis Center in Hodeida city. Sex was significantly associated with depression, where female patients were more frequently depressed than males (82.4% vs 56.4%, P < 0.001). In addition, employment status and medical insurance were significantly associated with depression, where unemployed patients were more frequently depressed than employed patients (67.6% vs 52.5%, P = 0.041) and patients with medical insurance were less frequently depressed than their counterparts (47.1% vs 66.3%, P = 0.035). Conclusion Depression is highly prevalent among HD patients in Hodeida city. Female sex, unemployment and lack of medical insurance are predictors of depression among HD patients. These findings emphasize the urgent need for targeted interventions. Implications for practice Depression is common among HD patients, so that, psychiatric physicians and nurses are increasingly needed in HD centers to implement mental health assessment of patients for depression signs and symptoms to help in early diagnosis and management of depression in order to improve patients' quality of life and preventing negative outcomes.
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Affiliation(s)
- Sameer A Alkubati
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Hodeida University, Hodeida, Yemen
| | - Khaled M Al-Sayaghi
- Department of Medical Surgical Nursing, Taibah University, Al‐Madinah Al‐Munawarah, Saudi Arabia
- Nursing Division, Sana’a University, Sana’a, Yemen
| | - Basma Salameh
- Department of Nursing, Arab American University, Jenin, Palestine
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen
- Discipline of Clinical Pharmacy, Universiti Sains Malaysia, Penang, Malaysia
| | - Waled A M Ahmed
- Community Health Nursing Department, Al-Baha University, Al-Baha, Saudi Arabia
| | | | - Mohamed A Zoromba
- Department of Nursing, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Psychiatric and Mental Health Nursing, Mansoura University, Mansoura, Egypt
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Qawaqzeh DTA, Masa’deh R, Hamaideh SH, Alkhawaldeh A, ALBashtawy M. Factors affecting the levels of anxiety and depression among patients with end-stage renal disease undergoing hemodialysis. Int Urol Nephrol 2023; 55:2887-2896. [PMID: 36995556 PMCID: PMC10061404 DOI: 10.1007/s11255-023-03578-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
BACK GROUND Hemodialysis (HD) is a lifesaving procedure required for many patients with end stage renal disease (ESRD) who are not able to undergo a kidney transplant. However, HD could cause anxiety and depression for those patients. This study aimed to assess the levels of anxiety and depressive symptoms and find out the predictors affecting them. MATERIALS AND METHODS A cross-sectional, descriptive correlational design was adopted on a sample of 230 patients who received HD. Patients answered the Hospital Anxiety and Depression Scale along with demographic and clinical variables. RESULTS The study found that patients with ESRD undergoing HD had a high level of anxiety (mean = 10.59 SD = 2.78) and depression (mean = 10.86 SD = 2.49). There were significant differences in anxiety and depressive symptoms in regard to comorbidity, vascular access type, fatigue, fear, and financial status. Predictors of anxiety and depressive symptoms were: creatinine level, fatigue level, HD duration, number of dialysis sessions, blood urea nitrogen level, and age. CONCLUSIONS Anxiety and depression are under-diagnosed in patients with ESRD undergoing HD in Jordan. Screening and referral to psychological health specialists are needed.
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Affiliation(s)
- Duaa Turki Ahmad Qawaqzeh
- Applied Science Private University, Queen Rania Hospital of Children in Royal Medical Services, Amman, Jordan
| | - Rami Masa’deh
- School of Nursing, Applied Science Private University, Amman, Jordan
| | - Shaher H. Hamaideh
- Community and Mental Health Nursing Department, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Abdullah Alkhawaldeh
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Mohammed ALBashtawy
- Department of Community and Mental Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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Alshelleh S, Alhawari H, Alhouri A, Abu-Hussein B, Oweis A. Level of Depression and Anxiety on Quality of Life Among Patients Undergoing Hemodialysis. Int J Gen Med 2023; 16:1783-1795. [PMID: 37193250 PMCID: PMC10183175 DOI: 10.2147/ijgm.s406535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Background Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. Methods This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. Results In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). Conclusion The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.
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Affiliation(s)
- Sameeha Alshelleh
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Hussein Alhawari
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Abdullah Alhouri
- Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, Reading, UK
- Correspondence: Abdullah Alhouri, Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK, Email
| | | | - Ashraf Oweis
- Division of Nephrology, Department of Medicine, Jordan University of Science and Technology, Amman, Jordan
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Sallam L, Alsharif F, Abaalalaa S, Alakeely R, Abdullah Z, Alkhamis Z, Sindi N, Sharif LS. Prevalence of depression in patients with end-stage renal disease undergoing hemodialysis in Saudi Arabia: A cross-sectional study. BELITUNG NURSING JOURNAL 2022; 8:296-303. [PMID: 37546499 PMCID: PMC10401383 DOI: 10.33546/bnj.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/27/2022] [Accepted: 08/02/2022] [Indexed: 08/08/2023] Open
Abstract
Background A hemodialysis is a treatment option for patients with End-Stage Renal Disease (ESRD). However, patients undergoing hemodialysis three times per week may experience psychological issues, including depression, which are highly prevalent among patients. Unfortunately, most healthcare providers fail to recognize the symptoms of depression due to overlap with other somatic symptoms; thus, depression remains undiagnosed. Objective This study aimed to estimate the prevalence of depression and compare the differences in depression symptoms according to the sociodemographic characteristics of patients with ESRD undergoing hemodialysis. Method A descriptive, cross-sectional study was conducted from August to October 2021 with a total of 132 hemodialysis patients using the Beck Depression Inventory (BDI II) questionnaire to examine symptoms of depression at multiple health centers in Jeddah. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Post-hoc analysis using Conover tests were used for data analysis. Results The prevalence of depression in hemodialysis patients was 51.5%, 25.8%, 15.9%, and 6.8%, with minimal, mild, moderate, and severe symptoms, respectively. Depression exhibited a significant relationship with sex (p = 0.034), with females showing higher mean depression scores than males. Additionally, depression scores were statistically significant across the different levels of education (p = 0.019), with the mean depression scores significantly highest in subjects who had only primary school level of education. Furthermore, the most common symptoms associated with depression were found to be energy loss and fatigue. Conclusion Depression prevalence was relatively low among patients with ESRD undergoing hemodialysis, and a loss of energy and fatigue were the most common symptoms correlated with depression. Hence, nurses should be trained on how to routinely use psychological screening scales among patients with ESRD undergoing hemodialysis.
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Affiliation(s)
- Lujain Sallam
- Medical Surgical Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Fatmah Alsharif
- Medical Surgical Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Sarah Abaalalaa
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Rawan Alakeely
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Zahraa Abdullah
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Zahra Alkhamis
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Najla Sindi
- King Fahad Hospital, Jeddah 23325, Saudi Arabia
| | - Loujain S Sharif
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
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Fotaraki ZM, Gerogianni G, Vasilopoulos G, Polikandrioti M, Giannakopoulou N, Alikari V. Depression, Adherence, and Functionality in Patients Undergoing Hemodialysis. Cureus 2022; 14:e21872. [PMID: 35273844 PMCID: PMC8901145 DOI: 10.7759/cureus.21872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 12/21/2022] Open
Abstract
Background Patients undergoing hemodialysis face multiple problems such as difficulties in performing daily activities, low functional capacity, non-adherence to the hemodialysis regimen, and depressive symptoms that lead to poor health outcomes. The present study aimed to assess the levels of depression, adherence, and functionality in patients undergoing hemodialysis, as well as the association between the above variables. Materials and methods In this cross-sectional study, 100 patients undergoing hemodialysis from a private hospital in Athens participated. Data were collected via the Zung Self-Rating Depression Scale, the Barthel Scale/Index, and the Greek Simplified Medication Adherence Questionnaire-Hemodialysis for the evaluation of patients’ depression, functionality, and adherence to hemodialysis regimen, respectively. In addition, sociodemographic and clinical characteristics were recorded. The study was conducted during the period of December 2020 to February 2021. IBM SPSS Statistics for Windows, Version 25.0 (Released 2017. IBM Corp., Armonk, New York) was used for the statistical analysis of the data. The statistical significance level was set up at 0.05. Results Of the patients, 50% scored < 38 (possible range 20-80) in the scale pof depression, and 25% of patients scored < 34. Regarding adherence, the median value was 7 (IQR: 7-7) while 77% scored 7 (possible range of 0-8). Regarding functionality, mild dependence (score 91-99) was referred by 77% of the participants, moderate dependence (score 61-90) by 17%, and severe dependence (score 21-60) was referred by 6% of the patients. A statistically significant negative association emerged between depression and functionality (r= -0.342, p=0.001) while no significant association arised between depression and adherence (r= 0.021,p=0.836) as well as between adherence and functionality (r = 0.078, p = 0.439). Statistical significantly higher scores of depression were seen in women (β = 3.65, p = 0.001) and elderly >70 years old (β = 3.51, CI=0.09-6.93, p = 0.044). Statistically significantly lower functionality were referred by patients >70 years old (β = -13.58, CI: -21.68-5.49, p = 0.001) and by patients with high depression score (β= -0.62, 95% CI: -1.06-0.20, p = 0.005). Conclusion Patients experienced moderate to low levels of depression and high levels of adherence and functionality. The higher the functionality scores, the lower the depression scores. Demographic characteristics, such as age and gender, seem to be significant predictors of depression and functionality.
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Affiliation(s)
- Zoi-Maria Fotaraki
- Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC
| | - Georgia Gerogianni
- Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC
| | - Georgios Vasilopoulos
- Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC
| | - Maria Polikandrioti
- Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC
| | | | - Victoria Alikari
- Department of Nursing, Postgraduate Program "Applied Clinical Nursing", University of West Attica, Athens, GRC
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AlAwwa I, Ibrahim S, Obeid A, Alfraihat N, Al-Hindi R, Jallad S, Al-Awwa A. Comparison of pre- and post-hemodialysis PHQ-9 depression scores in patients with end-stage renal disease: A cross-sectional study. Int J Psychiatry Med 2021; 56:433-445. [PMID: 33161785 DOI: 10.1177/0091217420973489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES An overlap between the somatic symptoms of depression and those of uremia seen in end-stage renal disease (ESRD) patients may affect the diagnosis of depression. This study aims to evaluate the effect of hemodialysis on the diagnosis of depression among patients on maintenance hemodialysis as dialysis diminishes the uremic symptoms, and to compare depression scores before and after dialysis. METHODS This was a cross-sectional analytic study conducted from November 2018 through April 2019, in three tertiary hospitals. Consenting participants aged 18 years or older, who had received hemodialysis for at least three months were included. The Patient Health Questionnaire (PHQ-9) tool was used to collect patients' data and to identify symptoms of depression Pre- and post-hemodialysis. Depression scores were compared using the paired sample Wilcoxon rank test or the McNemar test, where appropriate. RESULTS Overall, 163 participants were enrolled in the study. The average age of the participants was 56.5 years old, whereas 44.8% were females. The prevalence of depressive symptoms before hemodialysis was 48.5%, with prevalence of mild, moderate and moderately severe of 34.4%, 11.7% and 2.5%, respectively. On the other hand, the prevalence of depressive symptoms after hemodialysis was 46.6% with 36.8%, 9.2% and 0.6% of the participants reporting mild, moderate and moderately severe symptoms, respectively. We found no significant difference in depression scores before and after dialysis (p-values > 0.05). CONCLUSION Our study supports the fact that the prevalence of depression is high among patients with ESRD on maintenance hemodialysis. We didn't find a significant difference in depression scores among hemodialysis patients before and after dialysis, with negligible effect of uremic symptoms on the diagnosis of depression. We suggest adopting routine screening of depression among this high-risk group of patients.
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Affiliation(s)
- Izzat AlAwwa
- Internal Medicine and Nephrology, University of Jordan School of Medicine, Amman, Jordan
| | - Sarah Ibrahim
- Deanship of Research, University of Jordan, Amman, Jordan
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AlAzzam M, Abuhammad S, Tawalbeh L, Dalky H. Prevalence and Correlates of Depression, Anxiety, and Suicidality Among High School Students: A National Study. J Psychosoc Nurs Ment Health Serv 2021; 59:43-51. [PMID: 34110946 DOI: 10.3928/02793695-20210426-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study aimed to estimate the prevalence of depression, anxiety, and suicidality and their correlated factors among high school students in Jordan. A descriptive cross-sectional correlational research design was used. Data were collected using self-reported questionnaires completed by students attending high schools in Jordan. Data show that anxiety and depression are prevalent among adolescents and are associated with higher risk of suicide and disease prevalence. Twenty-seven percent of the variance in suicidality is explained by anxiety and depression. This finding indicates that the most significant predictor of suicidality is anxiety and depression among high school students. Results show that mental health issues are a genuine general health issue among high school students. Health care professionals should routinely screen for mental health problems among young people. Mental health and well-being advancement programs should be coordinated and directed by all parties involved in youth mental health. [Journal of Psychosocial Nursing and Mental Health Services, 59(8), 43-51.].
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AlAzzam MM, AL-Sagarat AY, Abdel Razeq NM, Alsaraireh FA. Depression and anxiety among school adolescent females: A national study from Jordan. SCHOOL PSYCHOLOGY INTERNATIONAL 2021. [DOI: 10.1177/01430343211017181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Depression and anxiety are major mental health concerns among adolescent females within the school community and inflect many implications for psychological service providers in schools. The aims of this descriptive correlational study are to estimate the prevalence of anxiety and depression among high school adolescent females in Jordan, and to determine the contributing factors associated with depression and anxiety. Data were collected using self-report questionnaires from a clustered stratified sample of 405 high school females attending public schools in Jordan. Severe levels of depression and anxiety were reported by 25.7% and 21% of high school adolescent females, respectively. Education challenges and having a history of health problems contributed to having higher levels of depression and anxiety among the high school adolescent females. School mental health services regarding adolescent females mental health should be activated and supported through policies and legislation in Jordan.
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Affiliation(s)
- Manar M. AlAzzam
- Community and Mental Health Nursing Department, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
- Mental Health and Community Health Nursing Department, Faculty of Nursing, Mutah University, Alkarak, Jordan
| | - Ahmad Y. AL-Sagarat
- Community and Mental Health Nursing Department, Faculty of Nursing, Mutah University, AL-Karak, Jordan
- Mental Health and Community Health Nursing Department, Faculty of Nursing, Mutah University, Alkarak, Jordan
| | - Nadin M. Abdel Razeq
- Maternal and Child Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
- Mental Health and Community Health Nursing Department, Faculty of Nursing, Mutah University, Alkarak, Jordan
| | - Faris A. Alsaraireh
- Mental Health and Community Health Nursing Department, Faculty of Nursing, Mutah University, Alkarak, Jordan
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Keser BN, Kirman UN, Kocaaslan C, Aydin E. The association between vascular access type and depressive symptoms in geriatric hemodialysis population. Vascular 2020; 28:390-395. [DOI: 10.1177/1708538120905725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives A well-functioning vascular access is crucial for hemodialysis treatment, and arteriovenous fistula is the recommended vascular access type. Arteriovenous fistula is superior to other vascular access types in many aspects, but the effect of arteriovenous fistula on patients’ psychiatric state is not well described yet. The aim of this study is to determine whether there is an association between vascular access type and depression scores. Methods This cross-sectional study was conducted at two hemodialysis centers. Geriatric Depression Scale-15 was administered to geriatric hemodialysis patients, using ≥5 score as the cut-off value for the presence of depressive symptoms. Descriptive tests, Kolmogorov–Smirnov test, Pearson’s Chi-square test, Mann–Whitney test, Kruskal–Wallis test, Spearman’s rank correlation calculation, and multiple logistic regression analysis were performed accordingly to analyze the data. Results Of 75 participants, 34 (45.3%) were female and the mean age was 73.4 ± 5.9 years (range: 65–92). The prevalence of depressive symptoms in the geriatric hemodialysis population was 53.3%. Central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for higher depression scores (aOR 10.505 (95% CI 1.435–76.900), p = 0.021; aOR 9.783 (95% CI 2.508–38.169), p = 0.001; aOR 1.019 (95% CI 1.003–1.035), p = 0.017, respectively). Among patients with arteriovenous fistula, those with hypertension had higher depression scores ( p = 0.008). Conclusions Geriatric hemodialysis patients were found to have depressive symptoms commonly, and central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for presence of depressive symptoms. To the best of our knowledge, this is the first study highlighting that arteriovenous fistula is associated with lower depression scores and lower prevalence of depressive symptoms.
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Affiliation(s)
- Betul Nur Keser
- School of Medicine, Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Ulku Nur Kirman
- School of Medicine, Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Cemal Kocaaslan
- Cardiovascular Surgery Department, Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Ebuzer Aydin
- Cardiovascular Surgery Department, Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
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