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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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Al-Hakeim HK, Twaij BAAR, Al-Naqeeb TH, Moustafa SR, Maes M. Neuronal damage and inflammatory biomarkers are associated with the affective and chronic fatigue-like symptoms due to end-stage renal disease. J Affect Disord 2024; 347:220-229. [PMID: 38007104 DOI: 10.1016/j.jad.2023.11.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Many biochemical, immunological, and neuropsychiatric changes are associated with end-stage renal disease (ESRD). Neuronal damage biomarkers such as glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), S100 calcium-binding protein B (S100B), ionized calcium-binding adaptor molecule-1 (IBA1), and myelin basic protein (MBP) are among the less-studied biomarkers of ESRD. AIM We examined the associations between these neuro-axis biomarkers, inflammatory biomarkers, e.g., C-reactive protein (CRP), interleukin (IL-6), IL-10, and zinc, copper, and neuropsychiatric symptoms due to ERSD. METHODS ELISA techniques were used to measure serum levels of neuronal damage biomarkers in 70 ESRD patients, and 46 healthy controls. RESULTS ESRD patients have higher scores of depression, anxiety, fatigue, and physiosomatic symptoms than healthy controls. Aberrations in kidney function tests and the number of dialysis interventions are associated with the severity of depression, anxiety, fibro-fatigue and physiosomatic symptoms, peripheral inflammation, nestin, and NFL. Serum levels of neuronal damage biomarkers (NFL, MBP, and nestin), CRP, and interleukin (IL)-10 are elevated, and serum zinc is decreased in ESRD patients as compared with controls. The neuronal damage biomarkers NFL, nestin, S100B and MBP are associated with the severity of one or more neuropsychiatric symptom domains. Around 50 % of the variance in the neuropsychiatric symptoms is explained by NFL, nestin, S00B, copper, and an inflammatory index. CONCLUSIONS The severity of renal dysfunction and/or the number of dialysis interventions may induce peripheral inflammation and, consequently, neurotoxicity to intermediate filament proteins, astrocytes, and the blood-brain barrier, leading to the neuropsychiatric symptoms of ESRD.
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Affiliation(s)
| | | | - Tabarek Hadi Al-Naqeeb
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Shatha Rouf Moustafa
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Havalan City, Erbil, Iraq
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea; Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China.
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Elezi B, Abazaj E, Zappacosta B, Hoxha M. Anxiety and depression in geriatric hemodialysis patients: factors that influence the border of diseases. Front Psychol 2023; 14:1281878. [PMID: 38078242 PMCID: PMC10704351 DOI: 10.3389/fpsyg.2023.1281878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/02/2023] [Indexed: 01/12/2025] Open
Abstract
INTRODUCTION The two main psychological issues that people with end-stage renal disease (ESRD) experience are depression and anxiety. We conducted this study to determine both the prevalence of depression and anxiety, and the factors associated with them, among hemodialysis patients. METHODS Patients aged 18 years or older, who had received hemodialysis in a hemodialysis center in Elbasan, for at least 3 months were included in this study. Beck Anxiety Inventory and Beck Depression Inventory Instruments were used to assess hemodialysis patients levels of depression and anxiety. RESULTS Overall, 107 hemodialysis patients (men 65.4%) with a mean age of 57 ± 8.9 years were enrolled in the study. The prevalence of anxiety and depression resulted to be 85.98, and 84.11%, respectively. We found a significant difference in depression and anxiety scores in patients age groups of 61-70 years old (OR = 1.8; 95% CI [0.7-3.7]; p = 0.041), in non-smoking patients (OR 3.4; 95% CI [1.09-8.2]; p = 0.04), in diabetic patients (OR 3.4; 95% CI [1.09-8.2]; p = 0.04), and in patients with a time in dialysis of 6-10 years and >11 years, respectively, (OR 3.4; 95% [1.5-9.0]; p = 0.01), (OR1.3; 95% CI [0.4-3.6]; p = 0.04). CONCLUSION Our study shows that the prevalence of mental disorders (depression and anxiety) is high among patients with ESRD on maintenance hemodialysis. We recommend a routine screening and referral to psychological health specialists to evaluate the mental health disorders among hemodialysis patients with the primary aim of improving their quality of life.
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Affiliation(s)
- Brunilda Elezi
- Department of Clinic, Faculty of Medical Technical Science, University of Elbasan Aleksander-Xhuvani, Elbasan, Albania
| | - Erjona Abazaj
- Department of Clinic, Faculty of Medical Technical Science, University of Elbasan Aleksander-Xhuvani, Elbasan, Albania
- Department of Epidemiology and Infectious Diseases Control, Institute of Public Health, Tirana, Albania
| | - Bruno Zappacosta
- Department for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Catholic University Our Lady of Good Counsel, Tirana, Albania
| | - Malvina Hoxha
- Department for Chemical-Toxicological and Pharmacological Evaluation of Drugs, Catholic University Our Lady of Good Counsel, Tirana, Albania
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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: 1.5] [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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Nagy E, Tharwat S, Elsayed AM, Shabaka SAEG, Nassar MK. Anxiety and depression in maintenance hemodialysis patients: prevalence and their effects on health-related quality of life. Int Urol Nephrol 2023; 55:2905-2914. [PMID: 37009953 PMCID: PMC10560136 DOI: 10.1007/s11255-023-03556-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/12/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The aims of the study are to explore the prevalence and risk factors of anxiety and depression in hemodialysis (HD) patients and to study their relationship with quality of life (QOL). METHODS This cross-sectional study involved 298 HD patients. Sociodemographic, clinical, and laboratory data of the patients were obtained from their records. Anxiety and depression were assessed by utilizing Hospital Anxiety and Depression Scale (HADS). In addition, QOL of the patients were evaluated by fulfilling the Kidney Disease Quality of Life-36. RESULTS This study included 298 HD patients (male 59.1%) with a median age of 49 years. Abnormal and borderline cases of anxiety were recognized in 49.6%, 26.2% of the patients, respectively, while depression cases and borderline cases were identified in 55 and 28.2% of the patients, respectively. Percentages of females (41 and 48% vs 26.4%, respectively), and patients who were not working (92.3 and 93.9% vs 72.2%, respectively) increased significantly in borderline and abnormal anxiety groups. Patients who did not work, led an inactive lifestyle, and smoked had considerably greater percentages in the borderline and abnormal HADS-depression categories than normal patients. Abnormal cases of depression and anxiety had significantly longer duration of HD than other two groups. Abnormal and borderline cases of anxiety and depression had worse QOL components than the normal patients. CONCLUSION Anxiety and depression are prevalent among HD patients in Egypt, and several sociodemographic and clinical risk factors are associated. In addition, these mental disorders are associated with poor QOL.
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Affiliation(s)
- Eman Nagy
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Samar Tharwat
- Rheumatology and Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Shimaa Abd El-Galeel Shabaka
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Kamal Nassar
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Longley RM, Harnedy LE, Ghanime PM, Arroyo-Ariza D, Deary EC, Daskalakis E, Sadang KG, West J, Huffman JC, Celano CM, Amonoo HL. Peer support interventions in patients with kidney failure: A systematic review. J Psychosom Res 2023; 171:111379. [PMID: 37270909 PMCID: PMC10340538 DOI: 10.1016/j.jpsychores.2023.111379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Peer support has been associated with improved health-related outcomes (e.g., psychological well-being and treatment adherence) among patients with serious, chronic conditions, including kidney disease. Yet, there is little existing research evaluating the effects of peer support programs on health outcomes among patients with kidney failure being treated with kidney replacement therapy. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a systematic review using five databases to assess the effects of peer support programs on health-related outcomes (e.g., physical symptoms, depression) among patients with kidney failure undergoing kidney replacement therapy. RESULTS Peer support in kidney failure was assessed across 12 studies (eight randomized controlled trials, one quasi-experimental controlled trial, and three single-arm trials) with 2893 patients. Three studies highlighted the links between peer support and improved patient engagement with care, while one found peer support did not significantly impact engagement. Three studies showed associations between peer support and improvements in psychological well-being. Four studies underscored the effects of peer support on self-efficacy and one on treatment adherence. CONCLUSIONS Despite preliminary evidence of the positive associations between peer support and health-related outcomes among patients with kidney failure, peer support programs for this patient population remain poorly understood and underutilized. Further rigorous prospective and randomized studies are needed to evaluate how peer support can be optimized and incorporated into clinical care for this vulnerable patient population.
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Affiliation(s)
- Regina M Longley
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Lauren E Harnedy
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Pia Maria Ghanime
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Daniel Arroyo-Ariza
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Emma C Deary
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Elizabeth Daskalakis
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Katrina G Sadang
- University of California San Francisco School of Medicine, San Francisco, CA, United States of America
| | - Jason West
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Jeff C Huffman
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Christopher M Celano
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Hermioni L Amonoo
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, Boston, MA, United States of America.
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Li B, Liu D, Zhang Y, Xue P. Stigma and related factors among renal dialysis patients in China. Front Psychiatry 2023; 14:1175179. [PMID: 37583843 PMCID: PMC10423816 DOI: 10.3389/fpsyt.2023.1175179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Background Stigma is an important psychological concept that is being studied in many diseases. However, there have been few studies on stigma in renal dialysis patients in China. This study aimed to investigate the level of stigma and its potential influencing factors among Chinese renal dialysis patients. Methods A cross-sectional study was conducted among renal dialysis patients in two Chinese dialysis centers between April 2022 and July 2022. Two hundred four renal kidney patients were interviewed with a questionnaire on demographic variables using the Social Impact Scale (SIS), Resilience Scale-14 (RS-14), Herth Hope Index(HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test(LOT-R), Perceived Stress Scale (PSS-4) and Fear of Progression (FoP). T-test/univariate one-way ANOVA, Pearson's R, and hierarchical linear regression analysis were used to investigate the factors that influence stigma. Results Renal dialysis patients in China experienced a moderate level of stigma (52.36 ± 8.16). Stigma was negatively correlated with resilience, hope, and perceived social support, whereas it was positively associated with perceived stress and fear of progression. However, it showed no significant relationship between optimism and stigma. Hierarchical linear regression analysis showed that hope (β = -0.318, P < 0.001), social support (β = -0.193, P < 0.01), perceived stress (β = 0.197, P < 0.01), and fear of progression (β = 199, P < 0.01) were found to be associated with stigma among the renal dialysis patients. All four variables in the model could explain 34.6% of the variance in stigma among renal dialysis patients in China. Conclusion According to this study, renal dialysis patients in China face a moderate level of stigma. Stigma was found to be negatively related to hope and social support but positively associated with perceived stress and fear of progression. Future research on the stigma of renal dialysis patients should include hope-based interventions, proper and specific social support strategies, stress management interventions, and more disease-related information.
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Affiliation(s)
| | | | | | - Pengshi Xue
- Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China
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Cao H, Zhang J, Sun Z, Wu J, Hao C, Wang W. Frailty in kidney transplant candidates and recipients: pathogenesis and intervention strategies. Chin Med J (Engl) 2023; 136:1026-1036. [PMID: 37052144 PMCID: PMC10228484 DOI: 10.1097/cm9.0000000000002312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Indexed: 04/14/2023] Open
Abstract
ABSTRACT With the rapid aging of the global population posing a serious problem, frailty, a non-specific state that reflects physiological senescence rather than aging in time, has become more widely addressed by researchers in various medical fields. A high prevalence of frailty is found among kidney transplant (KT) candidates and recipients. Therefore, their frailty has become a research hotspot in the field of transplantation. However, current studies mainly focus on the cross-sectional survey of the incidence of frailty among KT candidates and recipients and the relationship between frailty and transplantation. Research on the pathogenesis and intervention is scattered, and relevant review literature is scarce. Exploring the pathogenesis of frailty in KT candidates and recipients and determining effective intervention measures may reduce waiting list mortality and improve the long-term quality of life of KT recipients. Therefore, this review explains the pathogenesis and intervention measures for frailty in KT candidates and recipients to provide a reference for the formulation of effective intervention strategies.
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Affiliation(s)
- Huawei Cao
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiandong Zhang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zejia Sun
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jiyue Wu
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Changzhen Hao
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wei Wang
- Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China
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Al-hakeim HK, Al-raheem Twaij BA, Al-naqeeb TH, Moustafa SR, Maes M. Neuronal damage and inflammatory biomarkers are associated with the affective and chronic fatigue-like symptoms due to end-stage renal disease.. [DOI: 10.1101/2023.05.03.23289492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
AbstractBackgroundMany biochemical, immunological, and neuropsychiatric changes are associated with end-stage renal disease (ESRD). Neuronal damage biomarkers such as glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), S100 calcium-binding protein B (S100B), ionized calcium-binding adaptor molecule-1 (IBA1), and myelin basic protein (MBP) are among the less-studied biomarkers of ESRD.AimWe examined the associations between these neuro-axis biomarkers, inflammatory biomarkers, e.g., C-reactive protein (CRP), interleukin (IL-6), IL-10, and zinc, copper, and neuropsychiatric symptoms due to ERSD.MethodsELISA techniques were used to measure serum levels of neuronal damage biomarkers in 70 ESRD patients, and 46 healthy controls.ResultsESRD patients have higher scores of depression, anxiety, fatigue, and physiosomatic symptoms than healthy controls. Aberrations in kidney function tests and the number of dialysis interventions are associated with the severity of depression, anxiety, fibro-fatigue and physiosomatic symptoms, peripheral inflammation, nestin, and NFL. Serum levels of neuronal damage biomarkers (NFL, MBP, and nestin), CRP, and interleukin (IL)-10 are elevated, and serum zinc is decreased in ESRD patients as compared with controls. The neuronal damage biomarkers NFL, nestin, S100B and MBP are associated with the severity of one or more neuropsychiatric symptom domains. Around 50% of the variance in the neuropsychiatric symptoms is explained by NFL, nestin, S00B, copper, and an inflammatory index.ConclusionsThe severity of renal dysfunction and/or the number of dialysis interventions may induce peripheral inflammation and, consequently, neurotoxicity to intermediate filament proteins, astrocytes, and the blood-brain barrier, leading to the neuropsychiatric symptoms of ESRD.
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Antoun J, Brown DJ, Jones DJW, Clarkson BG, Shepherd AI, Sangala NC, Lewis RJ, McNarry MA, Mackintosh KA, Mason L, Corbett J, Saynor ZL. Exploring patients' experiences of the impact of dialysis therapies on quality of life and wellbeing. J Ren Care 2023; 49:15-23. [PMID: 35226403 DOI: 10.1111/jorc.12416] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/24/2022] [Accepted: 02/05/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND When people with chronic kidney disease reach kidney failure, renal replacement therapy is usually required to improve symptoms and maintain life. Although in-centre haemodialysis is most commonly used for this purpose, other forms of dialysis are available, including home haemodialysis and peritoneal dialysis. OBJECTIVES We aimed to explore the experiences of adults living with chronic kidney disease who were either approaching the need for dialysis or had reached kidney failure and were receiving a form of dialysis. In particular, we explored how different forms of dialysis affect their quality of life, wellbeing, and physical activity. METHODS Individual semistructured interviews were conducted with 40 adults with kidney failure, comprising four groups (n = 10 each): those receiving in-centre haemodialysis, home haemodialysis or peritoneal dialysis, or predialysis. Interviews were transcribed verbatim, thematically analysed, and then composite vignettes were subsequently developed to present a rich narrative of the collective experiences of each group. FINDINGS Compared with adults who were predialysis, quality of life and wellbeing improved upon initiation of their home haemodialysis or peritoneal dialysis. Conversely, minimal improvement was perceived by those receiving in-centre haemodialysis. Low physical activity was reported across all four groups, although those receiving home haemodialysis and peritoneal dialysis reported a greater desire and ability to be physically active than those in-centre. CONCLUSION These findings highlight that dialysis modalities not requiring regular hospital attendance (i.e., home haemodialysis and peritoneal dialysis) improve independence, quality of life, wellbeing, and can facilitate a more physically active lifestyle.
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Affiliation(s)
- Joe Antoun
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK.,Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Daniel J Brown
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Daniel J W Jones
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Beth G Clarkson
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Anthony I Shepherd
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK.,Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Nicholas C Sangala
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Robert J Lewis
- Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - Laura Mason
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), School of Sport and Exercise Sciences, Swansea University, Swansea, UK
| | - Jo Corbett
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Zoe L Saynor
- School of Sport, Health and Exercise Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK.,Academic Department of Renal Medicine, Wessex Kidney Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
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Asad HN, Al-Hakeim HK, Moustafa SR, Maes M. A Causal-Pathway Phenotype of Chronic Fatigue Syndrome due to Hemodialysis in Patients with End-Stage Renal Disease. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:191-206. [PMID: 35366785 DOI: 10.2174/1871527321666220401140747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/27/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND End-stage renal disease (ESRD) is associated with fatigue and physiosomatic symptoms. OBJECTIVE The objective of this study is to delineate the associations between severity of fatigue and physio-somatic symptoms and glomerular filtration rate, inflammatory biomarkers, and Wnt/cateninpathway proteins. METHODS The Wnt-pathway related proteins β-catenin, Dickkopf-related protein 1 (DKK1), R-spondin- 1, and sclerostin were measured by ELISA technique in 60 ESRD patients and 30 controls. The Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale was used to assess the severity of FF symptoms. RESULTS ESRD is characterized by a significant increase in the total FF score, muscle tension, fatigue, sadness, sleep disorders, gastro-intestinal (GI) symptoms, and a flu-like malaise. The total-FF score was significantly correlated with serum levels of urea, creatinine, and copper (positively), and β-catenin, eGFR, hemoglobin, albumin, and zinc (inversely). The total-FF score was associated with the number of total dialysis and weekly dialysis sessions, and these dialysis characteristics were more important in predicting FF scores than eGFR measurements. Partial Least Squares analysis showed that the FF score comprised two factors that are differently associated with biomarkers: a) 43.0% of the variance in fatigue, GI symptoms, muscle tension, sadness, and insomnia is explained by hemoglobin, albumin, zinc, β-catenin, and R-spondin-1; and b) 22.3% of the variance in irritability, concentration and memory impairments by increased copper and cations/chloride ratio, and male sex. CONCLUSION ESRD patients show high levels of fatigue and physio-somatic symptoms associated with hemodialysis and mediated by dialysis-induced changes in inflammatory pathways, the Wnt/catenin pathway, and copper.
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Affiliation(s)
- Halah Nori Asad
- Al Najaf Health Directorate, Higher Health Institute, Najaf, Iraq
| | | | - Shatha Rouf Moustafa
- Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- School of Medicine, IMPACT Strategic Research Centre, Deakin University, VIC, 3220, Australia
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12
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Classification Algorithms for Brain Magnetic Resonance Imaging Images of Patients with End-Stage Renal Disease and Depression. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:4795307. [PMID: 35854766 PMCID: PMC9279039 DOI: 10.1155/2022/4795307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
This study was aimed to explore the relationship between depression and brain function in patients with end-stage renal disease (ESRD) complicated with depression based on brain magnetic resonance imaging (MRI) image classification algorithms. 30 people in the healthy control group and 70 people in the observation group were selected as the research objects. First, the preprocessing algorithms were applied on MRI images. With the depression classification algorithm based on deep learning, the features were extracted from the capsule network to construct a classification network, and the network structure was compared to obtain the difference in the distribution of brain lesions. Different classifiers and degree centrality, functional connection, low-frequency amplitude ratio, and low-frequency amplitude were selected to analyze the effectiveness of features. In the deep learning method, the neural network model was constructed, and feature extraction and classification network were carried out. The classification layer was based on the capsule network. The results showed that the correct rate of the deep learning feature extraction network structure combined with the capsule network classification was 82.47%, the recall rate was 83.69%, and the accuracy was 88.79%, showing that the capsule network can improve the heterogeneity of depression. The combination of fractional amplitude of low-frequency fluctuation (fALFF), DC, and amplitude of low-frequency fluctuation (ALFF) can achieve the accuracy of 100%. In summary, MRI images showed that patients with depression may have neurological abnormalities in the white matter area. In this study, the classification algorithm based on brain MRI images can effectively improve the classification performance.
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13
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Biopsychosocial and Nutritional Factors of Depression among Type 2 Diabetes Mellitus Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084888. [PMID: 35457752 PMCID: PMC9031597 DOI: 10.3390/ijerph19084888] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022]
Abstract
The rising prevalence of depression among Type 2 Diabetes Mellitus (T2DM) patients has triggered an alarming situation, and further actions need to be taken by health care professionals and policymakers to curb the issue. There is a lack of evidence review in terms of the biopsychosocial and nutritional factors that are related to depression among T2DM. Hence, this review aimed to identify available evidence on the biopsychosocial and nutritional factors associated with depression among T2DM patients based on the existing literature. Articles were systematically searched from four databases, namely PubMed, Scopus, Web of Science, and EBSCOHost. The approach for the identification of the final articles followed PRISMA guidelines. The selected full-text articles were published between 2017 and 2021 in the English language, and included studies focused on depression among T2DM patients. Using AXIS tools, the eligible articles were evaluated to assess the quality of studies. A total of 19 studies were included in the review, and information related to research questions and associated factors was extracted. Biological, psychological, social, and nutritional factors were shown to be linked with depression among T2DM patients. Future studies need to considered using the biopsychosocial model and incorporating nutritional factors to manage the issues of depression among T2DM patients.
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14
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Donahue S, Quinn DK, Cukor D, Kimmel PL. Anxiety Presentations and Treatments in Populations With Kidney Disease. Semin Nephrol 2022; 41:516-525. [PMID: 34973696 DOI: 10.1016/j.semnephrol.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Anxiety is common in patients with chronic kidney disease, but in its extreme expressions, anxiety can also be a complicating comorbid psychiatric illness. There is only a small literature base on anxiety disorders in patients with renal disease, and many of the studies are not sufficiently specific about which anxiety disorders are being studied. Larger epidemiological studies are required to delineate the incidence, prevalence, and outcomes associated with the varied anxiety disorders. In addition, the impact of the co-occurrence of anxiety with other chronic psychiatric or medical problems, needs further study. Anxiety is a clinical condition that warrants treatment, primarily due to its association with mortality in end-stage renal disease patients, and its negative impact on perceived quality of life. Therapeutic options for patients with anxiety and kidney disease include both pharmacologic and nonpharmacologic approaches. Current treatment strategies for anxiety specific to patients with renal disease are provided.
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Affiliation(s)
| | - Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM
| | | | - Paul L Kimmel
- Department of Medicine, George Washington University, Washington, DC
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15
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Lv H, Meng J, Chen Y, Yang F, Wang W, Wei G, Zhang J, Wang H, Wang M, Zhou L, Liu H. Impact of COVID-19 Pandemic on Elevated Anxiety Symptoms of Maintenance Hemodialysis Patients in China: A One-Year Follow-Up Study. Front Psychiatry 2022; 13:864727. [PMID: 35664473 PMCID: PMC9160521 DOI: 10.3389/fpsyt.2022.864727] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies have shown that coronavirus disease 2019 (COVID-19) aggravates anxiety in patients with maintenance hemodialysis (MHD), but it is still unclear how long this adverse effect will last. This study aims to investigate the impact of COVID-19 on the elevated anxiety symptoms of MHD patients 1 year after the outbreak. Assessment of elevated anxiety symptoms was performed on patients with MHD during early COVID-19 (February 17-February 29, 2020) and 1-year follow-up (March 1-March 13, 2021), and a total of 100 patients had completed face-to-face questionnaires at the first and 1-year follow-up. At the beginning of the outbreak, 40% of the patients with MHD had anxiety symptoms [self-rating anxiety scale (SAS) score ≥ 50], and 11% (SAS score: 60-69) and 2% (SAS score ≥ 70) of the patients had moderate and severe anxiety symptoms, respectively. Multivariate analysis shows that possibility of unaccompanied transfer, possibility of family members or themselves being infected in a hospital, added body temperature monitoring during dialysis, and increased medical procedures are the risk factors in elevated anxiety symptoms during early COVID-19. At the 1-year follow-up, the incidence of anxiety symptoms in the same group of patients declined to 28%, and all the patients had mild anxiety symptoms (SAS score: 50-59), which is significantly lower than that of the early COVID-19 pandemic with statistically significant difference (p = 0.003). Increased protective measures taken by the medical staves were the only risk factor in elevated anxiety symptoms during the 1-year follow-up. This study shows that COVID-19 has a direct impact on the deterioration of anxiety symptoms in patients with MHD. With the changes of the requirements for COVID-19 prevention and control, as well as the enhancement of propaganda and education of the pandemic and psychological care, the severity and risk factors of anxiety symptoms in the patients with MHD are changing. Thus, targeted interventions are suggested to improve the psychological endurance of the patients with MHD.
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Affiliation(s)
- Honghong Lv
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Junping Meng
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Yang Chen
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Feng Yang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Wen Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Guohua Wei
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Jiaojiao Zhang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Huan Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Mengqiu Wang
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Lu Zhou
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
| | - Hongbao Liu
- Department of Nephrology, Tangdu Hospital, The Air Force Military Medical University, Xi'an, China
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16
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Goh ZZS, Chia JMX, Seow TYY, Choo JCJ, Foo M, Seow PS, Griva K. Treatment-related decisional conflict in pre-dialysis chronic kidney disease patients in Singapore: Prevalence and determinants. Br J Health Psychol 2021; 27:844-860. [PMID: 34865298 DOI: 10.1111/bjhp.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In advanced chronic kidney disease (CKD), patients face complex decisions related to renal replacement modality that can cause decisional conflict and delay. This study aimed to evaluate the prevalence of severe decisional conflict across decision types and to identify the psychosocial and clinical factors associated with decisional conflict in this population. DESIGN Observational cross-sectional study. METHODS Patients with CKD in renal care were recruited. The Decisional Conflict Scale (DCS), Functional, Communicative, and Critical Health Literacy (FCCHL), Health Literacy Questionnaire (HLQ), Hospital Anxiety and Depression Scale (HADS), Brief Illness Perception Questionnaire (BIPQ), and the Kidney-disease Quality of Life (KDQOL) questionnaires were used. Clinical data were obtained from medical records. Bivariate and multivariable logistic regression models were used to identify predictors of severe decisional conflict (DCS score ≥ 37.5). RESULTS Participants (N = 190; response rate = 56.7%; mean age = 62.8 ± 10.8) reported moderate levels of decisional conflict (29.7 ± 14.5). The overall prevalence of severe decisional conflict was 27.5% (n = 46) with no significant differences across decision types (dialysis, modality, access). Ethnicity (Chinese), marital status (married), BIPQ treatment control, coherence, KDQOL staff encouragement, and all health literacy domains, except functional health literacy, were significant predictors of decisional conflict in the unadjusted models. In the multivariable model, only the health literacy domains of FCCHL Communicative, and HLQ Active Engagement remained significant. CONCLUSION Even after pre-dialysis education, many CKD patients in this study still report severe decisional conflict, with rates remaining substantial across decision junctures. The associations of decisional conflict and health literacy skills related to communication and engagement with healthcare providers indicate that more collaborative and patient-centric pre-dialysis programs may support patient activation and resolve decisional conflict.
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Affiliation(s)
- Zack Zhong Sheng Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Jace Ming Xuan Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | | | | | | | | | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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17
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González-Flores CJ, García-García G, Lerma A, Pérez-Grovas H, Meda-Lara RM, Guzmán-Saldaña RME, Lerma C. Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11957. [PMID: 34831713 PMCID: PMC8620979 DOI: 10.3390/ijerph182211957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 12/11/2022]
Abstract
Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18-65 years. Beck's depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26-52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.
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Affiliation(s)
| | - Guillermo García-García
- Nephrology Department, Civil Hospital de Guadalajara Fray Antonio Alcalde, Guadalajara 44280, Mexico;
| | - Abel Lerma
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Juan Tilcuautla 42160, Mexico; (A.L.); (R.M.E.G.-S.)
| | | | - Rosa M. Meda-Lara
- Departments of Basic Psychology and Medical Clinics, Health Sciences Center, University of Guadalajara, Guadalajara 44340, Mexico;
| | - Rebeca M. E. Guzmán-Saldaña
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Juan Tilcuautla 42160, Mexico; (A.L.); (R.M.E.G.-S.)
| | - Claudia Lerma
- National Institute of Cardiology Ignacio Chávez, México City 14080, Mexico;
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18
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Diffusion Tensor Imaging Features of Watershed Segmentation Algorithm for Analysis of the Relationship between Depression and Brain Nerve Function of Patients with End-Stage Renal Disease. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7036863. [PMID: 34733456 PMCID: PMC8560248 DOI: 10.1155/2021/7036863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
The aim of this research was to explore the relationship between depression and brain nerve function in patients with end-stage renal disease (ESRD) and long-term maintenance hemodialysis (MHD) based on watershed segmentation algorithm using diffusion tensor imaging (DTI) technology. A total of 29 ESRD patients with depression who received MHD treatment in the hemodialysis center of hospital were included as the research subjects (case group). A total of 29 healthy volunteers were recruited as the control group, and a total of 29 ESRD patients with depression and brain lesions were recruited as the control group (HC group). Within 24 h after hemodialysis, the blood biochemical indexes were collected before this DTI examination. All participants completed the neuropsychological scale (MoCA, TMT A, DST, SAS, and SDS) test. The original DTI data of all subjects were collected and processed based on watershed segmentation algorithm, and the results of automatic segmentation according to the image were evaluated as DSC = 0.9446, MPA = 0.9352, and IOU = 0.8911. Finally, the average value of imaging brain neuropathy in patients with depression in the department of nephrology was obtained. The differences in neuropsychological scale scores (PSQI, MoCA, TMTA, DST, SAS, and SDS) between the two groups were statistically significant (P < 0.05). The differences of FA values in all the white matter partitions of Fu organs, except the cingulum of hippocampus (CgH) between the two groups, were statistically significant (P < 0.05). ESRD and DTI quantitative detection under the guidance of watershed segmentation algorithm in MHD patients showed that ESRD patients can be early identified, so as to carry out psychological nursing as soon as possible to reduce the occurrence of depression, and then protect the brain nerve to reduce brain neuropathy.
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19
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Ng MSN, Chan DNS, Cheng Q, Miaskowski C, So WKW. Association between Financial Hardship and Symptom Burden in Patients Receiving Maintenance Dialysis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189541. [PMID: 34574463 PMCID: PMC8464840 DOI: 10.3390/ijerph18189541] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many patients on maintenance dialysis experience financial hardship. Existing studies are mainly cost analyses that quantify financial hardship in monetary terms, but an evaluation of its impact is also warranted. This review aims to explore the definition of financial hardship and its relationship with symptom burden among patients on dialysis. METHODS A literature search was conducted in November 2020, using six electronic databases. Studies published in English that examined the associations between financial hardship and symptom burden were selected. Two reviewers independently extracted data and appraised the studies by using the JBI Critical Appraisal Checklists. RESULTS Fifty cross-sectional and seven longitudinal studies were identified. Studies used income level, employment status, healthcare funding, and financial status to evaluate financial hardship. While relationships between decreased income, unemployment, and overall symptom burden were identified, evidence suggested that several symptoms, including depression, fatigue, pain, and sexual dysfunction, were more likely to be associated with changes in financial status. CONCLUSION Our findings suggest that poor financial status may have a negative effect on physical and psychological well-being. However, a clear definition of financial hardship is warranted. Improving this assessment among patients on dialysis may prompt early interventions and minimize the negative impact of financial hardship.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
- Correspondence: ; Tel.: +852-3943-8165
| | - Qinqin Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (M.S.N.N.); (Q.C.); (W.K.W.S.)
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20
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Montalescot L, Rascle N, Combe C, Untas A. Patients' experience one year after dialysis initiation: a lexicometric analysis. Health Psychol Behav Med 2021; 9:380-397. [PMID: 34104566 PMCID: PMC8158193 DOI: 10.1080/21642850.2021.1918552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Dialysis implies huge changes in patients' lives. Yet, there is a need to better understand patients' experience in the time following dialysis initiation. OBJECTIVE The objective of this study was to investigate patients' experience of dialysis a year after treatment initiation and the associations between patients' discourse and their anxiety and depression symptoms. METHODS Twenty two patients (mean age 63.4; 68% men) took part in a semi-directed interview about their experience with dialysis. Participants completed the Hospital Anxiety and Depression Scale (HADS). Interviews were analyzed using a lexicometric analysis. RESULTS The analysis generated five classes: experience with nephrological care, facing loss and family relationships, family and acceptance, implementation of a new routine and making sense of the end-stage renal disease experience. Patients' felt very passive in their experience with care. They reported the importance of integrating dialysis in their lives and the role of family support when facing treatment initiation. Depressed patients were more likely to describe their nephrological monitoring very factually and to talk about what they lost with dialysis initiation. CONCLUSION Dialysis initiation is a hard time for patients during which they face many challenges. This first year represents a time of adaptation, in which family seems essential.
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Affiliation(s)
| | - Nicole Rascle
- Inserm U1219 ‘Bordeaux Population Health Research Center’ Team ‘Psychoepidemiology of Aging & Chronic Diseases’, University of Bordeaux, Bordeaux, France
| | - Christian Combe
- Department of Nephrology Transplantation Dialysis, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Inserm U1026, University of Bordeaux, Bordeaux, France
| | - Aurélie Untas
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France
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21
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Metzger M, Yoder J, Fitzgibbon K, Blackhall L, Abdel-Rahman E. Nephrology and Palliative Care Collaboration in the Care of Patients With Advanced Kidney Disease: Results of a Clinician Survey. Kidney Med 2021; 3:368-377.e1. [PMID: 34136783 PMCID: PMC8178464 DOI: 10.1016/j.xkme.2021.01.008] [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] [Indexed: 11/16/2022] Open
Abstract
Rationale & Objective Despite calls for integrating palliative care into chronic kidney disease (CKD) care, uptake remains low. The study aim was to describe clinicians’ perceptions of the clinical and research priorities in CKD care and the main barriers to collaboration. Study Design This was a descriptive cross-sectional study using an online survey developed by clinicians and researchers as the primary data collection method. Setting & Participants Clinicians in nephrology and palliative care departments (N = 195) at an academic health center in Virginia were invited to participate. Of the 48.7% (n = 95) who responded, most were registered nurses (65.3%) in nephrology (80%) with more than 15 years’ experience (40%). Predictors Factors including discipline (nursing, social work, and physician) and practice area (palliative care or nephrology) were assessed. Outcomes Main outcomes of interest included clinicians’ perceptions of the role of palliative care, barriers to collaboration, and the top clinical and research priorities for patients with advanced CKD. Analytic Approach Survey data were analyzed using SPSS using descriptive statistics. Results Respondents reported being comfortable caring for patients near the end of life and endorsed advance care planning and collaboration between nephrology and palliative care teams. However, both rarely happen. Fragmentation, or poor coordination of care, was perceived to be the main barrier to collaboration. Perceptions regarding collaboration facilitation differed; nephrology clinicians identified patient/family education as the most important facilitator while palliative care clinicians identified clinician education as most important. Top clinical priorities differed. Palliative care clinicians reported pain/symptom management as taking priority while nephrology clinicians identified caregiver/family support. Developing interventions to support treatment-related decision making was the top research priority. Limitations Results reflect perceptions of about half the clinicians at 1 academic health center. Conclusions Additional studies to capture patients’ and families’ perspectives and examine end-of-life care processes are needed. Results may inform future targeted interventions.
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Affiliation(s)
- Maureen Metzger
- University of Virginia School of Nursing, Charlottesville, VA
| | - Jonathan Yoder
- University of Virginia School of Nursing, Charlottesville, VA
| | - Kara Fitzgibbon
- Hemodialysis Unit and Home Hemodialysis Program, University of Virginia Health, University of Virginia School of Medicine, Charlottesville, VA
| | - Leslie Blackhall
- Weldon Cooper Center, Center for Survey Research, University of Virginia, Charlottesville, VA
| | - Emaad Abdel-Rahman
- Palliative Care Services, University of Virginia Health, University of Virginia School of Medicine, Charlottesville, VA
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22
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Hao W, Tang Q, Huang X, Ao L, Wang J, Xie D. Analysis of the prevalence and influencing factors of depression and anxiety among maintenance dialysis patients during the COVID-19 pandemic. Int Urol Nephrol 2021; 53:1453-1461. [PMID: 33675473 PMCID: PMC7936244 DOI: 10.1007/s11255-021-02791-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/30/2021] [Indexed: 12/27/2022]
Abstract
Objective Currently, the COVID-19 outbreak and its spread around the globe is significantly affecting mental health and health in general, worldwide. During the COVID-19 pandemic, the general medical complications have received the most attention, whereas only a few studies address the potential direct impact of SARS-CoV-2 on mental health. Methods A total of 321 maintenance hemodialysis (MHD) patients were selected using random sampling from the hemodialysis center of the second people’s Hospital of Yibin. They completed Zung’s self-rating anxiety scale (SAS) for anxiety, Zung’s self-rating depression scale (SDS) for depression, and the activity of daily living scale (ADL) for the ability of living. Demographic data and laboratory tests were used to analyze the risk factors. Results The proportions of the prevalence of anxiety and depression symptoms were between 34.89% and 30.02%, respectively, among the MHD patients. The SAS and SDS scores of the 321 patients were 45.42(± 10.99) and 45.23(± 11.59), respectively. The results show that monthly income, medical insurance, vascular access, the duration of dialysis, complication, hemoglobin (HGB), immunoreactive parathyroid hormone (iPTH) and blood phosphorus (P) are factors that influence anxiety among patients (p < 0.05 for all). Vascular access, monthly income, medical insurance, complication, CRP, Alb, are factors that influence depression among patients (p < 0.05 for all). Conclusion Our results suggest that during the pandemic period, the prevalence of anxiety and depression symptoms among MHD patients increased. Some demographic and clinical variables were associated with it. We should, therefore, pay more attention to the patients’ psychology, start targeted intervention to alleviate the patients’ anxiety and further improve their quality of life.
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Affiliation(s)
- Wen Hao
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China.,North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qianrong Tang
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China
| | - Xiaoqin Huang
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China
| | - Lina Ao
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China
| | - Jing Wang
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China
| | - Deqiong Xie
- Department of Nephrology, The Second People's Hospital of Yibin, Yibin, 644000, Sichuan, China.
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23
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Huang CW, Wee PH, Low LL, Koong YLA, Htay H, Fan Q, Foo WYM, Seng JJB. Prevalence and risk factors for elevated anxiety symptoms and anxiety disorders in chronic kidney disease: A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 69:27-40. [PMID: 33516963 DOI: 10.1016/j.genhosppsych.2020.12.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anxiety is associated with poor health outcomes among chronic kidney disease (CKD) patients. This review summarizes the prevalence and risk factors associated with elevated anxiety symptoms and disorders among CKD patients. METHODS Articles evaluating the prevalence and risk factors associated with elevated anxiety symptoms and disorders among CKD patients, as diagnosed via DSM 4th or 5th edition criteria, clinical interviews or validated questionnaires, were searched in Medline®, Embase®, PsychINFO® and CINAHL®. Using random-effects meta-analyses, the prevalence of elevated anxiety symptoms and disorders were estimated. A narrative review on the risk factors associated with elevated anxiety symptoms and disorders was presented. RESULTS From 4941 articles, 61 studies were included. The pooled prevalence of anxiety disorders (9 studies, n = 1071) among CKD patients across studies was 19% while that of elevated anxiety symptoms (52 studies, n = 10,739) was 43%. Across continents, prevalence of elevated anxiety symptoms was highest in Europe and Asia. Between pre-dialysis and dialysis patients, the prevalence of elevated anxiety symptoms was not statistically different at 31% and 42% respectively. Common risk factors associated with elevated anxiety symptoms included concomitant depression, lower parathyroid hormone levels, increased comorbidities, increased duration of hospitalization, reduced perceived quality of life, and decreased vitality levels. CONCLUSION Given the high prevalence of anxiety disorders and elevated anxiety symptoms, more studies are required to assess the role and outcomes of anxiety screening among CKD patients. This could facilitate early identification of at-risk patients and potentially improve their clinical outcomes.
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Affiliation(s)
| | - Poh Hui Wee
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore.
| | - Lian Leng Low
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Outram Rd, 169608, Singapore; SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, 169608, Singapore; Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, 168582, Singapore; SingHealth Regional Health System PULSES Centre, Singapore Health Services, Singapore, Outram Rd, 169608, Singapore.
| | - Ying Leng Agnes Koong
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore; SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, 169608, Singapore; Marine Parade Polyclinics, SingHealth Polyclinics, 80 Marine Parade Central, 440080, Singapore.
| | - Htay Htay
- Department of Renal Medicine, Singapore General Hospital, Outram Rd, 169608, Singapore.
| | - Qiao Fan
- Center for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
| | - Wai Yin Marjorie Foo
- Department of Renal Medicine, Singapore General Hospital, Outram Rd, 169608, Singapore.
| | - Jun Jie Benjamin Seng
- Duke-NUS Medical School, Singapore, 8 College Road, 169857, Singapore; SingHealth Regional Health System PULSES Centre, Singapore Health Services, Singapore, Outram Rd, 169608, Singapore.
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24
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Igarashi NS, Karam CH, Afonso RF, Carneiro FD, Lacerda SS, Santos BF, Kozasa EH, Rangel ÉB. The effects of a short-term meditation-based mindfulness protocol in patients receiving hemodialysis. PSYCHOL HEALTH MED 2021; 27:1286-1295. [PMID: 33449820 DOI: 10.1080/13548506.2021.1871769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mindfulness-based approaches that promote health, improve quality of life, and reduce the impact of comorbidities are key aspects in chronic diseases management. We aimed to verify the impact of a short-term meditation protocol on psychosocial and physiological parameters in chronic hemodialysis patients. We enrolled twenty-two patients, median age of 69.5 years old, into a 12-week meditation protocol that occurred during each hemodialysis session for 10-20 minutes, 3x/week, in a private tertiary hospital. We then evaluated clinical, psychological, and laboratorial parameters pre- and post-meditation. Patients exhibited a better control of serum phosphorus (-0.72 mg/dL; P = 0.002), a decrease in systolic blood pressure (-1.90 mmHg; P = 0.009), a 23% decrease in depressive symptoms (P = 0.014), and an increase of 7% in the self-compassion scale (P = 0.048) after meditation. To note, we observed an increase in 13% of the mindfulness score (P = 0.019). Our preliminary study describes the effects of a short-term meditation protocol in chronic hemodialysis setting. We observed a decrease in depressive symptoms and in blood pressure values, an improvement in self-compassion and serum phosphorous levels. In conjunction with the promising results of meditation in chronic kidney disease setting, this encouraging preliminary study supports the need for additional clinical trials.
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Affiliation(s)
- Nadja S Igarashi
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Christiane H Karam
- Einstein Dialysis Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Rui F Afonso
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Fabiana D Carneiro
- Einstein Dialysis Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Shirley S Lacerda
- Psychology Service, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Bento F Santos
- Einstein Dialysis Center, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Elisa H Kozasa
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Érika B Rangel
- Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Department of Medicine, Nephrology Division , Federal University of São Paulo, São Paulo, SP, Brazil
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25
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Al-Shammari N, Al-Modahka A, Al-Ansari E, Al-Kandari M, Ibrahim KA, Al-Sanea J, Al-Sabah R, Albatineh AN. Prevalence of depression, anxiety, and their associations among end-stage renal disease patients on maintenance hemodialysis: a multi-center population-based study. PSYCHOL HEALTH MED 2020; 26:1134-1142. [PMID: 33251848 DOI: 10.1080/13548506.2020.1852476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Depression and anxiety are the most common mood disorder among end-stage renal disease (ESRD) patients, which can negatively affect quality-of-life and treatment outcomes. This study aimed to estimate the prevalence of depression and anxiety symptoms among ESRD patients undergoing hemodialysis (HD) and test associations with several covariates. In across-sectional study, we collected data from 457 patients using Hospital Anxiety and Depression Scale (HADS). We used multinomial logistic regression to model the associations between depression/anxiety symptoms and several covariates. The prevalence of depression (anxiety) symptoms was 21.7%(21.4%). About 12.6% had both depression and anxiety. Males were significantly less likely to have anxiety (depression) compared to females. Married with children were significantly less likely to have anxiety compared to divorced/widowed. Patients with Glomerulonephritis were significantly more likely to have anxiety (depression) compared to other causes of dialysis. Depression and anxiety are prevalent among HD patients with their HADS scores significantly positively correlated. This requires regular screening for symptoms of anxiety/depression. Future interventions should target females, those on dialysis between one and three years, and those with glomerulonephritis as ESRD cause. Finally, HADS is ascreening tool for symptoms of anxiety and depression for which aspecialist should assess the definitive diagnosis clinically.
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Affiliation(s)
| | | | | | | | | | | | - Reem Al-Sabah
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait
| | - Ahmed N Albatineh
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait
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26
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Kao YY, Lee WC, Wang RH, Chen JB. Correlation of sociodemographic profiles with psychological problems among hospitalized patients receiving unplanned hemodialysis. Ren Fail 2020; 42:255-262. [PMID: 32146858 PMCID: PMC7144224 DOI: 10.1080/0886022x.2020.1736097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose In this prospective study, we aimed to examine the sociodemographic factors and clinical factors associated with psychological disorders in chronic kidney disease (CKD) patients receiving unplanned hemodialysis (HD). Methods We prospectively enrolled 187 CKD stage 5 patients receiving unplanned HD at a tertiary hospital from January 2015 to December 2016. We used structured questionnaires to gather data about participants’ anxiety, depression, and sleep disturbance. Generalized linear regression analysis was used to examine the relationships between sociodemographic and laboratory parameters, and severity of psychological distress. Results The mean age of the participants was 60 years, and the number of men and women was 97 and 90, respectively. We did not find a significant association between anxiety, depression, and sleep disturbance scores and gender, age, marital status, religion status, education levels, and employment status and number of comorbidities. Generalized linear regression analysis showed that a multidisciplinary CKD care program in outpatient clinic disclosed a significant negative association with psychological disorders in participants. Conclusions CKD patients exhibited psychological distress when receiving unplanned HD, not closely associated with sociodemographic profiles.
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Affiliation(s)
- Yu-Yin Kao
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Chin Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ruey-Hsia Wang
- College of Nursing, Department of Medical Research, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jin-Bor Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
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27
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Skoumalova I, Geckova AM, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7913. [PMID: 33126638 PMCID: PMC7663113 DOI: 10.3390/ijerph17217913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023]
Abstract
Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21-3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26-2.98) or anxiety (OR/95% CI: 1.81/1.22-2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients' psychological distress to ensure adequate adherence with recommended diet.
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Affiliation(s)
- Ivana Skoumalova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
- 2nd Department of Internal Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia
| | - Maria Majernikova
- FMC-Dialysis Services Slovakia, Trieda SNP 1, 040 01 Kosice, Slovakia;
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Trieda SNP 1, 040 01 Kosice, Slovakia; (A.M.G.); (J.R.); (P.K.)
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, P. J. Safarik University, Jesenna 5, 040 01 Kosice, Slovakia;
| | - Andrea F. de Winter
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Jitse P. van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P.J. Safarik University in Kosice, Trieda SNP 1, 040 01 Kosice, Slovakia;
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Olomouc University Social Health Institute, Palacky University, Univerzitni 22, 771 11 Olomouc, Czech Republic
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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Ahmad Othman A, Wan Jaafar WM, Zainuddin ZN, Mohamad Yusop Y. Effectiveness of cognitive behaviour therapy on depression among haemodialysis patients: A systematic review of literature. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1794680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Akmarina Ahmad Othman
- Counselor Education and Counseling Psychology, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor 43400 UPM, Malaysia
| | - Wan Marzuki Wan Jaafar
- Counselor Education and Counseling Psychology, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor 43400 UPM, Malaysia
| | - Zaida Nor Zainuddin
- Counselor Education and Counseling Psychology, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor 43400 UPM, Malaysia
| | - Yusni Mohamad Yusop
- Counselor Education and Counseling Psychology, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor 43400 UPM, Malaysia
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29
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Cimen SG, Oğuz E, Gundogmus AG, Cimen S, Sandikci F, Ayli MD. Listening to music during arteriovenous fistula surgery alleviates anxiety: A randomized single-blind clinical trial. World J Transplant 2020; 10:79-89. [PMID: 32405474 PMCID: PMC7205904 DOI: 10.5500/wjt.v10.i4.79] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/09/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Both end-stage renal disease and being wait-listed for a kidney transplant are anxiety-causing situations. Wait-listed patients usually require arteriovenous fistula surgery for dialysis access. This procedure is performed under local anesthesia. We investigated the effects of music on the anxiety, perceived pain and satisfaction levels of patients who underwent fistula surgery. AIM To investigate the effect of music therapy on anxiety levels and perceived pain of patients undergoing fistula surgery. METHODS Patients who were on a waiting list for kidney transplants and scheduled for fistula surgery were randomized to control and music groups. The music group patients listened to music throughout the fistula surgery. The State-Trait Anxiety Inventory was performed to assess anxiety, additionally visual analog scale was used to evaluate perceived pain, willingness to repeat the procedure and patient satisfaction. Demographic features, comorbidities, surgical history, basic surgical data (location of fistula creation, duration of surgery, incision length) and intra-operative hemodynamic parameters were recorded by an investigator blinded to the study group. An additional trait anxiety assessment was performed following the surgery. RESULTS There was a total of 55 patients included in the study. However, 14 patients did not fulfill the criteria due to requirement of sedation during surgery or uncompleted questionnaires. The remaining 41 patients were included in the analysis. There were 26 males and 15 females. The control and music groups consisted of 20 and 21 patients, respectively. With regard to basic surgical and demographic data, there was no difference between the groups. Overall patient satisfaction was significantly higher and intra-operative heart rate and blood pressure were significantly lower in the music group (P < 0.05). Postoperative state anxiety levels were significantly lower in the music group. CONCLUSION Music therapy can be a complimentary treatment for patients undergoing fistula surgery. It can reduce anxiety and perceived pain, improve intraoperative hemodynamic parameters and enhance treatment satisfaction, thus may contribute to better compliance of the patients.
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Affiliation(s)
- Sanem Guler Cimen
- Department of General Surgery, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Ebru Oğuz
- Division of Nephrology, Department of Internal Medicine, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Ayse Gokcen Gundogmus
- Department of Psychiatry, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Sertac Cimen
- Department of Urology, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Fatih Sandikci
- Department of Urology, Diskapi Research and Traning Hospital, Health Sciences University, Ankara 06110, Turkey
| | - Mehmet Deniz Ayli
- Division of Nephrology, Department of Internal Medicine, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey
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30
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Griva K, Yoong RKL, Nandakumar M, Rajeswari M, Khoo EYH, Lee VYW, Kang AWC, Osborne RH, Brini S, Newman SP. Associations between health literacy and health care utilization and mortality in patients with coexisting diabetes and end‐stage renal disease: A prospective cohort study. Br J Health Psychol 2020; 25:405-427. [DOI: 10.1111/bjhp.12413] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/09/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Konstadina Griva
- Centre for Population Health Sciences Lee Kong Chian School of Medicine Imperial College and Nanyang Technological University Singapore City Singapore
| | | | | | | | - Eric Y. H. Khoo
- Department of Medicine Yong Loo Lin School of Medicine National University Singapore Singapore
- Division of Endocrinology University Medicine Cluster National University Health System Singapore City Singapore
| | | | | | - Richard H. Osborne
- Centre for Global Health and Equity Faculty of Health, Arts and Design Swinburne University of Technology Melbourne Australia
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31
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Oliveira LM, Sari D, Schöffer C, Santi SS, Antoniazzi RP, Zanatta FB. Periodontitis is associated with oral health‐related quality of life in individuals with end‐stage renal disease. J Clin Periodontol 2020; 47:319-329. [DOI: 10.1111/jcpe.13233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/04/2019] [Accepted: 12/08/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Leandro M. Oliveira
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Daniélli Sari
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Caroline Schöffer
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Samantha S. Santi
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Raquel P. Antoniazzi
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Fabrício B. Zanatta
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
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32
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Nie XD, Wang Q, Zhang YH, Xiong ZY, Liao JL, Hao L, Liu GL, Duan LP, Zheng ZX, Ren YP, Dong J. Depression at Baseline is an Independent Risk Factor for Cognitive Decline in Patients on Peritoneal Dialysis: A Multicenter Prospective Cohort Study. Perit Dial Int 2019; 39:465-471. [PMID: 31501292 DOI: 10.3747/pdi.2018.00239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/26/2019] [Indexed: 11/15/2022] Open
Abstract
Background Depression has been recognized as a risk factor for cognitive impairment (CI) from cross-sectional datasets. This multicenter prospective study investigated the association between depression and cognitive decline in peritoneal dialysis (PD) patients. Methods This multicenter prospective cohort study included 458 PD patients who were followed up for 2 years. The Modified Mini-Mental State Examination (3MS) was used for assessment of global cognitive function, Trail-Making Tests A and B for executive function, subtests of the Battery for the Assessment of Neuropsychological Status for immediate and delayed memory, visuospatial skill, and language ability. Depression was assessed using Zung's Self-Rating Depression Scale. Results During the 2-year follow-up, patients with moderate/severe depression at baseline showed a significant decline in global cognitive function (80.5 ± 15.2 vs 76.6 ± 15.5, p = 0.008), while patients without depression or with mild depression kept a stable global cognitive function. In the meantime, patients without depression showed significant improvements in immediate memory, visuospatial skill, and language ability. However, no significant improvement in these parameters was shown in depression groups. In multivariable linear regression analysis, depression at baseline was a significant predictor of worsening global cognitive function, whether depression was analyzed as a continuous variable (odds ratio [OR] = -0.14, 95% confidence interval [CI] -0.27, -0.01, p = 0.031) or a rank variable (OR = -1.88, 95% CI -3.30, -0.45, p = 0.010). Moreover, higher depression score or more severe depression degradation was significantly associated with decline of immediate memory, delayed memory, and language skill. Conclusion Depression was a significant risk factor for worsening of CI in PD patients.
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Affiliation(s)
- Xue-dan Nie
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Qin Wang
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Yu-hui Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Zu-ying Xiong
- Renal Division, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jin-lan Liao
- Renal Division, Peking University Shenzhen Hospital, Shenzhen, China
| | - Li Hao
- Renal Division, The Second Hospital of Anhui Medical University, Anhui, China
| | - Gui-ling Liu
- Renal Division, The Second Hospital of Anhui Medical University, Anhui, China
| | - Li-ping Duan
- Renal Division, Handan Central Hospital, Hebei, China
| | | | - Ye-ping Ren
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
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Han E, Shiraz F, Haldane V, Koh JJK, Quek RYC, Ozdemir S, Finkelstein EA, Jafar TH, Choong HL, Gan S, Lim LWW, Legido-Quigley H. Biopsychosocial experiences and coping strategies of elderly ESRD patients: a qualitative study to inform the development of more holistic and person-centred health services in Singapore. BMC Public Health 2019; 19:1107. [PMID: 31412824 PMCID: PMC6694659 DOI: 10.1186/s12889-019-7433-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/01/2019] [Indexed: 12/02/2022] Open
Abstract
Background As the incidence and prevalence rates of end stage renal disease (ESRD) rise globally, a disproportionate increase has been observed in the elderly population. Singapore has the fifth highest incidence of treated ESRD worldwide, with the upward trend of ESRD being most apparent among those aged 70 years and older. Although it is well-documented that ESRD patients suffer an impaired quality of life compared to the general population, there is limited research focusing on the unique experiences and needs of elderly ESRD patients in Asian populations. To address the knowledge gap, this study seeks to explore the impact of ESRD and dialysis on the quality of life of elderly (≥70 years old) ESRD patients in Singapore and examine the coping strategies utilised by these patients. Methods This qualitative study involved semi-structured, in-depth interviews with 7 peritoneal dialysis patients, 5 haemodialysis patients, 4 patients on non-dialysis supportive care and 7 caregivers in Singapore. Interviews were conducted in English, Chinese, and Malay and fully transcribed. QSR NVivo 11 software was used for analysis. Results Participants reported that ESRD and dialysis had an impact on three highly interconnected areas of their quality of life: (a) biological/physical (general symptoms, neuromuscular problems, skin problems and poor sleep quality); (b) psychological (depressive symptoms, anxiety and fears, stress and negative self-perceptions); and (c) social (increased dependence on family and loss of social life). There were four key strategies that participants used to cope with these biopsychosocial challenges: (a) family support (financial, practical and emotional support); (b) religious/spiritual support (experiencing gratitude/contentment, the power of prayer and belonging to a faith community); (c) avoidance (cognitive avoidance and distraction techniques); and (d) acceptance (positive thinking and problem solving). Conclusions This study has provided insights into the biopsychosocial impact of ESRD and dialysis, as well as cultural and religious factors that shape the experiences and coping mechanisms of elderly ESRD patients and caregivers in Singapore, which can be used to further the development and implementation of more holistic and person-centred services to help each patient achieve a better quality of life. Electronic supplementary material The online version of this article (10.1186/s12889-019-7433-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore.
| | - Victoria Haldane
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Joel Jun Kai Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Rina Yu Chin Quek
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Semra Ozdemir
- Duke NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | | | | | - Hui-Lin Choong
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Sheryl Gan
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Lydia W W Lim
- Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03H, Tahir Foundation Building, Singapore, 117549, Singapore
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Ambrus L, Westling S. Inverse association between serum albumin and depressive symptoms among drug-free individuals with a recent suicide attempt. Nord J Psychiatry 2019; 73:229-232. [PMID: 31066604 DOI: 10.1080/08039488.2019.1610056] [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: 10/26/2022]
Abstract
Background and aim: Albumin is a protein with multifaceted functions in the human body. According to many studies, lower serum albumin may be associated with depression in various groups of psychiatric and non-psychiatric patients, as well as with attempted suicide. As more severe depressive symptoms have been identified as a reliable risk factor for suicide in patients with high suicide risk, it would be of interest to study whether, the inverse association between depressive symptoms and albumin may exist among patients with attempted suicide. Therefore, the aim of the study was to investigate the possible association between albumin and depressive symptoms among individuals who recently attempted suicide. Methods: One-hundred twenty-seven individuals with a recent suicide attempt were involved in the study between 1987 and 2001. Albumin was analyzed in serum. Patients were evaluated with the Comprehensive Psychopathological Rating Scale (CPRS) from which the Montgomery-Åsberg Depression Rating Scale (MADRS) and the item assessing Apparent sadness were derived. Results: Only among patients aged ≥45, serum albumin levels were significantly and negatively correlated with total scores of MADRS and the item Apparent sadness (all p values <.00625). Conclusions: Our findings indicate an inverse association between serum albumin and the severity of depressive symptoms in individuals who attempted suicide, older than 45 years.
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Affiliation(s)
- Livia Ambrus
- a Department of Clinical Sciences , Section of Psychiatry Lund University Clinical Psychiatric Research Center , Lund , Sweden
| | - Sofie Westling
- a Department of Clinical Sciences , Section of Psychiatry Lund University Clinical Psychiatric Research Center , Lund , Sweden
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Abstract
Although some studies have been conducted on the association between diabetes and anxiety symptoms, the data on this association remain controversial. The purpose of this meta-analysis was to examine the association between diabetes and anxiety symptoms. The authors systematically searched PubMed, Scopus, and Google Scholar databases until July 2018. After the screening process, 23 studies were included in the meta-analysis. Stata-14 was used for meta-analyzing. Forest plot was calculated for the whole 23 studies and subgroups, and publication bias was also examined. Overall, diabetes was positively associated with anxiety; pooled odds ratio was equal to1.48; 95% confidence interval was 1 .27-1.74. In cross-sectional study, the result was odds ratio = 1.50; 95% confidence interval = 1.26-1.77, and in prospective-cohort study, the result was odds ratio = 1.34; 95% confidence interval = 1.21-1.49. There was small evidence of publication bias. Overall, our findings indicate that diabetes is a risk factor for anxiety symptoms. Therefore, having a healthy medical condition can be an anxiety prevention agent.
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KauricKlein Z. Effect of yoga on physical and psychological outcomes in patients on chronic hemodialysis. Complement Ther Clin Pract 2019; 34:41-45. [DOI: 10.1016/j.ctcp.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
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Griva K, Rajeswari M, Nandakumar M, Khoo EYH, Lee VYW, Chua CG, Goh ZS, Choong YTD, Newman SP. The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach. BMC Nephrol 2019; 20:2. [PMID: 30606135 PMCID: PMC6318946 DOI: 10.1186/s12882-018-1183-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 12/11/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the "Combined Diabetes and Renal Control Trial" (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. METHODS An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. RESULTS Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. CONCLUSIONS The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients. TRIAL REGISTRATION NUMBER Trial registered with the International Standard Randomised Controlled Trial (ISRCTN10546597). Registered 12 September 2016 (Retrospectively registered).
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Affiliation(s)
- K. Griva
- Centre for Population Health Sciences, Clinical Sciences Building, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
- Department of Psychology, National University of Singapore, 9 Arts Link AS4, Singapore, 117570 Singapore
| | - M. Rajeswari
- National Kidney Foundation, 81 Kim Keat Road, Singapore, 328836 Singapore
| | - M. Nandakumar
- National Kidney Foundation, 81 Kim Keat Road, Singapore, 328836 Singapore
| | - E. Y. H. Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Division of Endocrinology, University Medicine Cluster, National University Health System, Singapore, Singapore
| | - V. Y. W. Lee
- Department of Psychology, National University of Singapore, 9 Arts Link AS4, Singapore, 117570 Singapore
| | - C. G. Chua
- National Kidney Foundation, 81 Kim Keat Road, Singapore, 328836 Singapore
| | - Z. S. Goh
- Centre for Population Health Sciences, Clinical Sciences Building, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232 Singapore
| | - Y. T. D. Choong
- Department of Psychology, National University of Singapore, 9 Arts Link AS4, Singapore, 117570 Singapore
| | - S. P. Newman
- School of Health Sciences, City University of London, Northampton Square, London, UK
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Sau A, Bhakta I. Screening of anxiety and depression among seafarers using machine learning technology. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.100228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Sau A, Bhakta I. Screening of anxiety and depression among the seafarers using machine learning technology. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2018.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Psychosocial Issues and Lifestyle Changes for the Renal Patient. Nurs Clin North Am 2018; 53:589-600. [PMID: 30388984 DOI: 10.1016/j.cnur.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This article provides an overview of the psychosocial issues faced by those with renal disease. The article discusses the physiologic connection between anxiety, depression, and pain-symptoms commonly seen in renal disease and other chronic illnesses. The application of integrative medicine or nonallopathic medicine and its role in the management of anxiety, depression, and pain are presented. Also presented is evidence surrounding several frequently used nonallopathic modalities appropriate for incorporation into a comprehensive management regimen for renal patients to reduce symptom burden. The article concludes with a discussion on the role of palliative care in treatment decisions for renal patients.
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Iani L, Lauriola M, Angeramo AR, Malinconico E, Porcelli P. Sense of meaning influences mental functioning in chronic renal patients. J Health Psychol 2018; 25:1978-1988. [PMID: 29944011 DOI: 10.1177/1359105318781908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In this preliminary study, we examined whether aspects of spiritual well-being accounted for mental and physical health-related quality of life in 68 patients with end-stage renal disease, when controlling for age, type of treatment, physical symptoms, and worries. Hierarchical multiple regressions showed that meaning was associated with better mental health, while worry and physical symptoms also accounted for poor mental health. Faith and peace did not contribute to mental health. Older age, type of treatment (hemodialysis), and physical symptoms accounted for poor physical health. Our findings suggest that clinicians should include spiritual well-being in future interventions for end-stage renal disease patients.
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Al Saraireh FA, Aloush SM, Al Azzam M, Al Bashtawy M. The Effectiveness of Cognitive Behavioral Therapy versus Psychoeducation in the Management of Depression among Patients Undergoing Haemodialysis. Issues Ment Health Nurs 2018; 39:514-518. [PMID: 29370555 DOI: 10.1080/01612840.2017.1406022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this randomized controlled trial was to compare the effectiveness of psychoeducation versus cognitive behavioral therapy (CBT) in the management of depression among renal dialysis patients. A sample of 130 dialysis patients participated in the study and they were assigned at random to one of two therapies: psychoeducation (N = 65) or CBT (N = 65). Hamilton depression rating scale was completed by the participants in both groups prior to the therapies and after completion. Both therapies were effective in the management of depression, although psychoeducation was superior. Psychoeducation is recommended over CBT in the management of depression among renal dialysis patients.
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Affiliation(s)
| | - Sami M Aloush
- b Al Al Bayet University, School of Nursing , Mafraq / Jordan
| | - Manar Al Azzam
- b Al Al Bayet University, School of Nursing , Mafraq / Jordan
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Goh ZS, Griva K. Anxiety and depression in patients with end-stage renal disease: impact and management challenges - a narrative review. Int J Nephrol Renovasc Dis 2018; 11:93-102. [PMID: 29559806 PMCID: PMC5856029 DOI: 10.2147/ijnrd.s126615] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Psychiatric disorders commonly co-exist with the diagnosis of chronic kidney disease (CKD). Research on depression and CKD has increased to a great extent. Multiple studies have demonstrated that depression is more prevalent in CKD and that end-stage renal disease is a robust risk factor for adverse outcomes such as hospitalization and mortality, yet these are often underdiagnosed or untreated. This review provides a selective overview on the prevalence rates of depression and anxiety in patients with CKD and across renal replacement therapies, the factors most consistently associated with symptoms of distress and their clinical implications. Finally, treatment and management strategies from relevant literature are appraised and discussed.
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Affiliation(s)
- Zhong Sheng Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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McDougall KA, Larkin JW, Wingard RL, Jiao Y, Rosen S, Ma L, Usvyat LA, Maddux FW. Depressive affect in incident hemodialysis patients. Clin Kidney J 2018; 11:123-129. [PMID: 29423211 PMCID: PMC5798120 DOI: 10.1093/ckj/sfx054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/15/2017] [Indexed: 11/22/2022] Open
Abstract
Background The prevalence of depressive affect is not well defined in the incident hemodialysis (HD) population. We investigated the prevalence of and associated risk factors and hospitalization rates for depressive affect in incident HD patients. Methods We performed a prospective investigation using the Patient Health Questionnaire 2 (PHQ2) depressive affect assessment. From January to July of 2013 at 108 in-center clinics randomly selected across tertiles of baseline quality measures, we contacted 577 and 543 patients by telephone for depressive affect screening. PHQ2 test scores range from 0 to 6 (scores ≥3 suggest the presence of depressive affect). The prevalence of depressive affect was measured at 1–30 and 121–150 days after initiating HD; depressive affect risk factors and hospitalization rates by depressive affect status at 1–30 days after starting HD were computed. Results Of 1120 contacted patients, 340 completed the PHQ2. In patients screened at 1–30 or 121–150 days after starting HD, depressive affect prevalence was 20.2% and 18.5%, respectively (unpaired t-test, P = 0.7). In 35 patients screened at both time points, there were trends for lower prevalence of depressive affect at the end of incident HD, with 20.0% and 5.7% of patients positive for depressive affect at 1–30 and 121–150 days, respectively (paired t-test, P = 0.1). Hospitalization rates were higher in patients with depressive affect during the first 30 days, exhibiting 1.5 more admissions (P < 0.001) and 10.5 additional hospital days (P = 0.008) per patient-year. Females were at higher risk for depressive affect at 1–30 days (P = 0.01). Conclusions The prevalence of depressive affect in HD patients is high throughout the incident period. Rates of hospital admissions and hospital days are increased in incident HD patients with depressive affect.
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Affiliation(s)
- Kathryn A McDougall
- Clinical Innovation Initiatives, Fresenius Medical Care North America, Waltham, MA 02451
| | - John W Larkin
- Integrated Care Analytics, Fresenius Medical Care North America, Waltham, MA 02451
| | - Rebecca L Wingard
- Clinical Innovation Initiatives, Fresenius Medical Care North America, Waltham, MA 02451
| | - Yue Jiao
- Integrated Care Analytics, Fresenius Medical Care North America, Waltham, MA 02451
| | - Sophia Rosen
- Integrated Care Analytics, Fresenius Medical Care North America, Waltham, MA 02451
| | - Lin Ma
- Reporting and Algorithms, Fresenius Medical Care North America, Waltham, MA 02451
| | - Len A Usvyat
- Integrated Care Analytics, Fresenius Medical Care North America, Waltham, MA 02451
| | - Franklin W Maddux
- Clinical and Scientific Affairs, Fresenius Medical Care North America, Waltham, MA 02451
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Chilcot J, Hudson JL, Moss-Morris R, Carroll A, Game D, Simpson A, Hotopf M. Screening for psychological distress using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS): Initial validation of structural validity in dialysis patients. Gen Hosp Psychiatry 2018; 50:15-19. [PMID: 28985589 DOI: 10.1016/j.genhosppsych.2017.09.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To validate the factor structure of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)- which is a composite measure of depression and anxiety using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder Scale (GAD-7), in a sample of haemodialysis patients. METHOD Screening data (n=182) used to select entry into a feasibility study of an online cognitive-behavioural therapy intervention for distress in dialysis patients were analysed here. Structural validity of the PHQ-ADS was evaluated using confirmatory factor analysis (CFA), assessing alternative models including a bi-factor model. In the bi-factor model all items from the PHQ-9 and GAD-7 (16-items in total) were loaded onto a general distress factor. Respective items of the PHQ-9 and GAD-7 were specified as subgroup factors. Omega-hierarchical was calculated to indicate the level of saturation of a multidimensional scale by a general factor. Construct validity was determined against the Brief Illness Perception Questionnaire. RESULTS A bi-factor PHQ-ADS model had good fit to the data (chi-square=96.1, p=0.26, CFI=0.99; TLI=0.99; RMSEA=0.02). The general distress factor accounted for approximately 84% of the explained variance (omega-h=0.90). Distress scores were significantly higher in females compare with males. There was a significant association between distress and negative illness perceptions (r=0.58, p<0.01). CONCLUSIONS The PHQ-ADS appears to have good structural validity in haemodialysis patients and is sufficiently unidimensional to warrant the use of a total distress score. A full psychometric analysis of the PHQ-ADS in a larger sample of dialysis patients is warranted.
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Affiliation(s)
- Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Joanna L Hudson
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Amy Carroll
- Guy's and St Thomas' NHS Foundation Trust, UK
| | - David Game
- Guy's and St Thomas' NHS Foundation Trust, UK
| | - Anna Simpson
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
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DeFerio JJ, Govindarajulu U, Brar A, Cukor D, Lee KG, Salifu MO. Association of restless legs syndrome and mortality in end-stage renal disease: an analysis of the United States Renal Data System (USRDS). BMC Nephrol 2017; 18:258. [PMID: 28764654 PMCID: PMC5540277 DOI: 10.1186/s12882-017-0660-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 07/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background Objective of the study is to assess prevalence and survival among end stage renal disease patients with restless legs syndrome (RLS) within a national database (USRDS). Methods A case-control, retrospective analysis was performed. Differences in characteristics between the groups, RLS and those with no sleep disorder (NSD), were determined using χ2 tests. Cox proportional hazard regression was used to assess survival between those with RLS and propensity score matched controls. Results Cases of restless legs syndrome were defined as patients that had received an ICD-9 code of 333.94 at any point during their treatment (n = 372). RLS group demonstrated a significantly higher proportion of patients with major depressive disorder, dysthymic disorder, anxiety, depression, minor depressive disorder, and psychological disorder. The difference between the survival was not statistically significant in those without sleep disorder as compared to those with RLS (HR =1.16±0.14, p = 0.3). Conclusions True prevalence of RLS in dialysis patients can only be estimated if knowledge gap for care providers in diagnosis of RLS is addressed. RLS patients also have increased incidence of certain psychological disorders which needs to be addressed. Electronic supplementary material The online version of this article (doi:10.1186/s12882-017-0660-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Joseph J DeFerio
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Usha Govindarajulu
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Amarpali Brar
- Division of Nephrology, Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 52, Brooklyn, NY, 11203, USA
| | - Daniel Cukor
- Department of Psychiatry and Behavioral Science, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Kathleen G Lee
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Moro O Salifu
- Division of Nephrology, Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 52, Brooklyn, NY, 11203, USA.
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