Coping mechanisms as a predictor for quality of life in patients on dialysis: a longitudinal and multi-centre study.

INTRODUCTION

Given the negative impacts of dialysis, we must assess and comprehend the psychological factors that affect quality of life and emotional health in dialysis patients.

OBJECTIVES

We sought to evaluate the most commonly used coping mechanisms during the first year of treatment and to analyse the influence of these strategies on quality of life and emotional health.

MATERIAL AND METHOD

Longitudinal study of 98 incident patients on haemodialysis and peritoneal dialysis. We interviewed patients at 1, 6, and 12 months after starting dialysis using the MOS-SF36, PNA (affectivity), and Coping Strategies questionnaires.

RESULTS

The most commonly used strategies were Information search, Problem solving, Cognitive restructuring, Delegation, and Regulated expression of emotions (P<.001). Adaptive coping strategies were used more frequently than Avoidance coping strategies (P<.01); these differences did not vary over time. Initially, Avoidance was a predictor for a stronger negative emotion (P<.001) and a worse score for the mental component of the MOS-SF36 survey after one year (P<.001). At 6 months, avoidance modulated the relationship between negative emotions after one month and one year (P<.01). Adaptive coping during the first month was a predictor for positive emotion at the end of one year (P<.001).

CONCLUSIONS

Avoidance and Adaptive mechanisms are coping strategies that influence the psychological well-being of patients on dialysis. Patients who use Avoidance strategies at the start of dialysis are at risk for worsening their psychological state of health. It is important for health care professionals to be able to identify Avoidance strategies at an early stage of dialysis treatment.