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终末期肾病中焦虑和抑郁与生活质量的相互作用。

Interplay of anxiety and depression with quality of life in endstage renal disease.

作者信息

Olagunju Andrew T, Campbell Elizabeth A, Adeyemi Joseph D

机构信息

Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria (ATO, JDA); Department of Psychiatry, Lagos University Teaching Hospital, Lagos, Nigeria (ATO, EAC, JDA).

Department of Psychiatry, Lagos University Teaching Hospital, Lagos, Nigeria (ATO, EAC, JDA).

出版信息

Psychosomatics. 2015 Jan-Feb;56(1):67-77. doi: 10.1016/j.psym.2014.03.006. Epub 2014 Mar 26.

Abstract

BACKGROUND

Endstage renal disease (ESRD) is increasingly being recognized as a major public health issue globally. Planning of intervention measures is preferably hinged on what is known about outcome parameters.

OBJECTIVES

This study investigated the influence of anxiety with depression and psychosocial- and treatment-related correlates on quality of life (QOL) in ESRD.

METHODOLOGY

Overall, 100 eligible individuals with ESRD were recruited by systematic random sampling technique. They were initially interviewed using the sociodemographic/clinical profile questionnaire, followed by assessment with the Hospital Anxiety and Depression Scale. Subsequently, subjective QOL of participants was assessed using the World Health Organization QOL-BREF.

RESULTS

The mean age of participants was 41.9 ± 10.9 years, and males (55.0%) were preponderant. A total of 29 (29.0%) participants had diagnosable anxiety with depression psychopathology based on Hospital Anxiety and Depression Scale scores ≥ 8. Different degrees of impairment across domains of QOL were observed. Factors like being employed, married status, younger age, and spending less on treatment correlated positively with good QOL across specific domains, whereas comorbid anxiety with depression, history of dialysis, monthly income less than ₦50,000 ($300), and having up to 50 dialysis sessions correlated negatively with good outcome in specific domains of QOL (p < 0.05). However, only age, anxiety/depression, employment, and history of dialysis were independently related to QOL following logistic regression analyses.

CONCLUSION

The care of ESRD should be matched with need-based mental health services, and psychosocial support across important illness trajectories is indicated for best outcome. Further research among people with ESRD is also warranted.

摘要

背景

终末期肾病(ESRD)日益被视为全球主要的公共卫生问题。干预措施的规划最好基于对结局参数的了解。

目的

本研究调查了焦虑伴抑郁以及心理社会和治疗相关因素对ESRD患者生活质量(QOL)的影响。

方法

总体而言,通过系统随机抽样技术招募了100名符合条件的ESRD患者。他们首先使用社会人口统计学/临床概况问卷进行访谈,随后使用医院焦虑和抑郁量表进行评估。随后,使用世界卫生组织生活质量简表(WHO QOL - BREF)评估参与者的主观生活质量。

结果

参与者的平均年龄为41.9±10.9岁,男性占多数(55.0%)。根据医院焦虑和抑郁量表得分≥8,共有29名(29.0%)参与者患有可诊断的焦虑伴抑郁心理障碍。观察到生活质量各领域存在不同程度的损害。就业、婚姻状况、年龄较小以及治疗费用较低等因素与特定领域的良好生活质量呈正相关,而焦虑伴抑郁、透析史、月收入低于50,000奈拉(300美元)以及透析次数达50次与特定生活质量领域的良好结局呈负相关(p<0.05)。然而,经过逻辑回归分析,只有年龄、焦虑/抑郁、就业和透析史与生活质量独立相关。

结论

ESRD的护理应与基于需求的心理健康服务相匹配,并且在重要疾病轨迹上提供心理社会支持以获得最佳结局。对ESRD患者进行进一步研究也很有必要。

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