Santos Paulo Roberto, de Sales Santos Ítala Mônica, de Freitas Filho João Laerte Alves, Macha Carlos Wellington, Tavares Priscila Garcia Câmara Cabral, de Oliveira Portela Ana Cláudia, Campos Ana Mayara Barros, de Azevedo Ana Raquel Ferreira, Ary Catarine Cavalcante, Nobre Felipe Peixoto, Carneiro Jamille Fernandes, Pontes Yandra Maria Gomes
Graduate Program in Family Health, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil.
School of Medicine, Federal University of Ceará, Sobral Campus, Rua Com. Maurocélio Rocha Ponte 100, Sobral, CE, CEP 62.042-280, Brazil.
Int Urol Nephrol. 2017 Sep;49(9):1667-1672. doi: 10.1007/s11255-017-1621-z. Epub 2017 May 18.
We investigated the possible association between coping style and depressive feelings among caregivers of end-stage renal disease patients undergoing hemodialysis.
We studied 107 main caregivers of hemodialysis patients. Main caregiver was defined as the person on whom the patient counts for daily care or the one the patient calls upon in case of difficulties. Demographic data of caregivers and clinical data of patients were collected. The Jalowiec Coping Scale was applied to score two styles of coping: problem-oriented coping (POC) and emotion-oriented coping (EOC). Depression was screened by the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). A score ≥16 was used to classify depression. Comparisons were made by Student's t and Chi-square tests. The Pearson's test was used to assess correlation between scores. Linear and logistic regressions were used, respectively, to test variables as predictors of the CES-D scores and the presence of depression.
The depression rate among caregivers was 71.9%. In the comparison between depressed and non-depressed caregivers, only EOC score differed, being higher among depressed ones (69.8 vs. 62.4; p < 0.001). EOC score was positively correlated with depression score (r = 0.368; p = <0.001). In the multivariate analysis, EOC independently predicted both the depression score (b = 0.272; p = 0.001) and the presence of depression (OR 1.221; 95% CI 1.123-1.339; p = 0.001).
Our results indicate that EOC is associated with and increases the risk of depression among caregivers of HD patients. We propose that strategies aiming to strengthen POC and diminish EOC can be applied to minimize depressive feelings.
我们调查了接受血液透析的终末期肾病患者的照料者的应对方式与抑郁情绪之间可能存在的关联。
我们研究了107名血液透析患者的主要照料者。主要照料者定义为患者日常护理所依赖的人或患者遇到困难时求助的人。收集了照料者的人口统计学数据和患者的临床数据。采用贾洛维茨应对量表对两种应对方式进行评分：问题导向型应对（POC）和情绪导向型应对（EOC）。采用20项流行病学研究中心抑郁量表（CES-D）进行抑郁筛查。得分≥16分被用于判定抑郁。采用学生t检验和卡方检验进行比较。采用皮尔逊检验评估得分之间的相关性。分别使用线性回归和逻辑回归来检验作为CES-D得分预测因子的变量以及抑郁的存在情况。
照料者的抑郁率为71.9%。在抑郁照料者和非抑郁照料者的比较中，只有EOC得分存在差异，抑郁照料者的得分更高（69.8对62.4；p<0.001）。EOC得分与抑郁得分呈正相关（r=0.368；p=<0.001）。在多变量分析中，EOC独立预测抑郁得分（b=0.272；p=0.001）以及抑郁的存在情况（OR 1.221；95%CI 1.123 - 1.339；p=0.001）。
我们的结果表明，EOC与血液透析患者照料者的抑郁相关，并增加了其抑郁风险。我们建议，可以采用旨在加强POC并减少EOC的策略来尽量减轻抑郁情绪。
