Santos Paulo Roberto, Capote Júnior José Roberto Frota Gomes, Cavalcante Filho José Renan Miranda, Ferreira Ticianne Pinto, Dos Santos Filho José Nilson Gadelha, da Silva Oliveira Stênio
Graduate Program in Health Sciences, Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil.
Sobral Faculty of Medicine, Federal University of Ceará, Brazil, Rua Comandante Maurocélio Rocha Ponte 100, Sobral, CEP 62.042-280, Brazil.
BMC Nephrol. 2017 Jun 17;18(1):197. doi: 10.1186/s12882-017-0619-1.
Poor quality of life (QOL) and a high prevalence of depression have been identified among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). We aimed to evaluate the associations between religious/spiritual (R/S) coping methods and both QOL and depression among ESRD patients undergoing hemodialysis (HD).
The sample included 161 ESRD patients over 18 years of age who had been undergoing HD for more than 3 months. R/S coping methods were assessed using the Religious Coping Questionnaire (RCOPE). The RCOPE generates scores (from 1 to 5) for positive and negative R/S coping methods. The higher the score, the more frequent the use of that coping method. Depression was evaluated using the 20-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Scores on the CES-D range from 0 to 60. A cutoff of 18 was used to define depression. QOL was evaluated using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36); this survey was used to generate scores for the eight dimensions of QOL, which can vary from 0 (worst) to 100 (best).
We identified a depression prevalence of 27.3%. Positive R/S coping scores were higher among non-depressed than depressed patients (2.98 vs. 2.77; p = 0.037). Positive R/S coping scores were negatively correlated with depression scores (r = -0.200; p = 0.012) and were an independent protective factor for depression (OR = 0.13; CI 95% = 0.02-0.91; p = 0.039). Regarding QOL, a positive correlation was identified between positive R/S coping scores and scores related to general health (r = 0.171; p = 0.030) and vitality (r = 0.183; p = 0.019), and an inverse correlation was identified between negative R/S coping scores and scores in the social functioning (r = -0.191; p = 0.015) and mental health (r = -0.214; p = 0.006) dimensions. In addition, positive R/S coping scores were an independent predictor of higher scores in the bodily pain (β = 14.401; p = 0.048) and vitality (β = 12.580; p = 0.022) dimensions. In contrast, negative R/S coping scores independently predicted lower social functioning scores (β = -21.158; p = 0.017).
Our results provide further evidence suggesting that R/S coping methods may be associated with QOL and depression among HD patients. In our opinion, the use of religious resources should be encouraged among HD patients, and psycho-spiritual interventions should be attempted to target religious struggles (negative R/S coping) in patients undergoing HD.
在接受血液透析（HD）的终末期肾病（ESRD）患者中，生活质量（QOL）较差且抑郁症患病率较高。我们旨在评估宗教/精神（R/S）应对方式与接受血液透析（HD）的ESRD患者的生活质量和抑郁症之间的关联。
样本包括161名年龄超过18岁且已接受HD超过3个月的ESRD患者。使用宗教应对问卷（RCOPE）评估R/S应对方式。RCOPE为积极和消极的R/S应对方式生成分数（范围为1至5）。分数越高，该应对方式的使用频率越高。使用流行病学研究中心抑郁量表（CES-D）的20项版本评估抑郁症。CES-D的分数范围为0至60。采用18分的临界值来定义抑郁症。使用医学结局研究36项简短健康调查（SF-36）评估生活质量；该调查用于生成生活质量八个维度的分数，分数范围可为0（最差）至100（最佳）。
我们确定抑郁症患病率为27.3%。非抑郁患者的积极R/S应对分数高于抑郁患者（2.98对2.77；p = 0.037）。积极R/S应对分数与抑郁分数呈负相关（r = -0.200；p = 0.012），并且是抑郁症的独立保护因素（OR = 0.13；95%CI = 0.02 - 0.91；p = 0.039）。关于生活质量，积极R/S应对分数与一般健康相关分数（r = 0.171；p = 0.030）和活力分数（r = 0.183；p = 0.019）之间存在正相关，消极R/S应对分数与社会功能（r = -0.191；p = 0.015）和心理健康（r = -0.214；p = 0.006）维度的分数之间存在负相关。此外，积极R/S应对分数是身体疼痛（β = 14.401；p = 0.048）和活力（β = 12.580；p = 0.022）维度得分较高的独立预测因素。相反，消极R/S应对分数独立预测较低的社会功能得分（β = -21.158；p = 0.017）。
我们的结果提供了进一步的证据，表明R/S应对方式可能与HD患者的生活质量和抑郁症有关。我们认为，应鼓励HD患者利用宗教资源，并尝试针对接受HD患者的宗教挣扎（消极R/S应对）进行心理 - 精神干预。
