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慢性肾脏病中疾病认知、身体活动与抑郁之间的关系。

Relationships between illness representations, physical activity and depression in chronic kidney disease.

作者信息

Nah Ryan, Robertson Noelle, Niyi-Odumosu Faatihah A, Clarke Amy L, Bishop Nicolette C, Smith Alice C

机构信息

Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.

School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.

出版信息

J Ren Care. 2019 Jun;45(2):74-82. doi: 10.1111/jorc.12274. Epub 2019 Apr 1.

Abstract

BACKGROUND

Chronic Kidney Disease (CKD) is exacerbated by depression and confers significant healthcare costs. Whilst adverse impacts may be mitigated by physical activity, many patients with CKD remain physically inactive, with this physical inactivity potentially influenced by how CKD is appraised.

OBJECTIVES

The study aims to explore the relationship between physical activity, depression and illness representations in CKD.

METHODS

Patients with CKD but not requiring dialysis completed the Revised Illness Perception Questionnaire (IPQ-R), Beck Depression Inventory (BDI-II) and Short-Form International Physical Activity Questionnaire (IPAQ-SF). Demographic information was obtained via medical records. Correlation and regression analyses were conducted to determine the relationship of illness representations with levels of physical activity. Moderation and mediation analyses were performed to investigate the role of depression in any relationship between illness representations and physical activity levels.

RESULTS

Seventy respondents, 60 % male, with a mean age of 60 ± 16 years, took part in the study. Of illness representation dimensions, personal control was positively associated with levels of physical activity whilst timeline cyclical (a subscale of the IPQ-R relating to patient beliefs about the nature of their illness) was a significant predictor. Severity of depression was neither a moderator nor a mediator of illness representations and levels of physical activity.

CONCLUSION

Facets of illness representations had significant relationships with levels of physical activity. Future research concerning the development and validation of psychological interventions based on an illness representations framework for patients with CKD not requiring dialysis is proposed. The efficacy of such interventions could be then evaluated using a randomised controlled method.

摘要

背景

抑郁症会加重慢性肾脏病(CKD),并带来高昂的医疗费用。虽然体育活动可能会减轻负面影响,但许多CKD患者仍然缺乏身体活动,这种身体不活动的状态可能受到对CKD评估方式的影响。

目的

本研究旨在探讨CKD患者的身体活动、抑郁与疾病认知之间的关系。

方法

未接受透析治疗的CKD患者完成了修订后的疾病认知问卷(IPQ-R)、贝克抑郁量表(BDI-II)和国际体力活动问卷简表(IPAQ-SF)。通过病历获取人口统计学信息。进行相关性和回归分析以确定疾病认知与身体活动水平之间的关系。进行调节和中介分析以研究抑郁在疾病认知与身体活动水平之间的任何关系中所起的作用。

结果

70名受访者参与了研究,其中60%为男性,平均年龄为60±16岁。在疾病认知维度中,个人控制与身体活动水平呈正相关,而时间线循环性(IPQ-R的一个子量表,与患者对其疾病性质的信念有关)是一个显著的预测因素。抑郁的严重程度既不是疾病认知与身体活动水平之间关系的调节因素,也不是中介因素。

结论

疾病认知的各个方面与身体活动水平有显著关系。建议未来针对未接受透析治疗的CKD患者,开展基于疾病认知框架的心理干预措施的开发和验证研究。然后可以使用随机对照方法评估此类干预措施的效果。

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