Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA.
Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549 USA.
Patient Educ Couns. 2021 Jan;104(1):149-154. doi: 10.1016/j.pec.2020.06.002. Epub 2020 Jun 6.
The researchers investigated the association of depression with treatment adherence, and examined the possible moderating roles of social support and of the physician-patient working alliance (PPWA) on treatment adherence, satisfaction with treatment, and quality of life.
The current study sampled ninety-five patients with End Stage Renal Disease who were receiving outpatient hemodialysis (HD) treatment.
Findings indicated that higher levels of depression were significantly associated with lower ratings of adherence, quality of life, and social support. In contrast, higher levels of social support and of the PPWA were significantly associated with higher ratings of adherence, satisfaction with treatment, and quality of life. Analyses of moderation showed no effect for PPWA between depression and adherence, satisfaction, or quality of life; however, there was a significant moderation effect for social support.
There are mild but significant associations between PPWA and social support. Positive associations between the PPWA and social support on adherence, satisfaction, and quality of life indicate that each one, PPWA and social support, plays its own role on patients' experiences of and behavior in treatment. Affective social support significantly limits the negative influence of depression on adherence.
Assessment of depression and social support is essential in hemodialysis treatment.
研究人员调查了抑郁与治疗依从性的关系，并检验了社会支持和医患工作联盟（PPWA）对治疗依从性、治疗满意度和生活质量的可能调节作用。
本研究抽取了 95 名接受门诊血液透析（HD）治疗的终末期肾病患者。
研究结果表明，抑郁程度越高，治疗依从性、生活质量和社会支持的评分越低。相反，社会支持和医患工作联盟水平越高，治疗依从性、治疗满意度和生活质量的评分越高。调节分析显示，医患工作联盟对抑郁与依从性、治疗满意度和生活质量之间没有影响；然而，社会支持则存在显著的调节作用。
医患工作联盟和社会支持之间存在轻度但显著的关联。医患工作联盟和社会支持与依从性、治疗满意度和生活质量之间的积极关联表明，每一个因素，医患工作联盟和社会支持，都在患者的治疗体验和行为中发挥着自己的作用。情感社会支持显著限制了抑郁对依从性的负面影响。
在血液透析治疗中，评估抑郁和社会支持是必要的。
