Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ann Palliat Med. 2021 Jun;10(6):6112-6121. doi: 10.21037/apm-20-2211. Epub 2021 May 26.
This study aimed to identify the association of factors and poorer mental health status and examinate the correlation between mental health status and quality of life (QOL) in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis.
A total of 190 patients were included in this observational, cross-sectional study. Psychological states of ESRD patients undergoing maintenance hemodialysis were evaluated by the Chinese version symptom checklist-90 (SCL-90) and QOL was assessed using the Chinese Version Kidney Disease Quality of Life-Short Form (KDQOL-SF).
A total of 190 patients with a mean age of 61.68 (13.39) years were included in this study. Multiple stepwise linear regression analyses suggested that when controlling for the confounding variables, prealbumin had the significant influence on average positive factors (Coef., -0.647; 95% CI: -1.314, 0.020; P=0.057), somatization (Coef., -1.334; 95% CI: -2.451, -0.217; P=0.020), obsessive-compulsive (Coef., -1.396; 95% CI: -2.255, -0.537; P=0.002), depression (Coef., -1.241; 95% CI: -2.252, -0.229; P=0.017), phobic anxiety (Coef., -2.576; 95% CI: -3.786, -1.367; P<0.001). In the correlation analysis, the score of average positive factors was significantly correlated with the score of the overall health rating (Coef., -0.343; P<0.001), symptom/problem (Coef., -0.337; P<0.001), effects of kidney disease on daily life (Coef., -0.198; P=0.006), burden of kidney disease (Coef., -0.233; P=0.001), cognitive function (Coef., 0.363; P<0.001), quality of social interaction (Coef., 0.292; P<0.001), social support (Coef., 0.237; P=0.001), physical functioning (Coef., -0.339; P<0.001), pain (Coef., 0.362; P<0.001), general health (Coef., -0.332; P<0.001), mental health (Coef., -0.537; P<0.001), social functioning (Coef., 0.202; P=0.005), vitality (Coef., -0.478; P<0.001), respectively.
In our study, prealbumin, type 2 diabetes mellitus, heart rate, educational level, duration of hemodialysis, coronary artery disease, heart failure, marital status, hemoglobin A1C, hemoglobin were significantly associated with poorer mental health status of ESRD patients undergoing maintenance hemodialysis, and patients with poorer psychological states were more significantly associated with decreased QOL. The results may help clinicians to adopt an effective treatment for early interventions, thus improving the QOL in such population.
本研究旨在确定因素与较差心理健康状况之间的关联,并检查维持性血液透析的终末期肾病(ESRD)患者心理健康状况与生活质量(QOL)之间的相关性。
本观察性、横断面研究共纳入 190 名患者。采用中文版症状清单 90(SCL-90)评估 ESRD 患者的心理状态,采用中文版肾脏病生活质量简表(KDQOL-SF)评估 QOL。
本研究共纳入 190 名平均年龄为 61.68(13.39)岁的患者。多步线性回归分析表明,在控制混杂变量的情况下,前白蛋白对平均阳性因素(Coef.,-0.647;95%CI:-1.314,0.020;P=0.057)、躯体化(Coef.,-1.334;95%CI:-2.451,-0.217;P=0.020)、强迫(Coef.,-1.396;95%CI:-2.255,-0.537;P=0.002)、抑郁(Coef.,-1.241;95%CI:-2.252,-0.229;P=0.017)、恐怖焦虑(Coef.,-2.576;95%CI:-3.786,-1.367;P<0.001)有显著影响。在相关性分析中,平均阳性因素评分与总体健康评分(Coef.,-0.343;P<0.001)、症状/问题评分(Coef.,-0.337;P<0.001)、肾脏疾病对日常生活的影响评分(Coef.,-0.198;P=0.006)、肾脏疾病负担评分(Coef.,-0.233;P=0.001)、认知功能评分(Coef.,0.363;P<0.001)、社会互动质量评分(Coef.,0.292;P<0.001)、社会支持评分(Coef.,0.237;P=0.001)、身体功能评分(Coef.,-0.339;P<0.001)、疼痛评分(Coef.,0.362;P<0.001)、一般健康评分(Coef.,-0.332;P<0.001)、心理健康评分(Coef.,-0.537;P<0.001)、社会功能评分(Coef.,0.202;P=0.005)、活力评分(Coef.,-0.478;P<0.001)显著相关。
本研究中,前白蛋白、2 型糖尿病、心率、教育程度、血液透析时间、冠状动脉疾病、心力衰竭、婚姻状况、糖化血红蛋白、血红蛋白与维持性血液透析的 ESRD 患者较差的心理健康状况显著相关,且心理状态较差的患者与生活质量降低显著相关。结果可能有助于临床医生采取有效的治疗方法进行早期干预,从而提高该人群的生活质量。