Lima Hellen de Carvalho, Barbosa Joubert Vitor de Souto, Santos Adson Aragão de Araújo, Cavalcanti Rafael Limeira, Tenório Adirlene Pontes de Oliveira, Lopes Matheus Rodrigues, Guedes Thais Sousa Rodrigues, Andrade Achilles de Souza, Sanchis Geronimo José Bouzas, Pegado Rodrigo, Lopes Johnnatas Mikael, Guedes Marcello Barbosa Otoni Gonçalves
Department of Medicine, Federal University of Vale do São Francisco, Paulo Afonso 56304-917, BA, Brazil.
Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil.
Int J Environ Res Public Health. 2024 Dec 17;21(12):1680. doi: 10.3390/ijerph21121680.
Chronic kidney disease (CKD) can impair activities of daily living (ADL), reducing quality of life. The influence of biopsychosocial factors on ADL limitations among CKD patients remains unclear. This study aims to investigate associations between these factors and ADL limitations among CKD patients in the Brazilian population. We analyzed data from 839 individuals diagnosed with CKD obtained from the National Health Survey. The outcome was the presence or absence of limitations in ADL caused by CKD. Biopsychosocial factors included clinical and health status, self-perceived behavior, contextual social support, lifestyle, and household characteristics. Cox regression was employed to adjust interactions between these factors, with the prevalence ratio used as a measure of effect (α ≤ 5%). From the analyzed sample, 373 CKD patients (40.7%; 95% CI: 35.4-46.1%) reported experiencing limitations in ADL. These limitations were associated with individual and contextual factors, including lack of private health insurance, residing in a rural area, poorer self-perceived health, presence of depressive symptoms, physical/mental disabilities, use of medications, and undergoing hemodialysis. Limitations in ADL among individuals with CKD are associated with biopsychosocial factors in the Brazilian population, emphasizing the necessity for public policies that support enhanced therapeutic management and address behavioral health.
慢性肾脏病（CKD）会损害日常生活活动（ADL），降低生活质量。生物心理社会因素对CKD患者ADL受限情况的影响仍不明确。本研究旨在调查巴西人群中这些因素与CKD患者ADL受限之间的关联。我们分析了从全国健康调查中获取的839名被诊断为CKD的个体的数据。结果是是否存在由CKD导致的ADL受限情况。生物心理社会因素包括临床和健康状况、自我感知行为、情境社会支持、生活方式和家庭特征。采用Cox回归来调整这些因素之间的相互作用，以患病率比作为效应量度（α≤5%）。在分析的样本中，373名CKD患者（40.7%；95%CI：35.4 - 46.1%）报告有ADL受限情况。这些受限情况与个体和情境因素相关，包括缺乏私人健康保险、居住在农村地区、自我感知健康较差、存在抑郁症状、身体/精神残疾、使用药物以及接受血液透析。巴西人群中CKD患者的ADL受限与生物心理社会因素相关，强调了制定支持加强治疗管理和解决行为健康问题的公共政策的必要性。
