Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

Abstract

Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire—Short Form, Beck Depression Inventory—Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory—Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (≥600 metabolic equivalent of task per min/week) exhibited less depression (B = −4.03; p < 0.001; 95% confidence interval [CI] = −6.04, −2.03) and anxiety (B = −2.64; p = 0.002; 95% CI = −4.27, −1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = −1.17; p = 0.001; 95% CI = −1.84, −0.49) and fatigue interference (B = −0.61; p = 0.015; 95% CI = −1.10, −0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress.

Factors Related to Quality of Life of Hemodialysis Patients during the COVID-19 Pandemic

“…This finding is consistent with the results of Schouten et al’s [ 62 , 63 ] study of HD and peritoneal dialysis patients at 10 dialysis centers in the Netherlands with a mean anxiety level of 10.3 ± 10.1. However, our results were higher than those of Zhang et al [ 64 ], Kurtgoz et al [ 65 ], Zahedian et al [ 66 ], Cukor et al [ 46 ], Wu et al [ 67 ], and Nadort et al [ 47 ]. This inconsistency might be due to different countries, single- or multi-centers, eligible participants, with or without COVID-19 infection, and before or during the COVID-19 pandemic.…”

Mental health and its influencing factors of maintenance hemodialysis patients: a semi-structured interview study

“…While undergoing treatment, MHD patients might experience both acute and chronic complications, which can cause intermittent or persistent physical discomfort and pain, which can lead to increased negative emotions [ 44 ]. The severity of these complications will affect the patient’s mental health both directly and indirectly [ 45 ]. Furthermore, studies have shown that an increased prevalence of complications is associated with a lower sense of well-being [ 45 , 46 ].…”

“…The severity of these complications will affect the patient’s mental health both directly and indirectly [ 45 ]. Furthermore, studies have shown that an increased prevalence of complications is associated with a lower sense of well-being [ 45 , 46 ]. For example, patients with systemic itching tend to demonstrate more obvious characteristics of a state of negative emotion than those who do not experience systemic itching [ 47 ].…”

Decline in Walking Independence and Related Factors in Hospitalization for Dialysis Initiation: A Retrospective Cohort Study

“…Comorbidities are associated with the severity of depression, anxiety, and fatigue, which reduce the amount of physical activity in patients. This may decrease physical function, which in turn affect the degree of walking independence [ 38 ].The presence of comorbidities has received increasing attention worldwide [ 39 ] and should also be noted in patients undergoing dialysis induction.…”