Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study

Abstract

BackgroundAcceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan.Methods262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis.ResultsOf the patients included in the analyses, 145 (55.3 %) whose total scores of AOD were below the median (86.00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1.89, 95 % confidence interval [CI]: 1.18-3.20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point.ConclusionAOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.

Interaction of Socio-demographic Characteristics on Acceptance of Disability Among Individuals With Physical Disabilities

“…In terms of gender, the mean with difference acceptance of disability results was consistent with previous studies that reported gender differences ( 7 ), but the main effect was not consistent. The results of employment status, health status, and functional outcomes were in line with those of previous studies ( 12 , 13 ).…”

“…Acceptance of being disabled is a factor that affects the adaptation and community participation of people with disabilities. Acceptance is a critical construct that reflects the extent to which persons cope with their disabilities ( 12 ) and is conceptualized as the acceptance of loss ( 13 ). Acceptance by people with disabilities has been reported to be a variable affecting successful adaptation ( 14 , 15 ).…”

“…Several studies have reported associations between demographic characteristics and acceptance of disability. It has been reported to be associated with gender ( 7 , 29 ) and health status ( 12 , 13 ). Job accommodation, facilitation of transitional duty, and communication with others are effective components of a disability management program ( 30 ).…”

Differences in the Quality of Life of Chronic Kidney Disease Patients Undergoing Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

“…Patients can put their faith to God and live at peace with the circumstances of their lives, no matter how difficult they are. [15][16][17] These results provide a better understanding of psychological determinants of a CKD patient's quality of life. The results can further be investigated by nephrologists, which will lead to the development of specific psychological interventions, or other supporting public health services.…”

Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China

“…In general, patients with chronic diseases should receive a psychological intervention program, which is helpful for them to accept the disabilities and adapt to the physical conditions ( 8 ). Acceptance of disability (AOD) is considered an important factor that accounts for psychological adjustment improvement ( 9 ). To specifically assess AOD, Linkowski et al developed an AOD scale with 50 items based on the notion of acceptance of loss ( 10 ).…”