Stress, Coping, and Comorbidity among Hemodialysis Patients

Abstract

Purposes:The primary purposes of this study were 1) to examine relationships among stress, coping and comorbidity and 2) to test the interaction effect of comorbidity.Background:Hemodialysis imposes a variety of physical and psychosocial stressors that challenge patients. Comorbidity is a risk factor for many health outcomes. Research on how comorbidity influences the relationship between coping and stress is limited.Method:In this cross-sectional study using face to face interviews, we interviewed 2642 hemodialysis patients fifteen years or older on dialysis for at least 3 months from October 2002 to January 2003. The Hemodialysis Stressor Scale measured stressors and the Jalowiec Coping Scale were used to measure coping strategies. A hierarchical regression was used to analyze the data.Results:Hemodialysis patients with comorbidities were found to have higher levels of stress. Comorbidity had a moderating effect between choice of problem-oriented responses and isolated thoughts as coping strategies. These findings show that hemodialysis patients with comorbidities often choose positive coping strategies.Conclusion:HD patients with comorbidity have a higher stress scores than those without comorbidities. Comorbidity not only has a direct impact on stress but also has a moderating effect on the relationship between coping and stress. Therefore, taking into account the comorbidity factor became very crucial when assessing the HD patients’ level of stress.