The influence of socioeconomic factors on depression in maintenance hemodialysis patients and their caregivers

Sezer, Sibel Demiral; Me, Uyar; Bal, Zeynep; Tutal, Emre; Fn, Ozdemir

doi:10.5414/cn107742

Cited by 19 publications

(26 citation statements)

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“…That may indicate that patients including their family members, caregivers and even the social employers should also be educated about treatment choices and therapeutic goals for kidney failure [6,26]. What's more, social support programs such as spiritual care, employment counseling or vocational rehabilitation may lower some of the barriers to employment and can help individuals with the greatest potential for workforce participation [27][28][29][30]. We acknowledge some potential limitations in our study.…”

Section: Discussionmentioning

confidence: 99%

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients

Huang

Lai

et al. 2017

Renal Failure

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Aim: Returning to society plays an important role in improving the quality of life in maintenance hemodialysis (MHD) patients, and retention of employment is one of the core enablers. The study is to assess the employment status and to determine the variables for unemployment in Chinese MHD patients. Methods: Prevalent MHD patients from four dialysis centers in Shanghai China were enrolled. We assessed patients' employment status, current social functioning, hemodialysis modality, annual income and general health condition. Among current unemployed working-age patients, the reasons of quitting jobs and willingness of being reemployed were evaluated. Results: A total of 231 patients were studied, among which 114 patients were unemployed 1 year before hemodialysis. Among 117 employed patients, 16 patients quitted jobs before dialysis inception, while 49 patients quitted jobs at the initiation of HD, and 26 patients followed after a few months' HD. The main reasons for ceasing employment were physical insufficiency, conflict between dialysis and work schedules, lack of support from employers and resistance from family members. Among the 166 patients who were in their working age, 26 patients were employed. The unemployed patients had the characters of elder age, lower education level, higher annual family income, higher female ratio, lower blood flow, lower physical functioning, and social functioning and lower frequency of weekend hemodialysis and HDF/HF. Among the 140 unemployed patients, only 47 patients had the willingness of being reemployed. Their unemployment status was positively associated with elder age ((OR) 3.13, 95% CI, 1.08-9.1), lower education level ((OR) 1.97, 95% CI, 1.05-5.92), and higher family income ((OR) 7.75, 95% CI, 2.49-24.14).

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Section: Discussionmentioning

confidence: 99%

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients

Huang

Lai

et al. 2017

Renal Failure

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“…The BDI consists of 21 self-reported items and each item is rated on the scale of 0–3, producing a possible score range from 0 to 63. A higher score correlates with more severe depression [21]. BDI score >16 is characteristic for presence of moderate to severe depressive symptoms.…”

Section: Methodsmentioning

confidence: 99%

Vitamin D status in chronic dialysis patients with depression: a prospective study

Zhang

et al. 2014

BMC Psychiatry

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BackgroundDepression is the most widely acknowledged psychological problem among end-stage renal disease (ESRD) patients. Depression may be associated with VD deficiency. The aims of this study are to (a) elucidate the prospective association between HsCRP, VD contents and depressive symptoms in the dialyzed population, and (b) find the effect of calcitriol supplementation on depression in dialyzed patients.MethodsIn this prospective study, 484 dialysis patients (382 hemodialysis [HD] cases and 102 peritoneal dialysis [PD] cases; aged 18–60 years) from two hospitals in southeast China were included. The depression in these patients was evaluated using the Chinese version of Beck’s Depression Inventory (BDI). All subjects answered the BDI-I questionnaire for assessment of depression levels in summer. A cut-off value of 16 was set to include dialysis patients with depression. All patients were divided into two groups depending on the absence (Group1) or presence (Group 2) of depression. The two groups took 0.5 μg/day 1,25-Dihydroxyvitamin D orally for one year. BDI Scores were recalculated for all patients. Sociodemographic, clinical data, and serum VD contents were also collected.ResultsA total of 484 participants (247 men [51.0%] and 237 women [49.0%]) were surveyed. Depressive symptoms were found in 213 (44.0%) patients. The baseline serum VD level (VD2 + VD3) was 17.6 ± 7.7 nmol/L. Patients with depressive symptoms have significantly higher serum HsCRP level and significantly lower serum VD level compared with the control group. After one-year follow-up, the supplementation of 0.5 μg/day calcitriol slightly improved the microinflammatory state such as lowering mean serum HsCRP level and improving serum VD level, but not in significantly enhancing the depressive symptoms.ConclusionsCalcitriol supplementation did not significantly enhance the depressive symptoms in our dialyzed population although patients with low levels of serum VD were more depressed. Therefore, more prospective randomized controlled trials are necessary to reveal the exact cause-and-effect relationship between VD status and depressive symptoms or VD status related to some specific subtypes in dialyzed patients.

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“…This is unpleasant and has a great impact on both the patients and their family members. Undoubtedly, the patients' illness affects the physical and mental health of families in this population[21]–[23]. On the other hand, family members as a primary source of social support can make great contributions to patients' disease management.…”

Section: Discussionmentioning

confidence: 99%

The Associations between the Family Education and Mortality of Patients on Peritoneal Dialysis

et al. 2014

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AimsTo investigate whether education level of family members predicts all-cause and cardiovascular death and initial-episode peritonitis in patients on peritoneal dialysis (PD).MethodsA total of 2264 patients on chronic PD were collected from seven centers affiliated with the Socioeconomic Status on the Outcome of Peritoneal Dialysis (SSOP) Study. All demographic, socioeconomic and laboratory data of patients and the education level of all family members were recorded at baseline. Multivariate Cox regression was used to calculate the hazard ratio (HR) of all-cause and cardiovascular mortality, and initial-episode peritonitis with adjustments for recognized traditional factors.ResultsThere were no significant differences in baseline characteristics between patients with (n = 1752) and without (n = 512) complete education information. According to the highest education level of patients' family, included 1752 patients were divided into four groups, i.e. elementary or lower (15%), middle (27%), high (24%) and more than high school (34%). The family highest education (using elementary school or lower group as reference, hazard ratio and 95% confidence interval of middle school group, high school group and more than high school group was 0.68[0.48–0.96], 0.64[0.45–0.91], 0.66[0.48–0.91], respectively) rather than their average education level or patients' or spouse's education was significantly associated with the higher mortality. Neither patients' nor family education level did correlate to the risk for cardiovascular death or initial-episode peritonitis.ConclusionsFamily members' education level was found to be a novel predictor of PD outcome. Family, as the main source of health care providers, should be paid more attention in our practice.

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The influence of socioeconomic factors on depression in maintenance hemodialysis patients and their caregivers

Cited by 19 publications

References 0 publications

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients

Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients

Vitamin D status in chronic dialysis patients with depression: a prospective study

The Associations between the Family Education and Mortality of Patients on Peritoneal Dialysis

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