Unplugging While Plugged In: A Peer to Peer Exploration Of The Impacts of Dialysis On The Mental Wellness of Patients With Chronic Kidney Disease

Carriere, Chris; Escoto, Manuel; Sherry, Vera; Zaman, Sabiha

doi:10.11575/prism/38912

Cited by 1 publication

(4 citation statements)

References 9 publications

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“…[14][15][16]18,19 Patients and clinicians first alerted us to this need: We identified that mental health symptoms experienced by Canadians receiving dialysis are not routinely assessed and inadequately addressed. 6,[20][21][22][23][24] This was confirmed in our realist synthesis on patient-reported outcome use in kidney care [25][26][27] and by some of our community advisors in a kidney patient-led Patient and Community Engagement Research (PaCER) study on mental wellness 28 who wrote, "the most glaring gap in care is the lack of psychosocial support available to patients" (p. 3). However, the perspectives of people receiving dialysis regarding mental health supports have rarely been addressed.…”

Section: Introductionmentioning

confidence: 59%

“…In the global movement toward patient-oriented research, Canadians receiving dialysis have resoundingly said that their mental health is a priority. 7,20,28 Of the Albertan respondents to our survey, the majority confirmed that addressing their mental health was an integral part of addressing their overall health; 59.6% were willing to engage in mental health support. Individuals with worse depressive symptoms, anxiety symptoms, and QOL were more likely to consider engaging in support for mental health.…”

Section: Discussionmentioning

confidence: 81%

“…Certainly, responses are subject to selection bias. While Canadians receiving dialysis have prioritized mental health, 7,20,28 our low response rate may indicate that people who chose not to answer the survey may have different experiences of mental health or willingness to engage in supports. While phone and mail options were available to complete the survey, sending a URL in the letter of invitation may have been a deterrent.…”

Section: Discussionmentioning

confidence: 99%

“…These findings will be used to inform this work to develop a pathway for mental health care for Albertans receiving dialysis. 54 Future work is urgently needed in Canada to support both patients and multidisciplinary kidney practitioners 6 , 7 , 28 toward recognition of mental health concerns and follow-up in ways that uphold person-centered principles 55 in kidney care. 56 Research is needed to explore implementation and access of non-pharmacologic mental health supports for Canadians receiving dialysis.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

How Are Albertans “Adjusting to and Coping With” Dialysis? A Cross-Sectional Survey

Schick‐Makaroff

Berendonk

Overwater

et al. 2022

Can J Kidney Health Dis

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Background: Depression and anxiety are commonly reported (40% and 11%-52%) among adults receiving dialysis, compared with ~10% among all Canadians. Mental health in dialysis care is underrecognized and undertreated. Objective: (1) To describe preferences for mental health support reported by Albertans receiving dialysis; (2) to compare depression, anxiety, and quality-of-life (QOL) domains for people who would or would not engage in support for mental health; and (3) to explore sociodemographic, mental health, and QOL domains that explain whether people would or would not engage in support for mental health. Design: A cross-sectional survey. Setting: Alberta, Canada. Patients: Adults receiving all modalities of dialysis (N = 2972). Measurements: An online survey with questions about preferences for mental health support and patient-reported outcome measures (Patient Health Questionnaire–9 [PHQ-9], Generalized Anxiety Disorder–7 [GAD-7], and Kidney Disease QOL Instrument–36 [KDQOL-36]). Methods: To address objectives 1 and 2, we conducted chi-square tests (for discrete variables) and t tests (for continuous variables) to compare the distributions of the above measures for two groups: Albertans receiving dialysis who would engage or would not engage in support for mental health. We subsequently conducted a series of binary logistic regressions guided by the purposeful variable selection approach to identify a subset of the most relevant explanatory variables for determining whether or not people are more likely to engage in support for mental health (objective 3). To further explain differences between the two groups, we analyzed open-text comments following a summative content analysis approach. Results: Among 384 respondents, 72 did not provide a dialysis modality or answer the PHQ-9. The final data set included responses from 312 participants. Of these, 59.6% would consider engaging in support, including discussing medication with a family doctor (72.1%) or nephrologist (62.9%), peer support groups (64.9%), and talk therapy (60%). Phone was slightly favored (73%) over in person at dialysis (67.6%), outpatient (67.2%), or video (59.4%). Moderate to severe depressive symptoms (PHQ-9 score ≥10) was reported by 33.4%, and most respondents (63.9%) reported minimal anxiety symptoms; 36.1% reported mild to severe anxiety symptoms (GAD-7 score ≥5). The mean (SD) PHQ-9 score was 8.9 (6.4) for those who would engage in support, and lower at 5.8 (4.8) for those who would not. The mean (SD) GAD-7 score was 5.2 (5.6) for those who would engage in support and 2.8 (4.1) for those who would not. In the final logistic regression model, people who were unable to work had 2 times the odds of engaging in support than people who are able to work. People were also more likely to engage in support if they had been on dialysis for fewer years and had lower (worse) mental health scores (odds ratios = 1.06 and 1.38, respectively). The final model explained 15.5% (Nagelkerke R2) of the variance and with 66.6% correct classification. We analyzed 146 comments in response to the question, “Is there anything else you like to tell us.” The top 2 categories for both groups were QOL and impact of dialysis environment. The third category differed: those who would engage wrote about support, whereas those who would not engage wrote about “dialysis is the least of my worries.” Limitations: A low response rate of 12.9% limits representativeness; people who chose not to participate may have different experiences of mental health. Conclusions: Incorporating patients’ preferences and willingness to engage in support for mental health will inform future visioning for person-centered mental health care in dialysis.

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