The Effects Of Stress,Self-efficacy On Depressive Symptoms Among Patients With Maintenance Haemodialysis

Objective: Maintenance haemodialysis can replace some kidney functions,but it cannot change the gradual deterioration of kidney function in patients with end-stage renal disease,nor can it prevent the damage caused by complications to the body.It can easily affect the psychological of patients.Most patients developed symptoms of depression of varying degrees.Therefore,this study will explore the prevalence and distribution of depressive symptoms in maintenance haemodialysis patients;explore the relationship between depressive symptoms and influencing factors in maintenance haemodialysis patients,and explore the role of self-efficacy in regulating the relationship between stress and depressive symptoms.According to the results,the health management measures to improve the depression symptoms of patients were proposed to provide scientific basis for improving the mental health status of patients.Methods: Five haemodialysis centers in Beijing were selected for multi-center questionnaire survey,and 429 valid questionnaires were recovered.The Questionnaire included the Patient’s demography and disease-related characteristics,the Patient Health Questionnaire(PHQ-9),Perceived Stress scale-10(PSS-10),and the General self-efficacy Scale(GSES).Univariate analysis of variance and t-test were used to compare the differences in depressive symptoms among MHD patients with different demographic characteristics and disease-related characteristics.Pearson correlation analysis was used to identify the correlation between depressive symptoms and its influencing factors in MHD patients.Hierarchical regression analyses were used to determine the influencing factors of depressive symptoms and the intensity of their effects.The adjustment effect of visual self-efficacy was tested by simple slope test.Results: The mean score of depressive symptoms in MHD patients was 5.34 ± 5.29,and the incidence of depressive symptoms was 48.25%.Gender,marital status,monthly family income,complications and self-care ability can affect the level of depressive symptoms in patients with MHD;Depressive symptoms of MHD patients are related to pressure perception,stress response and self-efficacy.The results of the hierarchical regression analysis of self-efficacy and stress response to depressive symptoms in MHD patients showed that the regression coefficients of stress response and self-efficacy in thesecond layer were-0.309(P < 0.01)and-0.172(P < 0.01),respectively,which jointly explained 14.3% variation of depressive symptoms in MHD patients.In the third layer,the product of stress response and self-efficacy after central treatment was added,and its interaction terms(β =0.601,P < 0.01)had significant influence on depressive symptoms of MHD patients,and self-efficacy played a moderating role in the relationship between stress response and depressive symptoms.MHD patients self-efficacy,pressure sensing multiple hierarchical regression analysis of the depressive symptoms,according to the results of the third layer in centralized pressure after processing the product of perception and self-efficacy,were not found the interaction term(β = 0.055,P > 0.05)has effect on depressive symptoms in patients with MHD self-efficacy between stress perception and depressive symptoms did not play a regulatory role.Conclusion: The incidence of depressive symptoms in MHD patients is high,and gender,marital status,monthly family income,complications and self-care ability can affect the level of depressive symptoms in MHD patients.Stress perception and stress response in patients with MHD are the influencing factors of depressive symptoms,and the influence of stress perception on depressive symptoms is slightly higher than that of stress response on depressive symptoms.Self-efficacy plays a regulating role in the effect of stress response on depressive symptoms and is a positive psychological resource to alleviate depressive symptoms and improve mental health of MHD patients.The health department should take corresponding health management measures according to the situation of MHD patients,such as improving the mental health level of MHD patients by developing and improving the self-efficacy of patients,so as to improve the depressive symptoms of MHD patients,improve the satisfaction of dialysis treatment as well as the quality of life.