The Status Of Emotional Distress And Its Predictive Factors Among Patients With Hemodialysis

ObjectiveTo investigate the status of emotional distress among patients with hemodialysis and explore the relationship between personality trait, resilience, social support and emotional distress, which would provide a theoretical foundation for improving their mental health.MethodsUsing convenient sampling,138 patients with hemodialysis from three tertiary hospitals of Shandong Province were enrolled and asked to finish questionnaires. Instruments include general information questionaire, the 10-item Kessler Psychological Distress Scale (K10), Connor-Davidson Resilience Scale-10 (CD-RISC 10). Big Five Inventory (BFI) and Social Support Scale. A total of 150 questionnaires were distributed, and 138 valid questionnaires were reclaimed. SPSS 17.0 software was used for statistical analysis including descriptive statistics, independent sample t-test, ANOVA, correlation analysis and multiple logistic regression analysis.Results1. The socio-demographic and disease information in patients with hemodialysisThe age of patients with hemodialysis ranged from 19 to 87 years, with an average score of 50.57±16.13; 65.2% of patients were male; 92% of patients were married. The time of average hemodialysis was 2.88±1.60 years; 74.6% of patients had blood dialysis 3 times per week. In addition,45.7% of the patients were unknown about primary disease, and 49.3% had at least one complication.2. The score of emotional distress and the difference between socio-demographic factors in patients with hemodialysisThe average score of emotional distress in patients with hemodialysis was 22.66±6.71. In terms of cutoff points with 22,79 patients (57.2%) were with emotional disturbance (score>22), and 59 patients (42.8%) were without emotional distress (score<22).T-test and chi-square analysis showed that, there was significant correlation between the emotional distress, cultural degree and complication (P<0.05). The incidence of emotional distress among individuals with low level of education and complications was significantly higher than those with high level of education without complications. Differences in occupational variables reached statistical significance (P=0.057), while there was no statistical difference in other variables3. The correlations of K10 with resilience, personality trait and social supportThe average scores of the psychological and social variables in patients with hemodialysis were:resilience (26.28±8.14), social support (37.37±7.33), neuroticism personality (20.92±6.00) and extroversion personality (25.51±5.95). The results of correlation analysis revealed that there was significantly negative correlation between K10, resilience, social support, the dimension of subjective support, objective support and extroversion in hemodialysis patients (r=-0.200～-0.552, P<0.05～0.01), but positively correlated with neuroticism (r= 0.661, p<0.05). There was significant positive or negative correlation between resilience, social support and personality trait.4. Logistic regression analysis on predictive factors of emotional distress in patients with hemodialysisIn the regression analysis, emotional distress was regarded as the dependent variable, while social support, personality trait and resilience was the independent variables, which was based on the control of the relevant demographic and disease variables (cultural degree, occupation and complications). Results indicated that neuroticism was a risk factor (OR=1.253,95% CI=1.117～1.406), while resilience was a protective factor (OR=0.890,95% CI=0.825～0.960).Conclusions1. There was a high incidence of emotional distress in patients with long-term hemodialysis.2. The level of emotional distress was significantly positively correlated with resilience, social support and extroversion trait, but negatively correlated with neuroticism trait.3. The neuroticism trait of patients with long-term hemodialysis was a risk factor of emotional distress, while resilience was a protective factor.