Prevalence And Associated Factors Of Mental Health Among End-stage Renal Disease Patients Undergoing Haemodialysis In Qiqihar City

Objectives:The objectives of this study were to understand the prevalence of mental health of end-stage renal disease(ESRD)patients with haemodialysis,and to analyze the associated factors of psychological distress from these perspectives of sociodemographic characteristics,disease-related conditions,family functioning,perceived social support,and medical coping styles.This study further explored the interrelationship between associated factors and its effect pathway on psychological distress.In order to provide basis for the improvement of the mental health of ESRD patients.Methods:A study of ESRD patients with haemodialysis was conducted at 25 hospitals from March to July 2018 in Qiqihar City,China.All information was collected using structured questionnaires that were self-administered by the patients.The patient's sociodemographic characteristics,lifestyles,and disease-related information were collected by a self-designed basic information questionnaire.The patient's psychological health status,family functioning,perceived social support,and coping styles were measured using the 12-item General Health Questionnaire(GHQ-12),the Family APGAR scale,the Multidimensional Scale of Perceived Social Support(MSPSS),and the Medical Coping Modes Questionnaire(MCMQ).Epidata 3.0 was used to establish a database and input data,and IBM SPSS 24.0 and AMOS 22.0software were used for data processing and analysis.P-values were two sided and values less than 0.05 were considered statistically significant.Results:1.The average score of the GHQ-12 scale of 769 haemodialysis patients participated in this survey was 5.04 ± 2.74.A total of 556 participants reported psychological distress,and the prevalence of distress was 72.3%.2.Self-rated health,self-care ability,family functioning,social support,and acceptance–resignation coping style were the associated factors for psychological distress(P <0.05).Compared with patients with better self-rated health,patients with fair or poor level self-rated health were 2.43(OR=2.43,95%CI: 1.357-4.351)and2.757(OR=2.757,95%CI: 1.336-5.689)times as likely to experience psychological distress,respectively.Patients with partial self-care ability and those without self-care ability were 1.71(OR=1.71,95%CI: 1.037-2.819)and 5.968(OR=5.968,95%CI:0.659-54.086)times as likely to experience psychological distress,respectively,compared with those with normal self-care ability.The risk of developing psychological distress of those with moderate or high family dysfunctionality were2.464(OR=2.464,95%CI: 1.5-4.048)and 4.453(OR=4.453,95%CI: 1.353-14.657)times as many as those with good family functionality.A higher social support score was associated with a lower risk of psychological distress(OR=0.967,95%CI:0.948-0.985).Greater use of the acceptance-resignation style was closely related to a higher risk of psychological distress in patients(OR=1.471,95%CI: 1.343-1.612).3.The structural equation model results showed that disease-related information,self-rated health,social support,and family functioning were the associated factors of psychological distress in ESRD patients with haemodialysis.Among them,disease-related information,self-rated health,and social support can directly affect the patient's psychological health,and family functioning takes social support as an intermediary variable to affect the patient's psychological health.Conclusion:1.The prevalence of psychological distress is high among ESRD patients undergoing haemodialysis.2.Self-rated health,self-care ability,family functioning,social support,and acceptance-resignation coping style are associated factors for psychological distress in ESRD patients with haemodialysis.Poor self-rated health,poor self-care ability,family dysfunctionality,low social support scores,and acceptance-resignation coping style are risk factors of psychological distress.3.Disease-related information,self-rated health and social support can directly affect the psychological health;Family functioning can indirectly affect the psychological health by acting on social support.