Association of Poor Social Support and Financial Insecurity with Psychological Distress of Chronic Kidney Disease Patients Attending National Nephrology Unit in Sri Lanka

Abstract

Background Chronic kidney disease (CKD) is associated with high morbidity and mortality. Hence, CKD patients are often in chronic psychological distress. The objective of the study was to describe factors associated with psychological distress of CKD patients attending National Nephrology Unit. Methods A descriptive cross-sectional study was conducted among 382 CKD patients above 18 years of age applying systematic sampling. The data was collected using self-administered questionnaires to assess the psychological distress (GHQ-12), social support (SSQ6), coping strategies (BRIEFCOPE), pain (0 to 10 numeric pain rating scale), and physical role limitation due to ill health (SF36QOL). Sociodemographic and disease-related data were collected using an interviewer administered questionnaire and a data extraction sheet. Multiple logistic regression was applied for determining the associated factors. The results were expressed as adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). Results Percentage of psychological distress was 55.2% (95% CI: 48.4% to 62%). Poor social support (AOR = 1.81, 95% CI: 1.14–2.88), low satisfaction with the social support received (AOR = 4.14, 95% CI: 1.59–10.78), stages IV and V of CKD (AOR = 2.67, 95% CI: 1.65–4.20), presence of comorbidities (AOR = 2.38, 95% CI: 1.21–4.67), within one year of diagnosis (AOR = 2.23, 95% CI: 1.36–3.67), low monthly income (AOR = 2.26, CI: 1.26–4.06), higher out-of-pocket expenditure per month (AOR = 1.75, 95% CI: 1.75–1.99), and being a female (AOR = 2.95, 95% CI: 1.79–4.9) were significantly associated with psychological distress. Conclusions More than half of the CKD patients were psychologically distressed. Factors such as financial and social support will be worth considering early because of their modifiability.

Psychological burden and disease-related quality of life in dialysis patients during the first wave of the COVID-19 pandemic — a cross-sectional observational study

“…[26] przeprowadzonym na 273 dializowanych pacjentach w Chinach autorzy oszacowali częstość występowania niespecyficznych zaburzeń psychicznych na poziomie 45,8% (GHQ-28) [26]. Inne badania opisują występowanie tych zaburzeń na poziomie 55,2% do 75,0% (GHQ-12) [27,28]. W porównaniu z naszymi wynikami i z ustaloną wysoką częstotliwością występowania objawów depresyjnych i lękowych w populacjach ESRD (End-Stage Renal Disease -Schyłkowa niewydolność nerek) te liczby nie wydają się wyższe, niż oczekiwano.…”

“…Ponadto stwierdzono istotne różnice między płcią męską i żeńską dla podskali "Pobudzenie" (IES-R), gdzie mężczyźni uzyskali istotnie niższy wynik niż kobiety. Wynik ten jest zgodny z innymi badaniami dotyczącymi zdrowia psychicznego podczas pandemii SARS-CoV-2, gdzie dystres psychologiczny występował częściej u kobiet, lecz również z publikacjami dotyczącymi pacjentów z przewlekłą chorobą nerek, niezależnie od pandemii [27,35,36]. Hettiarachchi i Abeysena [27] ustalili, że pacjentki płci żeńskiej z PChN wykazywały wyższy wskaźnik dystresu psychologicznego (mierzonego za pomocą GHQ), co potwierdził w swoim badaniu również Sfyrkou [36], opisując wyższy wynik dystresu psychologicznego u kobiet z ESRD (mierzonego z użyciem Kessler Psychological Distress Scale-K10).…”

Factors Affecting the Prevalence of Chronic Kidney Disease among Adult Population in Sri Lanka: With Special Reference to Badulla District

“…Income is one of the key determinants related to CKD. According to Hettiarachchi and Abeysena (2018) and Weerasekara (2017) have revealed that the majority of kidney patients do not earn an adequate income. Some of the important clinical factors identified concerning CKD under empirical studies are the time of having diabetes, time of having high blood pressure, duration of using Ayurveda medicines, family history of kidney failure, and also Body Mass Index (BMI).…”

Gender difference in the association of coping styles and social support with psychological distress among patients with end-stage renal disease

“…The 12-item General Health Questionnaire (GHQ-12) The Chinese version of the 12-item General Health Questionnaire (GHQ-12) was used to detect the level of general mental health among haemodialysis patients. This instrument was developed by Goldberg and revised by scholar Taian Cheng (Goldberg David & Williams, 1988;Cheng & Williams, 1986). The common method is binary GHQ scoring (0-0-1-1), which yields a possible score range of 0-12.…”