Beyond quality of life: a cross sectional study on the mental health of patients with chronic kidney disease undergoing dialysis and their caregivers

Abstract

BackgroundPatients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers.MethodThis cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015. We included patients aged over 18 years, with at least 6 months on dialysis treatment, and caregivers who were family members. The participants’ social, demographic, clinical, laboratory, and psychological variables were evaluated. A descriptive analysis and an examination of the association between patients and caregivers were performed.ResultsAmong patients, we observed that 38.1% had symptoms that indicated anxiety and depression. The average score for practical social support was 3.15 ± 0.769 and that for emotional social support was 3.16 ± 0.79. As for fatigue, 14.3% of patients reported being ‘extremely tired’ and 14.3% reported that they engaged in all the activities they usually performed before the illness. Further, 57.1% presented stress, and of these, 66.7% were at the resistance stage, with predominance of psychological symptoms in 60.0%. The quality of life domain in terms of functional capacity (FC) presented a correlation with haemoglobin level (r = 0.581, p = 0.006) and non-anaemic patients presented better FC. Among caregivers, we observed symptoms that indicated anxiety and depression in 33.3% of the sample. Caregivers exhibited an average score of 2.88 ± 0.77 for practical social support and 3.0 ± 0.72 for emotional social support. Further, 14.3% reported being ‘extremely tired’ and 28.8% reported that they engaged in all activities that they usually performed before the patient’s illness. When comparing the two groups (patients vs. caregivers), we observed that they presented similar results for the presence of anxiety, depression, and fatigue. Caregivers received less social support than patients did. Both groups presented similar predominance of stress levels; however, patients presented more predominance of psychological symptoms. With reference to quality of life, patients and caregivers presented similar results on the social aspects, vitality, mental health, and mental domains.ConclusionThe mental health characteristics of patients and caregivers were similar, and within the context of dialysis for renal disease, both must undergo specific interventions.

Informal caregivers’ experiences of caring for people receiving dialysis: A mixed‐methods systematic review

“…; Pereira et al . ). Support sources (from family members and others outside family) and types (instrumental, financial, practical and emotional support) were examined from caregivers’ perspectives.…”

“…) or practical and emotional support (Pereira et al . ). No study however examined the relationships between the type of support provided to informal caregivers and whether this reduced the level of burden.…”

Caregivers of Patients on Haemodialysis

“…However, with the progression of the illness, caregivers present a worse mental health, with depression being identiied as the most common problem [26]. Caregivers face inancial problems and feel depression, anxiety, fatigue, social isolation, tension in relationships [27], and disappointment due to the demands of haemodialysis treatment [28].…”

Experience of the waiting area as perceived by haemodialysis patients and family carers

“…Patients diagnosed with end‐stage renal disease (ESRD) visit haemodialysis facilities for the remainder of their lives unless they undergo a kidney transplant; family carers frequently accompany the patient for treatment 3 days a week and on each occasion spend 3–4 hr in a waiting area. The patients and family carers undergo considerably higher stress and have less flexibility in family adaptability than healthy individuals and their families (Jiang et al., ; Mashayekhi, Pilevarzadeh, & Rafati, ; Pereira et al., ). Particularly strong family ties characterize Korean culture; hence, dependency on family members in times of illness is high.…”