Defensive coping and health-related quality of life in chronic kidney disease: a cross-sectional study

Abstract

BackgroundCoping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Little is known though about these associations in chronic kidney disease (CKD). The present study aimed to investigate the relationship of defensive coping and HRQL among patients in different CKD stages, after adjusting for psychological distress, sociodemographic and disease-related variables.MethodsThe sample consisted of 98 CKD patients, attending a university nephrology department. Seventy-nine (79) pre-dialysis patients of disease stages 3 to 4 and 19 dialysis patients were included. HRQL was assessed by the 36-item Short-Form health survey (SF-36), defensive coping by the Rationality/Emotional Defensiveness (R/ED) scale of the Lifestyle Defense Mechanism Inventory (LDMI) and psychological distress by the depression and anxiety scales of the revised Hopkins Symptom CheckList (SCL-90-R). Regression analyses were carried out to examine the association between SF-36 dimensions and defensive coping style.ResultsPatients on dialysis had worse scores on SF-36 scales measuring physical aspects of HRQL. In the fully adjusted analysis, a higher defensive coping score was significantly associated with a lower score on the mental component summary (MCS) scale of the SF-36 (worse mental health). In contrast, a higher defensive score showed a small positive association with the physical component summary (PCS) scale of the SF-36 (better health), but this was marginally significant.ConclusionsThe results provided evidence that emotional defensiveness as a coping style tends to differentially affect the mental and the physical component of HRQL in CKD. Clinicians should be aware of the effects of long-term denial and could examine the possibility of screening for defensive coping and depression in recently diagnosed CKD patients with the aim to improve both physical and mental health.

Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review

“…A search of the PsychInfo database using the term "rationality emotional defensiveness" showed that it appears only in 19 publications. It has demonstrated adequate internal consistency when used with other populations than breast cancer (e.g., α = .77 in a sample of university students (Ritz & Dahme, 1996) and α = .76 in chronic kidney disease (Kaltsouda et al, 2011)). …”

The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia

“…Based on previous studies, 2,[8][9][10]12,13,15,16,18,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] we assumed the existence of a 20% difference in the prevalence of depression between the general population and ESRD patients on HD. In order to obtain a confidence level (power) of 95% and a confidence limit of 10%, we aimed to study 246 patients (calculated using the QuesGen Systems sample size calculator).…”

“…[1][2][3][4][5][6][7] Patients suffering from chronic kidney disease have poor QOL and mental well-being, often suffering from anxiety and depression. [8][9][10] It has been reported that depression is the most common psychiatric abnormality among end-stage renal disease (ESRD) patients. [11][12][13] In terms of frequency, it is second to hypertension as a comorbid diagnosis among ESRD patients.…”

Social support as a determinant of health-related quality of life in breast cancer survivors in California.

“…SF-36 physical and Studies show that patients with chronic illnesses have lower scores for HRQOL as compared to general populations (67,(184)(185)(186). Physical HRQOL is generally more adversely affected in patients with chronic illness (184,185).…”

“…Physical HRQOL is generally more adversely affected in patients with chronic illness (184,185). In some cases such as chronic kidney disease, prolonged exposure to disease can also result in lower mental HRQOL for chronically ill patients (186).…”