The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan: a cross-sectional design

Abstract

Background End-stage kidney disease is highly prevalent worldwide. Currently, one of the most effective treatment modalities is dialysis therapy, which leads to serious side effects. Furthermore, psychiatric illnesses are prevalent among dialysis patients. Recently, researchers asserted that psychological resilience and family support could be helpful to maintain or improve patients’ mental well-being. Therefore, the purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients. Methods To investigate the aim of this study, a cross-sectional design was employed. A total of 110 hemodialysis patients, who were receiving outpatient treatment from dialysis units at the University of Fukuoka and St. Maria Health Care Center in Japan, participated. Only the patients who met the criteria and who were willing to participate in this 30-min study were given The General Health Questionnaire-12, Conner-Davidson Resilience Scale, and Family Assessment Device. Structural Equation Modeling (SEM) was performed to test the hypothesis that resilience would mediate the relationship between each subscale of family functioning, namely, cohesion, adaptability, communication, and mental well-being. Then Sobel’s test was employed to examine the indirect effect. Results The results of the SEM showed that the model had an acceptable fit (RMSEA = .077; CFI = .93; and IFI = .94). According to the results, resilience fully mediated the relationship between family functioning, specifically family adaptability and communication, and mental health well-being of the dialysis patients. However, family cohesion was not associated with resilience. Conclusions The present study revealed that higher family adaptability and communication resulted in greater resilience, thus associated with better mental health. Given that poor mental health among dialysis patients is significantly associated with a decreased likelihood to adhere to treatment plans, it may lead to a significant risk to therapeutic compliance. As such, patients may experience detrimental consequences, such as death. This study showed that in order to maintain healthy mental well-being, developing resilience is a vital factor for hemodialysis patients.

Resilience, Self-Perceived Burden, Social Support and Their Correlation in Cancer Patients – A Cross-Sectional Study in China

“…Path analysis found that social support played an intermediary role in the process of SPB affecting resilience. This result was similar to those of Kukihara's research [25]. Good social support is an important line of defense for patients in overcoming the psychological burden of cancer and may result in a better quality of life [26].…”

The correlation between family support and psychological well-being in patients with end-stage renal disease

“…Poor psychological well-being has an impact on physical health conditions (Hamdan-Mansour et al, 2015). Our study was supported by a previous study, that better family adaptability and communication resulted in greater resilience, thus it is associated with better mental health (Kukihara et al, 2020). Family support affects the quality of life (Bestari, 2016), and the health behaviors of ESRD patient receiving family support was significantly higher than before receiving family support (p < 0.01) (Shahgholian and Yousefi, 2015).…”

“…The questions used a Likert scale with the following options: always (4), often (3), rarely (2), and never (1). The scores were combined into an index and categorized as good (49-64), sufficient (33-48), and less than sufficient (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

The Impact of COVID-19 on the mental health of dialysis patients

“…In one of these studies the resilience of dialysis patients was quantified with a frequently used resilience scale. They found a score of 82.4 in dialysis patients, comparable to the general population (80.4) and reasonably higher than among patients visiting a general practitioner (71.8) [21,24]. Dialysis patients may have a high level of resilience compared to primary care patients, as they have learned to adapt over time to bear the burden of dialysis and their disease in general, which could explain their ability to deal better with different stressors such as the COVID-19 pandemic.…”

“…In a Spanish study, a higher level of resilience was associated with higher HRQoL scores [23]. The importance of resilience for both haemodialysis and peritoneal dialysis patients to overcome the burden of dialysis has been emphasized in multiple studies [24][25][26]. In one of these studies the resilience of dialysis patients was quantified with a frequently used resilience scale.…”