A Study Of The Relationship Between Positive Mental Quality,Anxiety&Depression And Life Qualities Of Patients With Maintenance Hemodialysis Needs

Objectives To examine the relationship between positive psychological quality(hope trait,Self-compassion)and anxiety,depression,and quality of life in maintained hemodialysis(MHD)patients.Research findings may provide empirical implications for implementing psychological interventions from the perspective of positive psychology to reduce anxiety and depression and to improve quality of life in MHD patients.Methods A convenient sample of MHD patients was recruited from two tertiary first-class hospitals and one joint venture hospital in Jinan from May 2018 to December 2018 according to pre-specified inclusion and exclusion criteria.The Medical Outcomes Study 36-item Short Form(MOS SF-36),Patient Health Questionnaire(PHQ-9),General Anxiety Disorder Questionnaire(GAD-7),Self-Compassion Scale(SCS),Herth Hope Index(HHI)was used as survey measurement.SPSS 21.0 was applied for data input and analysis.Statistical analysis methods included descriptive statistical analysis,t-test,one-way ANOVA,Pearson correlation analysis and multiple linear regression analysis.Results1.General demographic and disease information of MHD patients:Among 216 MHD patients,34(15.7%)were aged 20-40 years,64(29.6%)were aged 41-60 years,and 118(54.6%)were aged over 60 years;122(56.5%)were males,and 94(43.5%)were females;209(96.8%)were with Han nationality,and only 7(3.2%)were with other nationalities;165 participants had stable work or retirement,accounting for 76.4%,and the remaining 51(23.6%)people were currently unemployed;8.3%of the participants were unmarried,77.3%were married,5.1%were divorced,and the remaining 9.3%were widowed;54.9%of the participants have been received dialysis treatment for less than 1 year,39.1%for 1-5 years,and only 5.1%for more than 5 years.The proportions of the average family monthly income per capita below 1000 yuan,1001-2000 yuan,2001-3000 yuan and 3000 yuan were 28.7%,20.4%,21.3%and 29.6%,respectively.2.Anxiety,depression and quality of life of MHD patients;Anxiety scores ranged from 0 to 21,with an average of 8.22(SD=6.05).The score of depression ranged from 0 to 27,with an average of 12.45(SD=7.79);the positive rate of anxiety was 37.0%,and the positive rate of depression was 59.7%.The positive rate of anxiety in hemodialysis patients in this study was significantly higher than that in general hospitalized patients(x2=104.90,P<0.001),whereas the positive rate of depression was significantly lower than that in general patients(x2=127.44,P<0.001).The total score of QOL ranged from 94 to 730,with an average score of 362.99(SD=149.23),the score of somatic component subscale ranged from 0 to 357,with an average score of 169.67(SD=79.65),and the score of psychological component subscale ranged from 17 to 413,with an average score of 193.32(SD=83.51).Compared with the general population,the score of somatic and psychological subscales of MHD patients in this study was lower(t=32,068,P<0.001 for physical subscale;t=18.754,P<0.001 for psychological subscale).3.Comparison of anxiety and depression scores among different Demographic groups:Anxiety scores and depression scores of MHD patients with different monthly income per capita were statistically different(P=0.016 and 0.023,respectively).Anxiety and depression scores of hemodialysis patients had significance differences in the number of weekly exercises(P=0.020 and 0.024 respectively).There was no statistical difference in anxiety scores and depression scores across other demographic and disease information.4.Comparison of quality of life scores between different Demographic groups:There were no differences in score of somatic component subscale across demographic and disease information except for gender with males scored higher than females(p=0.042).The scores of psychological components showed differences among different monthly income per capita groups and different number of exercises perweek(P=0.009 and 0.017,respectively).No statistical differences in the scores of psychological components by other demographic and disease information groups were found.5.The correlation between positive psychological quality and anxiety,depression,and quality of life in MHD patients:Self-compassion was negatively correlated with anxiety(r=-0.340,P<0.001)and depression(r=-0.439,P<0.001),whereas,self-compassion was positively correlated with somatic(r=0.325,P<0.001)and psychological(r=0.419,P<0.001).Hope trait was negatively correlated with anxiety and depression,and both correlation coefficients were-0.232(P<0.01).Hope trait was positively correlated with the somatic and psychological scores of quality of life,and the correlation coefficients were 0.179(P<0.01)and 0.209(P<0.01),respectively.6.The relationship between self-compassion on anxiety,depression and quality of life among MHD patients:hierarchical multiple linear regression analysis was constructed using somatic and psychological scores of quality of life,anxiety,depression as dependent variables separately,self-compassion and the demographic variables that were statistically significant in the bivariate analysis as independent variables.The results showed that self-compassion was negatively associated with anxiety(?=-0.315,P<0.001)and depression(?=-0.419,P<0.001),and positively associated with their physical quality of life(?=0.323,P<0.001)and psychological quality of life(?=0.387,P<0.001).7.The relationship between hope trait and anxiety,depression and quality of life among maintained hemodialysis patients:hierarchical multiple linear regression analysis was constructed using somatic and psychological scores of quality of life,anxiety,depression as dependent variables separately,hope trait and the demographic variables that were statistically significant in the bivariate analysis as independent variables The results showed that hope traits was negatively associated with anxiety(?=-0.177,P = 0.009)and depression(?=-0.180,P= 0.007),and positively associated with physical related quality of life(?=0.168,P=0.013)and psychological related quality of life(?=-0.156,P= 0.021).Conclusion:1.The anxiety and depression level of MHD patients were high and the quality of life of MHD patients was poor.2.Self-compassion and hope trait of MHD patients was negatively correlated with their anxiety and depression,and positively correlated with their quality of life.3.Self-compassion and hope traits may protect MHD patients from anxiety and depression and help improve quality of life.