Psychological predictors for health-related quality of life in patients on peritoneal dialysis

Varela, Laura; Varela, L.; Vázquez, Mª Isabel; Vázquez, M.I.; Bolaños, Luis; Bolaños, L.; Alonso, Rafael; Alonso, R.

doi:10.3265/Nefrologia.pre2010.Jun.10279

Article information

Introduction: It is currently recognized the impact of different clinical and sociodemographics variables on the health-related quality of life (HRQL) of patients undergoing peritoneal dialysis (DP), albeit the influence of psychological variable has not been thoroughly studied. The objective of this study is to identify the psychological predictors of HRQL in patients under DP. Method: 53 patients on DP participated in the study (49.54 ± 17.03 years, 54.7% women) in whom HRQL was evaluated by the Kidney Disease Quality of Life Short Form and it was obtained information related with psychological variables (depressive and anxious symptoms , alexithymia, health-related locus of control and coping strategies) besides socio-demographical and clinical variables. Results: Patients on DP presented a worse HRQL than general population, particularly in the physical dimension. The comorbility, the number of visits to urgency department, previous hospital admissions, serum albumin and previous treatment with hemodialysis showed a negative impact on several dimensions of HRQL, but depressive symptoms, alexithymia and particularly anxious symptoms were the main determinants of the variability of HRQL in DP patients. We did not obtain a significant relationship between HRQL and the locus of control or the coping strategies. Conclusions: Among patients undergoing DP, anxiety, depression and alexithymia are important determinants of HRQL and they should be considered both in the evaluation and the treatment of this population of patients.

Keywords:

Coping

Keywords:

Locus of control

Keywords:

Alexithymia

Keywords:

Peritoneal dialysis

Keywords:

Health-related quality of life

Keywords:

Anxiety

Keywords:

Depression

Introducción: Actualmente se reconoce el efecto de distintas variables clínicas y sociodemográficas en la calidad de vida relacionada con la salud (CVRS) de los pacientes en diálisis peritoneal (DP), pero la influencia de los factores psicológicos no ha sido suficientemente explorada. El objetivo de este estudio es identificar los predictores psicológicos de la CVRS en pacientes en DP. Método: Participaron 53 pacientes en tratamiento en DP (49,54 ± 17,03 años, 54,7% mujeres) en los que se evaluó su CVRS mediante el Kidney Disease Quality of Life Short Form y se recogió información de variables psicológicas (síntomas depresivos y ansiosos, alexitimia, locus de control relacionado con la salud y estrategias de afrontamiento), así como de variables sociodemográficas y clínicas. Resultados: Los pacientes en DP presentaron peor CVRS que la población general, particularmente en las dimensiones físicas. La comorbilidad, el número de visitas a urgencias, las hospitalizaciones previas, la albúmina, y el tratamiento previo en HD mostraron un efecto negativo en algunas dimensiones de la CVRS, pero los síntomas depresivos, la alexitimia y particularmente los síntomas ansiosos fueron los principales determinantes de la variabilidad en la CVRS de los pacientes en DP. No se encontraron relaciones significativas entre la CVRS y el locus de control o las estrategias de afrontamiento. Conclusiones: En los pacientes en DP, la ansiedad, la depresión y la alexitimia son importantes determinantes de la CVRS, por lo que deberían ser consideradas tanto en la evaluación como en el tratamiento de esta población de enfermos.

Palabras clave:

Afrontamiento

Palabras clave:

Locus de control

Palabras clave:

Alexitimia

Palabras clave:

Diálisis peritoneal

Palabras clave:

Calidad de vida relacionada con la salud

Palabras clave:

Ansiedad

Palabras clave:

Depresión

Full text is only aviable in PDF

Bibliography

[1]

Valderr??bano F, Jofre R, L??pez-G??mez JM. Quality of life in end stage renal disease patients. Am J Kidney Dis 2001;38(3):443-64. [Pubmed]

[2]

Merkus MP, Jager KJ, Dekker FW, De Haan RJ, Boeschoten EW, Krediet RT. Quality of life over time in dialysis: the Netherlands Cooperative Study on the Adequacy of Dialysis. Kidney Int 1999;56(2):720-8. [Pubmed]

[3]

Bakewell AB, Higgins RM, Edmunds ME. Quality of life in peritoneal dialysis patients: decline over time and association with clinical outcomes. Kidney Int 2002;61:239-48. [Pubmed]

[4]

Manns B, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C. Quality of life in patients treated with hemodialysis or peritoneal dialysis: what are the important determinants? Clin Nephrol 2003;60(5):341-51. [Pubmed]

[5]

Steele TE, Baltimore D, Finkelstein SH, Juergensen P, Kliger AS, Finkelstein FO. Quality of Life in Peritoneal Dialysis Patients. J Nerv Mental Dis 1996;184(6):368-74.

[6]

Martin CR, Thompson DR. Prediction of quality of life in patients with end-stage renal disease. Br J Clin Psychol 2000;5:41-55.

[7]

Bilgic A, Akman B, Sezer S, Ozisik L, Arat Z, Ozdemir FN, et al. Predictors for quality of life in continuous ambulatory peritoneal dialysis patients. Nephrology 2008;13:587-92. [Pubmed]

[8]

Pucheu S, Consoli SM, D??Auzac C, Fran??ais P, Issad B. Do health causal attributions and coping strategies act as moderators of quality of life in peritoneal dialysis patients? J Psychosom Res 2004;56(3):317-22. [Pubmed]

[9]

Taylor GJ. Recent developments in alexithymia theory and research. Can J Psychiatry 2000;45:134-42. [Pubmed]

[10]

10.??Pucheu S, Consolini SM, Fran??ais P, Issad B, D??Auzac C. The relationship of quality of life with the severity of disease and non-expression of emotions in peritoneal dialysis. Perit Dial Int 2004;24(1):77-9. [Pubmed]

[11]

11.??Jula A, Salminen JK, Saarijarvi S. Alexithymia: a facte of esencial hypertension. Hypertension 1999;33:1057-61. [Pubmed]

[12]

12.??Todarello O, Taylor GJ, Parker JDA, Fanelli M. Alexithymia in essentials hypertensive and psychiatric outpatients: a comparative study. J Psychosom Res 1995;39:987-94. [Pubmed]

[13]

13.??Verissimo R, Mota-Cardosa R, Taylor G. Relationships between alexithymia, emotional control, and quality of life in patients with inflammatory bowel disease. Psychother Psychosom 1998;67:75-80. [Pubmed]

[14]

14.??Charlson ME, Pompei P, Ales KL, McKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987;40(5):373-83. [Pubmed]

[15]

15.??Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the Kidney Disease Quality of Life (KDQOL) Instrument. Qual Life Res 1994;3:329-38.

[16]

16.??Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473-83. [Pubmed]

[17]

17.??Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361-70. [Pubmed]

[18]

18.??Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale: I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994;38:23-32. [Pubmed]

[19]

19.??Wallston KA, Kaplan GD, Maides SA. Development and validation of the Health Locus of Control (HLC) scale. J Consult Clin Psychol 1976;44(4):580-5. [Pubmed]

[20]

20.??Carver CS, S??ller MF, Weintraub JK. Assessing Coping Strategies: A Theoretically Based Approach. J Pers Soc Psychol 1989;56(2):267-83. [Pubmed]

[21]

21.??Ingledew DK, Hardy L, Cooper CL, Jemal H. Health behaviours reported as coping strategies: A factor analytical study. Br J Health Psychol 1996;1:263-81.

[22]

22.??Lyne K, Roger D. A psychometric re-assessment of the COPE questionnaire. Pers Indiv Diff 2000;29:321-35.

[23]

23.??Martin CR, Tweed AE, Metcalfe MS. A psychometric evaluation of the Hospital Anxiety and Depression Scale in patients diagnosed with end-stage renal disease. Br J Clin Psychol 2004;43(1):51-64. [Pubmed]

[24]

24.??Parker JDA, Taylor GJ, Bagby RM. The 20-Item Toronto Alexitimia Scale III. Realibility and factorial validity in a community population. J Psychosom Res 2003;55:260-75.

[25]

25.??Hays RD, Amin N, Alonso J, Kallich J, Coons SJ, Carter WB, et al.??Kidney Disease Quality of life Short Form (KDQOL-SF), Version 1.2: A Manual for Use and Scoring (Spanish Questionnaire, Spain). P-7928/1. Santa Monica, CA: Rand, 1997.

[26]

26.??Caro I, Ib????ez E. La escala hospitalaria de ansiedad y depresi??n. Bol Psicol 1992;36:43-69.

[27]

27.??Sandin B, Chorot P, Santed MA, Jim??nez P. Dimensiones de la alexitimia y estados emocionales de ansiedad, depresi??n e ira. Psiquis 1996;17(1):37-45.

[28]

28.??Bueno AM, Buceta JM. Tratamiento psicol??gico despu??s del infarto de miocardio: estudios de caso. Madrid: Dykinson, 1997.

[29]

29.??Crespo M, Cruzado JA. La evaluaci??n del afrontamiento: adaptaci??n espa??ola del cuestionario COPE con una muestra de estudiantes universitarios. Anal Modif Cond 1997;23(92):797-830.

[30]

Garc??a L??pez FJ, L??pez Revuelta K, ??lvaro F, Prieto L, Alonso J. Spanish validation of the short form of the Kidney Disease Quality of Life Instrument [Resumen]. Qual Life Res 1999;8:602.

[31]

31.??Tejero A, Guimer?? EM, Farr?? JM, Peri JM. Uso cl??nico del HAD (Hospital Anxiety and Depression Scale) en poblaci??n psiqui??trica: un estudio de su sensibilidad, fiabilidad y validez. Rev Depto Psiquiatr??a Fac Med Barna 1986;12:233-8.

[32]

32.??Mart??nez S??nchez F. Adaptaci??n Espa??ola de la escala de Alexitimia de Toronto (TAS-20). Cl??nica y Salud 1996;7(1):19-32.

[33]

33.??Alonso J, Regidor E, Barrio G, Prieto L, Rodr??guez C, De la Fuente L. Valores poblacionales de referencia de la versi??n espa??ola del Cuestionario de Salud SF-36. Med Clin (Barc) 1998;111:410-6.

[34]

34.??Abraira V, P??rez de Vargas A. M??todos multivariantes en bioestad??stica. Madrid: Centro de Estudios Ram??n Areces, 1996.

[35]

Rebollo P, Bobes J, Gonz??lez MP, Saiz P, Ortega F. Factores asociados a la calidad de vida relacionada con la salud (CVRS) de los pacientes en terapia renal sustitutiva (TRS). Nefrologia 2000;20(2):171-81. [Pubmed]

[36]

36.??Simmons RG, Abress L. Quality of life issues for end-stage renal disease patients. Am J Kidney Dis 1990;15(3):201-8. [Pubmed]

[37]

37.??Paniagua R, Amato D, Vonesh E, Guo A, Mujais S. Health-related quality of life predicts outcomes but is not affected by peritoneal clearance: The ADEMEX trial. Kidney Int 2005;67(3):1093-104. [Pubmed]

[38]

38.????lvarez-Ude F, Fern??ndez-Reyes MJ, V??zquez A, Mon C, S??nchez R, Rebollo P. S??ntomas f??sicos y trastornos emocionales en pacientes en programa de hemodi??lisis peri??dicas. Nefrologia 2001;21(2):191-9. [Pubmed]

[39]

V??zquez I, Valderr??bano F, Fort J, Jofr?? R, L??pez-G??mez JM, Moreno F, et al. Psychosocial factors and health-related quality of life in hemodialysis patients. Qual Life Res 2005;14:179-90. [Pubmed]

[40]

V??zquez I, Valderr??bano F, Jofr?? R, Fort J, L??pez-G??mez JM, Moreno F, et al. Psychosocial factors and quality of life in young hemodialysis patients with low comorbidity. J Nephrol 2003;16:886-94. [Pubmed]

[41]

Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol 2007;18:3042-55. [Pubmed]

[42]

Griffin KW, Wadhya NK, Friend R, Suh H, Howell N, Cabralda, et al. Comparison of quality of life in hemodialysis and peritoneal dialysis patients. Adv Perit Dial 1994;10:104-8. [Pubmed]

[43]

43.??Sensky T, Leger C, Gilmour S. Psychosocial and cognitive factors associated with adherence to dietary and fluid restriction regimen by people on chronic hemodialysis. Psychother Psychosom 1996;65:36-42. [Pubmed]

[44]

44.??Wuerth DB, Finkelstein SH, Finkelstein FO. The identification and treatment of depression in patients maintained on dialysis. Sem Dialysis 2005;18:142-6.

[45]

45.??Fukunishi I, Maeda K, Kubota M, Tomino Y. Association of alexithymia with low utilization and perception on a measure of social support in patients on peritoneal dialysis. Psychol Rep 1997;80:127-30. [Pubmed]

Indexed in:

Follow us:

Indexed in:

Follow us:

Subscribe to our newsletter

Subscribe to our newsletter