Psychological burden in individuals with chronic kidney diseases: A cross sectional study

Journal title PSICOLOGIA DELLA SALUTE
Author/s Marta Acampora, Serena Barello, Elena Guida, Caterina Bosio, Vincenzo Irace, Carlo Maria Guastoni, Barbara Bertani, Guendalina Graffigna
Publishing Year 2023 Issue 2023/3 Language English
Pages 20 P. 85-104 File size 265 KB
DOI 10.3280/PDS2023-003006
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Recent studies underlined the impact that chronic kidney disease (CKD) has on patients’ well-being and the need for mental health support. However, literature suggests that psycho-logical support is not often requested by patients, and barriers and prejudices that impede them to access mental health care are not well-known. This study aims to analyse the CKD patient’s level of well-being and explore their demand of psychological care, beside possible barri-ers/levers that motivate them to search for psychological support. A cross-sectional study in-volved 361 Italian patients diagnosed with chronic kidney disease was conducted. Patient’s health engagement was measured by the Patient Health Engagement Scale (PHE-s); anxiety and depression were assessed by the Zung Self-rating Anxiety Scale and Zung Self-rating Depression Scale respectively. Quality of life was measured with an ad hoc item. Demograph-ic characteristics were also collected. Most patients were male (66.9%) and the mean age was of 57 years old. Overall, the 19% of patients reported a low level of health engagement and almost 30% of the sample reported a low level of quality of life. The 61.9% reported depres-sive symptoms and the 11.6% of the respondents referred the presence of anxiety. However, only the 40.5% referred to have thought of asking for a psychological support. Although study participants frequently reported psychological needs, it seems that is difficult for them to translate these needs into an actual psychological demand, due to prejudices against psycholo-gists and the stigma attached to patients undergoing psychological treatment.

Keywords: care expectations, chronic kidney disease, haemodialysis, mental health care, psy-chological burden.

  1. Wang L.J. and Chen C.K. (2012). The psychological impact of hemodialysis on patients with chronic renal failure. Renal Failure-The Facts, 13: 220.
  2. Abbey S., Charbonneau M., Tranulis C., Moss P., Baici W., Dabby L., Gautam M. and Paré M. (2011). Stigma and discrimination. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 56(10): 1–9.
  3. Alkhaqani A. (2022). Psychological Impact of Chronic Kidney Disease and Hemodialysis: Narrative Review. Psychosom Med Res, 4(2): 1-5. DOI: 10.53388/20220
  4. Bikbov B., Purcell C.A., Levey A.S., Smith M., Abdoli A., Abebe M., Adebayo O.M., Afarideh M., Agarwal S.K., Agudelo-Botero M., Ahmadian E., Al-Aly Z., Alipour V., Almasi-Hashiani A., Al-Raddadi R.M., Alvis-Guzman N., Amin S., Andrei, T., Andrei C.L., Murray C.J.L. (2020). Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 395(10225): 709-733. DOI: 10.1016/S0140-6736(20)30045-
  5. Barello S., Graffigna G. and Vegni E. (2012). Patient engagement as an emerging challenge for healthcare services: mapping the literature. Nursing Research and Practice, 2012. DOI: 10.1155/2012/90593
  6. Chan R., Dear B.F., Titov N., Chow J., and Suranyi M. (2016). Examining internet-delivered cognitive behaviour therapy for patients with chronic kidney disease on haemodialysis: a feasibility open trial. Journal of Psychosomatic Research, 89: 78-84.
  7. Corrigan P.W., Druss B.G. and Perlick D.A. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 15(2): 37–70. DOI: 10.1177/152910061453139
  8. Cukor D., Ver Halen N. and Fruchter Y. (2013). Anxiety and quality of life in ESRD. Seminars in Dialysis, 26(3): 265–268.
  9. Zalai D., Szeifert L. and Novak M. (2012). Psychological distress and depression in patients with chronic kidney disease. Seminars in Dialysis, 25(4): 428-438.
  10. DiMatteo M.R., Lepper H.S. and Croghan T.W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160(14): 2101–2107.
  11. Eknoyan G., Lameire N., Eckardt K., Kasiske B., Wheeler D., Levin A., ... and Coresh J.J. K. I. (2013). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int, 3(1): 5-14.
  12. Ganu V.J., Boima V., Adjei D.N., Yendork J.S., Dey I.D., Yorke E., Mate-Kole C.C. and Mate-Kole M.O. (2018). Depression and quality of life in patients on long term hemodialysis at a nationalhospital in Ghana: a cross-sectional study. Ghana Medical Journal, 52(1): 22–28.
  13. Gerogianni S.K. and Babatsikou F.P. (2014). Psychological aspects in chronic renal failure. Health Science Journal, 8(2): 205.
  14. Goldstein C.M., Gathright E.C. and Garcia S. (2017). Relationship between depression and medication adherence in cardiovascular disease: the perfect challenge for the integrated care team. Patient Preference and Adherence, 11: 547–559. DOI: 10.2147/PPA.S12727
  15. Graffigna G., Barello S., Bonanomi A. and Lozza E. (2015) Measuring patient engagement: development and psychometric properties of the Patient Health Engagement (PHE) Scale. Frontiers in psychology, 6: 274.
  16. Graffigna G. and Barello S. (2015). Patient engagement in healthcare: pathways for effective medical decision making. Neuropsychol Trends, 17: 53-65.
  17. Graffigna G. and Barello S. (2018). Patient Health Engagement (PHE) model in enhanced recovery after surgery (ERAS): monitoring patients’ engagement and psychological resilience in minimally invasive thoracic surgery. Journal of Thoracic Disease, 10(4): S517–S528.
  18. Henderson C., Noblett J., Parke H., Clement S., Caffrey A., Gale-Grant O., Schulze B., Druss B. and Thornicroft G. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet Psychiatry, 1(6): 467-482. DOI: 10.1016/S2215-0366(14)00023-
  19. Innamorati M., Lelli M., Aiello S., Di Lorenzo del Casale F.L., Russo S. and Ferrari V. (2006). Validazione convergente e discriminante della versione italiana della Zung Self-Rating Depression Scale. Psicoterapia Cognitiva e Comportamentale, 12(3): 343-353.
  20. Kalantar‐Zadeh K., Tortorici A.R., Chen J.L., Kamgar M., Lau W.L., Moradi H., ... and Kovesdy C.P. (2015). Dietary restrictions in dialysis patients: is there anything left to eat?. Seminars in Dialysis, 28(2): 159-168).
  21. Khan S. and Ahmad I. (2020). Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis. Middle East Current Psychiatry, 27: 1-5.
  22. Knaak S., Patten S. and Ungar T. (2015). Mental illness stigma as a quality-of-care problem. The lancet. Psychiatry, 2(10): 863-864.
  23. Knaak S., Mantler E. and Szeto A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2): 111-116. DOI: 10.1177/084047041667941
  24. Leucht S., Burkard T., Henderson J., Maj M. and Sartorius N. (2007). Physical illness and schizophrenia: a review of the literature. Acta psychiatrica Scandinavica, 116(5): 317-333.
  25. Lew S.Q. and Piraino B. (2005). Psychosocial factors in patients with chronic kidney disease: quality of life and psychological issues in peritoneal dialysis patients. Seminars in Dialysis, 18(2): 119-123.
  26. Logias, F., Sequenza, M.J., Granata, A. and Soru, D. (2012). Depressione e patologia renale: rassegna della letteratura e prospettive di intervento. Giornale di Clinica Nefrologica e Dialisi, 24(4): 8-13.
  27. Maeda U., Shen B.J., Schwarz E.R., Farrell K.A. and Mallon S. (2013). Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International Journal of Behavioral Medicine, 20(1): 88–96.
  28. Mehrabi Y., Ghazavi Z. and Shahgholian N. (2017). Effect of Fordyce’s Happiness Program on Stress, Anxiety, and Depression among the Patients Undergoing Hemodialysis. Iranian Journal of Nursing and Midwifery Research, 22(3): 190–194. DOI: 10.4103/1735-9066.20816
  29. Mitchell A.J., Malone D. and Doebbeling C.C. (2009). Quality of medical care for people with and without comorbid mental illness and substance misuse: systematic review of comparative studies. The British Journal of Psychiatry: The Journal of Mental Science, 194(6): 491–499.
  30. Ngorsuraches S., Da Rosa P., Ge X., Djira G., Michael S. and Wey H. (2018). Patient engagement as a predictor for health outcomes and costs in multiple chronic conditions. Value in Health, 21: S88-S89.
  31. Strosahl K. (2000). The psychologist in primary health care. In Kent A.J. and Hersen M. (Eds.), A psychologist’s proactive guide to managed mental health care (pp. 87–112). Lawrence Erlbaum Associates Publishers.
  32. Perlman R.L., Finkelstein F.O., Liu L., Roys E., Kiser M., Eisele G., Burrows-Hudson S., Messana J.M., Levin N., Rajagopalan S., Port F.K., Wolfe R.A. and Saran R. (2005). Quality of life in chronic kidney disease (CKD): a cross-sectional analysis in the Renal Research Institute-CKD study. American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation, 45(4): 658-666.
  33. RIDT ‒ Registro Italiano dialisi e trapianto (2018). Società Italiana di Nefrologia.
  34. Roshanravan B., Khatri M., Robinson-Cohen C., Levin G., Patel K.V., de Boer I.H., ... and Kestenbaum B. (2012). A prospective study of frailty in nephrology-referred patients with CKD. American Journal of Kidney Diseases, 60(6): 912-921.
  35. Seekles M.L., Ormandy P. and Coyne E. (2019). Mapping the UK renal psychosocial workforce: the first comprehensive workforce survey. BMC Nephrology, 20(1): 100.
  36. Sousa L.M., Antunes, A.V., Baixinho C.R., Severino S.S., Marques-Vieira C. and José H.M. (2018). Subjective Wellbeing Assessment in People with Chronic Kidney Disease Undergoing Hemodialysis. Chronic Kidney Disease-from Pathophysiology to Clinical Improvements. Croácia: InTech, 281-93.
  37. Stuart H., Arboleda-Flòrez J. and Santorius N. (2012). Paradigms Lost: Fighting Stigma and the Lessons Learned. Oxford: Oxford University Press.
  38. Tanaka-Matsumi J. and Kameoka V.A. (1986). Reliabilities and concurrent validities of popular self-report measures of depression, anxiety, and social desirability. Journal of Consulting and Clinical Psychology, 54(3): 328–333. DOI: 10.1037/0022-006X.54.3.32
  39. Tattersall J., Martin-Malo A., Pedrini L., Basci A., Canaud B., Fouque D., ... and Vanholder R. (2007). EBPG guideline on dialysis strategies. Nephrology Dialysis Transplantation, 22(2): ii5-ii21.
  40. Theofilou P. (2011). Quality of life in patients undergoing hemodialysis or peritoneal dialysis treatment. Journal of Clinical Medicine Research, 3(3): 132–138.
  41. Thornicroft G., Rose D. and Kassam A. (2007). Discrimination in health care against people with mental illness. International Review of Psychiatry, 19(2): 113-122. DOI: 10.1080/0954026070127893
  42. Vasilieva I.A. (2006). Quality of life in chronic hemodialysis patients in Russia. Hemodialysis international. International Symposium on Home Hemodialysis, 10(3): 274-278.
  43. Zung W.W.K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12: 63-70.
  44. Zung W.W.K. (1974). The measurement of affects: depression and anxiety. Modern Problems of Pharmacopsychiatry, 7(0): 170-188. DOI: 10.1159/00039507
  45. Zung W.W.K. (1986). Zung self-rating depression scale and depression status inventory. In Assessment of depression (pp. 221-231). Berlin, Heidelberg: Springer.

Marta Acampora, Serena Barello, Elena Guida, Caterina Bosio, Vincenzo Irace, Carlo Maria Guastoni, Barbara Bertani, Guendalina Graffigna, Psychological burden in individuals with chronic kidney diseases: A cross sectional study in "PSICOLOGIA DELLA SALUTE" 3/2023, pp 85-104, DOI: 10.3280/PDS2023-003006