Stressors, coping and depression in haemodialysis patients.
BACKGROUND
Depression is common in persons receiving outpatient haemodialysis, but little work has been done to explore the variables associated with depression.


OBJECTIVE
The primary purposes of this study were to (i) examine relationships among stressors, coping and depression and (ii) test the mediating role of coping.


METHODS
Data were collected at two points in time, three months apart in 1995/1996. The final convenience sample at Time 2 was 86 participants from two United States midwestern, inner-city dialysis units. Structured interviews were conducted using the Centre for Epidemiologic Studies Depression Scale, the haemodialysis stressor scale (HSS) and the coping strategy indicator.


RESULTS
At Time 1 more psychosocial stressors were associated with greater use of problem-solving, social-support and avoidance coping. Both avoidance coping and more psychosocial stressors at Time 1 were related to depression at Time 2. Finally, avoidance coping was found to explain much of the relationship between psychosocial stressors and depression.


CONCLUSIONS
Research is now needed that explicates the causal relationships among stress, coping and depression in haemodialysis patients.
Welch
J L
JL
Department of Adult Health, Indiana University School of Nursing, Indianapolis, USA. jwelch@iupui.edu
Austin
J K
JK
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001362:Avoidance Learning; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales; D006435:Renal Dialysis / Q000009:adverse effects* / Q000451:nursing / Q000523:psychology*; D012648:Self Care / Q000379:methods / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires