title: Possible interactive effects of demographic factors and stress coping mechanisms on depression and anxiety in maintenance hemodialysis patients.
abstract: OBJECTIVE
  The aim of this study was to assess the possible interactive effects of age, sex, duration of hemodialysis (HD), educational and income levels, and stress coping mechanisms on depression and anxiety in patients on maintenance HD.
  
  
  METHODS
  Uremic patients (N=416), regularly undergoing HD for more than 1 year, who did not have apparent cerebrovascular disease or serious intellectual impairment, were investigated. The interactive effects of age, sex, duration of HD, and educational and income levels, in relation to stress coping mechanisms, on depression or anxiety were assessed by hierarchical multiple regression analyses.
  
  
  RESULTS
  Regression lines illustrating significant (P<.05) interactions were constructed. The decrease in depression accompanying the increase in task-oriented stress coping was greater in highly educated patients than it was in the other patients. Anxiety levels decreased when patients had both high income and demonstrated a range of task-oriented stress coping mechanisms. For patients undergoing HD for long duration, or with a relatively high income, the decrease of depression and anxiety accompanying a decrease of emotion-oriented stress coping was greater, as compared with other patients. The decrease of depression accompanying an increase of avoidance-oriented stress coping was greater in patients with low income and in older patients than it was in the other patients.
  
  
  CONCLUSIONS
  These findings may lead to the development of specific and focused interventions for depression or anxiety in maintenance HD patients.
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. jirosinryounaika-tky@umin.ac.jp
authors.forename: Jiro
authors.initials: J
authors.lastname: Takaki
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Nishi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shimoyama
authors.forename: Toshio
authors.initials: T
authors.lastname: Inada
authors.forename: Norimasa
authors.initials: N
authors.lastname: Matsuyama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kumano
authors.forename: Tomifusa
authors.initials: T
authors.lastname: Kuboki
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D006435:Renal Dialysis / Q000523:psychology*; D012803:Sick Role; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D013812:Therapeutics; D014511:Uremia / Q000523:psychology*