Relationships among coping, comorbidity and stress in patients having haemodialysis.
OBJECTIVE
This paper is a report of a study to examine relationships among stress, coping and comorbidity and test the interaction effect of comorbidity.


BACKGROUND
Haemodialysis imposes a variety of physical and psychosocial stressors that challenge patients. Comorbidity is a risk factor for many health outcomes. Research on how comorbidity influences the relationship between coping and stress is limited.


METHODS
In this cross-sectional study, conducted from October 2002 to January 2003, 2642 patients, who had been having haemodialysis for at least 3 months, were interviewed by nursing managers in the 27 participating centres. The Haemodialysis Stressor Scale measured stressors and the Jalowiec Coping Scale were used to measure coping strategies. Hierarchical regression was used to analyse the data.


RESULTS
Haemodialysis patients with comorbidities were found to have higher levels of stress. Comorbidity had a moderating effect between choice of problem-oriented responses and isolated thoughts as coping strategies. These findings show that haemodialysis patients with comorbidities often choose positive coping strategies.


CONCLUSIONS
Comorbidity not only has a direct impact on stress but also has a moderating effect on the relationship between coping and stress. Comorbidity may hold the key to healthcare professionals' understanding of why patients having haemodialysis perceive different levels of stress and use various coping strategies. A personalized programme may be needed for each patient based on their different levels of comorbidity.
Department of Business Management, National Sun Yat-sen University, Taiwan. syehboston@gmail.com
Shu-Chuan Jennifer
SC
Yeh
Chia-Hsiung
CH
Huang
Hsueh-Chih
HC
Chou
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*