title: Psychosocial status of hemodialysis patients one year after Hurricane Katrina.
abstract: BACKGROUND
  Hemodialysis patients experience a high degree of psychosocial impairment.
  
  
  METHODS
  The psychosocial status of hemodialysis patients after Hurricane Katrina was evaluated using the Hurricane Coping Self-Efficacy (HCSE) measure, the Short Form-12 Health Survey (physical component summary [PCS] and mental component summary [MCS]), and the Center for Epidemiologic Studies Short Depression Scale (CES-D). These scales were administered to 391 hemodialysis patients (86% participation rate), 7 to 14 months after Hurricane Katrina.
  
  
  RESULTS
  The mean score (standard deviation) was 36.2 (9.6) for the HCSE scale, 37.1 (10.9) and 46.7 (12.7) for the PCS and MCS, respectively, and 10.0 (6.5) on the CES-D. Symptoms of depression (CES-D scores > or =10) were present in 45.5% of patients. After age, race, and gender adjustment, evacuating less than 2 days before Hurricane Katrina making landfall and more fear of dying were associated with less favorable scores on the HCSE, MCS, and CES-D scales. Patients placed in a shelter and with a longer displacement had significantly lower MCS scores and more depressive symptoms. More depressive symptoms were observed among patients hospitalized in the month after the storm. Those who evacuated to a hotel, with more fear of dying and who were hospitalized in the month after Hurricane Katrina had lower scores on the PCS.
  
  
  CONCLUSIONS
  Impaired psychosocial status was common among dialysis patients surviving Hurricane Katrina and associated with reduced coping. These data demonstrate the need for screening and management of psychosocial issues in hemodialysis patients after disasters.
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA. ahyre@mail.med.upenn.edu
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Hyre
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Cohen
authors.forename: Nancy
authors.initials: N
authors.lastname: Kutner
authors.forename: Arnold B
authors.initials: AB
authors.lastname: Alper
authors.forename: Albert W
authors.initials: AW
authors.lastname: Dreisbach
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000368:Aged; D004190:Disasters; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000523:psychology* / Q000628:therapy; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D006435:Renal Dialysis; D013997:Time Factors