Social support from health care providers is associated with reduced illness intrusiveness in hemodialysis patients.
BACKGROUND
End-stage renal disease (ESRD) disrupts patients' life styles, interests and activities negatively affecting their quality of life. Social support has been previously associated with favorable health outcomes. However, no study has examined the association of social support from health care providers with perceived health and ESRD intrusiveness on patients' lives.


METHODS
A self-administered questionnaire was completed by 1,238 Italian hemodialysis patients. The Self-Rated Health (SRH) and the Illness Intrusiveness Rating Scale (IIRS) assessed disease burden. 10 items assessed social support from health care providers (SS-HC). The nursing staff of each center provided patients' clinical information. Linear regression was used to assess correlates of SRH and IIRS. Mediational analysis was used to assess direct and indirect associations of SS-HC with SRH through IIRS.


RESULTS
Higher SS-HC was associated with smaller IIRS and higher SRH. Further correlates of better SRH were younger age, no post-dialysis hypotension, no diabetes and cardiovascular diseases, better sleep quality, and smaller burden of oral therapy.


CONCLUSIONS
Our results suggest that social support might reduce illness burden and improve patients' perceived health. Further research should assess the efficacy and cost-effectiveness of structured support programs for dialysis patients.
Dipartimento di Medicina del Lavoro, Clinica del Lavoro L. Devoto-Ospedale San Paolo, Università di Milano, Milano, Italy. lneri@slu.edu
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Andreucci
D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010465:Perception; D011369:Professional-Patient Relations; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult