title: Distance between residence and the dialysis unit does not impact self-perceived outcomes in hemodialysis patients.
abstract: BACKGROUND
  Patients have to travel long distances to undergo hemodialysis (HD) in some regions. We aimed to search for an association of the distance between patients' residence and the dialysis unit with quality of life, depression and coping among end-stage renal disease (ESRD) patients undergoing maintenance HD.
  
  
  METHODS
  We studied 161 ESRD patients undergoing HD during April 2009. Quality of life, depression and coping were assessed by the SF-36, the 10-item CES-D and the Jalowiec Coping Scale, respectively. The sample was stratified in three groups: I-patients residing in Sobral (where the dialysis unit is located); II-patients residing in towns up to 100 km from Sobral; and III-patients residing in towns distant greater than 100 km from Sobral. Analysis of variance was used to detect differences in quality of life and coping scores between the groups. Logistic regression was used to test distance as a predictor of depression.
  
  
  RESULTS
  There were 47 (29.2%) patients residing in Sobral, 46 (28.6%) up to 100 km away and 68 (42.2%) greater than 100 km from Sobral. There were no differences related to quality of life and coping scores between the groups. Distance was not a predictor of depression.
  
  
  CONCLUSIONS
  Social and cultural factors may explain the lack of differences. Studies from other regions are needed to clarify the distance effects on self-perceived outcomes among HD patients.
authors.affiliation: Sobral School of Medicine, Federal University of Ceará, Avenida Comandante Maurcélio Rocha Ponte 100, Sobral, 62042-280, Brazil. prsantos@fortalnet.com.br
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Santos
authors.forename: Francisco Plácido Nogueira
authors.initials: FP
authors.lastname: Arcanjo
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003863:Depression / Q000523:psychology; D005260:Female; D062306:Geography, Medical; D006297:Health Services Accessibility; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D011795:Surveys and Questionnaires