title: Indicators and correlates of psychological disturbance in Chinese patients receiving maintenance hemodialysis: a cross-sectional study.
abstract: OBJECTIVE
  Depression and anxiety have been considered as the most common comorbidities in maintenance hemodialysis (MHD) patients. This study aimed to assess mental disorder in hemodialysis patients and to study the indicators and correlates of psychological disturbance among patients receiving MHD in China.
  
  
  METHODS
  A cross-sectional study was conducted in 187 outpatients undergoing regular hemodialysis for at least 3 months. All the participants completed the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue, Chinese mainland version), Pittsburgh Sleep Quality Index (PSQI), Family APGAR Index (PAGAR), Family Adaptability and Cohesion Evaluation Scale (FACES II, Chinese version) and the Social Functioning Questionnaire (SFQ).
  
  
  RESULTS
  Based on the cutoff point of HADS-D/A ≥ 8, 51 (27.3%) and 29 (15.5%) patients reported depression and anxiety, respectively; 26 (13.9%) of all reported both depression and anxiety. Depressive patients had lower economic status, less subsidies, less than 3 years duration on hemodialysis and comorbidities when compared to patients without depression (all P < 0.05). HADS-D showed positive correlations with HADS-A, PSQI and SFQ and negative correlations with FACIT-Fatigue, PAGAR, family cohesion and adaptability (all P < 0.001). Patients with better family cohesion showed higher level of psychosocial well-being no matter their economic status. Binary logistic regression analysis demonstrated that anxiety (OR 1.80, P < 0.001) and bad social functioning (OR 1.31, P < 0.001) were independently associated with depression.
  
  
  CONCLUSIONS
  More attention should be paid on assessment and management psychological disturbance, and development family/social/medical supporting system for Chinese patients receiving MHD.
authors: School of Nursing, Tianjin Medical University, 22 Qi Xiang Tai Road, Heping District, Tianjin, 300070, China, wangsiyuan8951@126.com.
authors: Si-Yuan
authors: SY
authors: Wang
authors: Xiao-Ying
authors: XY
authors: Zang
authors: Jun-Duo
authors: JD
authors: Liu
authors: Mei
authors: M
authors: Cheng
authors: Yue-Xian
authors: YX
authors: Shi
authors: Yue
authors: Y
authors: Zhao
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
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