Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score

Abstract Introduction Haemodialysis patients self-report increased levels of anxiety and depression. We wished to determine the prevalence of distress in a multi-ethnic dialysis population and patient factors associated with distress. Methods We reviewed self-reported distress thermometer (DT) score...

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Main Authors: Suree Yoowannakul, Surachet Vongsanim, Kamonwan Tangvoraphonkchai, Andrew Davenport
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Renal Replacement Therapy
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Online Access:https://doi.org/10.1186/s41100-024-00586-4
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author Suree Yoowannakul
Surachet Vongsanim
Kamonwan Tangvoraphonkchai
Andrew Davenport
author_facet Suree Yoowannakul
Surachet Vongsanim
Kamonwan Tangvoraphonkchai
Andrew Davenport
author_sort Suree Yoowannakul
collection DOAJ
description Abstract Introduction Haemodialysis patients self-report increased levels of anxiety and depression. We wished to determine the prevalence of distress in a multi-ethnic dialysis population and patient factors associated with distress. Methods We reviewed self-reported distress thermometer (DT) scores from 971 haemodialysis patients with corresponding laboratory investigations, bioimpedance body composition and hand grip strength (HGS). Results The median age was 66.0 (55–75) years, 62.9% were male, 46.5% were of white ethnicity and 45.4% were diabetic. The results showed that 57.4% were classified as having no/minimal, 34% moderate, and 8.7% severe distress. Frailty increased from 31.5% to 47.9% and 56%, in the none/minimal, mild to moderate and severe distress groups (χ 2 17.6, p = 0.001), as did smoking (12.9% versus 16.7% versus 25%, χ 2 12.5, p = 0.001), and more patients reporting severe distress had suffered a previous myocardial infarction (MI) (17.4% versus 16.7% versus 27.4%, χ 2 7.1, p = 0.029). Haemoglobin decreased (109.6 ± 14.6 versus 107.6 ± 14.2 versus 103.5 ± 14.4 g/L, p < 0.001) as did HGS (18.9 (12.8–26.5) versus 17.1 (11.8–23.9) versus 15.4 (11.1–22.6) kg, p < 0.05). On ordinal multivariable analysis, increasing distress was associated with smoking (β 0.55, 95% confidence interval (CI) (0.17–0.92), p = 0.004), previous MI (β 0.47 (0.09–0.83), p = 0.015), serum calcium (β 1.11, (0.3–1.9), p = 0.007), lower age (β  −0.016, (−0.03 to −0.005), p = 0.003), haemoglobin (β  −0.014 (−0.02 to −0.004), p = 0.008) and HGS (β  −0.12 (−0.04 to −0.005), p = 0.013). Conclusion Younger age, higher calcium, lower haemoglobin and muscle strength, previous MI and smoking were associated with increasing levels of distress in this multi-ethnic dialysis population. Thus, both psychological and physical treatments are required to reduce stress levels for haemodialysis patients.
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spelling doaj-art-78bbbe5077dd4609a604a5f77c5c38bc2025-08-20T02:33:05ZengBMCRenal Replacement Therapy2059-13812024-11-011011810.1186/s41100-024-00586-4Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer scoreSuree Yoowannakul0Surachet Vongsanim1Kamonwan Tangvoraphonkchai2Andrew Davenport3Division of Nephrology, Department of Medicine, Bhumibol Adulyadej HospitalRenal Division, Department of Internal Medicine, Chiang Mai UniversityFaculty of Medicine, Mahasarakham UniversityUCL Centre for Kidney and Bladder Health, Royal Free Hospital, University College LondonAbstract Introduction Haemodialysis patients self-report increased levels of anxiety and depression. We wished to determine the prevalence of distress in a multi-ethnic dialysis population and patient factors associated with distress. Methods We reviewed self-reported distress thermometer (DT) scores from 971 haemodialysis patients with corresponding laboratory investigations, bioimpedance body composition and hand grip strength (HGS). Results The median age was 66.0 (55–75) years, 62.9% were male, 46.5% were of white ethnicity and 45.4% were diabetic. The results showed that 57.4% were classified as having no/minimal, 34% moderate, and 8.7% severe distress. Frailty increased from 31.5% to 47.9% and 56%, in the none/minimal, mild to moderate and severe distress groups (χ 2 17.6, p = 0.001), as did smoking (12.9% versus 16.7% versus 25%, χ 2 12.5, p = 0.001), and more patients reporting severe distress had suffered a previous myocardial infarction (MI) (17.4% versus 16.7% versus 27.4%, χ 2 7.1, p = 0.029). Haemoglobin decreased (109.6 ± 14.6 versus 107.6 ± 14.2 versus 103.5 ± 14.4 g/L, p < 0.001) as did HGS (18.9 (12.8–26.5) versus 17.1 (11.8–23.9) versus 15.4 (11.1–22.6) kg, p < 0.05). On ordinal multivariable analysis, increasing distress was associated with smoking (β 0.55, 95% confidence interval (CI) (0.17–0.92), p = 0.004), previous MI (β 0.47 (0.09–0.83), p = 0.015), serum calcium (β 1.11, (0.3–1.9), p = 0.007), lower age (β  −0.016, (−0.03 to −0.005), p = 0.003), haemoglobin (β  −0.014 (−0.02 to −0.004), p = 0.008) and HGS (β  −0.12 (−0.04 to −0.005), p = 0.013). Conclusion Younger age, higher calcium, lower haemoglobin and muscle strength, previous MI and smoking were associated with increasing levels of distress in this multi-ethnic dialysis population. Thus, both psychological and physical treatments are required to reduce stress levels for haemodialysis patients.https://doi.org/10.1186/s41100-024-00586-4DialysisEnd-stage kidney diseaseDistress thermometerSarcopeniaFrailtyCo-morbidity
spellingShingle Suree Yoowannakul
Surachet Vongsanim
Kamonwan Tangvoraphonkchai
Andrew Davenport
Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
Renal Replacement Therapy
Dialysis
End-stage kidney disease
Distress thermometer
Sarcopenia
Frailty
Co-morbidity
title Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
title_full Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
title_fullStr Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
title_full_unstemmed Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
title_short Correlates of self-reported distress in end-stage kidney dialysis patients using the distress thermometer score
title_sort correlates of self reported distress in end stage kidney dialysis patients using the distress thermometer score
topic Dialysis
End-stage kidney disease
Distress thermometer
Sarcopenia
Frailty
Co-morbidity
url https://doi.org/10.1186/s41100-024-00586-4
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