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Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis

Authors Liu YM, Chang HJ, Wang RH, Yang LK, Lu KC, Hou YC

Received 21 September 2017

Accepted for publication 9 January 2018

Published 1 March 2018 Volume 2018:14 Pages 441—451


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Yueh-Min Liu,1 Hong-Jer Chang,2 Ru-Hwa Wang,3 Li-King Yang,4 Kuo-Cheng Lu,4 Yi-Chou Hou4

1Department of Nursing, Ching Kuo Institute of Management and Health, Taiwan; 2Graduate Institute of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan; 3Department of Nursing, Fu-Jen Catholic University, New Taipei City, Taiwan; 4Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan

Background: Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD).
Patients and methods: In this descriptive, correlational study, 194 older patients undergoing HD were enrolled from the HD centers of three hospitals in northern Taiwan. The Barthel ADL Index, RES scale, Inventory of Socially Supportive Behavior, and Beck Depression Inventory-II were used. Hierarchical regression analysis was applied to evaluate the interaction of RES and social support with illness severity, demographics, and ADLs.
Results: Of the total participants, 45.9% experienced depressive symptoms. Demographic analysis showed that men and those with high educational level and income and financial independence had less depression (p<0.01). Patients with a higher Barthel Index (n=103), RES scale (n=33), and social support (n=113) showed less depressive symptoms (p<0.01). We found a significant negative correlation between depressive symptoms and social support (r=-0.506, p<0.01) and RES (r=-0.743, p<0.01). Hierarchical regression analysis showed that RES could buffer the effects of symptom severity on depression (b=-0.436, p<0.01), but social support did not exert a buffering effect.
Conclusion: The severity of illness symptoms and ADLs were the major determinants of depressive symptoms. High RES could alleviate depressive symptoms in the older patients undergoing HD.

Keywords: depressive symptom, resilience, social support, older hemodialysis patient

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