Dataset Information

Psychological Distress and Self-Management in CKD: A Cross-Sectional Study.

ABSTRACT:

Rationale & objective

Patients with chronic kidney disease (CKD) not receiving dialysis, including kidney transplant recipients, often experience difficulties regarding self-management. An important barrier for adherence to self-management recommendations may be the presence of psychological distress, consisting of depressive and anxiety symptoms. We investigated relationships between psychological distress and adherence to self-management recommendations.

Study design

Cross-sectional online questionnaire data as part of the E-GOAL study.

Setting & participants

Patients with CKD (estimated glomerular filtration rate, 20-89 mL/min/1.73 m²) were recruited from April 2018 to October 2020 at 4 hospitals in The Netherlands and completed online screening questionnaires.

Exposures

Psychological distress, depressive symptoms, and anxiety symptoms.

Outcomes

Dietary adherence, physical activity, medication adherence, smoking, body mass index, and a CKD self-management index (ie, the sum of 5 binary indicators of nonadherence to the recommended self-management factors).

Analytical approach

Adjusted multivariable regression and ordinal logistic regression analyses.

Results

In our sample (N = 460), 27.2% of patients reported psychological distress, and 69.8% were nonadherent to 1 or more recommendations. Higher psychological distress was significantly associated with poorer dietary adherence (β^adj, -0.13; 95% CI, -0.23 to -0.04), less physical activity (β^adj, -0.13; 95% CI, -0.22 to -0.03), and lower medication adherence (β^adj, -0.15; 95% CI, -0.24 to -0.05), but not with smoking and body mass index. Findings were similar for depressive symptoms, whereas anxiety was only associated with poorer dietary and medication adherence. Every 1-point higher psychological distress was also associated with a higher likelihood of being nonadherent to an accumulating number of different recommendations (adjusted OR, 1.04; 95% CI, 1.02-1.07).

Limitations

Cross-sectional design, possible residual confounding, and self-report.

Conclusions

Many people with CKD experience psychological distress, of whom most have difficulties self-managing their CKD. Given the relationship between psychological distress and adherence to CKD self-management recommendations, behavioral interventions are needed to identify and treat psychological distress as a potential barrier to CKD self-management.

Plain-language summary

This online questionnaire study investigated relationships between psychological distress and self-management among 460 people with chronic kidney disease. Over a quarter of them reported mild-to-severe psychological distress. Alarmingly, 4 out of 5 patients with psychological distress were also nonadherent to 1 or more self-management recommendations, and higher levels of psychological distress were associated with poorer dietary and medication adherence and lower physical activity. Moreover, patients who suffered from moderate-to-severe distress were relatively more often nonadherent to 3 or more recommendations compared with patients with no or mild distress symptoms. So, it seems that psychological distress can be a barrier for self-management. To support patients in managing chronic kidney disease, researchers and health professionals should not overlook patients' mental health.

SUBMITTER: Cardol CK

PROVIDER: S-EPMC10518713 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Psychological Distress and Self-Management in CKD: A Cross-Sectional Study.

Cardol Cinderella K CK Meuleman Yvette Y van Middendorp Henriët H van der Boog Paul J M PJM Hilbrands Luuk B LB Navis Gerjan G Sijpkens Yvo W J YWJ Sont Jacob K JK Evers Andrea W M AWM van Dijk Sandra S

Kidney medicine 20230811 10

<h4>Rationale & objective</h4>Patients with chronic kidney disease (CKD) not receiving dialysis, including kidney transplant recipients, often experience difficulties regarding self-management. An important barrier for adherence to self-management recommendations may be the presence of psychological distress, consisting of depressive and anxiety symptoms. We investigated relationships between psychological distress and adherence to self-management recommendations.<h4>Study design</h4>Cross-secti ...[more]

PMID: 37753249

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Dataset Information

Psychological Distress and Self-Management in CKD: A Cross-Sectional Study.

Rationale & objective

Study design

Setting & participants

Exposures

Outcomes

Analytical approach

Results

Limitations

Conclusions

Plain-language summary

Publications

Psychological Distress and Self-Management in CKD: A Cross-Sectional Study.

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