Psychological Distress and Self-Management in CKD : A Cross-Sectional Study
© 2023 The Authors..
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 (βadj, -0.13; 95% CI, -0.23 to -0.04), less physical activity (βadj, -0.13; 95% CI, -0.22 to -0.03), and lower medication adherence (βadj, -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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Kidney medicine - 5(2023), 10 vom: 14. Okt., Seite 100712 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cardol, Cinderella K [VerfasserIn] |
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| Links: |
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| Themen: |
Adherence |
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| Anmerkungen: |
Date Revised 28.09.2023 published: Electronic-eCollection Citation Status Publisher |
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| doi: |
10.1016/j.xkme.2023.100712 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362495750 |
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| 100 | 1 | |a Cardol, Cinderella K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Psychological Distress and Self-Management in CKD |b A Cross-Sectional Study |
| 264 | 1 | |c 2023 | |
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| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 28.09.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a 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 | ||
| 520 | |a Study Design: Cross-sectional online questionnaire data as part of the E-GOAL study | ||
| 520 | |a 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 | ||
| 520 | |a Exposures: Psychological distress, depressive symptoms, and anxiety symptoms | ||
| 520 | |a 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) | ||
| 520 | |a Analytical Approach: Adjusted multivariable regression and ordinal logistic regression analyses | ||
| 520 | |a 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 (βadj, -0.13; 95% CI, -0.23 to -0.04), less physical activity (βadj, -0.13; 95% CI, -0.22 to -0.03), and lower medication adherence (βadj, -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) | ||
| 520 | |a Limitations: Cross-sectional design, possible residual confounding, and self-report | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chronic kidney disease (CKD) | |
| 650 | 4 | |a adherence | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a lifestyle | |
| 650 | 4 | |a psychological distress | |
| 650 | 4 | |a self-management | |
| 700 | 1 | |a Meuleman, Yvette |e verfasserin |4 aut | |
| 700 | 1 | |a van Middendorp, Henriët |e verfasserin |4 aut | |
| 700 | 1 | |a van der Boog, Paul J M |e verfasserin |4 aut | |
| 700 | 1 | |a Hilbrands, Luuk B |e verfasserin |4 aut | |
| 700 | 1 | |a Navis, Gerjan |e verfasserin |4 aut | |
| 700 | 1 | |a Sijpkens, Yvo W J |e verfasserin |4 aut | |
| 700 | 1 | |a Sont, Jacob K |e verfasserin |4 aut | |
| 700 | 1 | |a Evers, Andrea W M |e verfasserin |4 aut | |
| 700 | 1 | |a van Dijk, Sandra |e verfasserin |4 aut | |
| 700 | 0 | |a E-GOAL Study Group |e verfasserin |4 aut | |
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