The relationship between depression, resilience and quality of life in a sample of dialysis patients

Abstract

Chronic kidney disease (CKD) is a continuous and permanent disorder responsible for high morbidity and mortality. Kidney disease patients undergoing dialysis often have impaired quality of life (QOL), depression, and resilience. Patients’ QOL, more narrowly their social, physical, and psychological aspects of life, tend to diminish with the progress of treatment, which gives rise to depressive symptoms and, in particular, depression. In these patients’ cases, resilience is a key factor responsible for continuing the treatment and thriving for survival; however, it has proven very challenging under their circumstances. Therefore, this study aims to assess the QOL, depression, and resilience in patients undergoing dialysis and evaluate different socio-demographic factors affecting the QOL of these patients in Lebanon. The study was conducted on 44 patients with kidney disease, undergoing dialysis in the Orange Nassau Hospital, Northern of Lebanon. QOL was assessed using the World Health Organization Quality of life questionnaire (WHOQOL-BRIEF), depression was evaluated using the Patient Health Questionnaire 9 Arabic (PHQ-9), and resilience was assessed with the Brief Resilience Scale - Arabic (BRS-A). Pearson’s Chi-square, Student T-test, and ANOVA tests were conducted to examine the association between socio-demographic characteristics as an independent variable and the WHOQOL BRIEF domains, depression and resilience as dependent variables. Spearman’s correlations (r) were used to explore the correlation between depression, resilience and WHOQOL BRIEF domains. Multiple linear regression analysis was carried out to investigate factors associated with the four domains of the WHOQOL BRIEF scale. Unstandardized regression coefficients (β) with their 95% confidence intervals were computed to present the results of multivariate analysis. Patients with chronic kidney disease on dialysis had an overall poor QOL. Furthermore, gender and education affected one or more domains of their QOL. Our study suggests that dialysis negatively affects their overall life, when we encountered the following indicators: an overall poor QOL, an elevated prevalence of severe depressive symptoms, and an elevated proportion of participants presenting with low resilience. These data suggest that treatment of depression in CKD patients, may improve their QOL and resilience. Future considerations for investigating anxiety and psychological wellbeing amongst dialysis patients are recommended, in addition to more expansion in terms of population and hospitals for better effective results.