Association of Poor Social Support and Financial Insecurity with Psychological Distress of Chronic Kidney Disease Patients Attending National Nephrology Unit in Sri Lanka.

Ramya Hettiarachchi,Chrishantha Abeysena

doi:10.1155/2018/5678781

Ramya Hettiarachchi, Chrishantha Abeysena

Open Access

https://doi.org/10.1155/2018/5678781

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Abstract

Background Chronic kidney disease (CKD) is associated with high morbidity and mortality. Hence, CKD patients are often in chronic psychological distress. The objective of the study was to describe factors associated with psychological distress of CKD patients attending National Nephrology Unit. Methods A descriptive cross-sectional study was conducted among 382 CKD patients above 18 years of age applying systematic sampling. The data was collected using self-administered questionnaires to assess the psychological distress (GHQ-12), social support (SSQ6), coping strategies (BRIEFCOPE), pain (0 to 10 numeric pain rating scale), and physical role limitation due to ill health (SF36QOL). Sociodemographic and disease-related data were collected using an interviewer administered questionnaire and a data extraction sheet. Multiple logistic regression was applied for determining the associated factors. The results were expressed as adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). Results Percentage of psychological distress was 55.2% (95% CI: 48.4% to 62%). Poor social support (AOR = 1.81, 95% CI: 1.14–2.88), low satisfaction with the social support received (AOR = 4.14, 95% CI: 1.59–10.78), stages IV and V of CKD (AOR = 2.67, 95% CI: 1.65–4.20), presence of comorbidities (AOR = 2.38, 95% CI: 1.21–4.67), within one year of diagnosis (AOR = 2.23, 95% CI: 1.36–3.67), low monthly income (AOR = 2.26, CI: 1.26–4.06), higher out-of-pocket expenditure per month (AOR = 1.75, 95% CI: 1.75–1.99), and being a female (AOR = 2.95, 95% CI: 1.79–4.9) were significantly associated with psychological distress. Conclusions More than half of the CKD patients were psychologically distressed. Factors such as financial and social support will be worth considering early because of their modifiability.

Highlights

Chronic kidney disease (CKD) is associated with high morbidity and mortality
Researchers have identified female gender, living alone, loss of employment, high out-of-pocket expenditure and reduced economic productivity, multimorbidity, increasing severity of illness, and stages four and five of the disease as factors significantly associated with psychological distress among CKD patients [8, 9], while social support and coping strategies are known to reduce the distress [10, 11]
All the CKD patients registered in the clinic with evidence of chronic renal disease documented in a diagnosis card or in a clinic book participated in the study irrespective of cause and duration of illness

Summary

Introduction

Chronic kidney disease (CKD) is associated with high morbidity and mortality. More than half of the CKD patients were psychologically distressed Factors such as financial and social support will be worth considering early because of their modifiability. Chronic kidney disease (CKD) is reported as a major global public health problem due to growing number of patients and heavy cost [1, 2]. Researchers have identified female gender, living alone, loss of employment, high out-of-pocket expenditure and reduced economic productivity, multimorbidity, increasing severity of illness, and stages four and five of the disease as factors significantly associated with psychological distress among CKD patients [8, 9], while social support and coping strategies are known to reduce the distress [10, 11]

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