Abstract
BackgroundCoping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Little is known though about these associations in chronic kidney disease (CKD). The present study aimed to investigate the relationship of defensive coping and HRQL among patients in different CKD stages, after adjusting for psychological distress, sociodemographic and disease-related variables.MethodsThe sample consisted of 98 CKD patients, attending a university nephrology department. Seventy-nine (79) pre-dialysis patients of disease stages 3 to 4 and 19 dialysis patients were included. HRQL was assessed by the 36-item Short-Form health survey (SF-36), defensive coping by the Rationality/Emotional Defensiveness (R/ED) scale of the Lifestyle Defense Mechanism Inventory (LDMI) and psychological distress by the depression and anxiety scales of the revised Hopkins Symptom CheckList (SCL-90-R). Regression analyses were carried out to examine the association between SF-36 dimensions and defensive coping style.ResultsPatients on dialysis had worse scores on SF-36 scales measuring physical aspects of HRQL. In the fully adjusted analysis, a higher defensive coping score was significantly associated with a lower score on the mental component summary (MCS) scale of the SF-36 (worse mental health). In contrast, a higher defensive score showed a small positive association with the physical component summary (PCS) scale of the SF-36 (better health), but this was marginally significant.ConclusionsThe results provided evidence that emotional defensiveness as a coping style tends to differentially affect the mental and the physical component of HRQL in CKD. Clinicians should be aware of the effects of long-term denial and could examine the possibility of screening for defensive coping and depression in recently diagnosed CKD patients with the aim to improve both physical and mental health.
Highlights
Coping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL)
These findings may have important clinical implications when considering the prognostic value of HRQL in several chronic diseases, including End-stage renal disease (ESRD): decreases in HRQL have been repeatedly associated with increased morbidity and hospitalizations [7], increased mortality [7,8] as well as limited adherence to ESRD regimens [9,10] among hemodialysis (HD) patients
88% were in the pre-dialysis stage (120/136) and 12% were in ESRD (16/136), while for those who took part, the figures were 81% (79/98) and 19% (19/98) respectively (p = 0.03)
Summary
Coping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Coping with the stresses of chronic disease plays a key role in determining changes in health-related quality of life (HRQL) [2] It reflects how well patients adjust to chronic illnesses [3]. Several authors confirmed these assumptions in spinal cord lesion [4], systemic lupus erythematosus [5] and prostate cancer [6] These findings may have important clinical implications when considering the prognostic value of HRQL in several chronic diseases, including ESRD: decreases in HRQL have been repeatedly associated with increased morbidity and hospitalizations [7], increased mortality [7,8] as well as limited adherence to ESRD regimens [9,10] among hemodialysis (HD) patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
