Emotion Regulation, Affect, Psychosocial Functioning, and Well-being in Hemodialysis Patients

Abstract

Emotion regulation refers to the psychological strategies people use to cope with such stressors as hemodialysis therapy. These strategies are associated with a range of physical and psychological variation that may be related to kidney disease and its management. This study explores the associations of 2 emotion regulation strategies, reappraisal and suppression, and considers their impact on patient well-being and kidney disease management. Cross-sectional study. 106 hemodialysis patients undergoing renal replacement therapy and 94 friends or relatives. Reappraisal and suppression, measured by using the Emotion Regulation Questionnaire. Outcome parameters were measures of affect, psychosocial functioning, and well-being, measured using the Positive and Negative Affect Scale, the Brief COPE questionnaire, the Kidney Disease Quality-of-Life Short Form, and the Brief Symptom Inventory. The Emotion Regulation Questionnaire measured reappraisal and suppression. Greater use of reappraisal was associated with lower levels of anxiety (r = -0.22; P = 0.03) and greater acceptance of the disease (r = 0.20; P = 0.04). It was also associated with more experience (r = 0.26; P < 0.01) and expression (r = 0.23; P = 0.02) of positive emotion and less experience (r = -0.35; P < 0.01) and expression (r = -0.29; P < 0.01) of negative emotion. Suppression was associated with less positive emotional expression (r = -0.28; P < 0.01), greater levels of depression (r = 0.22; P = 0.03) and somatization (r = 0.25; P < 0.01), and greater dissatisfaction with the time spent dealing with their kidney disease (r = -0.21; P = 0.04). Suppression also was associated with less emotional coping (r = -0.29; P < 0.01) and greater dissatisfaction with the support received from other people (r = -0.34; P < 0.01). The study focuses on emotion regulation strategies and well-being rather than clinical parameters; therefore, extensive medical data were not recorded. Reappraisal has more positive clinical and psychosocial associations than suppression. The emotion regulation strategy used by hemodialysis patients has important implications for well-being and disease management.