P0319DEPRESSIVE BURDEN, QUALITY OF LIFE AND CAREGIVER BURDEN IN END STAGE RENAL DISEASE - A PARADIGMATIC SHIFT IN HOLISTIC MANAGEMENT

Abstract

Abstract Background and Aims Depressive illness is not only common in patients of End Stage Renal Disease (ESRD) but also an independent risk factor for morbidity and mortality. The relation between depressive illness, Quality of Life and caregiver burden in this vulnerable group is complex. We attempted to study these 3 important psychosocial domains in patients of ESRD on hemodialysis, peritoneal dialysis as well as those ESRD patients who were not on any dialysis yet Method A cross sectional analytical comparative controlled design was done to compare 3 domains of depressive burden, quality of life and caregiver burden in 3 group of patients – ESRD patients on hemodialysis, ESRD patients on peritoneal dialysis and ESRD patients not on any dialysis Statistical methods used - χ2 statistic or Fisher‘s exact test for categorical variables and comparison of group means. ANOVA was used for continuous variables where more than 3 groups were compared. Correlational analysis done using Spearman’s correlation coefficient . A p-value of <0.05 was considered significant. SPSS 20.0 was used Results Depressive symptoms were present significantly across all 3 groups of ESRD. Depressive disorder was significantly higher in the Hemodialysis group (HD) as compared to peritoneal dialysis (PD) group( p=0.038). Mean QOL was significantly higher for PD. Caregiver burden was higher in the HD group. The study brought out the huge burden of depressive symptoms and depressive illness in patients on ESRD across all 3 group of patients and the significantly higher burden of depressive illness and lower QoL and higher caregiver burden in the hemodialysis group. This assumes significance because the majority of our ESRD patients are on HD Conclusion This depressive burden is the hidden factor behind poor Quality of Life as well as poor overall satisfaction as well as treatment outcome in our patients of ESRD whether or not on dialysis. Apart from the inherent factors related to the illness or the type of dialysis, sociodemographic factors seem to play a role in QoL and CG burden in the hemodialyis group. To address this hidden depressive burden comprehensively, we recommend closer cooperation between nephrologist, psychiatrist and psychosocial workers to improve the overall treatment outcome in ESRD patients.