The effect of psychological intervention on anxiety, depression and quality of life in peritoneal dialysis patients

Abstract

Objective To investigate the association of anxiety or depression and quality of life in peritoneal dialysis(PD) patients and use the corresponding psychological intervention to improve their quality of life(QoL).Methods 164 peritoneal dialysis patients' QoL were evaluated by the short form 36 health survey questionnaire (SF-36).Depression and anxiety were estimated by Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) respectively.All the patients were divided into anxiety or depression group and non-anxiety or depression group.QoL and quality of PD were compared between two groups.Patients of anxiety or depression group were divided randomly into psychological intervention group and non-anxiety or depression group. Patients of anxiety or depression group were treated with psychological intervention in addition to routine treatment. Patients of non- anxiety or depression group were treated only with routine treatment.QoL and quality of FD were recompared between two groups. Results Incidence of depression and anxiety was 21.95% and 41.46% respectively of patients with PD. Depression and anxiety scores were negatively correlated with 7 out of 8 scales SF-36 questionnaire. Two groups had significantly difference especially emotional well-being and role limitations caused by bodily pain and emotional problems(r=-0.310,-0.367,-0.409 especially,P<0.01).The anxiety or depression group' total score of SF-36 [(46.23±16.25) vs(73.69±19.17), P<0.01],subjective global assessment [(19.84±4.41)vs(57.34±6.14),P<0.01]and urea clearance divided by volume of distribution [(2.00±0.43)vs(3.76±0.35),P=0.000]were lower than non- anxiety or depression group.After treatment , anxiety or depression group' total score of SF-36[(70.96±20.86)vs (46.60±18.85),P<0.01],subjective synthesis nutrition evaluate and urea urea clearance divided by volume of distribution are higher than those of non- anxiety or depression group. Conclusion Incidence of anxiety or depression are high in PD patients,which have close association with quality of Life. Key words: Psychological interfere; Peritoneal dialysis; Depression; Anxiety; Quality of life