Abstract
BackgroundEnd-stage kidney disease is highly prevalent worldwide. Currently, one of the most effective treatment modalities is dialysis therapy, which leads to serious side effects. Furthermore, psychiatric illnesses are prevalent among dialysis patients. Recently, researchers asserted that psychological resilience and family support could be helpful to maintain or improve patients’ mental well-being. Therefore, the purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients.MethodsTo investigate the aim of this study, a cross-sectional design was employed. A total of 110 hemodialysis patients, who were receiving outpatient treatment from dialysis units at the University of Fukuoka and St. Maria Health Care Center in Japan, participated. Only the patients who met the criteria and who were willing to participate in this 30-min study were given The General Health Questionnaire-12, Conner-Davidson Resilience Scale, and Family Assessment Device. Structural Equation Modeling (SEM) was performed to test the hypothesis that resilience would mediate the relationship between each subscale of family functioning, namely, cohesion, adaptability, communication, and mental well-being. Then Sobel’s test was employed to examine the indirect effect.ResultsThe results of the SEM showed that the model had an acceptable fit (RMSEA = .077; CFI = .93; and IFI = .94). According to the results, resilience fully mediated the relationship between family functioning, specifically family adaptability and communication, and mental health well-being of the dialysis patients. However, family cohesion was not associated with resilience.ConclusionsThe present study revealed that higher family adaptability and communication resulted in greater resilience, thus associated with better mental health. Given that poor mental health among dialysis patients is significantly associated with a decreased likelihood to adhere to treatment plans, it may lead to a significant risk to therapeutic compliance. As such, patients may experience detrimental consequences, such as death. This study showed that in order to maintain healthy mental well-being, developing resilience is a vital factor for hemodialysis patients.
Highlights
Kidney disease has become one of the major threats to humanity’s health worldwide
Measurement model The measurement model comprised of three latent factors (Cohesion, Adaptability, and Communication) and 14 observed variables showed acceptable fit to the present data: root mean-square error of approximation (RMSEA) = .086; Comparative Fit Index (CFI) = .93; and Incremental Fit Index (IFI) =
The mediation model of resilience in the relationship between family functioning and mental health demonstrated an acceptable fit to the data, with RMSEA = .077; CFI = .93; and IFI =
Summary
Kidney disease has become one of the major threats to humanity’s health worldwide. It has indirect impact on global morbidity and mortality [1], but it is associated with enormous economic burden [2]. An estimated 2.3 to 7.1 million people with end-stage kidney disease (ESKD) died in 2010 without access to dialysis. Because this disease is associated with increased risk of deadly diseases, such as cardiovascular disease, diabetes, and hypertension [4], it is crucial to have effective prevention programs and access to treatments. They must continuously adhere to dietary and fluid restrictions for the rest of their lives [10] Such restrictions may lead patients to be socially isolated because of their need for time-consuming dialysis treatment to successfully manage ESKD [10]. The purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients
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