Association between quality of life and anxiety, depression, physical activity and physical performance in maintenance hemodialysis patients.
Association between quality of life and anxiety, depression, physical activity and physical performance in maintenance hemodialysis patients.
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DOI：
10.1016/j.cdtm.2016.09.004
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发表时间：
2016-06
影响因子：
--
通讯作者：
Kopple JD
中科院分区：
文献类型：
--
作者：
Li YN;Shapiro B;Kim JC;Zhang M;Porszasz J;Bross R;Feroze U;Upreti R;Martin D;Kalantar-Zadeh K;Kopple JD
维持性血液透析（MHD）患者通常生活质量（QOL）受损，焦虑，抑郁，日常体力活动（DPA）和体力活动减少。这些因素对MHD患者生活质量降低的影响尚不清楚。我们研究了生活质量与焦虑、抑郁、DPA和体能的关系。72例相对健康的成年MHD患者，年龄≥6个月，和39名年龄范围和性别分布相似的正常人进行了研究。使用肾脏疾病生活质量简表（KDQOL-SF）评估QOL。焦虑和抑郁分别用两份问卷进行评估。DPA和身体表现进行了评估与体力活动监测，人体活动概况，6分钟步行，坐到站，爬楼梯测试。与正常人相比，MHD患者的大多数KDQOL组分降低。患者KDQOL各分量表与焦虑、抑郁呈负相关（P < 0.05），且焦虑、抑郁患者KDQOL各分量表下降更明显。KDQOL在焦虑或抑郁患者中经常受损。然而，大多数KDQOL评分在没有焦虑或抑郁的患者和正常人之间没有差异。在调整后的模型中，DPA、人类活动概况和身体表现通常与KDQOL评分相关，但在进一步调整焦虑和抑郁后，DPA、人类活动概况和身体表现与KDQOL评分的相关性较低。在调整焦虑和抑郁后，KDQOL和DPA之间的相关性尤其明显。在相对健康的MHD患者中，KDQOL评分通常在焦虑和/或抑郁的患者中降低，但在没有焦虑或抑郁的患者中通常正常。KDQOL评分降低的MHD患者的DPA较低通常与焦虑和抑郁相关。生活质量和身体表现之间的关系似乎受焦虑和/或抑郁的影响较小。这些数据表明，治疗MHD患者的焦虑和抑郁可能会改善他们的QOL，DPA，并可能改善身体表现。
Maintenance hemodialysis (MHD) patients often have impaired quality of life (QOL), anxiety, depression, and reduced daily physical activity (DPA) and physical performance. The contributions of these latter factors to reduced QOL in MHD are poorly understood. We examined the association of QOL with anxiety, depression, DPA, and physical performance. Seventy-two relatively healthy adult MHD patients, vintage ≥6 months, and 39 normals of similar age range and gender distribution were studied. QOL was assessed using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). Anxiety and depression were each evaluated with two questionnaires. DPA and physical performance were assessed with a physical activity monitor, Human Activity Profile, and 6-minute walk, sit-to-stand, and stair-climbing tests. Most KDQOL components were reduced in MHD patients versus normals. KDQOL components in patients were commonly inversely correlated with measures of anxiety and depression (P < 0.05) and were more reduced in patients with both anxiety and depression. KDQOL was often impaired in patients with either anxiety or depression. However, most KDQOL scores did not differ between patients and normals without anxiety or depression. DPA, Human Activity Profile, and physical performance often correlated with KDQOL scores in adjusted models, but after further adjustment for anxiety and depression, DPA, Human Activity Profile, and physical performance correlated less frequently with KDQOL scores. This reduction in significant correlations after adjustment for anxiety and depression was particularly pronounced for the association between KDQOL and DPA. In relatively healthy MHD patients, KDQOL scores are usually decreased in those with anxiety and/or depression but are usually normal in those without anxiety or depression. Lower DPA in MHD patients with reduced KDQOL scores often appears to be associated with anxiety and depression. The relationship between QOL and physical performance appears to be less influenced by anxiety and/or depression. These data suggest that treatment of anxiety and depression in MHD patients may improve their QOL, DPA, and possibly physical performance.