Abstract: SA-PO777
Psychological Distress in Dialysis-Dependent CKD
Session Information
- Standard Hemodialysis for ESRD - I
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 601 Standard Hemodialysis for ESRD
Authors
- Zaidi, Syed S.A., Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Nixon, Andrew, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Todd, Judi M, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Brannigan, Dawn, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Anderton, John, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Brady, Mark, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Dhaygude, Ajay Prabhakar, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
Background
The burden of chronic kidney disease (CKD) and renal replacement therapy results in a high prevalence of psychological distress. It is not routine practice to screen for psychological distress in patients with CKD. The Distress Thermometer (DT) is a screening tool for psychological distress that has been validated in the renal population. Our aims were to establish healthcare provider ability to perceive patient psychological distress and to assess factors that are associated with psychological distress in those with dialysis-dependent CKD.
Methods
One-hundred patients with dialysis-dependent CKD were recruited. Patient age-modified Charlson Comorbidity Index (CCI) and WHO performance status were assessed. Dialysis unit nursing staff assessed patient psychological distress using the DT. Patients completed the DT on the same day as the nurse assessment. A DT cut off score of ≥7 was used to define severe levels of psychological distress. The correlation between nurse and patient DT scores was assessed using Pearson's correlation coefficient. Linear regression was performed to assess the magnitude of associations. A p value of <0.05 was considered statistically significant.
Results
Mean age was 63.19 years (SD: 14.18) with 58 male patients. Median time on haemodialysis was 38 months (IQR 16.25 to 66.75). Mean CCI score was 5.56 (SD: 1.97). The prevalence of WHO score ≥3 was 37%. The prevalence of severe psychological distress was 29%. Mean nurse DT score was 4.34 (SD: 2.69) and mean patient DT score was 4.32 (SD: 3.37). There was a weak to moderate correlation between the nurse and patient DT scores (r=0.50, p= 0.00, 95% CI 0.32-0.65). After adjusting for age, gender, dialysis vintage and CCI, only WHO score was associated with patient DT score. Each 1 point increase in WHO score was associated with an increase in patient DT score by 0.91 (p=0.01, 95% CI 0.27-1.55).
Conclusion
Psychological distress is highly prevalent in those with dialysis-dependent CKD. Psychological distress is associated with performance status; however, it is not associated with multimorbidity. Healthcare provider perceptions of patient psychological distress do not correlate strongly with patient reported psychological distress. Therefore, patients should be offered the opportunity to complete a psychological distress screening tool, such as the DT.