ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: TH-OR42

Self-Efficacy and Social Support Determine Self-Reported Health in Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Cromm, Krister, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Pham, Le Hong Ngoc, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
  • Jaha, Hanna, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Schappert, Anna, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Liegl, Gregor, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Fischer, Kathrin Irmgard, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Fischer, Felix, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Rose, Matthias, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany

Group or Team Name

  • CONVINCE Scientific Committee and CONVINCE Investigators.
Background

Patients with kidney disease receiving dialysis are a highly vulnerable population. There is some evidence from small studies that Health-Related Quality of Life (HRQL) in these patients is influenced by psychosocial determinants, but their relevance for clinical outcomes is debated. We investigated whether Self-Efficacy (SE) and Social Support (SS) can explain differences in HRQL outcome domains over time in hemodialysis patients.

Methods

HRQL in 1264 participants from the CONVINCE randomized, controlled trial investigating hemodiafiltration versus hemodialysis were assessed, using screening and quarterly follow-up data up to 24 months. Measures included the MOS Social Support Scale, General Self-Efficacy Scale, Perceived Stress Questionnaire and PROMIS short forms for fatigue, physical function, pain interference and intensity, sleep disturbance, anxiety, cognitive function, depression, and ability to participate in social roles. SE and SS were included as independent variables and HRQL domains as dependent variables in a linear mixed effects model with random intercept and slope for SE and SS.

Results

Participants were 20-92 (M=62.33, SD=13.50) years old, 62.9% were male. Linear mixed effect regression models showed significant main effects for self-efficacy (β=.85-4.84, p<.001) on all HRQL domains. Main effects for social support were found for Cognition, Depression, Pain Intensity and Sleep (β=.27-2.17, p<.01). For time, significant main effects were found for Anxiety and Sleep (β=.56 & .50, p<.01). Significant SE x Time interactions were found for Anxiety, Depression and Sleep (β=.11-.19, p<.05). Significant SS x Time interactions were found for Cognition and Sleep (β=.17 & .18, p<.01).

Conclusion

Our results indicate that higher SE is associated with higher HRQL of dialysis patients over time. Effects of SE are larger than those of SS and larger than previously reported. This bears the chance to develop targeted psychosocial interventions to improve health outcomes when undergoing dialysis.

Funding

  • Government Support – Non-U.S.