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      Psychosocial, Spiritual, and Biomedical Predictors of Hope in Hemodialysis Patients

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          Abstract

          Background

          Hemodialysis patients deal with some psychological and social problems. These problems may be the predictors of hope. This study aimed to determine the psychosocial, spiritual, and biomedical predictors of hope in hemodialysis patients.

          Methods

          This cross-sectional study was conducted on 350 hemodialysis patients in hemodialysis centers affiliated to Shiraz University of Medical Sciences. Adult Hope Scale, Depression Anxiety Stress Scales, Personal Resources Questionnaire-85, Spiritual Well-Being Scale, and biomedical markers were used for data collection. The data were entered into the SPSS 22 software and were analyzed using Pearson’s correlation coefficient and linear regression analysis.

          Results

          The mean score of hope was 28.54 (SD=5.27). The mean scores of depression, anxiety, and stress were 17.87 (SD=7.62), 13.12 (SD=3.47), and 12.99 (SD=3.88), respectively. The mean scores of social support and spiritual well-being were 126.35 (SD=17.53) and 74.02 (SD=5.84), respectively. The means of biomedical markers including interdialytic weight gain, urea nitrogen, creatinine, phosphate, sodium, and potassium were 2.10 (SD=1.04), 51.55 (SD=13.10), 6.98 (SD=2.48), 4.71 (SD=1.08), 139.32 (SD=4.91), and 4.87 (SD=0.93), respectively. The results revealed a significant association between hope and depression, anxiety, stress, social support, and spiritual well-being (p<0.05). In addition, stress (β=−0.14, p=0.01), anxiety (β=−0.20, p=0.002), and social support (β=0.49, p<0.001) were the predictors of hope.

          Conclusion

          The hemodialysis patients reported moderate levels of hope, social support, anxiety, and depression. In addition, most of them adhered to dietary and fluid restrictions. Considering the association between hope and social support, spiritual well-being, anxiety, depression, and stress, using some interventions regarding the mentioned variables might increase hope among hemodialysis patients.

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          Most cited references30

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          TARGET ARTICLE: Hope Theory: Rainbows in the Mind

          C R Snyder (2002)
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            The short version of the Depression Anxiety Stress Scales (DASS-21): factor structure in a young adolescent sample.

            This study explored the factor structure of the short form of the Depression Anxiety Stress Scales (DASS-21; Lovibond & Lovibond, 1995b) in a young adolescent sample. A group of 484 high school students (Mean age=13.62 years, Min=11.83, Max=15.67 years, 52 % boys) completed the DASS-21. Several models were tested using Confirmatory Factor Analysis. A model consistent with the factor structure of the adult DASS, with correlated error terms, provided good fit to the data. However, correlations among the factors were very high. A 'quadripartite' model involving a common 'Negative Affect' factor as well as the three specific factors of Depression, Anxiety and Tension/Stress was tested to explain these correlations and was supported by the data. This model suggests that the core symptoms of Depression and Anxiety are similar in adults and adolescents, but the conceptualisation and assessment of Tension/Stress in adolescents needs further refinement. Copyright (c) 2009 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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              Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients.

              Dialysis patients experience tremendous symptom burden and substantial impaired health-related quality of life (HRQL). We determined the association between symptom burden and HRQL in 591 hemodialysis patients. Patients completed the modified Edmonton Symptom Assessment System and the Kidney Dialysis Quality of Life Short Form at baseline and after six months. There were no demographic, serological, or dialysis-related predictors for either HRQL or symptom burden. Pain, tiredness, lack of well-being, and depression were the only independent predictors of mental HRQL, accounting for 42.5% of the variation in the baseline mental health composite (MHC). Pain, fatigue, lack of well-being, and shortness of breath were the only independent predictors of physical HRQL, accounting for 38.5% of the variation in the baseline physical health composite (PHC). After follow-up, only changes in depression, anxiety, tiredness, and lack of appetite were independently associated with a change in MHC score, accounting for 48.7% of the variability. Only changes in pain, tiredness, and lack of appetite were independently associated with a change in PHC, accounting for 44.6% of the variability in the final multivariate regression model. No change in biochemical parameters predicted a change in either the MHC or the PHC. Symptom burden in end-stage renal disease was substantial and had a tremendous negative impact on all aspects of hemodialysis patients' HRQL. These patients, therefore, would likely benefit from the institution of programs to reduce symptom burden. (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Int J Nephrol Renovasc Dis
                Int J Nephrol Renovasc Dis
                IJNRD
                ijnrd
                International Journal of Nephrology and Renovascular Disease
                Dove
                1178-7058
                26 June 2020
                2020
                : 13
                : 163-169
                Affiliations
                [1 ]Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences , Shiraz, Iran
                [2 ]School of Nursing and Midwifery, Shiraz University of Medical Sciences , Shiraz, Iran
                [3 ]Student Research Committee, Shiraz University of Medical Sciences , Shiraz, Iran
                Author notes
                Correspondence: Nilofar Pasyar Email npasyar@sums.ac.ir
                Author information
                http://orcid.org/0000-0002-7334-9364
                Article
                255045
                10.2147/IJNRD.S255045
                7326188
                32617015
                27ac5789-053a-4595-8e38-00d75009cd85
                © 2020 Rambod et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 22 March 2020
                : 28 May 2020
                Page count
                Tables: 4, References: 39, Pages: 7
                Funding
                This study was financially supported by Shiraz University of Medical Sciences.
                Categories
                Original Research

                Nephrology
                hemodialysis,hope,anxiety,depression,spirituality,social support
                Nephrology
                hemodialysis, hope, anxiety, depression, spirituality, social support

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