Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the most significant public health issues in the USA. They cause premature death, influence quality of life, and impact patients’ economic and social status. They also provoke mental health issues such as depression, especially at end-stages of the disease when dialysis treatment is needed. As Murphy (2019) states, “many patients do require psychological support from the renal healthcare team” (p. 81). That is why it is vitally important to study the psychical condition of patients under dialysis treatment, analyze the reasons, and propose the solution to the problem.
Problem Statement
Dialysis treatment is used at the end-stage kidney failure and can be of two types: peritoneal dialysis and hemodialysis. Both methods negatively impact the psychical condition of patients, causing anxiety and depression. According to Rubio, Asencio and Raventos, (2017), the study shows the anxiety and depression rates as 26.6% and 27% among the observed patients (p. 73). Researches prove the importance of treating depression among dialysis patients, stating that: “depression was a significant predictor of mortality in dialysis population” (Ma & Li, 2016, p. 639). Taking this into account, mental health, as well as the quality of life of nephrology patients, is the question of grave concern.
Objectives
The objective of the research is to analyze the factors that impact the psychical condition of patients under dialysis treatment and propose prevention methods. The research aims to focus on the reasons that provoke depression and anxiety of patients, such as their physical and social position and health literacy. The idea is that by reducing these factors, it is possible to reduce depression and anxiety rates.
Current Knowledge of the Issue
Current studies reveal the issues that negatively influence the mental health of nephrology patients as such: physical challenges, lack of knowledge of the treatment options, social changes, and lack of proper psychiatric counseling. Alemayehu, Seylani, and Bahramnezhad (2019) found a direct relationship between patients’ health literacy and their quality of life and their mental condition. Other researchers share this idea; for example, Patzer et al. (2016) state the importance of communication in treatment centers and providing information about patients’ condition, treatment options, and individualized predictions. This communication strategy is aimed at taking better decisions concerning treatment procedures and reducing the stress level of patients.
Physical struggle, such as the necessity of visiting treatment centers on a regular basis is one of the reasons for mental health issues. According to Álvarez-Villarreal et al. (2019), patients experience emotional struggle concerning the acceptance of their bodies, as the presence of catheter or fistula impact patients’ body image. In addition to this, nephrology patients face severe social challenges. As Nakayama et al. (2015) affirm, “The employment status of those with end‐stage kidney disease is significantly hampered by the inception of chronic dialysis” (p. 530). Due to the reasons stated above, dialysis patients experience various risk factors and require patient‐centered support.
Project Proposal
As the aim of the project is to focus on risk factors of mental health issues among dialysis patients, the methods proposed here will concentrate on the prevention of depression and anxiety. First of all, it is necessary to organize the communication process and mutual decision making between patients and treatment centers staff. For the prediction purpose, it is possible to use tools for the statistical prognosis of individual risks, such as iChoose kidney proposed by Patzer et al. (2016) which can help individualize treatment process.
Secondly, it is necessary to cooperate with psychiatrists for the sake of regular counseling, preventing and detecting the mental health issues in the early stages. According to Chilcot and Hudson (2018), antidepressant treatment or cognitive behavioral therapy are also necessary steps to the improvement of the mental health of dialysis patients. The psychiatric consulting team, involving psychiatrists, nephrologists, dialysis nurses, and physiotherapists, is today a basic need of each treatment institution which strives to provide high-quality care and support.
References
- Alemayehu, Y. H., Seylani, K., & Bahramnezhad, F. (2019). The relationship between health literacy and quality of life among hemodialysis patients: An integrative review. Human Antibodies, 10(3), 1-7. doi: 10.3233/hab-190394
- Álvarez-Villarreal, M., Velarde-García, J. F., Chocarro-Gonzalez, L., Pérez-Corrales, J., Gueita-Rodriguez, J., & Palacios-Ceña, D. (2019). Body changes and decreased sexual drive after dialysis: A qualitative study on the experiences of women at an ambulatory dialysis unit in Spain. International Journal of Environmental Research and Public Health, 16(17), 3086.
- Chilcot, J., & Hudson, J. L. (2018). Is successful treatment of depression in dialysis patients an achievable goal? Seminars in Dialysis, 32(3), 210-214. doi: 10.1111/sdi.12755
- Ma, T. K.-W., & Li, P. K.-T. (2016). Depression in dialysis patients. Nephrology, 21(8), 639-646. doi: 10.1111/nep.12742
- Murphy, F. (2019). Psychological perspectives. In N. Thomas (Ed.), Renal nursing: Care and management of people with kidney disease (5th ed.) (pp. 81-104). Hoboken, NJ: Wiley-Blackwell.
- Nakayama, M., Ishida, M., Ogihara, M., Hanaoka, K., Tamura, M., Kanai, H., … Marshall, M. R. (2015). Social functioning and socioeconomic changes after introduction of regular dialysis treatment and impact of dialysis modality: A multi-centre survey of Japanese patients. Nephrology, 20(8), 523-530. doi: 10.1111/nep.12482
- Patzer, R. E., Basu, M., Larsen, C. P., Pastan, S. O., Mohan, S., Patzer, M., … Arriola, K. J. (2016). iChoose Kidney: A clinical decision aid for kidney transplantation vs. dialysis treatment. Transplantation, 100(3), 630-639. doi: 10.1097/tp.0000000000001019
- Rubio, A. R., Asencio, J. M. M., & Raventos, M. E. P. (2017). Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment. Journal of Renal Care, 43(2), 73-82. doi: 10.1111/jorc.12195