Emotional management and biological markers of dietetic regimen in chronic kidney disease patients

Effectiveness of Expressive Writing in Kidney Transplanted Patients: A Randomized Controlled Trial Study

The present study aimed to assess the effectiveness of an expressive writing (EW) intervention on psychological and physiological variables after kidney transplant. The final sample of 26 were randomly assigned to an expressive writing group (EWG) and control group (CG). Outcomes were focused on depression, anxiety, alexithymia, empathy, resilience, locus of control, creatinine, CDK-EPI, and azotemia. Depressive symptoms and alexithymia levels decreased in the EWG, with better adherence. Resilience declined over time in both groups. The EWG showed a significantly higher CDK-EPI, indicating better renal functioning. EW seems an effective intervention to improve the psychological health of transplanted patients, with a possible effect on renal functioning. These findings open the possibility of planning brief psychological interventions aimed at processing emotional involvement, in order to increase adherence, the acceptance of the organ, and savings in healthcare costs.

Preoperative psychological characteristics affecting mid-term outcome after bariatric surgery: a follow-up study

BACKGROUND

The purpose of this study was to investigate the relationship between preoperative psychological factors and percentage of total weight loss (%TWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB) to identify possible psychological therapy targets to improve the outcome of bariatric surgery.

METHODS

Seventy-six patients completed the Hamilton's Anxiety and Depression Scales (HAM-A, HAM-D) and Toronto Alexithymia Scale (TAS-20) the day before surgery (T0). The pre-operative body weight and the %TWL at 3 (T1), 6 (T2), and 24-30 (T3) months were collected.

RESULTS

At T3, depressed and alexithymic patients showed a lower %TWL compared to non-depressed patients (p = 0.03) and to non-alexithymic patients (p = 0.02), respectively. Finally, patients who had at least one of the three analyzed psychological factors showed less weight loss, at T2 (p = 0.02) and T3 (p = 0.0004).

CONCLUSIONS

Psychological factors may also affect long-term outcome of bariatric surgery. This study shows an association between alexithymia/depression pre-operative levels and the weight loss at 30 months'follow-up after bariatric surgery.

LEVEL OF EVIDENCE

Level III, longitudinal cohort study.

Influence of Selected Biomarkers on Stress and Alexithymia in Patients Under Hemodialysis Treatment

Background

Hemodialysis treatment and the high stress brought about by the treatment are the circumstances which set the background for alexithymia. Alexithymic feelings basically emerge as restriction in the world of emotion and thought, and the inability to recognize physiological changes. Biomarkers that are indicators of physical change are influential in the stress lives of individuals. This research was carried out to discover the relationships between, and to determine the influence of urea, creatinine, sodium, potassium, hemoglobin, hematocrit, albumin, calcium, phosphorus and C-reactive protein biomarkers on stress and alexithymia in individuals, who are diagnosed with chronic renal failure and receive hemodialysis treatment.

Methods

The research environment was formed of patients who underwent hemodialysis treatment in a hospital in Turkey. The subject group was comprised of 72 individuals. Demographic data form, biomarker list form, Hemodialysis Stressor Scale and Toronto Alexithymia Scale were used in the research.

Results

It was found that the levels of perceived stress of individuals who participated in the research were high at all dimensions, and 59.7% were alexithymic. The means of the total scale scores of all patients were calculated as 87.81 ± 13.59 for Hemodialysis Stressor Scale and 62.46 ± 9.84 for Toronto Alexithymia Scale. The relationship between the Toronto Alexithymia Scale and Hemodialysis Stressor Scale and selected biomarkers were determined (P < 0.05).

Conclusion

It was concluded that stress and alexithymic feelings were high in patients who received hemodialysis treatment, and that there is a relationship between C-reactive protein, creatinine, sodium, hemoglobin, hematocrit, potassium from the biomarkers and the scales and scale sub-dimensions. It is necessary to increase the awareness of nurses on the importance of the skills to communicate with individuals who have to cope with stress, manage emotions, and have high stress and emotional deprivation.