Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients

Psychosocial well-being among individuals with chronic kidney disease undergoing hemodialysis treatment and their caregivers: a protocol of a mixed method study in Sri Lanka and Poland

Chronic Kidney Disease (CKD) can be identified as one of the non-communicable diseases (NCDs) which affect millions of people worldwide, including in Sri Lanka and Poland. The prevalence of CKD has been rising over the last three decades due to the identification of CKD with unknown etiology and the increment of NCDs such as hypertension and diabetes mellitus among the Sri Lankan population. Poland can be identified as a European country that has 4 million patients with CKD, which is the second most common chronic disease in the country. CKD is associated with the physical, economic, psychological, and social burden on patients and their caregivers. The current study is aimed to investigate the psychosocial well-being of CKD patients and their caregivers in Sri Lanka and Poland. The current study is a mixed-method study aimed to investigate the psychosocial well-being of individuals with chronic kidney disease undergoing hemodialysis and their caregivers in Sri Lanka and Poland. Participants in the quantitative part of the project will be individuals with chronic kidney disease undergoing hemodialysis from Sri Lanka (n = 63) and Poland (n = 63) who are currently undergoing hemodialysis treatment. Kidney Disease Quality of Life-Sort Form, Beck Depression Scale, Test of Self-Conscious Affect, The Courtauld Emotional Control Scale, Acceptance of Illness Scale, and a demographic and medical information sheet will be used in both Sri Lankan and Polish samples. Apart from that, the qualitative phase of the study will involve semi-structured interviews with individuals diagnosed with CKD, selected randomly from the initial part of the research, and their close relatives. Notably, the participant count will remain undetermined, as this approach addresses the inherent challenges of exploratory research.

The Mediating Effect of Resilience on the Relationship Between Symptom Burden and Anxiety/Depression Among Chinese Patients with Primary Liver Cancer After Liver Resection

Purpose

Primary liver cancer (PLC) is a common cancer of the digestive system. Patients with PLC often experience a heavy symptom burden and along with a significant levels of anxiety and depression after liver resection. High levels of symptom burden can lead to increased anxiety and depression, whereas high levels of resilience can alleviate these conditions. Therefore, we aimed to explore the relationships among symptom burden, resilience, and anxiety/depression in Chinese patients with PLC after liver resection and to determine whether resilience mediates the relationship between symptom burden and anxiety/depression.

Patients and Methods

A total of 223 postoperative PLC patients were recruited from two public hospitals in Anhui Province, China. All participants completed the MD Anderson Symptom Inventory (MDASI), Hospital Anxiety and Depression Scale (HADS), and Connor-Davidson Resilience Scale (CD-RISC). The mediating effect of resilience was estimated using the bootstrap method via IBM SPSS AMOS 26.0.

Results

The mean HADS score was 12.37 ± 6.03 points in postoperative PLC patients. Among these patients, 78 (34.98%) had anxiety, and 64 (28.70%) had depression, as indicated by a subscale score ≥ 8. Pearson correlation analysis revealed that anxiety/depression was positively associated with symptom burden (p < 0.05) and negatively associated with resilience (p < 0.05). Furthermore, resilience partially mediated the relationship between symptom burden and anxiety/depression (β = 0.04; 95% confidence interval: 0.01-0.08).

Conclusion

The levels of anxiety and depression in postoperative PLC patients should be decreased. Resilience partially mediated the relationship between symptom burden and anxiety/depression, but the indirect effect was much weaker than the direct effect of symptom burden on anxiety/depression. Consequently, rather than focusing primarily on resilience interventions, joint symptom-psychological interventions focusing on symptoms should be considered for patients with PLC after hepatectomy to reduce the levels of anxiety/depression.

The relationship between uncertainty and acute procedure anxiety among surgical patients in Chinese mainland: the mediating role of resilience

BACKGROUND

Surgery, as one of the main diagnostic and treatment methods, is a routine work in medical settings. Patients undergoing surgery often experience acute procedure anxiety due to uncertainty. There is ample evidence showing that uncertainty is a risk factor for the acute procedure anxiety in surgical patients. However, little is known about the psychological processes mediating this relationship. Therefore, this study aims to evaluate resilience as a mediator of the association between uncertainty and anxiety.

METHODS

A population-based cross-sectional survey with a convenience sampling method was conducted, involving 243 surgical patients in Jiaxing, Zhejiang province of China was carried out. Relevant data were collected by self-reporting questionnaires, including demographic characteristics questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), Mishel's Illness Uncertainty Scale (MUIS), Connor-Davidson Resilience Scale (CD-RISC). Pearson correlation analysis was employed to examine correlations between various variables. A path model was used to assess the mediation effect of resilience with respect to uncertainty and acute procedure anxiety.

RESULTS

In the path model, uncertainty have an indirect effect on acute procedure anxiety through resilience. The results suggest that resilience has a mediating role in uncertainty and acute procedure anxiety among surgical patients.

CONCLUSIONS

These findings call for the development of interventions targeting the role of resilience in effectively predicting and preventing acute procedure anxiety and uncertainty among surgical patients.

The effects of a physical exercise program in Chinese kidney transplant recipients: a prospective randomised controlled trial

Background

Kidney transplant has become the preferred therapy for end-stage renal disease. However, kidney transplant recipients (KTRs) still face several challenges, such as physical inactivity. The purpose of this study was to explore the effects of a nurse-led physical exercise program in Chinese KTRs.

Methods

A total of 106 participants were enrolled from the Third Xiangya Hospital of Central South University between July 2021 and June 2022 and randomly assigned to the control or intervention groups. Participants in the control group were provided with routine nursing care and participants in the intervention group received a nurse-led rigorous physical exercise program that was divided into two stages: the pre-discharge stage and the post-discharge stage. The pre-discharge stage included the non-ambulatory and ambulatory stages. The Chinese traditional exercise Baduanjin was incorporated into the physical exercise during the ambulatory stage. The post-discharge stage continued the same exercise as the ambulatory stage at home. After 3 months of intervention, both groups received the same follow-up for 3 months. The primary and secondary outcomes of all participants were collected. The data were analysed with repeated measures analysis of variance to examine the effectiveness of the intervention.

Results

Compared with the control group, the intervention group had less fatigue and more motivation to be active in primary outcomes. Moreover, patients in the intervention group had a higher phase angle, a longer 6-minute walk distance, more 30-second chair stand times and decreased anxiety and depression levels in secondary outcomes. No adverse events were observed during the intervention. There were no significant differences in all dimensions of the quality-of-life questionnaire between the intervention and the control group.

Conclusion

Chinese KTRs could benefit from the nurse-led physical exercise program post-operatively.

Trial registration

ChiCTR2100048755.

Effect of Cognitive Behavioral Intervention Combined with the Resilience Model to Decrease Depression and Anxiety Symptoms and Increase the Quality of Life in ESRD Patients Treated with Hemodialysis

The aim of this study was to compare the effect of cognitive behavioral intervention (CBI) combined with the resilience model (CBI + R) vs CBI alone on depression symptoms, anxiety symptoms, and quality of life of end-stage renal disease (ESRD) patients undergoing hemodialysis replacement therapy.

METHOD

Fifty-three subjects were randomly assigned to one of two treatment groups. The control group (n = 25) was provided with treatment strategies based on a cognitive behavioral approach, while the experimental group (n = 28) were given the same techniques plus resilience model strategies. Five psychological instruments were applied: Beck Depression Inventory, Beck Anxiety Inventory, Mexican Resilience Scale, cognitive distortions scale, and the Kidney Disease related Quality of Life questionnaire. Participants were assessed at baseline (before treatment), eight weeks later (end of treatment), and four weeks after the end of treatment (follow up). The results were analyzed by ANOVA for repeated measures with a Bonferroni-adjusted test method, with p < 0.05 considered significant.

RESULTS

The experimental group had significant differences in total and somatic depression as well as differences in the dimensions of cognitive distortions and a significant increase in the dimensions of resilience. The control group had significant differences in all variables but showed lower scores in the evaluated times.

CONCLUSIONS

The resilience model strengthens and enhances the effectiveness of the cognitive behavioral approach to reduce symptoms of depression and anxiety in patients with ESRD.

Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis

OBJECTIVE

Cervical spondylosis (CS) is a potential stressor threatening mental health among affected individuals. This study was to analyze resilience level and associated factors among cervical spondylosis (CS) patients, and to explore the underlying mechanism of anxiety based on resilience-focused psychological variables.

METHODS

Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10) were used in this cross-sectional investigation among 250 CS patients.

RESULTS

The score of resilience was 65.58 ± 16.14. Hierarchical linear regression analysis revealed that hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases were the independent associates of resilience among CS patients, which explained 63.9% of the total variance. The structural equation model showed that hope, optimism, perceived social support and perceived stress affected anxiety via resilience, and hope and optimism also had direct effects on anxiety.

CONCLUSION

Chinese patients with CS had moderate level of mental resilience, which was independently related to hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases. Resilience played a mediating role between various psychological variables and anxiety. Improving the level of resilience, hope, optimism and perceived social support and reducing the level of perceived stress are important strategies to reduce anxiety level. Relevant healthcare professionals should put more focus on the mental problems of Chinese CS patients and help maintain good psychological status by improving their resilience and associated psychological variables thereof.