Factors Affecting Anxiety and Depression in Caregivers of Hemodialysis Patients.

Anxiety and depression have high levels in caregivers of patients on hemodialysis and are strongly associated with demographic factors. The aim of this study was to evaluate the factors affecting anxiety and depression in caregivers of hemodialysis patients. Four hundred and fourteen (414) caregivers (98 males and 316 females) participated in this study. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels. Multiple linear regression was performed to estimate the factors being independently associated with Beck Depression Inventory and State-Trait Anxiety Inventory. From a total of 414 participants, 125 (30.2%) had depression and 215 (52%) had anxiety. The median age of respondents was 54.34 (43.9-66.28) years, with half of the sample's age ranging from 43.9 to 66.28 (IQR). Depression and anxiety were significantly associated with parents or siblings, low level of education, increased caregivers' age, retirement, poor financial condition, having children, and comorbidities. In this study, a significant proportion of caregivers were found to have high levels of depression and anxiety. Thus, a formal screening can contribute to early diagnosis and treatment of depression and anxiety in caregivers of patients on hemodialysis.

Anxiety and Depression in Hemodialysis: Sex Differences.

INTRODUCTION: Approach to hemodialysis care from a gender perspective has received a great deal of attention globally since two sexes may have different experiences and manifestations of the same disease. PURPOSE: To explore sex differences in anxiety and depression among hemodialysis patients. METHOD AND MATERIAL: In the study were enrolled 200 patients (100 men and 100 women) who underwent hemodialysis. Data were collected by the completion of "The Hospital Anxiety and Depression Scale (HADS)" which included patients' self-reported characteristics. The statistical significance level was p < 0.05. RESULTS: In men and women, anxiety was statistically significantly associated with relations with nurses (p = 0.033 and p = 0.001, respectively), concealment of hemodialysis (p = 0.013 and p = 0.001, respectively), and insomnia (p = 0.001 and p = 0.001, respectively). Only in women, anxiety was statistically significantly associated with years under hemodialysis (p = 0.002), relation with doctors (p = 0.001), and their belief that life had changed (p = 0.002), whereas only in men, anxiety was associated with help in daily activities (p = 0.001). In men and women, depression was statistically significantly associated with relations with nurses (p = 0.002 and p = 0.001, respectively) and dependency on health professionals (p = 0.001 and p = 0.002, respectively). Only in women, depression was statistically significantly associated with years under hemodialysis (p = 0.002), level of information (p = 0.022), relations with doctors (p = 0.001), concealment of hemodialysis (p = 0.001), their belief that life had changed (p = 0.001), and insomnia (p = 0.001). CONCLUSIONS: The development of an effective treatment that may alleviate anxiety and depression needs to capture how patients perceive and respond to hemodialysis.

Fatigue in heart failure outpatients: levels, associated factors, and the impact on quality of life.

INTRODUCTION: Heart failure (HF) patients experience various psychosocial issues and physical symptoms such as fatigue, which adversely affect their quality of life (QoL). The aim of the study was to assess levels of fatigue in HF outpatients and the associated factors, as well as to explore the correlation between fatigue and QoL. MATERIAL AND METHODS: One hundred and thirty patients were enrolled in the study. Data collection was performed by the completion of "Minnesota Living With Heart Failure" questionnaire (MLHFQ) and the Greek version of the Modified Fatigue Impact Scale (MFIS-Greek). Data also included self-reported patients' characteristics. RESULTS: Of the 130 HF outpatients, 50% scored above 69 (median) in total fatigue and above 41 and 29 (median) in physical and mental fatigue, respectively. Furthermore, 50% scored above 66 (median) in total QoL and above 32.5 and 13 (median) in the physical and mental state, respectively. These values indicate moderate to high impact of HF on fatigue and on patients' QoL. Total fatigue was statistically significantly associated with NYHA stage (p = 0.001), confidence to acknowledge health deteriorations (p = 0.004), decrease in appetite (p = 0.001), dyspnoea at night (p = 0.001), oedema in lower limbs (p = 0.023), relation with health professionals (p = 0.031), and whether patients had limited daily activities (p = 0.002), social contacts (p = 0.014), and if they had financial worries (p = 0.003). Finally, as the score of fatigue increased, so the QoL score also increased. CONCLUSIONS: A broader understanding of this distressing symptom in HF may contribute to the development of suitable interventions with the ultimate goal of improving QoL.