Social support as a mediator between sleep disturbances, depressive symptoms, and health-related quality of life in patients undergoing hemodialysis.

BACKGROUND: The hemodialysis regimen is an inevitable and mandatory treatment for patients with end-stage renal disease (ESRD). During the dialysis journey, patients may experience maladaptation in terms of sleep disturbances, depressive symptoms, and reduced health-related quality of life (HRQOL). Psychosocial resources such as social support may have beneficial influences on health outcomes, but studies have rarely analyzed the integrated relationships among risk factors which include pain, sleep disturbances, duration since diagnosis and various health outcomes in Taiwan. This study aimed to bridge this gap by investigating the relationships among related risk factors, social support, sleep disturbances, depressive symptoms, and HRQOL, which is composed of physical quality of life (PQOL) and mental quality of life (MQOL), in ESRD patients. METHOD: A correlational design was used, and 178 patients aged 20 years or older were recruited via convenience sample. The relationships among the risk factors, the mediators, depressive symptoms, PQOL, and MQOL were analyzed using structural equation modeling. RESULTS: The findings showed that more than 70% of the participants reported poor sleep quality, and 32% reported depressive symptoms. When participants had greater pain and more sleep disorders, they were more likely to be depressed. When participants had more appraisal support; they had better PQOL and fewer depressive symptoms. Overall, the structural equation model explained 31.8% of the variance in self-reported depressive symptoms, 29.4% of the variance in PQOL, and 5.7% of the variance in MQOL. Moreover, appraisal support enhanced PQOL and reduced depressive symptoms by exerting its two mediating effects on sleep disturbances. CONCLUSION: Our findings indicate that patients with ESRD who have more social support have better PQOL and MQOL and fewer depressive symptoms than those with less social support.

Depression, coronary artery disease, type 2 diabetes, metabolic syndrome and quality of life in Taiwanese adults from a cardiovascular department of a major hospital in Southern Taiwan.

AIMS: To examine the relationships between depression, coronary artery disease, type 2 diabetes, metabolic syndrome and quality of life in Taiwanese adults from a cardiovascular department of a major hospital in Taiwan. BACKGROUND: Research suggests associations between depression, metabolic syndrome and quality of life. Despite this fact, few studies have investigated these relationships among Taiwanese. DESIGN: A cross-sectional descriptive correlational design was used to conduct this study. METHODS: A convenience sample of 140 adults participated in the study. Data were analysed with descriptive statistics, Pearson's correlations, hierarchical regression and t-tests. RESULTS: Almost a half of the subjects (46.5%) had metabolic syndrome. The most common combination of metabolic syndrome criteria was elevated blood glucose, central obesity and high blood pressure (23.7%). A greater number of individuals had coronary artery disease (72.9%), type 2 diabetes (35%) and/or depression (21.4%). Type 2 diabetes and depression were significant predictors of overall quality of life (ß = -0.16, p < 0.01 and ß = -0.63, p < 0.001, respectively). In addition, there were significant differences between individuals with and without type 2 diabetes and/or depression regarding overall quality of life scores; t (138) = 3.50, p < 0.01); and t (138) = 7.80, p < 0.001), respectively. CONCLUSIONS: Coronary artery disease, type 2 diabetes and depression were common among our sample of individuals with metabolic syndrome. Those with diabetes and/or depression had worse quality of life than those without those diseases. RELEVANCE TO CLINICAL PRACTICE: Nurses need to be prepared to assess and intervene in preventing or treating depression among patients with chronic diseases, especially those with coronary artery disease, type 2 diabetes and metabolic syndrome. When individuals are treated for depression, they are more likely to engage in self-management of their diseases, which will prevent complications and improve their quality of life.

[Nursing care for bariatric surgery patients].

The sedentary lifestyle, common to most modern societies, has turned obesity into an increasingly prevalent and universal problem. Obesity correlates positively with many diseases and health risk factors. Medical therapies currently used to treat obesity are generally limited in terms of long-term effectiveness. Bariatric surgery has been demonstrated an effective treatment for morbid obesity. Special nursing care considerations for bariatric surgery include providing wider cuffs for blood pressure checks, preventing deep venous thrombosis and post operation dietary education in order to accommodate changes in the gastrointestinal system. The purposes of this article were to introduce obesity therapy trends as well as to share nursing care principles for those undergoing bariatric surgery.