Psychosocial Determinants for Self-Reported Health Status in Hemodialysis Patients: A Cohort Analysis of the CONVINCE Randomized Trial

Krister Cromm; Le Hong Ngoc Pham; Hanna Jaha; Kathrin I Fischer; Gregor Liegl; Anna Schappert; Andrew Davenport; Claudia Barth; Peter J Blankestijn; Jörgen Hegbrant; Felix H Fischer; Giovanni F M Strippoli; Matthias Rose; CONVINCE Scientific Committee and Investigators

doi:10.34067/KID.0000000599

Psychosocial Determinants for Self-Reported Health Status in Hemodialysis Patients: A Cohort Analysis of the CONVINCE Randomized Trial

Kidney360. 2024 Oct 2. doi: 10.34067/KID.0000000599. Online ahead of print.

Authors

Affiliations

¹ Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
² Global Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany.
³ UCL Department of Renal Medicine, Royal Free Hospital, Division of Medicine, University College London, London, UK.
⁴ Medical Scientific Affairs, B.Braun Avitum, Melsungen, Germany.
⁵ Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
⁶ Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden.
⁷ Sydney School of Public Health, The University of Sydney, NSW Australia.
⁸ Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J) University of Bari Aldo Moro, Bari, Italy.

PMID: 39356555
DOI: 10.34067/KID.0000000599

Abstract

Background: We investigated whether psychosocial determinants self-efficacy and social support are associated with Health-Related Quality of Life in hemodialysis patients enrolled in the CONVINCE trial.

Methods: We used baseline data from the cohort of patients involved in the CONVINCE randomized trial of hemodiafiltration versus hemodialysis. Measures included age, gender, relationship status, children, housing, education, employment, comorbidities, dialysis schedules, time of first dialysis, residual kidney function, general self-efficacy and social support scores, and PROMIS measurements for health-related quality of life. Associations were analyzed using hierarchical regression.

Results: One thousand three hundred and sixty patients from CONVINCE were the cohort of interest. Mean age was 62±13.5 years (range 20-92), and 66.9% were men. Self-efficacy was a significant predictor for all health-related quality of life domains: depression (β = -0.36, p < 0.001), anxiety (β = -0.35, p < 0.001), social participation (β = 0.32, p < 0.001), cognition (β = 0.29, p < 0.001), fatigue (β = -0.29, p < 0.001), physical function (β = 0.27, p < 0.001), sleep disturbance (β = -0.23, p < 0.001), pain interference (β = 0.21, p < 0.001), pain intensity (β = -0.17, p < 0.001), interdialytic symptoms (β = -0.14, p = 0.002) and intradialytic symptoms (β = -0.14, p = 0.002). Social support was a significant predictor for cognition (β = 0.21, p < 0.001), sleep disturbance (β = -0.11, p = 0.017) and intradialytic symptoms (β =- 0.11, p = 0.02).

Conclusions: Higher general self-efficacy scale scores are associated with improvements in cognition, depression, anxiety, social participation, fatigue, physical function, sleep disturbance, pain interference, interdialytic symptoms, pain intensity and intradialytic symptoms. Associations for self-efficacy are larger than those for social support and stronger than previously reported. It is plausible that targeted psychosocial interventions may improve health outcomes in people on hemodialysis.

Abstract

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