Background: The impact of illness acceptance in assessment of health-related quality (HRQoL) between chronic diseases remains unclear. Depression and anxiety reduce HRQoL and worsen prognosis. We describe the relationship between illness acceptance, anxiety and depression, and HRQoL in chronic dialysis patients.
Material: The study included 105 patients with chronic kidney disease (mean age 65.8 years), treated with chronic dialysis. Three validated instruments were used, including the Acceptance of Illness Scale (AIS), the Hospital Anxiety and Depression Scale (HADS) and the Short Form Health Survey (SF-36). For statistical analysis, Student's t-test and Pearson's r correlation coefficient were carried out.
Results: Spearman's rho correlation analyses were carried out on the patients' quality of life (PCS and MCS), and their anxiety, depression and illness acceptance scores. The results showed acceptance of illness to be positively correlated with quality of life in terms of PCS (rho = 0.43) and MCS (rho = 0.36), and depression and anxiety to be negatively correlated with quality of life in both domains (PCS: rho = -0.39 and rho = -0.56, respectively; MCS: rho = -0.56 and rho = -0.78, respectively). The multiple-factor analysis for anxiety, depression and acceptance of illness showed acceptance of illness to be a significant independent determinant of higher quality of life in the PCS (β = 1.580; p < 0.000) and MCS (β = 1.980; p < 0.000) domains. The analysis also showed anxiety to be a significant independent determinant of lower quality of life in the MCS domain (β = -0.432; p = 0.041), while depression was found to be a significant independent determinant of lower scores in both the PCS (β = -3.557; p < 0.00) and the MCS (β = -1.257; p < 0.00) domains.
Conclusion: Acceptance of illness significantly affects HRQoL in dialysis patients - higher acceptance scores result in higher quality-of-life scores. Symptoms of depression and anxiety also significantly affect HRQoL in dialysis patients - a higher intensity of symptoms lead to lower quality-of-life scores.
Keywords: anxiety; depression; dialysis; illness acceptance; quality of life.
© 2019 Nordic College of Caring Science.